Emerging From the “Ku:” Fluctuating in Adjusting With Breast Cancer—A Post-Traumatic Growth Theory Situated Within Chinese Culture

Abstract

This purpose of the study was to construct a model (theory) to understand Chinese women’s adjustment process in living with breast cancer. A constructivist grounded theory method was adopted in this study. A total of 24 women were recruited through purposive and theoretical sampling. Semi-structured, audio-recorded interviews were undertaken in Chinese and transcribed. Initial coding, focused coding, and theoretical coding approaches were used to identify subcategories and categories, and to construct the emergent theory. The basic social process these women used to deal with the breast cancer diagnosis was identified as: Emerging from the ‘ku’: Fluctuating in adjusting with breast cancer. Four categories were revealed following analysis: confronting challenges, orienting to reality, accommodating the illness, and transforming their lives, which encapsulated the main cognitive and emotional processes in which Chinese women engaged in their adjustment to living with their illness. The core process was influenced by a variety of contextual influences, which were identified as personal factors, social-environmental factors, and some specific cultural factors which emphasized positive changes. Chinese cultural values such as “Wuwei” coping strategies, familial primacy, and Chinese self-disclosure contribute to Chinese women’s adjustment processes and post-traumatic growth experiences. Hence, there is a need to consider Chinese cultural features, in designing culturally tailored supportive programs in multi-cultural clinical settings.

Effects of nurse‐led supportive‐expressive group intervention for post‐traumatic growth among breast cancer survivors: A randomized clinical trial

“…To help cancer survivors achieve psychological growth, several studies developed effective interventions such as supportive expressive therapy (Ramos et al, 2017), mindfulness‐based stress reduction (Kenne Sarenmalm et al, 2017), and narrative nursing (Shulin et al, 2017) but these interventions require certain application conditions and personnel qualifications. A qualitative study revealed that “emerging from suffering” is the main cognitive and emotional process of post‐traumatic growth for Chinese women with breast cancer and self‐disclosure, a culturally specific feature, contributes to their adjustment (Zhai et al, 2020). Thus, implementing and evaluating a PTG intervention based on Eastern cultural contexts is imperative for Chinese women with breast cancer.…”

Academic burnout and posttraumatic growth predict trajectories of posttraumatic stress disorder symptoms of adolescents following Yancheng tornado in China.

“…One important point to note is that PTG could differ across cultures (Spencer-Oatey & Kádár, 2016). There is evidence showing that Chinese sociocultural context may influence the appraisal of stressors, coping strategies and processes, and thus PTG (Zhai et al, 2020; Zhang et al, 2020). For example, unfortunate or traumatic events, such as cancers, are perceived as the result of karma in Chinese culture.…”

A Qualitative Meta-synthesis of the Post-Traumatic Growth Experiences among Female Breast Cancer Patients and Survivors

“…But that does not deprive you from being what you can do, who you are. It is my meaning for that [70].…”

“…I feel that after becoming ill, I cherish what I need to treasure more and spend more time with my families and children [70].…”