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Zeng L, Xu X, Perry L. Self-care behaviours of first-generation Chinese immigrants living with cardiovascular disease: A qualitative study. J Adv Nurs 2024. [PMID: 38923031 DOI: 10.1111/jan.16302] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/16/2024] [Revised: 05/07/2024] [Accepted: 06/07/2024] [Indexed: 06/28/2024]
Abstract
AIM To identify and describe self-care behaviours performed by Chinese immigrants living with cardiovascular disease in Australia, and factors perceived as barriers and facilitators to evidence-based cardiac self-care. DESIGN A qualitative descriptive design. METHODS Individual semi-structured phone interviews were conducted among participants meeting the following criteria: (1) first-generation Chinese immigrants to Australia, born in Mainland China, Hong Kong, Macao or Taiwan; (2) Australian permanent residents or citizens; (3) self-reported or medically diagnosed with coronary heart disease, stroke or heart failure; (4) able to speak English or Mandarin; (5) able to provide informed consent, excluding those with history or evidence of impaired cognition such as dementia. Participants were recruited via social media, Chinese community associations and medical centres from September 2021 to June 2022. Data were analysed using inductive and deductive thematic analysis, guided by the Middle-Range Theory of Self-Care of Chronic Illness. The study was reported in line with the COREQ checklist. RESULTS Twenty participants were interviewed, 60% female, mean age 69.9 years. Most migrated to Australia at older age following their retirement in China; most had limited English proficiency. Many practiced adequate self-care for their CVD in self-care maintenance and monitoring. Variously, they adopted heart-healthy diets, developed exercise routines, attended medical services and closely monitored their body signs and symptoms. However, self-adjusting medications, taking Traditional Chinese Medicine and self-administering health supplements were prevalent practices and first-response management of acute cardiac symptoms was suboptimal. Linguistic and cultural barriers to obtaining mainstream heart health information meant most participants resorted to informal, anecdotal and mainland Chinese sources. CONCLUSION Diverse factors were held responsible for sub-optimal self-care behaviours but lack of access to linguistically and culturally appropriate heart health information was widely blamed. Linguistically and culturally appropriate community-based heart health education programmes are urgently needed, targeting healthy lifestyle modification, medication literacy and cardiac symptom management. IMPACT Study findings can be used to improve cardiac nurses' cultural sensitivity and practices targeting Chinese immigrants. Partnering with Chinese community associations offers health service providers and policymakers an innovative route to co-design and deliver targeted heart health education interventions and support for this population. PUBLIC CONTRIBUTION Chinese community centre managers contributed to data collection by supporting participant recruitment.
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Affiliation(s)
- Ling Zeng
- School of Nursing and Midwifery, Faculty of Health, University of Technology Sydney, Ultimo, New South Wales, Australia
| | - Xiaoyue Xu
- School of Nursing and Midwifery, Faculty of Health, University of Technology Sydney, Ultimo, New South Wales, Australia
- School of Population Health, Faculty of Medicine, University of New South Wales, Kensington, New South Wales, Australia
| | - Lin Perry
- School of Nursing and Midwifery, Faculty of Health, University of Technology Sydney, Ultimo, New South Wales, Australia
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Gupta AK, Kleinig O, Tan S, Nagarathinam B, Kovoor JG, Bacchi S, Zaka A, He C, Stroebel A, Beltrame JF, Vallely MP, Bennetts JS, Maddern GJ. Lost in Translation: The Impact of Language Barriers on the Outcomes of Patients Receiving Coronary Artery Revascularization. CARDIOVASCULAR REVASCULARIZATION MEDICINE 2023; 52:94-98. [PMID: 36990850 DOI: 10.1016/j.carrev.2023.03.016] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/22/2023] [Accepted: 03/23/2023] [Indexed: 03/28/2023]
Abstract
INTRODUCTION Clear and effective communication is vital in discussions regarding coronary revascularization. Language barriers may limit communication in healthcare settings. Previous studies on the influence of language barriers on the outcomes of patients receiving coronary revascularization have produced conflicting results. The aim of this systematic review was to evaluate and synthesise the existing evidence regarding the effects of language barrier on the outcomes of patients receiving coronary revascularization. METHODS A systematic review was conducted, including a search of the PubMed, EMBASE, Cochrane, and Google Scholar databases on 01/10/2022. The review was conducted in accordance with PRISMA guidelines. This review was also prospectively registered on PROSPERO. RESULTS Searches identified 3983 articles of which a total 12 studies were included in the review. Most studies describe that language barriers result in delayed presentation, but not delays in treatment following hospital arrival with respect to coronary revascularization. The findings with respect to the likelihood of receiving revascularization have varied significantly; however, some studies have indicated that those with language barriers may be less likely to receive revascularization. There have been some conflicting results with respect to the association between language barrier and mortality. However, most studies suggest that there is no association with increased mortality. In studies that evaluated length of stay variable results have been reported based on geographical location. Namely Australian studies have suggested no association between language barrier and length of stay, but Canadian studies support an association. Language barriers may also be associated with readmissions following discharge, and major adverse cardiovascular and cerebrovascular events (MACCE). CONCLUSION This study demonstrates that patients with language barriers may have poorer outcomes from coronary revascularization. Future interventional studies will be required to consider the sociocultural context of patients with language barriers, and may be targeted at timepoints including prior to, during, or after hospitalisation for coronary revascularization. Further examination of the adverse health outcomes of those with language barriers in fields outside of coronary revascularization are required in view of the stark inequities identified in this field.
