Skip to main content

Advertisement

SpringerLink
Log in

Patient perspectives on adapting meaning-centered psychotherapy in advanced cancer for the Chinese immigrant population

  • Original Article
  • Published:
Supportive Care in Cancer Aims and scope Submit manuscript

Abstract

The Chinese immigrant community faces multiple obstacles to effective cancer support and psychosocial care post diagnosis. Meaning-centered psychotherapy (MCP) is an empirically based treatment (EBT) that has been found to significantly reduce psychological distress while increasing spiritual well-being and a sense of meaning and purpose in life in patients with advanced cancer. However, it has not yet been adapted for Chinese immigrants who have unique linguistic and cultural needs. This study presents a community needs assessment to inform the cultural adaptation of MCP for Chinese patients with advanced cancer using Bernal et al.’s ecological validity model and the cultural adaptation process model of Domenech-Rodriquez and Weiling. Interviews were conducted until saturation with 12 Chinese immigrants with advanced cancer to determine the community’s needs and preferences regarding the MCP intervention. Transcripts were translated and analyzed using Atlas.ti and six frequently occurring themes were identified: Coping; End of Life; Family; Culture, Religion, and Language; Immigration; and Specific Adaptations to MCP. Sociocultural values, beliefs, and practices such as filial piety and the use of Traditional Chinese Medicine (TCM) should be considered when adapting EBTs for Chinese immigrant cancer patients.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Similar content being viewed by others

References

  1. Lopez G, Cillufo A, Patten E. Chinese in the U.S. fact sheet. Pew Research Center: Social & Demographic Trends Web site. http://www.pewsocialtrends.org/fact-sheet/asian-americans-chinese-in-the-u-s/. Published September 8 2017. Updated 2018. Accessed 6 June 2018

  2. NYC Department of City Planning (2017) Info brief: NYC’s foreign-born, 2000 to 2015. 2017; March 2017

  3. Chen MS Jr (2005) Cancer health disparities among Asian Americans: what we know and what we need to do. Cancer 104(S12):2895–2902

    Article  PubMed  Google Scholar 

  4. McCracken M, Olsen M, Chen MS et al (2007) Cancer incidence, mortality, and associated risk factors among Asian Americans of Chinese, Filipino, Vietnamese, Korean, and Japanese ethnicities. CA Cancer J Clin 57(4):190–205

    Article  PubMed  Google Scholar 

  5. Guidry JJ, Torrence W, Herbelin S (2005) Closing the divide: diverse populations and cancer survivorship. Cancer 104(S11):2577–2583

    Article  PubMed  Google Scholar 

  6. Lam WW, Fielding R (2003) The evolving experience of illness for Chinese women with breast cancer: a qualitative study. Psycho-Oncology 12(2):127–140

    Article  PubMed  Google Scholar 

  7. Ngo-Metzger Q, Massagli MP, Clarridge BR, Manocchia M, Davis RB, Iezzoni LI, Phillips RS (2003) Linguistic and cultural barriers to care. J Gen Intern Med 18(1):44–52

    Article  PubMed  PubMed Central  Google Scholar 

  8. Liang W, Wang JH, Chen M et al (2008) Developing and validating a measure of Chinese cultural views of health and cancer. Health Educ Behav 35(3):361–375

    Article  PubMed  Google Scholar 

  9. Mui AC, Kang S, Kang D, Domanski MD (2007) English language proficiency and health-related quality of life among Chinese and Korean immigrant elders. Health Soc Work 32(2):119–127

    Article  PubMed  Google Scholar 

  10. Yu MY, Hong OS, Seetoo AD (2003) Uncovering factors contributing to under-utilization of breast cancer screening by Chinese and Korean women living in the United States. Ethn Dis 13(2):213–219

    PubMed  Google Scholar 

  11. Surbone A (2008) Cultural aspects of communication in cancer care. Support Care Cancer 16(3):235–240

    Article  PubMed  Google Scholar 

  12. Thorne SE, Hislop TG, Armstrong E, Oglov V (2008) Cancer care communication: the power to harm and the power to heal? Patient Educ Couns 71(1):34–40

    Article  PubMed  Google Scholar 

  13. Castillo-Page L (2010) Diversity in the physician workforce: facts and figures 2010. Association of American Medical Colleges. (Summer 2010)

