Nursing Discovers Culture

Today's LA Times reports on a dissertation research project focusing on modesty among Jewish women, and its impact on seeking medical care:

Caryn Andrews had been in search of a dissertation topic when a member of her synagogue happened to pose a question: "Do you think religious Jews would be less likely to go for a mammogram?"

Intrigued, Andrews, a doctoral candidate at the University of Maryland School of Nursing, pondered the question with her rabbi, Susan Grossman, at Beth Shalom in Columbia, Md. "She suggested that I couldn't look at religion; I had to look at modesty," Andrews says.

It was a crucial distinction in a faith in which healing oneself and others is a requirement, but one that can often be difficult because of some forms of modesty practiced in the Jewish community.

A dissertation topic was born.

The concept of modesty and its role in Jewish culture led Andrews, an oncology nurse practitioner at Northwest Hospital Center in Randallstown, Md., to research whether modesty among Jewish women might discourage them from receiving breast cancer screenings.

Andrews hopes that her findings and further studies will have an effect on the administration of healthcare in any community where rules of modesty may pose obstacles to mammography, other forms of preventive healthcare and treatment.

My reactions over morning coffee were twofold. One, congratulations on perceiving the role of culture in shaping medical decisions - it's been done for decades by others, especially in the field of medical anthropology (Caveat: Yours truly has been a blind reviewer for Medical Anthropology Quarterly). Two, reading along I had hoped that the study would involve more than a relatively small sample of interviews and creation of a psychometric scale (a methodological crutch in many medical-behavioral studies), but then, I was wrong:

In interviews with 40 women, Andrews also gleaned the many dimensions of the role played by modesty in their lives, from the clothing they wore to the books they read.

The result, Andrews says, was the development of a "modesty scale that provides evidence that modesty can be measured."