Barbara Potrata1. 1. Leeds Institute of Health Sciences, University of Leeds, Leeds, UK. b.potrata@leeds.ac.uk
Abstract
BACKGROUND: There has been an increased recognition of the importance of socio-cultural factors affecting late presentation in breast cancer. Socio-culturally mediated symbolic meanings, attached to " breasts" might importantly affect understandings of breast cancer in connection with late presentation. OBJECTIVE: To explore symbolic meanings of " breasts" which might affect late presentation, as observed by the practitioners of complementary, alternative and religious (CAM) healing who worked with women with breast cancer in the Boston area, USA. METHOD: We conducted semi-structured interviews with 46 CAM practitioners who worked with approximately 70 CAM modalities. The interviews were entered into the database and analysed using thematic approach. RESULTS: The CAM practitioners observed that late presentation is related to two symbolic meanings of " breasts". Firstly, " breasts" are a symbol of maternity and consequently some women delayed seeking medical help because such understanding affected their perceived capacity to take care of their families. Secondly, among White American women " breasts" are related to the culturally highly relevant concept of " beauty", but among African American women " beauty" is equated with " health". Such understandings lead to very different reasons for late presentation, different illness experiences and require different psycho-social intervention to support women. DISCUSSION AND CONCLUSION: In planning and designing effective health promotion strategies and appropriate supportive care strategies for women coming from different cultural and sub-cultural backgrounds it is important to carefully examine concepts affecting late presentation in all their different social and (sub-)cultural settings.
BACKGROUND: There has been an increased recognition of the importance of socio-cultural factors affecting late presentation in breast cancer. Socio-culturally mediated symbolic meanings, attached to " breasts" might importantly affect understandings of breast cancer in connection with late presentation. OBJECTIVE: To explore symbolic meanings of " breasts" which might affect late presentation, as observed by the practitioners of complementary, alternative and religious (CAM) healing who worked with women with breast cancer in the Boston area, USA. METHOD: We conducted semi-structured interviews with 46 CAM practitioners who worked with approximately 70 CAM modalities. The interviews were entered into the database and analysed using thematic approach. RESULTS: The CAM practitioners observed that late presentation is related to two symbolic meanings of " breasts". Firstly, " breasts" are a symbol of maternity and consequently some women delayed seeking medical help because such understanding affected their perceived capacity to take care of their families. Secondly, among White American women " breasts" are related to the culturally highly relevant concept of " beauty", but among African American women " beauty" is equated with " health". Such understandings lead to very different reasons for late presentation, different illness experiences and require different psycho-social intervention to support women. DISCUSSION AND CONCLUSION: In planning and designing effective health promotion strategies and appropriate supportive care strategies for women coming from different cultural and sub-cultural backgrounds it is important to carefully examine concepts affecting late presentation in all their different social and (sub-)cultural settings.
Authors: Thomas Kolben; Susanne Beyer; Sanaz Ghasemi; Kerstin Hermelink; Sarah Meister; Tom Degenhardt; Isabelle Himsl; Franz Edler von Koch; Theresa M Kolben; Rachel Wuerstlein; Sven Mahner; Nadia Harbeck; Anna Hester Journal: Breast Care (Basel) Date: 2020-09-21 Impact factor: 2.268