Tranquil action: Eastern cultural beliefs as a source of coping strength among Chinese women with breast cancer

Abstract

PURPOSE: Cancer confronts people with enormous challenges in different aspects. Study into how people derive strength in coping the illness has long been an interest among researchers. This study endeavors to understand how Chinese women harness their innate strength in their experience with cancer. Our particular interest is how Eastern cultural beliefs contribute to coping strengths and shape the experiences of meaning making in Chinese women with breast cancer. METHOD: With purposive sampling, a total of 23 in-depth interviews were conducted with 18 Hong Kong Chinese women with breast cancer. Interviews were transcribed and coded. Procedures of data analysis were informed by Constructivist Grounded Theory approach (Charmaz, 2000, 2003). Member check was conducted to enhance credibility and trustworthiness of findings. RESULT: Chinese women in this study attributed cause of cancer as ‘tienming’ (pre-destined fate), ‘karma’ (law of cause and effect) or ‘test from Heaven’ (challenge given by Heaven to test an individual’s mind and spirit). According to Eastern culture, ‘tienming’ is the ultimate power; people have to accept it. On the other hand, the law of karma stipulates that the present is the result of past deed, and people can do good to accumulate good karma for the future, even for future lives. Finally, when Heaven test an individual, it is always with a good intention to use the challenge as a means to cultivate virtues and prefect character of the person. The utilization of these cultural concepts helped women in our study ascribe meaning and make sense of the experiences. As such, they cope with the illness using tranquil action. These include: (1) Letting go (relinquish efforts to control, forgo cling to or indulgence in thoughts, people and things); (2) Zen living (appreciate what is present as well as what is not, live fully in the present moment); (3) Maintaining ‘pingchangxin’ (keep an unperturbed and temperate state of mind); (4) Sowing good seeds of karma for the future (actively contribute to the well-being of self and others). These women reported gaining joy and inner peace, finding meaning, experiencing spiritual contentment as well as personal growth in the experiences. CONCLUSION: Indigenous Eastern cultural concepts were found to be relevant in understanding informants’ experiences and their strengths, and were found contributive to adjustment to cancer. RESEARCH IMPLICATIONS: Further researches on adaptation of cultural beliefs on meaning making, coping and resilience among cancer patients are warranted. CLINICAL IMPLICATIONS: Our findings suggest that integrating meaning making with an emphasis of identifying indigenous strengths in intervention would have great potentials in alleviating distress and fostering resilience. Eastern strategies of ‘tranquil action’ offer an alternative to Western therapeutic approaches in helping people with cancer, especially in situations where control and mastery are not possible.