Kagawa-Singer M, Wellisch D K, Durvasula R
UCLA School of Public Health and Asian American Studies, Los Angeles, CA 90095-1772, USA.
Cult Med Psychiatry. 1997 Dec;21(4):449-80. doi: 10.1023/a:1005314602587.
This pilot study constitutes the first exploration of the impact of breast cancer on Asian American women. Three hypotheses guided this study: (1) Asian American women would choose breast conserving therapy and breast reconstruction at a lower rate than the Anglo American women due to cultural differences in body image, (2) Asian American women with breast cancer would express psychological distress somatically and Anglo American women would express distress emotionally, and acculturation levels of the Asian American women would modify the expressions of distress such that women with high acculturation will express distress more emotionally and less acculturated women would express distress more somatically, and (3) Asian American women would seek assistance for psychosocial problems at a significantly lower rate than Anglo women. Ethnicity, age, and levels of acculturation were found to be significant variables that had to be considered simultaneously. The three hypotheses were only partially supported: (1) Asian American women chose breast conserving therapy and adjuvant therapy at a significantly lower rate than the Anglo American women, (2) Contrary to the hypothesis, somatization did not appear to be a dominant form of symptom presentation for Asian American women regardless of level of acculturation, and (3) Asian American women sought professional assistance for psychosocial problems at a significantly lower rate than Anglo women. Asian American women reported using different modes of help-seeking behavior for emotional concerns and receiving different sources of social support than the Anglo American women. Cultural interpretations of the findings are offered to explain the differences in the physical, emotional, and social responses to the breast cancer experience of Asian American women compared with the Anglo Americans, and notably between the Chinese- and Japanese Americans as well. The findings of this study warrant more refined exploration in order to improve the medical, psychological and social outcomes for Asian American women with breast cancer.
这项试点研究首次探讨了乳腺癌对亚裔美国女性的影响。本研究受三个假设指导：（1）由于身体形象方面的文化差异，亚裔美国女性选择保乳治疗和乳房重建的比例会低于英裔美国女性；（2）患有乳腺癌的亚裔美国女性会以躯体方式表达心理困扰，而英裔美国女性会以情绪方式表达困扰，亚裔美国女性的文化适应水平会改变困扰的表达方式，即文化适应程度高的女性会更多地以情绪方式表达困扰，文化适应程度低的女性会更多地以躯体方式表达困扰；（3）亚裔美国女性寻求心理社会问题帮助的比例会显著低于英裔女性。研究发现种族、年龄和文化适应水平是必须同时考虑的重要变量。这三个假设仅得到部分支持：（1）亚裔美国女性选择保乳治疗和辅助治疗的比例显著低于英裔美国女性；（2）与假设相反，无论文化适应水平如何，躯体化似乎都不是亚裔美国女性症状表现的主要形式；（3）亚裔美国女性寻求心理社会问题专业帮助的比例显著低于英裔女性。亚裔美国女性报告在情绪问题上使用不同的求助行为模式，且获得的社会支持来源与英裔美国女性不同。本文提供了对研究结果的文化解读，以解释与英裔美国人相比，尤其是华裔和日裔美国人之间，亚裔美国女性在乳腺癌经历中的身体、情绪和社会反应差异。本研究结果值得进行更精细的探索，以改善亚裔美国乳腺癌女性的医疗、心理和社会结局。