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Affiliation(s)
- Aashray K Gupta
- University of Adelaide, Adelaide, Australia; Gold Coast University Hospital, Southport, Australia.
| | | | - Sheryn Tan
- University of Adelaide, Adelaide, Australia
| | | | - Joshua G Kovoor
- University of Adelaide, Adelaide, Australia; Royal Adelaide Hospital, Adelaide, Australia
| | - Stephen Bacchi
- University of Adelaide, Adelaide, Australia; Flinders University, Adelaide, Australia; Royal Adelaide Hospital, Adelaide, Australia
| | - Ammar Zaka
- Gold Coast University Hospital, Southport, Australia
| | - Cheng He
- Gold Coast University Hospital, Southport, Australia
| | | | - John F Beltrame
- University of Adelaide, Adelaide, Australia; Royal Adelaide Hospital, Adelaide, Australia
| | | | - Jayme S Bennetts
- Flinders University, Adelaide, Australia; Flinders Medical Centre, Adelaide, Australia
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Abudiab S, de Acosta D, Shafaq S, Yun K, Thomas C, Fredkove W, Garcia Y, Hoffman SJ, Karim S, Mann E, Yu K, Smith MK, Coker T, Dawson-Hahn E. "Beyond just the four walls of the clinic": The roles of health systems caring for refugee, immigrant and migrant communities in the United States. Front Public Health 2023; 11:1078980. [PMID: 37064664 PMCID: PMC10097984 DOI: 10.3389/fpubh.2023.1078980] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/24/2022] [Accepted: 03/06/2023] [Indexed: 04/18/2023] Open
Abstract
This article is part of the Research Topic 'Health Systems Recovery in the Context of COVID-19 and Protracted Conflict'. Introduction Refugee, immigrant and migrant (hereafter referred to as "immigrant") communities have been inequitably affected by the COVID-19 pandemic. There is little data to help us understand the perspectives of health systems on their role, in collaboration with public health and community-based organizations, in addressing inequities for immigrant populations. This study will address that knowledge gap. Methods This qualitative study used semi-structured video interviews of 20 leaders and providers from health systems who cared for immigrant communities during the pandemic. Interviewees were from across the US with interviews conducted between November 2020-March 2021. Data was analyzed using thematic analysis methods. Results Twenty individuals representing health systems participated with 14 (70%) community health centers, three (15%) county hospitals and three (15%) academic systems represented. The majority [16 health systems (80%)] cared specifically for immigrant communities while 14 (70%) partnered with refugee communities, and two (10%) partnered with migrant farm workers. We identified six themes (with subthemes) that represent roles health systems performed with clinical and public health implications. Two foundational themes were the roles health systems had building and maintaining trust and establishing intentionality in working with communities. On the patient-facing side, health systems played a role in developing communication strategies and reducing barriers to care and support. On the organizational side, health systems collaborated with public health and community-based organizations, in optimizing pre-existing systems and adapting roles to evolving needs throughout the pandemic. Conclusion Health systems should focus on building trusting relationships, acting intentionally, and partnering with community-based organizations and public health to handle COVID-19 and future pandemics in effective and impactful ways that center disparately affected communities. These findings have implications to mitigate disparities in current and future infectious disease outbreaks for immigrant communities who remain an essential and growing population in the US.