  14. Reeves T, Bennett CE (2004) We the people: Asians in the United States. Vol 17. US Department of Commerce, Economic and Statistics Administration, US Census Bureau

  15. MLA Language Map Data Center (2008) Data center results

  16. Hsiao S, Gau M, Ingleton C, Ryan T, Shih F (2011) An exploration of spiritual needs of Taiwanese patients with advanced cancer during the therapeutic processes. J Clin Nurs 20(7–8):950–959

    Article  PubMed  Google Scholar 

  17. Lin JS, Finlay A, Tu A, Gany FM (2005) Understanding immigrant Chinese Americans’ participation in cancer screening and clinical trials. J Community Health 30(6):451–466

    Article  PubMed  Google Scholar 

  18. Breitbart W, Rosenfeld B, Gibson C, Pessin H, Poppito S, Nelson C, Tomarken A, Timm AK, Berg A, Jacobson C, Sorger B, Abbey J, Olden M (2010) Meaning-centered group psychotherapy for patients with advanced cancer: a pilot randomized controlled trial. Psycho-Oncology 19(1):21–28

    Article  PubMed  PubMed Central  Google Scholar 

  19. Breitbart W (2002) Spirituality and meaning in supportive care: spirituality-and meaning-centered group psychotherapy interventions in advanced cancer. Support Care Cancer 10(4):272–280

    Article  PubMed  Google Scholar 

  20. Breitbart W, Rosenfeld B, Pessin H, Applebaum A, Kulikowski J, Lichtenthal WG (2015) Meaning-centered group psychotherapy: an effective intervention for improving psychological well-being in patients with advanced cancer. J Clin Oncol 33(7):749–754

    Article  PubMed  PubMed Central  Google Scholar 

  21. Breitbart W, Poppito S, Rosenfeld B, Vickers AJ, Li Y, Abbey J, Olden M, Pessin H, Lichtenthal W, Sjoberg D, Cassileth BR (2012) Pilot randomized controlled trial of individual meaning-centered psychotherapy for patients with advanced cancer. J Clin Oncol 30(12):1304–1309

    Article  PubMed  PubMed Central  Google Scholar 

  22. Breitbart W, Poppito SR (2014) Meaning-centered group psychotherapy for patients with advanced cancer: a treatment manual. Oxford University Press, USA

    Google Scholar 

  23. Breitbart WS, Poppito SR (2014) Individual meaning-centered psychotherapy for patients with advanced cancer: a treatment manual. Oxford University Press, USA

    Book  Google Scholar 

  24. Hall GC, Hong JJ, Zane NW, Meyer OL (2011) Culturally competent treatments for Asian Americans: the relevance of mindfulness and acceptance-based psychotherapies. Clin Psychol Sci Pract 18(3):215–231

    Article  Google Scholar 

  25. Leng J, Lui F, Chen A, Huang X, Breitbart W, Gany F (2018) Adapting meaning-centered psychotherapy in advanced cancer for the Chinese immigrant population. J Immigr Minor Health 20(3):680–686

    Article  PubMed  PubMed Central  Google Scholar 

  26. Domenech-Rodríguez M, Wieling E (2004) Developing culturally appropriate evidence based treatments for interventions with ethnic minority populations. In: Rastogi M, Wieling E (eds) Voices of color: first person accounts of ethnic minority therapists. Sage Publications, Thousand Oaks, pp 313–333

  27. Bernal G, Bonilla J, Bellido C (1995) Ecological validity and cultural sensitivity for outcome research: issues for the cultural adaptation and development of psychosocial treatments with Hispanics. J Abnorm Child Psychol 23(1):67–82

    Article  CAS  PubMed  Google Scholar 

  28. Strauss A, Corbin JM (1990) Basics of qualitative research: grounded theory procedures and techniques. Sage Publications, Inc, Thousand Oaks

    Google Scholar 

  29. ATLAS.ti: The qualitative data analysis & research software (2012). http://www.atlasti.com/index.html. Accessed Jan 2018

  30. Thomas DR (2006) A general inductive approach for analyzing qualitative evaluation data. Am J Eval 27(2):237–246

    Article  Google Scholar 

  31. Takeuchi DT, Sue S, Yeh M (1995) Return rates and outcomes from ethnicity-specific mental health programs in Los Angeles. Am J Public Health 85(5):638–643

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  32. Yeh M, Takeuchi DT, Sue S (1994) Asian-American children treated in the mental health system: a comparison of parallel and mainstream outpatient service centers. J Clin Child Psychol 23(1):5–12

