Self-Management of Chronic Illness Among Chinese Immigrants: An Integrative Review

To advance the understanding of chronic illness self-management among Chinese immigrants in Western countries by synthesising evidence and through the lens of the Middle Range Theory of Self- and Family Management of Chronic Illness.

Integrative review following Whittemore and Knafl.

Two reviewers used Covidence software to screen potential articles. After identifying the sample, reviewers extracted data into a matrix and appraised study quality using Critical Appraisal Skills Programme checklists. Reviewers used the constant comparative method to categorise data into categories: (1) facilitators/barriers, (2) processes and (3) outcomes. Findings were then synthesised and mapped to the theory domains.

MEDLINE, CINAHL, Web of Science, Embase, PsycINFO and ProQuest Central (database inception-August 2025).

Of 3205 records screened, 20 studies met the inclusion criteria with acceptable quality. Personal characteristics/health status, resources/environment, Chinese-Western cross-cultural experiences, family and healthcare systems, and linguistic barriers shaped the processes of Focusing on Illness Needs (developing illness insights, taking ownership of health needs, and health promotion); Activating Resources (Western health care, traditional Chinese practices, community and family support, and blended spiritual resources); and Living with a Chronic Illness (processing emotions, adjusting, integrating, and meaning-making). These processes lead to outcomes including improved disease control, psychological/cognitive well-being, and healthcare utilisation and unintended negative consequences such as emotional burden and delayed care-seeking.

While Chinese immigrants share certain aspects of self-management with Western populations, their approaches are shaped by culturally grounded, family-centred values, traditional health practices, and immigrant experiences, which underscore the need for culturally and contextually sensitive self-management support. The findings also expand the applicability of the guiding theory by identifying new cultural elements.

Nurses can support self-management among Chinese immigrants by developing culturally and linguistically tailored interventions, engaging family members in health education and treatment planning, enhancing accessible digital, community and navigational resources, providing language assistance and strengthening staff training.

We used the PRISMA 2020 checklist for adherence to review protocols.

This study did not include patient or public involvement in its design, conduct or reporting.