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Affiliation(s)
- Seja Abudiab
- Department of Pediatrics, University of Washington, Seattle, WA, United States
| | | | - Sheeba Shafaq
- Community Leadership Board, National Resource Center for Refugees, Immigrants and Migrants, San Francisco, CA, United States
| | - Katherine Yun
- Department of Pediatrics, University of Pennsylvania Perelman School of Medicine, Philadelphia, PA, United States
| | - Christine Thomas
- Department of Medicine, University of Minnesota, Minneapolis, MN, United States
| | - Windy Fredkove
- Center for Global Health and Social Responsibility, University of Minnesota, Minneapolis, MN, United States
| | - Yesenia Garcia
- Seattle Children's Research Institute, Seattle, WA, United States
| | - Sarah J. Hoffman
- School of Nursing, University of Minnesota, Minneapolis, MN, United States
| | - Sayyeda Karim
- Center for Global Health and Social Responsibility, University of Minnesota, Minneapolis, MN, United States
| | - Erin Mann
- Center for Global Health and Social Responsibility, University of Minnesota, Minneapolis, MN, United States
| | - Kimberly Yu
- Independent Consultant, Seattle, WA, United States
| | - M. Kumi Smith
- Division of Epidemiology and Community Health, School of Public Health, University of Minnesota, Minneapolis, MN, United States
| | - Tumaini Coker
- Department of Pediatrics, University of Washington, Seattle, WA, United States
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da Costa AC, da Conceição AP, Butcher HK, Butcher RDCGES. Factors that influence health literacy in patients with coronary artery disease. Rev Lat Am Enfermagem 2023; 31:e3878. [PMID: 36995856 PMCID: PMC10077861 DOI: 10.1590/1518-8345.6211.3878] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/02/2022] [Accepted: 11/06/2022] [Indexed: 03/31/2023] Open
Abstract
OBJECTIVE to investigate the factors that exert an influence on health literacy in patients with coronary artery disease. METHODS a crosssectional study, including 122 patients with coronary diseases (60.7% male; 62.07 ± 8.8 years old). Health literacy and specific knowledge about the disease were evaluated through interviews with the participants by means of the Short Test of Functional Health Literacy in Adults and the Short version of the coronary artery disease education questionnaire. The data were described by means of central tendency measures and frequencies. The factors that exert an influence on health literacy were determined by means of a linear regression model. The significance level adopted was 5%. The study was approved by the Research Ethics Committee. RESULTS age and arterial hypertension presented an inverse and significant relationship with health literacy. On the other hand, higher schooling levels and having a job were associated with better scores in the health literacy instrument. Specific knowledge about the disease did not exert any influence on health literacy. The variables included in the regression model explained 55.3% of inadequate literacy. CONCLUSION this study, knowledge about the disease exerts no influence on health literacy: however, the professionals should consider the sociodemographic and clinical factors to plan the interventions.
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Affiliation(s)
- Ana Caroline da Costa
- Faculdade Wenceslau Braz, Departamento de Enfermagem, Itajubá, MG, Brasil
- Universidade de São Paulo, Escola de Enfermagem, São Paulo, SP, Brasil
| | - Ana Paula da Conceição
- Universidade de São Paulo, Escola de Enfermagem, São Paulo, SP, Brasil
- Instituto Dante Pazzanese de Cardiologia, Departamento de Enfermagem, São Paulo, SP, Brasil
| | - Howard Karl Butcher
- Florida Atlantic University, Christine E. Lynn College of Nursing, Boca Raton, Florida, Estados Unidos da América
| | - Rita de Cassia Gengo e Silva Butcher
- Universidade de São Paulo, Escola de Enfermagem, São Paulo, SP, Brasil
- Florida Atlantic University, Christine E. Lynn College of Nursing, Boca Raton, Florida, Estados Unidos da América
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Zhang YZ, Hwang SY. The Moderating Effect of Mental Health on the Relationship Between Cardiovascular Disease Awareness and Health Behaviors of Middle-Aged Korean Chinese Workers With Cardiovascular Risk Factors in Korea. J Transcult Nurs 2023; 34:131-142. [PMID: 36752276 DOI: 10.1177/10436596221147078] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/09/2023] Open
Abstract
INTRODUCTION Cardiovascular disease (CVD) remains a leading cause of death in China and Korea, yet little is known about in Korean Chinese workers. The purpose of the study was to investigate the effects of CVD awareness and mental health on health behaviors and evaluate the moderating effect of mental health on the relationship between CVD awareness and health behaviors among Korean Chinese workers. METHOD We used a cross-sectional design and convenience sampling of participants from Seoul in December 2021. Data were analyzed using descriptive statistics, Pearson's correlation coefficient, independent t tests, and hierarchical multiple regression analysis. RESULTS CVD awareness, mental health, and health behaviors were relatively low and mental health showed a moderating effect on the relationship between the two variables. DISCUSSION Understanding relationships between CVD awareness, socioculturally mediated health behaviors, and mental health issues is critical to CVD prevention among participants; moreover, mental health should be specifically assessed and targeted for improvement.
