| Summary: | 碩士 === 慈濟大學 === 原住民健康研究所 === 89 === Facing the rapid escalation of head and neck cancer incidence, the medical authorities still cannot find an efficient way to persuade people to quit smoking, drinking, and betel nut chewing. Why there is a big gap between ordinary people and the medical professionals? From the sociocultural point of view, the aim of this study is to decipher the thinking of advanced head and neck cancer patients, and to work out better ways to prevent the disease in the future. The study encompasses two parts: first to analyze the incidence and severity of head and neck cancers in Eastern Taiwan from the health statistics, then to study the illness behaviors of advanced head and neck cancer patients by participant observation and in-depth interview. The patient samples were gathered from the inpatients of otorhinolaryngology department of Tzu Chi General Hospital. Among 33 interviewees, 16 were Amis and 17 were Han Chinese. The results showed that the incidence of head and neck cancers was higher in Eastern Taiwan than the national average. The aboriginal patients have higher incidence of pharyngeal cancers instead of oral cancer although they were habitual betel nut chewers. Patients of different ethnic groups behaved differently when coping with head and neck cancers. Most of the Amis patients were fatalistic, gentle, happy, and cooperative. They had good kin and social supports. They can accept hospice care at the terminal stage. Han Chinese patients acted not the same as Amis, they struggled throughout the disease course. They were aggressive, mastering, anxious and not willing to surrender. When entering the final stage of cancer, they still asked for survival and prayed for miracle. This study suggested that the medical system in Eastern Taiwan should notice the severity of head and neck cancers and keep higher index of suspicion. It is inappropriate to treat patients from different ethnic groups the same way. For Amis patients, education about health knowledge would be very important to alert people at the early stage of cancer. For Han Chinese, improvement of supporting system and propagation of hospice care would be helpful. By the way, the campaign of no smoking, drinking, and betel nut chewing should be proposed from patients’ prospect of view.
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