Conference Programme, Abstracts & Papers

Session 9A - At Risk? Social Perspectives on Health and Health Promotion
Chair: Katherine Powis

Personal and Communal Reactions to Cancer: An Interpretive Phenomenological Analysis of the Beliefs held by charedi Jewish Breast Cancer Patients
Kate Coleman
School of Health and Social Sciences, Middlesex University and Centre for Behavioural and Social Sciences in Medicine, University College London, United Kingdom

The objectives of the present paper are to investigate the meanings charedi breast cancer patients give to their cancer and how they interpret community perceptions of their illness.
Semi-structured interviews were carried out with a purposive sample of five charedi breast cancer patients in London.  The transcripts were analysed using interpretative phenomenological analysis.  Demographic and personal data were collected using a structured questionnaire.
Two strong themes emerged from participants’ accounts of the meanings they attributed to their cancer: firstly, the cancer came from God as part of a pre-determined and meaningful plan; secondly, the disease took the form of a test.  Participants conceptualised this test in different ways.  For all participants, the interpretations of their illness accorded with their existing religious beliefs, normative to charedi Judaism, where virtually every event ultimately is understood with reference to the Divine.  The meaning that participants gave to their illness brought the occurrence of cancer within the scope of their existing cognitive schemas.  Hence, the stressful and potentially destabilising event of diagnosis was positioned within an existing socially and religiously endorsed framework making the diagnosis religiously logical and causing minimal disruption to participants’ belief systems. 
Participants believed that cancer was stigmatised in the charedi community.  This had implications for personal identity.  Cultural taboos meant that breast cancer entailed a double stigma.  Participants believed that the stigma would devolve onto their children making it difficult for them to find marriage partners.  Negative perceptions about others may be articulated in relation to the religious or cultural practices comprising the orienting framework within which a group operates.  The centrality to the charedi framework of beliefs and practices of the highly regulated and controlled method of finding a marriage partner means that it becomes both a focal point and a stimulus for negative perceptions of cancer.

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Health as Balance: Illness and Wellness among Persons with Musculoskeletal Disorders
Birgitta. Wiitavaara
Department of Nursing, Umeå University, S-901 87 Umeå, Sweden and Centre for Musculoskeletal Research, University of Gävle, Box 7629, S-907 12 Umeå, Sweden.

Musculoskeletal disorders is a condition mostly approached from an out-side perspective and with quantitative methodology. This paper presents health experiences of men with musculoskeletal problems, explored through narrative interviews and constant comparative analysis. As there is a need for further research concerning people with early musculoskeletal symptoms, we turned to persons still active in working life. Ten men working as ambulance personnel were interviewed about their health experiences.
The analysis revealed a process ofstriving for balance between experiences of illness and wellness. The informants’ health experiences were not a state of either wellness or illness but both, in varying degrees at different times. The process of striving for balance started when the illness experience became too intrusive, and was a process of both minimising the impact of illness by accepting and handling it and attaining and maintaining enough wellness to strike a balance. The state of balance was the experience of feeling “well enough”.
Illness was characterised by disembodiment, vulnerability, and exhaustion, as the illness experiences incorporated feelings of that the previously silent body made it self heard, of being vulnerable when suffering gets too close and ofgetting worn out. Those experiences were counterbalanced by wellness, which was nurtured by experiences of relatedness, usefulness, being some one, and by excitement, challenge, and freedom.
Key Words: chronic illness; embodiment and disembodiment; emotion; grounded theory; health promotion and prevention; illness and wellness; musculoskeletal problems; qualitative research.

Understanding the doctrine of the five periods and six qi in the Yellow Emperor's Inner Canon
Han-Rog Kang
The Institute of Oriental Studies, University of Oxford, United Kingdom

            The illustration shows the traditional East Asian concept of human anatomical structure. The traditional East Asian body encompasses psyche and emotions, blurring the mind-body dualism that makes the English word “body” into the object of the West’s medical gaze. The traditional East Asian concept also privileges process over structures, effacing the anatomical foundations of the biomedical body we think of as the norm today. Traditional East Asian medical classics did not take the “body” as their object of study but spoke instead of an ensemble of functions. The locus classicus for the East Asian view of the body is The Yellow Emperor’s Inner Canon, (Huang Di nei jing 黃帝內經; hereafter Inner Canon), one of the world’s first medical texts and the medical bible of traditional East Asian medicine.
            Although modern scientific medicine has penetrated very deeply in East Asia, the medical systems of the past are still very much alive. Many East Asians receive medical care from physicians trained in modern medical schools and they also seek care from indigenous practitioners who follow the precepts of ancient and medieval medicine. The Inner Canon plays a role in East Asian medical history comparable to that of the Hippocratic writings in ancient Europe. Progress and significant paradigm changes have reduced Hippocrates to the honoured originator of a tradition that has become obsolete. In contrast, many practitioners of traditional East Asian medicine still consider The Inner Canon a valuable source of theoretical inspiration and practical knowledge in modern clinical settings.
The importance of The Inner Canon as a source of ancient East Asian intellectual history lies in its formative period over about one thousand years. The Inner Canon offers invaluable data on cognitive dynamics in ancient East Asian medicine and knowledge of nature, and it also provides a much needed starting point for serious and well-informed discussions on differences and parallels between European and East Asian approaches to health and illness. Especially, the doctrine of the five periods (wu yun 五運; wood, fire, earth, metal, and water) and six qi (liu qi 六氣; windy, cold, hot, moist, dry, and fiery)—the basic medical theory of traditional Chinese medicine—are outlined in seven “comprehensive discourses” (da lun 大論). The Inner Canon explains relationships ancient Chinese observers assumed to exist between climate and a broad range of natural phenomena, including human health and illness. The theory expounded in the Inner Canon has remained the dominant theory of traditional East Asian medicine to the present day.
There are thousands of commentaries on The Inner Canon by Chinese, Japanese, and Korean authors and herein we can see that Chinese, Japanese, and Koreans have understood The Inner Canon differently, even though they have shared the basic theory and approach to human health. For example, some Korean medical professionals in the eighteenth century denied the doctrine of the five periods and six qi under the influence of contemporary Western medical knowledge imported by missionaries, whereas no contemporary Chinese medical professionals criticised the doctrine.
My research will be historically reviewed the doctrine of the five periods and six qi to survey and examine East Asian’s different views on health and illness. The differences indicate cultural variations, and they suggest differences in the take up of European-style medical approaches.