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Affiliation(s)
- Yu Zhu Zhang
- Doctoral student, College of Nursing, Hanyang University, Seoul, Republic of Korea
| | - Seon Young Hwang
- Professor, College of Nursing, Hanyang University, Seoul, Republic of Korea
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Wang LYT, Lua JYH, Chan CXC, Ong RLL, Wee CF, Woo BFY. Health information needs and dissemination methods for individuals living with ischemic heart disease: A systematic review. PATIENT EDUCATION AND COUNSELING 2023; 108:107594. [PMID: 36563574 DOI: 10.1016/j.pec.2022.107594] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/05/2022] [Revised: 12/08/2022] [Accepted: 12/13/2022] [Indexed: 06/17/2023]
Abstract
OBJECTIVES This review aimed to identify the health information needs and preferred approaches to receive health information of individuals with Ischaemic Heart Disease (IHD). METHODS A systematic review was conducted. Relevant literature, published in English (January 2011 to October 2021), was identified across six databases. Guided by Coulter et al.'s framework for developing patient information materials, thematic analysis was performed. The findings were presented in tables and prose. RESULTS Fifty-nine studies were included. Eleven themes summarised the information needs of individuals with IHD. Each theme was supported with subthemes. Forty-five studies included information on preferred methods of dissemination. CONCLUSIONS Our review has characterised the diverse information needs of individuals living with IHD and dissemination methods for outreach to this population. Such insights inform healthcare providers in formulating patient-centred educational interventions to empower patients to undertake successful behavioural modification. PRACTICE IMPLICATIONS Patient education should be personalised and delivered according to individuals' risks for IHD and modifiable risk factors. The use of web-based dissemination of patient education has gained popularity among healthcare providers but sub-optimal adherence to these web-based interventions limits behavioural modification. Adding elements of in-person patient education session to complement web-based interventions may be more propitious to effecting behavioural modification.
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Affiliation(s)
- Laureen Y T Wang
- Alexandra Hospital, National University Health System, Singapore; National University Heart Centre, Singapore, National University Health System, Singapore
| | | | - Cassandra X C Chan
- Yong Loo Lin School of Medicine, National University of Singapore, Singapore
| | - Rachel L L Ong
- Yong Loo Lin School of Medicine, National University of Singapore, Singapore
| | - Caitlin F Wee
- Yong Loo Lin School of Medicine, National University of Singapore, Singapore
| | - Brigitte F Y Woo
- Alice Lee Centre for Nursing Studies, Yong Loo Lin School of Medicine, National University of Singapore, Singapore.
