Korean Immigrant Women's Meanings of Breast, Breast Cancer, and Breast Cancer Screenings

  • 발행 : 2006.06.01

초록

Purpose. Koreans are one of the fastest growing Asian populations in the U.S. since 1960s. In Korean immigrant women (KIW), breast cancer was reported as the most frequently diagnosed cancer. However, their screening rates for breast cancer are lower than national guidelines; it is assumed that underlying cultural schemas of breast, breast cancer, and its screening modalities exist and need to be studied. This study was aimed to investigate cultural meanings of breast, breast cancer, and breast cancer screenings in KIW. Methods. Using cultural models theory from cognitive anthropology, naturalistic qualitative methodology was utilized. Three focus group interviews with fifteen KIW were conducted. Thematic analysis with constant comparison technique was performed eliciting units of meaning, categories, and themes. Results. The cultural schema of the meaning of breast is 'mother who is breast-feeding her baby,' with two themes of 'balance in size,' and 'shyness.' Regarding breast cancer, three themes, i.e., 'indifference,' 'fear,' and 'uncertainty' are emerged. 'Lack of information about screening modalities' is the overarching schema with reference to breast cancer screenings. Conclusions. The findings of this study demonstrate unique cultural models of KIW related to breast cancer and its screenings, which are critical to understand and penetrate their barriers to breast cancer screening.

키워드

참고문헌

  1. AMC Cancer Research Center. (1995). Breast and cervical cancer screening: Barriers and use among specific populations. Denver, Colorado: AMC Cancer Research Center
  2. Bastani, R, Marcus, A.C., Maxwell, A.E., Das, I.P., & Yan, K.X. (1994). Evaluation of an intervention to increase mammography screening in Los Angeles. Prev Med, 23, 83-90 https://doi.org/10.1006/pmed.1994.1012
  3. Breen, N., & Kessler, L. (1994). Changes in the use of screening mammography: Evidence form the 1987 and 1990 national health interview Surveys. Am J Public Health, 84(1), 62-67 https://doi.org/10.2105/AJPH.84.1.62
  4. D'Andrade, R.G., & Strauss, C. (1992). Human motives and cultural models. New York: Cambridge University Press
  5. Facione, N.C., Giancarlo, C., & Chan, L. (2000). Perceived risk and help-seeking behavior for breast cancer: A Chinese-American perspective. Cancer Nurs, 23(4), 258-267 https://doi.org/10.1097/00002820-200008000-00002
  6. Glaser, B.G., & Strauss, A.L. (1967). The discovery of grounded theory: Strategies for qualitative research. Chicago: Aldine Publication
  7. Han, Y., Williams, R.D., & Harrison, R.A. (2000). Breast cancer screening knowledge, attitudes, and practices among Korean American women. Oncol Nurs Forum, 27(10), 1585-1591
  8. Harper, A.P. (1993). Mammography utilization in the poor and medically underserved. Cancer, 72(4), 1478-1482 https://doi.org/10.1002/1097-0142(19930815)72:4+<1478::AID-CNCR2820721411>3.0.CO;2-Q
  9. Hedeen, A.N., White, E., & Taylor, V. (1999). Ethnicity and birthplace in relation to tumor size and stage in Asian American women with breast cancer. Am J Public Health, 89(8), 1248-1252 https://doi.org/10.2105/AJPH.89.8.1248
  10. Holland, D. & Quinn, N. (1987). Cultural models in language and thought. New York: Cambridge University Press
  11. Im, E.O., Lee, E.O., & Park, Y.S. (2002). Korean women's breast cancer experience. West J Nurs Res, 24(7), 751-771 https://doi.org/10.1177/019394502762476960
  12. Maxwell, A.E., Bastani, R., & Warda, U.S. (1998). Mammography utilization and related attitudes among Korean-American women. Women Health, 27(3), 89-107 https://doi.org/10.1300/J013v27n03_07
  13. Miller, B.A., Kolonel, L.N., Bernstein, L., Young, J.L., Swanson, G.M., West, D., Key, C.R., Lift, J.M., Glover, C.S., & Alexander, G.A. (1996). Racial/ ethnic patterns of cancer in the United States 1988-1992. (NIH Publication No. 96-4104). Bethesda, MD: National Cancer Institute
  14. Min, P.G. (1995). Korean Americans. In P.G. Min (Ed.), Asian Americans: Contemporary trends and issues, (pp.89-101). Thousdsand Oaks, CA: Sage
  15. Morgan, D.L. (1988). Focus groups as qualitative research. Thousands Oaks, CA: SAGE publication
  16. Roetzheim, R.G., Van Durme, D.J., Brownlee, H.J., Herold, A.H., Woodard, L.J., & Blair, C. (1993). Barriers to screening among participants of a media-promoted breast cancer screening project. Cancer Detect Prev, 17(3),367-377
  17. Smith, R.A., Cokkinides, V., & Harmon, J.E. (2006). American Cancer Society guidelines for the early detection of cancer, 2006. CA Cancer J Clin, 56(1), 11-25 https://doi.org/10.3322/canjclin.56.1.11
  18. Strauss, C., & Quinn, N. (1997). A cognitive theory of cultural meaning. New York: Cambridge University Press
  19. Suh, E.E., Kagan, S.H., & Strumpf, N.E. (2004). Cultural competence in qualitative interview methods with Asian Americans. Unpublished manuscript. Universtiy of Pennsylvania, Philadelphia, PA
  20. Urban, N., Anderson, G.L., & Peacock, S. (1994). Mammography screening: How important is cost as a barrier to use? Am J Public Health, 84(1),50-55 https://doi.org/10.2105/AJPH.84.1.50
  21. U.S. Department of commerce. (2000). U.S. Census 2000. [Accessed December, 10, 2005] http://census.gov
  22. U.S. Department of Health and Human Services, Public Health Service. (2000). Healthy People 2010: National Health Objectives: Women. Washington, DC
  23. Wismer, B.A., Moskowitz, J.M., Chen, A.M., Kang, S.H., Novotny, T.E., Min, K., Lew, R., & Tager, I.B. (1998). Mammography and clinical breast examination among Korean American women in two California counties. Prev Med, 27(1),144-151 https://doi.org/10.1006/pmed.1997.0259