Conectar
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.
The incidence of psychological distress in patients with malignant tumors is high, which seriously affects the treatment compliance and quality of life of patients and even reduces the survival time. Non-pharmacological interventions are acceptable to patients because of their minor side effects. However, among the numerous interventions, which non-pharmacological intervention has demonstrated the most significant effect is still unclear.
This study aimed to compare the efficacy of different non-pharmacological interventions on psychological distress in patients with malignant tumors.
The databases, including Wanfang databases, Chinese National Knowledge Infrastructure, China Science and Technology Journal Database, SinoMed, PubMed, Embase, Web of Science, Cochrane Library, and PsycINFO, were searched systematically for randomized controlled trials on non-pharmacological interventions for psychological distress in patients with malignant tumors that were published up to July 5, 2025. Revman 5.3 and Stata 18.0 were used for paired and network meta-analysis, respectively.
A total of 43 randomized controlled trials were included. The area under the cumulative sorting curve was ranked as Naikan Morita therapy (99.6%) > acceptance and commitment therapy (79.0%) > music therapy (78.3%) > logotherapy (77.8%) > behavioral activation (67.5%) > solution-focused nursing (66.1%) > dignity therapy (51.2%) > mindfulness-based stress reduction (50.6%) > mindfulness-based cognitive therapy (46.7%) > Mika app (39.8%) > psychological education (38.5%) > multi-dimensional collaborative nursing (29.0%) > life review therapy (26.0%) > exercise therapy (14.7%) > usual care (5.0%).
Non-pharmacological interventions had overall benefits in reducing the psychological distress of patients with malignant tumors, especially Naikan Morita therapy, acceptance and commitment therapy, music therapy and logotherapy. However, more high-quality randomized controlled trials are still needed to obtain more reliable conclusions.
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