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Khatri RB, Assefa Y. Access to health services among culturally and linguistically diverse populations in the Australian universal health care system: issues and challenges. BMC Public Health 2022; 22:880. [PMID: 35505307 PMCID: PMC9063872 DOI: 10.1186/s12889-022-13256-z] [Citation(s) in RCA: 36] [Impact Index Per Article: 18.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/04/2022] [Accepted: 04/19/2022] [Indexed: 12/14/2022] Open
Abstract
Background About half of first- or second-generation Australians are born overseas, and one-in-five speak English as their second language at home which often are referred to as Culturally and Linguistically Diverse (CALD) populations. These people have varied health needs and face several barriers in accessing health services. Nevertheless, there are limited studies that synthesised these challenges. This study aimed to explore issues and challenges in accessing health services among CALD populations in Australia. Methods We conducted a scoping review of the literature published from 1st January 1970 to 30th October 2021 in four databases: PubMed, Scopus, Embase, and the Web of Science. The search strategy was developed around CALD populations and the health services within the Australian context. We used Preferred Reporting Items for Systematic Reviews and Meta-Analysis guidelines for selection and Arksey and O’Malley framework for analysis of relevant articles. A narrative synthesis of data was conducted using inductive thematic analysis approach. Identified issues and challenges were described using an adapted socioecological model. Results A total of 64 studies were included in the final review. Several challenges at various levels were identified to influence access to health services utilisation. Individual and family level challenges were related to interacting social and health conditions, poor health literacy, multimorbidity, diminishing healthy migrants’ effect. Community and organisational level challenges were acculturation leading to unhealthy food behaviours and lifestyles, language and communication problems, inadequate interpretation services, and poor cultural competency of providers. Finally, challenges at systems and policy levels included multiple structural disadvantages and vulnerabilities, inadequate health systems and services to address the needs of CALD populations. Conclusions People from CALD backgrounds have multiple interacting social factors and diseases, low access to health services, and face challenges in the multilevel health and social systems. Health systems and services need to focus on treating multimorbidity through culturally appropriate health interventions that can effectively prevent and control diseases. Existing health services can be strengthened by ensuring multilingual health resources and onsite interpreters. Addressing structural challenges needs a holistic policy intervention such as improving social determinants of health (e.g., improving living and working conditions and reducing socioeconomic disparities) of CALD populations, which requires a high level political commitment. Supplementary Information The online version contains supplementary material available at 10.1186/s12889-022-13256-z.
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Affiliation(s)
- Resham B Khatri
- School of Public Health, the University of Queensland, Brisbane, Australia.
| | - Yibeltal Assefa
- School of Public Health, the University of Queensland, Brisbane, Australia
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Primary Exploration of Efficacy of Community-Family Management Mode under Internet-Based Mobile Terminal Monitoring in Elderly Patients with Stable Coronary Heart Disease. JOURNAL OF HEALTHCARE ENGINEERING 2022; 2022:7043928. [PMID: 35126941 PMCID: PMC8808194 DOI: 10.1155/2022/7043928] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/13/2021] [Revised: 12/31/2021] [Accepted: 01/03/2022] [Indexed: 11/18/2022]
Abstract
Objective To explore the efficacy of community-family management mode under Internet-based mobile terminal (MT) monitoring in stable coronary heart disease (CHD) in the elderly. Methods A total of 86 patients with stable CHD treated in our hospital from May 2018 to May 2021 were selected as the study objects for the retrospective study and were divided into the control group (routine intervention) and the research group (community-family management mode intervention under Internet MT monitoring) according to the health management modes, with 43 cases each, and the health behaviors and control of CHD were compared between the two groups. Results No statistical between-group differences in general information were observed (P > 0.05); 6 months after intervention, the control of laboratory indexes including blood pressure, blood glucose, triglyceride, and total cholesterol in patients was obviously better in the research group than in the control group (P > 0.05); after intervention, the scores on rehabilitation knowledge level and secondary prevention behavior were obviously higher in the research group than in the control group (P > 0.05); 6 months after intervention, the scores on physical limitation, anginal stabilization, anginal frequency, disease perception, and treatment satisfaction were obviously higher in the research group than in the control group (P > 0.05); compared with the control group within 1 year of intervention, the readmission rate of the research group was significantly lower (P > 0.05); and compared with the control group, the total score of CQQC and scores on physical strength, condition, general life, and social mentality were significantly better in the research group (P > 0.05). Conclusion Community-family management mode under Internet-based MT monitoring is the valid continuation of clinical nursing for elderly patients with stable CHD, which plays an effective role in terms of daily monitoring indexes, stabilizing condition, improving disease cognition, reducing the readmission rate, and improving the prognostic quality of life of patients.
