Publication:
Optimising clinical practice in cancer genetics with cultural competence: lessons to be learned from ethnographic research with Chinese-Australians

dc.contributor.author Eisenbruch, Isaac en_US
dc.contributor.author Yeo, Soo en_US
dc.contributor.author Meiser, Bettina en_US
dc.contributor.author Goldstein, David en_US
dc.contributor.author Tucker, Katherine en_US
dc.contributor.author Barlow-Stewart, K en_US
dc.date.accessioned 2021-11-25T13:03:19Z
dc.date.available 2021-11-25T13:03:19Z
dc.date.issued 2003 en_US
dc.description.abstract Hereditary cancer is about families, and clinicians and genetic counsellors need to understand the cultural beliefs of patients and families about cancer and inheritance. In the light of their kinship patterns Chinese-Australians were chosen for the present study, which aims to determine the explanatory models of inheritance, cancer, and inherited cancer, with a view to identifying the relationship between these culture-specific lay attributions and help-seeking behaviour, and to identify possible barriers to genetic counselling and testing. Qualitative ethnographically informed methodology involving semi-structured interview was used as a method to uncover latent beliefs held by the families who are represented by the subjects. In-depth interviews were conducted with 16 informants of Chinese ethnicity, who had been recruited through two major Sydney familial cancer clinics. We report the attributions of cancer in general, then on inheritance, kinship, genes and genetics and then focus on the way in which these beliefs come together around hereditary cancer. The majority of informants, despite high acculturation and belief in biomedical explanations about hereditary cancer, also acknowledged the influence of traditional family Chinese beliefs, where 'inheritance' and 'genetics' were related to retribution for ancestral misdeeds and offending ancestors. Extensive mismatch of attributes and beliefs were identified in those who attended the clinic and senior family members, creating barriers to optimal service utilisation. Three traditional patterns of beliefs were identified: (a) father and mother contributed in equal share to one's genetic makeup, linked to the ying-yang theory; (b) the dominance of life force (yang chi) and the shaping of genes were transmitted through the paternal line; and (c) natural and supernatural forces operated in the cause of hereditary cancer. The study provided guidance for clinical practice. Exploration and acknowledgement of family beliefs, regardless of cultural background and therefore avoiding stereotyping, can enable the clinician to work with the whole family - those who hold Western attributions, those who maintain traditional notions of genetics and inheritance, and those who incorporate both into their belief systems - and provide effective clinical services. Further ethnographic studies are needed, focusing on the Chinese groups who do not attend the clinic and those with lower acculturation and educational levels. en_US
dc.identifier.issn 0277-9536 en_US
dc.identifier.uri http://hdl.handle.net/1959.4/39041
dc.language English
dc.language.iso EN en_US
dc.rights CC BY-NC-ND 3.0 en_US
dc.rights.uri https://creativecommons.org/licenses/by-nc-nd/3.0/au/ en_US
dc.source Legacy MARC en_US
dc.title Optimising clinical practice in cancer genetics with cultural competence: lessons to be learned from ethnographic research with Chinese-Australians en_US
dc.type Journal Article en
dcterms.accessRights metadata only access
dspace.entity.type Publication en_US
unsw.accessRights.uri http://purl.org/coar/access_right/c_14cb
unsw.identifier.doiPublisher http://dx.doi.org/10.1016/j.socscimed.2003.10.016 en_US
unsw.relation.faculty Medicine & Health
unsw.relation.ispartofissue 2 en_US
unsw.relation.ispartofjournal Social Science and Medicine en_US
unsw.relation.ispartofpagefrompageto 235-248 en_US
unsw.relation.ispartofvolume 59 en_US
unsw.relation.originalPublicationAffiliation Eisenbruch, Isaac, Public Health & Community Medicine, Faculty of Medicine, UNSW en_US
unsw.relation.originalPublicationAffiliation Yeo, Soo en_US
unsw.relation.originalPublicationAffiliation Meiser, Bettina, Prince of Wales Clinical School, Faculty of Medicine, UNSW en_US
unsw.relation.originalPublicationAffiliation Goldstein, David, Prince of Wales Clinical School, Faculty of Medicine, UNSW en_US
unsw.relation.originalPublicationAffiliation Tucker, Katherine, Prince of Wales Clinical School, Faculty of Medicine, UNSW en_US
unsw.relation.originalPublicationAffiliation Barlow-Stewart, K en_US
unsw.relation.school School of Population Health *
unsw.relation.school Clinical School Prince of Wales Hospital *
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