| Summary: | 碩士 === 國立陽明大學 === 臨床護理研究所 === 93 === The medical circles have used Hormonal Replacement Therapy (HRT) on menopausal women for over 70 years, but the controversy remains. The findings reported by NIH, U.S.A in July 2002 indicated that women using HRT might cause cardiovascular and cancer risks. The finding raised significant concerns for menopausal women currently using HRT in Taiwan. To minimize the impacts of NIH report has been attempted such as the differentiation of western women’s constitution from the Taiwanese, and modification of the dose and types of HRT. Currently, HRT has not only been widely used, also becomes one of the most controversial medical technologies. The knowledge of HRT risk is ambiguous and uncertain. The aim of this study is to explore how Taiwanese women interpret the meanings of HRT risk and how to manage HRT risk.
The theoretical perspective of the study focuses on the sociocultural approaches of risk discourse. These approaches emphasize that risk is culturally defined and historically embedded. The deconstruction of risk knowledge development examines the gap between professional and lay knowledge. Ethnography is applied. Ethnographic interviews and moderate participant observation were used to collect data from March 2004 to the end of July 2004. The total of 18 women under HRT at least 1 year, aged from 48-60, were sampled. In addition, newspaper articles about HRT dated January 2004 to the end of June were obtained using the key words of “menopause” “HRT” and “osteoporosis”. The constant comparison method was used to analyze data and resulted in five cultural themes. They are, 1.The interaction between expert knowledge of doctors and local knowledge of women under HRT. 2. The uncertainty of medical knowledge as opening for negotiation. 3. The conflicts between social risk and health risk. 4. The management strategies of HRT risk. 5. The prevention of osteoporosis is the additional chapter of menopausal health risk.
The results of this study help health professionals understand how menopausal women interpret and manage HRT risk in their social contexts. It is suggested that health professionals incorporate the assessment of menopausal women’s experiences in HRT and HRT risk. Health policy regarding HRT risk needs to incorporate knowledge and experiences of lay menopausal women used HRT.
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