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Zeng L, Perry L, Xu X. Self-care behaviours and related cultural factors among Chinese immigrants with cardiovascular disease in western countries: an integrative review. J Clin Nurs 2021; 32:1599-1614. [PMID: 34761466 DOI: 10.1111/jocn.16120] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/03/2021] [Revised: 08/25/2021] [Accepted: 10/22/2021] [Indexed: 11/29/2022]
Abstract
AIMS AND OBJECTIVES This review aimed to demonstrate the self-care behaviours of first-generation Chinese immigrants with cardiovascular disease in western countries and identify related cultural factors. BACKGROUND Self-care is the cornerstone to mitigate disease symptoms and maintain health status. Chinese immigrants to western countries, operating within a cross-cultural context, may find self-care to manage their cardiovascular disease challenging. DESIGN An integrative review was conducted. METHODS Seven databases were searched Scopus, ProQuest Health & Medicine, Medline (Ovid), Embase (Ovid), AMED (Ovid), PsycINFO and CINAHL, with output limited to peer-reviewed studies published from 2000 to 2020 in English or Chinese. Initially, 2037 papers were screened. Six papers were retained and critiqued using the Joanna Briggs Institute critical appraisal tools. Deductive and inductive approaches were utilised to analyse the findings. The PRISMA 2020 checklist informed review reportage. RESULT In general, Chinese immigrants with cardiovascular disease took an active role in management of their cardiovascular disease, including through diet and activity adaptation and adherence to western medication. Families also played a significant role in disease decision-making and management. However, language and cultural barriers impeded their access to health information and resources in host countries. RELEVANCE TO CLINICAL PRACTICE Understanding self-care behaviours and associated cultural factors among Chinese immigrants with cardiovascular disease is important to improve nurses' culturally sensitive practices and provide tailored health education interventions to promote self-care behaviours among immigrant populations. The scarcity of literature on self-care behaviours among Chinese first-generation immigrants with cardiovascular disease indicates the need for further research in this area. Development of culturally and linguistically sensitive health resources and education programs is urgently needed.
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Affiliation(s)
- Ling Zeng
- School of Nursing and Midwifery, Faculty of Health, University of Technology Sydney, Ultimo, New South Wales, Australia
| | - Lin Perry
- School of Nursing and Midwifery, Faculty of Health, University of Technology Sydney, Ultimo, New South Wales, Australia
| | - Xiaoyue Xu
- School of Population Health, University of New South Wales, Kensington, New South Wales, Australia
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Vanzella LM, Rouse V, Ajwani F, Deilami N, Pokosh M, Oh P, Ghisi GLDM. Barriers and facilitators to participant adherence of dietary recommendations within comprehensive cardiac rehabilitation programmes: a systematic review. Public Health Nutr 2021; 24:4823-4839. [PMID: 34344495 PMCID: PMC11082819 DOI: 10.1017/s1368980021002962] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/23/2020] [Revised: 06/03/2021] [Accepted: 07/08/2021] [Indexed: 11/07/2022]
Abstract
OBJECTIVE To identify individual-, provider- and system/environmental-level barriers and facilitators affecting cardiac rehabilitation (CR) participants' adherence to dietary recommendations. DESIGN A systematic review of the medical literature was conducted. Six databases were searched from inception through March 2021: APA PsycInfo, CINAHL, Embase, Emcare, Medline and PubMed. Only those studies referring to barriers and facilitators reported by CR participants were considered. Pilot and case report studies, non-peer-reviewed literature and studies published in a language other than English, Portuguese or Spanish were excluded. RESULTS Data were extracted and analysed on the basis of individual-, provider- and system/environmental-level factors. Of 2083 initial citations, sixteen studies were included, with nine being qualitative and seven observational in design. From these, ten multi-level barriers and seven multi-level facilitators were identified. Dietary recommendations included developing healthy eating habits, transitioning to vegetarian-rich diets and increasing fish oil and n-3 intake. Only one study reported on all of the nutrition education programme factors recommended by the Workgroup for Intervention Development and Evaluation Research. CONCLUSION To the best of our knowledge, this review is the first to summarise specific barriers and facilitators to recommendation adherence among CR participants. Few of the studies offered any conclusions regarding programme design that could facilitate improved dietary adherence practices. Future studies should aim to explore patient perspectives on the nutritional patterns and recommendations outlined in the Mediterranean Diet, the Dietary Approaches to Stop Hypertension Diet, Vegetarian or Vegan diets and the Portfolio Diet.
