In this article, we present findings from a larger study that explored how Chinese women cope with breast cancer. We report on the process of early psychological adjustment, along with contextual factors and how they influence the women's coping mechanisms at the beginning of the cancer experience. Twenty-four women with diagnoses of breast cancer were interviewed. The grounded theory method was adopted in data collection and analysis. “Reframing” was the core category of the early adjustment process. Focus and approach were the two contextual conditions. Women adopted “fighting,” “following the natural course,” “struggling,” and “bearing” modes in coping with the disease. These findings highlight the significance of focusing on coping and realizing the role of the self in creating a subjective positive interpretation, which subsequently enhances acceptance of the disease at the beginning of the cancer experience. Characteristics of the Chinese people with respect to coping include the collaborative meaning of control and the philosophy of acquiescence to fate.
Aldwin, C.M. (2007). Stress, coping, and development: An integrative perspective (2nd ed.). New York : Guilford Press.
2.
Ali, N.S., & Khalil, H.Z. (1991). Identification of stressors, level of stress, coping strategies, and coping effectiveness among Egyptian mastectomy patients . Cancer Nursing, 14(5), 232-239.
3.
Arman, M., & Backman, M. (2007). A longitudinal study on women's experiences of life with breast cancer in anthroposophical (complementary) and conventional care. European Journal of Cancer Care, 16(5), 444-450.
4.
Arman, M., & Rehnsfeldt, A. (2003). The hidden suffering among breast cancer patients: A qualitative metasynthesis. Qualitative Health Research, 13, 510-527.
5.
Blumer, H. (1969). Symbolic interactionism: Perspective and method . Berkeley, CA: University of California Press.
6.
Burgess, C., Morris, T., & Pettingale, K.W. (1988). Psychological response to cancer diagnosis-II. Evidence for coping styles (coping styles and cancer diagnosis). Psychosomatic Research, 32(3), 263-272.
7.
Calhoun, L. G., & Tedeschi, R. G. (Eds.). (2006). Handbook of posttraumatic growth: Research and practice. Mahwah, New Jersey: Lawrence Erlbaum Associates.
8.
Chan, C.W.H., Hon, H.C., Chien, W.T., & Lopez, V. (2004). Social support and coping in Chinese patients undergoing cancer surgery. Cancer Nursing, 27(3), 230-236.
9.
Chiu, L. (2000). Transcending breast cancer, transcending death: A Taiwanese population. Nursing Science Quarterly, 13(1), 64-72.
10.
Cobb, S. (1974). A model for life events and their consequences . In B. S. Dohrenwend, & B. P. Dohrenwend (Eds.), Stressful life events: Their nature and effects (pp. 151-156). New York: John Wiley & Sons.
11.
Denz-Penhey, H., & Murdoch, J.C. (2008). Personal resiliency: Serious diagnosis and prognosis with unexpected quality outcomes. Qualitative Health Research , 18, 391-404.
12.
Dunkel-Schetter, C., Feinstein, L.G., Taylor, S.E., & Falke, R.L. (1992). Patterns of coping with cancer. Health Psychology, 11(2), 79-87.
13.
Fielding, R., & Hung, J. (1996). Preferences for information and involvement in decisions during cancer care among a Hong Kong Chinese population. Psycho-Oncology, 5, 321-329.
14.
Folkman, S., & Lazarus, R.S. (1980). An analysis of coping in a middle-aged community sample. Journal of Health and Social Behavior, 21, 219-239.
15.
Glaser, B.G. (1978). Theoretical sensitivity. Mill Valley, CA: Sociology Press.
16.
Glaser, B.G., & Strauss, A.L. (1967). The discovery of grounded theory: Strategies of qualitative research. New York: Aldine de Gruyter.
17.
Greer, H.S., Morris, T., & Pettingale, K.W. (1979). Psychological response to breast cancer: Effect on outcome. Lancet, 2, 785-789.
18.
Haan, N. (1977). Coping and defending: Processes of self-environmental organization. New York: Academic Press.
19.
He, G., & Liu, S. (2005). Quality of life and coping styles in Chinese nasopharyngeal cancer patients after hospitalization. Cancer Nursing, 28(3), 179-186.
20.
Ho, S.M.Y., Wong, K.F., Chan, C.L.W., Watson, M., & Tsui, Y.K.Y. (2003). Psychometric properties of the Chinese version of the Mini-Mental Adjustment to Cancer (MINI-MAC) Scale. Psycho-Oncology, 12, 547-556.
