Self-management of cancer treatment-related fatigue, nausea, vomiting and oral mucositis in Chinese cancer patients

Background: Treatment-related symptoms continue to place a significant burden on many cancer patients. Many side effects require patients to engage in a range of self-management actions. While some studies have explored self-management of treatment-related side effects in Western settings, very few studies were identified that described the self-management practices of cancer patients in China. Objective: The purposes of this study are to: (1) Investigate Chinese cancer patients. self-management behaviours in dealing with the fatigue, nausea/vomiting and oral mucositis that result from treatment, as well as the perceived effectiveness of these behaviours and related self-efficacy in performing them. (2) Explore factors influencing symptom self-management behaviours using the Cancer Symptom Self-management Framework based on Grey, Knafl and McCorkle.s (2006) self-management framework as a guide. Methods: This study was divided into two phases. Phase One consisted of the translation and modification of two instruments. The adaptation of these instruments to ensure applicability in the Chinese context was achieved through semi-structured interviews with six cancer patients, and content evaluation with eight experienced oncology nurses. A pilot study was conducted with nine cancer patients to trial the questionnaire set in the Chinese context. Based on the results of Phase One, Phase Two involved a cross-sectional survey of Chinese cancer patients undergoing cancer treatment using these instruments. A total of 277 chemotherapy patients with fatigue and/or nausea and vomiting, and 100 radiotherapy patients with oral mucositis were surveyed. Results: Participants in this study reported a variety of self-management behaviours to cope with fatigue, nausea, vomiting and oral mucositis. There are some consistencies as well disparities between strategies that are frequently used and those rated as effective. For fatigue self-management, participants were more likely to use strategies related to rest and sleep, while activity enhancement strategies were rated as achieving higher relief. For nausea and vomiting self-management, dietary modification and taking medication were most frequently used and rated as moderately effective. Psychological strategies were used by more than a third of participants and were rated as mildly effective. Some other infrequently used strategies, such as distraction by keeping busy and acupressure, were rated as moderately effective. For oral mucositis self-management, having soft, bland food and keeping the mouth moisturised were most frequently reported and they were rated as achieving moderate relief. A prescribed mouthwash was used by most but not all participants and brought moderate relief. In general, patients had low-to-moderate self-efficacy in nausea and vomiting self-management behaviours, moderate self-efficacy in fatigue self-management behaviours, and low-to-moderate self-efficacy in oral mucositis self-management behaviours. In terms of the factors influencing symptom self-management, different predictors were identified affecting engagement in fatigue, nausea/vomiting and oral mucositis self-management behaviours. Self-efficacy scores of different behaviours were consistently found to be a positive predictor of the relief level from corresponding behaviours, after controlling for other variables. Perceived social support from health care professionals was identified as an important factor influencing nausea and vomiting self-management behaviours, while neighbourhood support was important for fatigue self-management. In addition, symptom distress was identified as an important factor influencing nausea and vomiting self-management. Conclusion: Similar to reports from overseas, Chinese cancer patients initiate a wide range of self-management behaviours in response to treatment-related side effects. While some behaviours were reported to provide relief, many did not. Given these results, this study has a number of practical implications for health care professionals, particularly in relation to developing tailored self-management programs for fatigue, nausea, vomiting and oral mucositis. Additionally, this study suggests a number of theoretical implications and directions for future research. It is envisaged that these recommendations may pave the way for further studies understanding and promoting cancer symptom self-management in Chinese people affected by cancer.

Learning Chinese as a Heritage Language: An Australian Perspective

Summary: This book explores the fascinating topic of heritage language learning, looking in particular at Chinese Australians' learning of Chinese. The author studies the investment, challenges and benefits of heritage language learning across varied contexts including school, work, home and in the community. The book investigates how Chinese Australians navigate and negotiate their Chineseness and how resources are used to support their learning. The book is based on a mixed methods study which uses Bourdieu's sociological theory, and offers implications for sociologists of language and education, Chinese heritage language learners and teachers, as well as language and cultural policy makers. Review: This book is a compelling account of the habitus of Chineseness in a world of mobility. It offers up a plethora of insights into the implication of heritage language learning in the constitution of Chinese identity; it makes available a sophisticated mixed methods approach for using the thinking tools of Pierre Bourdieu; it adds to these tools a nuanced cultural dimension. Karen Dooley, Queensland University of Technology, Australia In our increasingly trans-migratory world, language can be central to cultural identity. Dr Mu’s research breaks new ground by adapting Bourdieu’s insights to examine how cultural identity (‘Chinese-ness’) is linguistically learned and practiced in Australia. His remarkable book will interest educators and researchers grappling with how language pertains to identity. Tom Strong, University of Calgary, Canada A thought-provoking, highly engaging work that has deftly shown how Bourdieusian framework can be applied in the research field of literacy education and Heritage Language learning. A must-read for those interested in overseas Chinese communities and Heritage Language learning across various immigrant communities in general! Liang Du, Beijing Normal University, China

Franchise nations : the future of nations?

