The social construction of cancer chemotherapy toxicity: the case of Taiwan

• Published in: Cancer nursing Vol. 36; no. 4; p. E61
• Main Authors: Chen, Hai-Chiao, Allan, Helen, Lu, Zxy-Yann Jane
• Format: Journal Article
• Language: English
• Published: United States 01.07.2013
• Subjects: Antineoplastic Agents - adverse effects; Antineoplastic Agents - therapeutic use; Asian Continental Ancestry Group; Attitude of Health Personnel - ethnology; Attitude to Health - ethnology; Cultural Characteristics; Drug-Related Side Effects and Adverse Reactions - diagnosis; Drug-Related Side Effects and Adverse Reactions - ethnology; Female; Humans; Male; Medicine, Chinese Traditional; Neoplasms - drug therapy; Neoplasms - pathology; Patient Education as Topic - organization & administration; Taiwan; Taiwan
• ISSN: 1538-9804
• DOI: 10.1097/NCC.0b013e31826a7235

Chemotherapy toxicity hinders cancer treatment outcomes. Healthcare professionals educated in biomedical-oriented systems tend to label patients who refuse or discontinue chemotherapy as "noncompliant." How diverse discourses in public texts related to chemotherapy toxicity, which may significantly shape patients' actions, has not been formally explored. The aims of this study were to explore the 2 dominant discourses in Taiwan related to chemotherapy toxicity within their sociocultural context and to ascertain how chemotherapy toxicity is constructed in the texts of journals and newspapers. Public, medical, and nursing texts about chemotherapy from 1950 to 2010 were collected and analyzed using Foucaultian discourse analytical techniques; juxtaposing dominant and marginalized discourses, we identified cultural themes. In traditional Chinese medicine, toxic chemotherapy drugs are believed to interfere with circulation of energy flow and blood and to disturb the harmony of yin/yang in the body. Findings indicate that biomedical and traditional Chinese medical doctors do not agree about the best management of chemotherapy toxicity. Moreover, lay knowledge and patient voices regarding chemotherapy toxicity are often ignored in medical discourses. Cultural beliefs and covert power relations between diverse medical traditions shape patients' experiences of chemotherapy toxicity. The preferential use by patients of traditional Chinese medicine over biomedicine to manage chemotherapy toxicity sustains its pivotal role. The disparity of perceptions between healthcare professionals and patients regarding chemotherapy toxicity needs to be thoroughly assessed. Thus, culturally specific nursing care models may be developed.