21.
Hwang, K.K. (1977). The patterns of coping strategies in a Chinese society. Acta Psychologica Taiwanica, 19, 61-73.
22.
Jiang, Y., Liu, C., Li, J., Huang, M., Yao, W., Zhang, R., et al. (2007). Different attitudes of Chinese patients and their families toward truth telling of different stages of cancer. Psycho-Oncology, 16(10), 928-936.
23.
Krohne, H.W. (1996). Individual differences in coping. In M. Zeidner & N. S. Endler (Eds.), Handbook of coping: Theory, research, applications (pp. 381-409). New York: John Wiley & Sons.
24.
Lam, W.W.T., Chan, M., Hung, W.K., & Fielding, R. (2007). Treatment decision difficulties and post-operative distress predict persistence of psychological morbidity in Chinese women following breast cancer surgery. Psycho-Oncology, 16(10), 904-912.
25.
Lam, W.W.T., & Fielding, R. (2003). The evolving experience of illness for Chinese women with breast cancer: A qualitative study. Psycho-Oncology , 12, 127-140.
26.
Lam, W.W.T., Fielding, R., Chan, M., Chow, L., & Or, A. (2005). Gambling with your life: The process of breast cancer treatment decision making in Chinese women. Psycho-Oncology , 14, 1-15.
27.
Lazarus, R.S., & Folkman, S. (1984). Stress, appraisal, and coping. New York: Springer.
28.
Lemieux, J., Maunsell, E., & Provencher, L. (2007). Chemotherapy-induced alopecia and effects on quality of life among women with breast cancer: A literature review. Psycho-Oncology, DOI: 10.1002/pon.1245. Retrieved March 3, 2008, from http://www.3.interscience.wiley.com/journal/5807/home
29.
Leung, P.W.L., & Lee, P.W.H. (1996). Psychotherapy with the Chinese. In M. H. Bond (Ed.), The handbook of Chinese psychology (pp. 441-456). Hong Kong: Oxford University Press.
30.
Lindop, C.R., & Gibson, S. (1982). The concept of coping. Psychological Medicine, 12, 385-395.
31.
Loveys, B.J., & Klaich, K. (1991). Breast cancer: Demands of illness. Oncology Nursing Forum, 18(1), 75-80.
32.
Lu, K.Y., Chin, C.C., & Huang, H.P. (1993). Coping behaviors of women with breast cancer. Nursing Research (China), 1(3), 247-256.
33.
Lu, W., Cui, Y., Zheng, Y., Gu, K., Cai, H., Li, Q., et al. (2007). Impact of newly diagnosed breast cancer on quality of life among Chinese women. Breast Cancer Research & Treatment, 102(2), 201-210.
34.
Ma, L.C. (1996). Psychosocial stresses and adjustment of nasopharyngeal carcinoma patients in Hong Kong: A panel study. Cancer Practice , 4(5), 258-266.
35.
Maes, S., Leventhal, H., & DE Ridder, D.T.D. (1996). Coping with chronic diseases . In M. Zeidner & N. S. Endler (Eds.), Handbook of coping: Theory, research, applications (pp. 221-251). New York: John Wiley & Sons.
36.
Manuel, G.M., Roth, S., Keefe, F.J., & Brantley, B.A. (1987). Coping with cancer. Journal of Human Stress, 13, 149-154.
37.
Meyerowitz, B.E. (1983). Postmastectomy coping strategies and quality of life. Health Psychology, 2(2), 117-132.
38.
Meyerowitz, B.E., Heinrich, R.L., & Schag, C.C. (1983). A competency-based approach to coping with cancer . In T. G. Burish & L. A. Bradley (Eds.), Coping with chronic disease: Research and applications (pp. 137-158). New York: Academic Press.
39.
Mok, E. (1998). A model of empowerment for Hong Kong Chinese cancer patients and the role of self-help groups in the empowering process. Unpublished doctoral dissertation, The Hong Kong Polytechnic University , Hong Kong.
40.
Molassiotis, A., Chan, C.W.H., Yam, B.M.C., Chan, E.S.J., & Lam, C.S.W. (2002). Life after cancer: Adaptation issues faced by Chinese gynaecological cancer survivors in Hong Kong. Psycho-Oncology, 11, 114-123.
41.
Morse, J.M., & Carter, B. (1996). The essence of enduring and expressions of suffering: The reformulation of self. Scholarly Inquiry for Nursing Practice , 10, 43-60.
42.