In this paper, I extend the notion of franchise nations, borrowed from Neal Stephenson’s cyberpunk novel Snow Crash (1993), in order to employ it as a device for thinking about the future of the nation. I argue the concept to be particularly well suited for such contemplation because of its sound grounding in the historical intermesh of economic, political and cultural motivations intrinsic to the concept as well as lived experience of the nation. I illustrate this very briefly by casting (mainland) China as the master franchisor and the overseas Chinese as franchisees. Specifically, I discuss the media events concerning China that took place during 2008, such as the protests and counter-protests that occurred at various legs of the Olympic Torch Relay, the Sichuan earthquake of 12 May and the opening ceremony of the Beijing Olympics on 8 August, and reactions to these happenings from overseas Chinese located variously in Australia, Canada and the United States. I argue that employing the notion of franchise nations lays bare the commercial and political instrumentalism behind the promotion and courtship of diasporas by home nations but, crucially, also aids in the understanding of the reciprocal processes by which franchisees are fashioned out of these communities. Finally, I suggest that, aside from China, franchise nations may also be a useful approach for thinking about how nations like India and Singapore are expanded, exported and explained into the future.

Virtual diasporas and the dilemma of multiple belongings in cyberspace

One of the most celebrated qualities of the Internet is its enabling of simultaneity and multiplicity. By allowing users to open as many windows into the world as they (and their computers) can withstand, the Internet is understood to have brought places and cultures together on a scale and in a manner unprecedented. Yet, while the Internet has enabled many to reconnect with cultures and places long distanced and/or lost, it has also led to the belief that these reconnections are established with little correspondent cost to existent ties of belonging. In this paper, I focus on the dilemma multiple belongings engender for the ties of national belonging and question the sanguinity of multiple belongings as practised online. In particular, I use Lefebvre's notion of lived space to unpack the problems and contradictions of what has been called 'Greater China' for the ethnic Chinese minority in nations like Malaysia, Singapore and Australia.

Does 'habitus' count in Chinese Australians' mathematics achievement?

Large-scale international comparative studies and cross-ethnic studies have revealed that Chinese students, whether living in China or overseas, consistently outperform their counterparts in mathematics achievement. These studies tended to explain this result from psychological, educational, or cultural perspectives. However, there is scant sociological investigation addressing Chinese students’ better mathematics achievement. Drawing on Bourdieu’s sociological theory, this study conceptualises Chinese Australians’ “Chineseness” by the notion of ‘habitus’ and considers this “Chineseness” generating but not determinating mechanism that underpins Chinese Australians’ mathematics learning. Two hundred and thirty complete responses from Chinese Australian participants were collected by an online questionnaire. Simple regression model statistically significantly well predicted mathematics achievement by “Chineseness” (F = 141.90, R = .62, t = 11.91, p < .001). Taking account of “Chineseness” as a sociological mechanism for Chinese Australians’ mathematics learning, this study complements psychological and educational impacts on better mathematics achievement of Chinese students revealed by previous studies. This study also challenges the cultural superiority discourse that attributes better mathematics achievement of Chinese students to cultural factors.

Chinese Australians’ Chineseness and their mathematics achievement : the role of habitus

Large-scale international comparative studies and cross-ethnic studies have revealed that Chinese students, living either in China or overseas, consistently outperform their counterparts in mathematics. Empirical research has discussed psychological, educational, and cultural reasons behind Chinese students’ better mathematics performance. However, there is scant sociological investigation of this phenomenon. The current mixed methods study aims to make a contribution in this regard. The study conceptualises Chineseness through Bourdieu’s sociological notion of habitus and considers this habitus of Chineseness generating, but not determining, mechanism that underpins commitment to mathematics learning. The study firstly analyses the responses of 230 Chinese Australian participants to a set of questionnaire items. Results indicate that the habitus of Chineseness significantly mediates the relationship between participants’ commitment to mathematics learning and their mathematics achievement. The study then reports on the interviews with five participants to add nuances and dynamics to the mediating role of habitus of Chineseness. The study complements the existing literature by providing sociological insight into the better mathematics achievement of Chinese students.