title: The social construction of cancer chemotherapy toxicity: the case of Taiwan.
abstract: BACKGROUND
  Chemotherapy toxicity hinders cancer treatment outcomes. Healthcare professionals educated in biomedical-oriented systems tend to label patients who refuse or discontinue chemotherapy as "noncompliant." How diverse discourses in public texts related to chemotherapy toxicity, which may significantly shape patients' actions, has not been formally explored.
  
  
  OBJECTIVE
  The aims of this study were to explore the 2 dominant discourses in Taiwan related to chemotherapy toxicity within their sociocultural context and to ascertain how chemotherapy toxicity is constructed in the texts of journals and newspapers.
  
  
  METHODS
  Public, medical, and nursing texts about chemotherapy from 1950 to 2010 were collected and analyzed using Foucaultian discourse analytical techniques; juxtaposing dominant and marginalized discourses, we identified cultural themes.
  
  
  RESULTS
  In traditional Chinese medicine, toxic chemotherapy drugs are believed to interfere with circulation of energy flow and blood and to disturb the harmony of yin/yang in the body. Findings indicate that biomedical and traditional Chinese medical doctors do not agree about the best management of chemotherapy toxicity. Moreover, lay knowledge and patient voices regarding chemotherapy toxicity are often ignored in medical discourses.
  
  
  CONCLUSIONS
  Cultural beliefs and covert power relations between diverse medical traditions shape patients' experiences of chemotherapy toxicity. The preferential use by patients of traditional Chinese medicine over biomedicine to manage chemotherapy toxicity sustains its pivotal role.
  
  
  CONCLUSIONS
  The disparity of perceptions between healthcare professionals and patients regarding chemotherapy toxicity needs to be thoroughly assessed. Thus, culturally specific nursing care models may be developed.
authors.affiliation: School of Nursing, National Yang-Ming University, Taiwan.
authors.forename: Hai-Chiao
authors.initials: HC
authors.lastname: Chen
authors.forename: Helen
authors.initials: H
authors.lastname: Allan
authors.forename: Zxy-Yann Jane
authors.initials: ZY
authors.lastname: Lu
mesh_terms: D000970:Antineoplastic Agents / Q000009:adverse effects* / Q000627:therapeutic use; D044466:Asian People; D001291:Attitude of Health Personnel / Q000208:ethnology; D001294:Attitude to Health / Q000208:ethnology*; D003466:Cultural Characteristics; D064420:Drug-Related Side Effects and Adverse Reactions / Q000175:diagnosis / Q000208:ethnology*; D005260:Female; D006801:Humans; D008297:Male; D008516:Medicine, Chinese Traditional; D009369:Neoplasms / Q000188:drug therapy* / Q000473:pathology; D010353:Patient Education as Topic / Q000458:organization & administration; D013624:Taiwan
chemical_list: D000970:Antineoplastic Agents