The evolving experience of illness for Chinese women with breast cancer: a qualitative study

The study of illness meaning in cancer in western communities has usually focused on causal attributions. We report a phenomenological study of 17 Hong Kong Chinese women with breast cancer, interviewed on completion of initial treatment, and describe how the illness experience and hence, meaning evolves for women in the Hong Kong Chinese culture. Themes arising from the identification and treatment of the disease include the difficulty of living in uncertainty and of maintaining and regaining normalcy in a superstitious society. The initial uncertainty of disease detection and the diagnostic process are characterized by shock and disbelief mingled with fear of death. Treatment choice presents women with difficulties arising from more uncertainty over the pressure to make quick decisions and the dilemma of death or mutilation. Following treatment, re-evaluation, re-prioritizing and positive life-re-evaluation occur. Changes in appearance proved problematic for those women who tried to hide their disease to protect themselves against stigmatization and social exclusion. In many ways, these findings parallel studies on western populations, suggesting that a common disease-medical care process is a predominant influence in shaping breast cancer experience. Implications for care are drawn from these data.