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Interrelatedness of Distress Among Chinese-Speaking Patients and Family Caregivers

Lee, Joyce W.K., PhD; Gotay, Carolyn, PhD; Sawatzky, Richard, PhD, RN; Kazanjian, Arminée, DrSoc

doi: 10.1097/NCC.0000000000000620
Article: PDF Only

Background Cancer is a family disease, affecting the individual patient and the family. For Chinese patients and their families in Canada, adjusting to cancer may be particularly distressing when culture and language are not congruent with the mainstream model of care delivery.

Objective In view of the limited research on the cancer experience of Chinese families, this study aims to examine the interrelatedness of patients and family caregivers' distress among a Chinese-speaking cancer population in Canada.

Methods Semi-structured interviews were conducted with a purposive sample of 10 Chinese-speaking cancer patients and 6 family caregivers. Qualitative analysis of the interview data was conducted to construct cross-cutting themes regarding the experiences of distress after a cancer diagnosis.

Results Four overarching themes emerged from the analysis: (1) misconception about cancer, (2) tensions in disclosure, (3) patient and family caregiver distress, and (4) concealing emotion in patient and family caregiver. Notably, the interrelatedness of patients and family caregivers' distress was highlighted, as patients and family caregivers both sought to regulate their own emotions to protect one another's mental well-being.

Conclusion The study provides insights into the distress of living with cancer and the impact on family relationships. Understanding the patients and family members' cultural and social contexts also provides the foundation for patient- and family-centered care.

Implications for Practice Healthcare professionals can provide culturally appropriate care by recognizing the needs, values, and beliefs of cancer patients and their families. Furthermore, the patient–family caregiver dyad needs to be considered as the unit of care.

Author Affiliations: BC Cancer (Dr Lee); and School of Population and Public Health, University of British Columbia (Drs Lee, Gotay, and Kazanjian), Vancouver; School of Nursing, Trinity Western University (Dr Sawatzky), Langley; and Centre for Health Evaluation and Outcome Sciences, St Paul's Hospital (Dr Sawatzky), Vancouver, British Columbia, Canada.

Dr Lee's dissertation project was funded by a graduate trainee award from Western Regional Training Centre for Health Services Research, scholarships from University of British Columbia, a graduate fellowship from Canadian Institutes of Health Research Team for Supportive Cancer Care, and an interdisciplinary fellowship from Canadian Frailty Network. Dr Sawatzky is supported by a Canada Research Chair in Patient-Reported Outcomes.

The authors have no conflicts of interest to disclose.

Correspondence: Joyce W.K. Lee, PhD, BC Cancer, Ste 600, 750 W Broadway, Vancouver, BC V5Z 1H1, Canada (

Accepted for publication March 27, 2018.

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