title: Responses to advanced cancer: Chinese-Australians.
abstract: OBJECTIVE
  This paper describes a study identifying the impact of key aspects of Chinese culture on the responses of mid-aged Chinese-Australians to their advanced cancer in order to make recommendations about their care within the health system.
  
  
  BACKGROUND
  Studies conducted in the 1960s and 1970s focused on understanding people's psychological responses to their experiences of terminal illness, but the issue of culture was not addressed. In recent years, a few studies have been conducted with Chinese-Australians, but were limited to issues related to their information needs and the disclosure of a cancer diagnosis. There is a lack of understanding of the impact of Chinese culture on the experiences of these patients.
  
  
  METHODS
  A grounded theory approach was used to generate a substantive theory to explain how mid-aged Chinese-Australians respond to advancing cancer. Eleven participants were recruited and data were collected from face-to-face interviews, telephone contacts, observation and researcher field notes. Data generation occurred between 1997 and 1999.
  
  
  RESULTS
  Four modes of response to advanced cancer were identified: acute crisis, combat, despondency and waiting for death. This paper deals particularly with the combat mode which incorporated five culturally specific strategies used by participants in their struggle against advanced cancer. These were traditional Chinese medicine, traditional Chinese beliefs on the use of food for health maintenance, qi gong (a form of exercise), feng shui (which involves paying attention to spatial organization) and the worship of ancestors and gods. Deeply entrenched within these responses is the influence of Chinese culture, rooted in the beliefs and practices of traditional Chinese medicine and the philosophy of harmony and balance of yin and yang and qi.
  
  
  CONCLUSIONS
  Health care professionals need to be aware of the cultural practices and beliefs of the different ethnic groups for whom they care, and of the importance of accommodation to and negotiation about these cultural practices.
authors.affiliation: Department of Nursing Studies, The University of Hong Kong, Pokfulam, Hong Kong, China. yycchui@hkucc.hku.hk
authors.forename: Ying-Yu
authors.initials: YY
authors.lastname: Chui
authors.forename: Judith
authors.initials: J
authors.lastname: Donoghue
authors.forename: Lynn
authors.initials: L
authors.lastname: Chenoweth
mesh_terms: D000328:Adult; D044466:Asian People / Q000208:ethnology*; D001294:Attitude to Health; D001315:Australia / Q000453:epidemiology; D002681:China / Q000208:ethnology; D003469:Culture; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009369:Neoplasms / Q000208:ethnology*; D010166:Palliative Care / Q000592:standards; D019452:Terminally Ill / Q000523:psychology*