Paper
Thursday, 20 July 2006
This presentation is part of : Strategies Addressing Women's Health Issues
Interpretive Flexibility of Risks of Hormone Replacement Therapy and Risk Management
Zxy-yann J. Lu, PhD, RN, Department of Nursing, China Medical University College of Medicine, Taichung, Taiwan and Yueh-ching Juan, MS, RN, Mackey Medicine, Nursing and Management College, Taipei, Taiwan.
Learning Objective #1: To learn the flexible interpretations of HRT risks among Taiwanese menopausal women
Learning Objective #2: To ascertain the culturally diversed HRT management strategies of menopausal women
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. 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 was 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 generated five cultural themes including, the interaction between expert knowledge of doctors and local knowledge of women under HRT, the uncertainty of medical knowledge as opening for negotiation, the conflicts between social risk and health risk, the management strategies of HRT risk, the prevention of osteoporosis is the additional chapter of menopausal health risk.  The results 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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