    Article  Google Scholar 

  33. Betancourt JR (2003) Cross-cultural medical education: conceptual approaches and frameworks for evaluation. Acad Med 78(6):560–569

    Article  PubMed  Google Scholar 

  34. Betancourt JR, Green AR, Carrillo JE, Ananeh-Firempong O 2nd (2003) Defining cultural competence: a practical framework for addressing racial/ethnic disparities in health and health care. Public Health Rep 118(4):293–302

    Article  PubMed  PubMed Central  Google Scholar 

  35. Kagawa-Singer M, Kassim-Lakha S (2003) A strategy to reduce cross-cultural miscommunication and increase the likelihood of improving health outcomes. Acad Med 78(6):577–587

    Article  PubMed  Google Scholar 

  36. Kearney MK, Weininger RB, Vachon ML, Harrison RL, Mount BM (2009) Self-care of physicians caring for patients at the end of life: “Being connected... a key to my survival”. JAMA 301(11):1155–1164

    Article  CAS  PubMed  Google Scholar 

  37. Lin T, Tardiff K, Donetz G, Goresky W (1978) Ethnicity and patterns of help-seeking. Cult Med Psychiatry 2(1):3–13

    Article  CAS  PubMed  Google Scholar 

  38. Sue D, Sue S (1987) Cultural factors in the clinical assessment of Asian Americans. J Consult Clin Psychol 55(4):479–487

    Article  PubMed  Google Scholar 

  39. Sue S (1977) Psychological theory and implications for Asian Americans. J Couns Dev 55(7):381–389

    Google Scholar 

  40. Hwang W (2006) The psychotherapy adaptation and modification framework: application to Asian Americans. Am Psychol 61(7):702–715

    Article  PubMed  Google Scholar 

  41. Tervalon M, Murray-Garcia J (1998) Cultural humility versus cultural competence: a critical distinction in defining physician training outcomes in multicultural education. J Health Care Poor Underserved 9(2):117–125

    Article  CAS  PubMed  Google Scholar 

  42. Vasquez MJ (2007) Cultural difference and the therapeutic alliance: an evidence-based analysis. Am Psychol. 62(8):878–885

    Article  Google Scholar 

  43. Chen SW, Davenport DS (2005) Cognitive-behavioral therapy with Chinese American clients: cautions and modifications. Psychother Theory Res Pract Train 42(1):101–110

    Article  Google Scholar 

  44. Lorence DP, Park H, Fox S (2006) Racial disparities in health information access: resilience of the digital divide. J Med Syst 30(4):241–249

    Article  PubMed  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Immigrant Health and Cancer Disparities Center, Department of Psychiatry and Behavioral Sciences, Memorial Sloan Kettering Cancer Center, New York, NY, USA

    Jennifer Leng, Florence Lui, Xiaoxiao Huang & Francesca Gany

  2. Department of Medicine, Memorial Sloan Kettering Cancer Center, New York, NY, USA

    Jennifer Leng & Francesca Gany

  3. Department of Healthcare Policy and Research, Weill Cornell Medical College, New York, NY, USA

    Jennifer Leng & Francesca Gany

  4. Department of Clinical Psychology, The City College of New York, New York, NY, USA

    Florence Lui

  5. Department of Psychiatry and Behavioral Sciences, Memorial Sloan Kettering Cancer Center, New York, NY, USA

    William Breitbart

  6. Department of Medicine, Weill Cornell Medical College, New York, NY, USA

    Francesca Gany

Authors
  1. Jennifer Leng
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Florence Lui
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Xiaoxiao Huang
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. William Breitbart
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Francesca Gany
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Jennifer Leng.

Ethics declarations

Conflict of interest

This study was funded by the National Institutes of Health Research Project Grant Program (3R01CA128134-05S1) and the National Institutes of Health Small Grant Program (R03CA178124-01A1). The authors have full control of all primary data and agree to allow the journal to review the data if requested.

Additional information

Publisher’s note

Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Leng, J., Lui, F., Huang, X. et al. Patient perspectives on adapting meaning-centered psychotherapy in advanced cancer for the Chinese immigrant population. Support Care Cancer 27, 3431–3438 (2019). https://doi.org/10.1007/s00520-019-4638-2

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00520-019-4638-2

Keywords

Search

Navigation