Ngan, H.S.S., Tang, G.W.K., & Lau, O.W.K. (1994). Psychosocial study on Hong Kong Chinese with gynecological cancer. Journal of Psychosomatic Obstetrics and Gynaecology, 15, 111-117.
43.
Ngan, Y.S., & Tang, G.W.K. (1984). Needs and emotional states in cancer patients: A study of 21 Chinese women with carcinoma of the ovary. Journal of Psychosomatic Obstetrics and Gynaecology, 3, 223-231.
44.
Öhman, M., Söderberg, S., & Lundman, B. (2003). Hovering between suffering and enduring: The meaning of living with serious chronic illness. Qualitative Health Research, 13, 528-542.
45.
Roth, S., & Cohen, L.J. (1986). Approach, avoidance, and coping with stress. American Psychologist, 41(7), 813-819.
46.
Samarel, N., Fawcett, J., Krippendorf, K., Piacentino, J., Eliasof, B., Hughes, P., et al. (1998). Women's perceptions of group support and adaptation to breast cancer. Journal of Advanced Nursing, 28, 1259-1268.
47.
Scott, D.W., Oberst, M.T., & Dropkin, M.J. (1980). A stress-coping model. Advances in Nursing Science, 3, 9-23.
48.
Shapiro, D.H., & Astin, J.A. (1998). Control therapy: An integrated approach to psychotherapy, health, and healing. New York: John Wiley & Sons.
49.
Silberfarb, P.M., & Greer, S. (1982). Psychological concomitants of cancer: Clinical aspects. American Journal of Psychotherapy, 36, 470-478.
50.
Simpson, P. (2005). Hong Kong families and breast cancer: Beliefs and adaptation strategies. Psycho-Oncology, 14, 671-683.
51.
Skinner, E.A., Edge, K., Altman, J., & Sherwood, H. (2003). Searching for the structure of coping: A review and critique of category systems for classifying ways of coping. Psychological Bulletin, 129(2), 216-269.
52.
Stanton, A.L., & Snider, P.R. (1993). Coping with a breast cancer diagnosis: A prospective study. Health Psychology, 12(1), 16-23.
Strauss, A., & Corbin, J. (1990). Basics of qualitative research: Grounded theory procedures and techniques. Newbury Park: Sage.
55.
Strauss, A., & Corbin, J. (1998). Basics of qualitative research: Techniques and procedures for developing grounded theory (2nd ed.). Thousand Oaks: Sage.
56.
Suls, J., & Fletcher, B. (1985). The relative efficacy of avoidant and non-avoidant coping strategies: A meta-analysis. Health Psychology, 4, 249-288.
57.
Thompson, S.C. (2002). The role of personal control in adaptive functioning . In C. R. Snyder & S. J. Lopez (Eds.), Handbook of positive psychology (pp. 202-213). New York: Oxford University Press.
58.
Thorne, S., Hislop, T.G., Kuo, M., & Armstrong, E. (2006). Hope and probability: Patient perspectives of the meaning of numerical information in cancer communication. Qualitative Health Research, 16, 318-336.
59.
Vargens, O.M., & Berterö, C.M. (2007). Living with breast cancer: Its effect on the life situation and the close relationship of women in Brazil. Cancer Nursing, 30(6), 471-478.
60.
Wellisch, D., Kagawa-Singer, M., Reid, S.L., & Lin, Y. (1999). An exploratory study of social support: A cross-cultural comparison of Chinese-, Japanese-, and Anglo-American breast cancer patients . Psycho-Oncology, 8, 207-219.
61.
Wen, C.Y., & Xiao, X.H. (1995). Zhongguo ren : Guan nian yu xing wei [Chinese people: Value and behavior]. Taibei, Taiwan: Ju Liu.
62.
Yan, H., & Sellick, K. (2004). Symptoms, psychological distress, social support, and quality of life of Chinese patients newly diagnosed with gastrointestinal cancer. Cancer Nursing, 27(5), 389-399.
63.
Yang, G. S., & Tu, A. B. (Eds.). (1993). Zhongguo ren de xin li yu xing wei: Li nian ji fang fa pian (1992) [Psychology and behavior of Chinese people: Theory and method (1992)]. Taibei Shi, Taiwan: Gui Guan.
64.
Zeidner, M., & Saklofske, D. (1996). Adaptive and maladaptive coping. In M. Zeidner & N. S. Endler (Eds.), Handbook of coping: Theory, research, applications (pp. 505-531). New York: John Wiley & Sons.
