Acculturation in the adaptation of Chinese-American women to breast cancer: A mixed-method approach

Tzu I. Tsai*, Donald E. Morisky, Marjorie Kagawa-Singer, Kimlin T. Ashing-Giwa

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

23 Scopus citations


Aims. To explore how and to what extent acculturation and immigration affect Chinese-American immigrant women's breast cancer experience. Background. Acculturation is an important indicator for immigrant health. Less empirical research has been conducted on the association between acculturation and breast cancer experience among Chinese immigrant women in the USA. Design. A mixed methods study. Methods. A total of 107 Chinese-American women with breast cancer completed the structured questionnaire survey, and 16 women completed face-to-face in-depth interviews. Results. In the quantitative findings, acculturation was related to health beliefs, social support and life stress. Cultural interpretations of the qualitative information are offered to show that breast cancer experience was intertwined with cultural adaptation in a given immigrant environment. Chinese cultural beliefs persistently, even after years of immigration, guide Chinese-American immigrant women to respond to breast cancer across the meaning of health and illness, family ties and involvement and social interaction. Conclusion. Our findings show that acculturation is related to health beliefs, social support and life stress in the trajectory of breast cancer adaptation among Chinese-American immigrant women. Life stresses derived from immigration bring additional difficulties for immigrant women living with cancer. Relevance to clinical practice. This study pinpoints that traditional cultural beliefs and immigration stress may influence Chinese-American women to cope with breast cancer. To promote culturally sensitive cancer care for immigrants, healthcare professionals should be aware of and learn intercultural competence. Ethnic social support or outreach healthcare programme may benefit new immigrant families or the immigrant families, who lack social connection, to cope with cancer.

Original languageEnglish
Pages (from-to)3383-3393
Number of pages11
JournalJournal of Clinical Nursing
Issue number23-24
StatePublished - Dec 2011


  • Acculturation
  • Breast cancer
  • Cancer adaptation
  • Chinese-American
  • Cultural belief
  • Immigrant


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