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Affiliation(s)
- Lais Manata Vanzella
- São Paulo State University, School of Technology and Sciences, Presidente Prudente, São Paulo, Brazil
| | - Veronica Rouse
- Toronto Rehabilitation Institute, Cardiovascular Prevention and Rehabilitation Program, University Health Network, 347 Rumsey Road, Toronto, ONM4G 2R6, Canada
| | - Fatim Ajwani
- Toronto Rehabilitation Institute, Cardiovascular Prevention and Rehabilitation Program, University Health Network, 347 Rumsey Road, Toronto, ONM4G 2R6, Canada
| | - Niloufar Deilami
- Toronto Rehabilitation Institute, Cardiovascular Prevention and Rehabilitation Program, University Health Network, 347 Rumsey Road, Toronto, ONM4G 2R6, Canada
| | - Maureen Pokosh
- Library and Information Services, University Health Network, Toronto Rehabilitation Institute, Toronto, ON, Canada
| | - Paul Oh
- Toronto Rehabilitation Institute, Cardiovascular Prevention and Rehabilitation Program, University Health Network, 347 Rumsey Road, Toronto, ONM4G 2R6, Canada
| | - Gabriela Lima de Melo Ghisi
- Toronto Rehabilitation Institute, Cardiovascular Prevention and Rehabilitation Program, University Health Network, 347 Rumsey Road, Toronto, ONM4G 2R6, Canada
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Vanzella LM, Oh P, Pakosh M, Ghisi GLM. Barriers to Cardiac Rehabilitation in Ethnic Minority Groups: A Scoping Review. J Immigr Minor Health 2021; 23:824-839. [DOI: 10.1007/s10903-021-01147-1] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/12/2021] [Indexed: 12/21/2022]
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Chung S, Lee HY, Lee M, Chung S. Health Literacy in Korean Adults and Korean American Immigrants: Implications for Achieving Health Equity. INTERNATIONAL QUARTERLY OF COMMUNITY HEALTH EDUCATION 2020; 42:29-36. [PMID: 33201774 DOI: 10.1177/0272684x20973511] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Health literacy is necessary to understand health information and make appropriate decisions regarding one's health. This study aims to investigate (1) the health literacy level of Korean citizens and Korean American (KA) immigrants in the United States and (2) factors that influence health literacy across three age groups. A quota sampling method was used to collect cross-sectional survey data from 404 Korean participants and 404 KA immigrants. Andersen's behavioral model was used as the theoretical framework for this study. Overall, Korean participants had a higher mean score on health literacy than did the KA immigrants. Only one of predisposing and enabling factors were significant variables influencing health literacy in KA immigrants, while several predisposing, enabling and need factors were significantly associated with health literacy in Korean adults. Our findings indicate that both countries need to have a community-based health literacy educational program that is tailored to each age group.
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Affiliation(s)
- Soondool Chung
- Department of Social Welfare, Graduate School of Social Welfare, Ewha Womans University, Seoul, Korea
| | - Hee Yun Lee
- School of Social Work, University of Alabama, Tuscaloosa, United States
| | - Miwoo Lee
- Department of Social Welfare, Graduate School of Social Welfare, Ewha Womans University, Seoul, Korea
| | - Semi Chung
- Department of Social Welfare, Graduate School of Social Welfare, Ewha Womans University, Seoul, Korea
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Health-related quality of life in adult CHD surgical patients in a low middle-income country: a mixed-methods study. Cardiol Young 2020; 30:1126-1137. [PMID: 32633708 DOI: 10.1017/s1047951120001663] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
BACKGROUND AND OBJECTIVES This mixed-methods study aimed to assess health-related quality of life in young adults with CHD following surgery in a low middle-income country, Pakistan. Despite the knowledge that geographic, cultural and socio-economic factors may shape the way health and illness is experienced and managed and consequently determine a person's health-related quality of life, few health-related quality of life studies are conducted in low middle-income countries. This deficit is pronounced in CHD, so there is little guidance for patient care. METHODS The study utilised concurrent, mixed methods. Adults with CHD (n = 59) completed health-related quality of life surveys (PedsQLTM 4.0 Generic Core Scale, PedsQLTM Cognitive Functioning Scale and PedsQLTM 3.0 Cardiac Module). Semi-structured interview data were collected from a nested sub-sample of 17 participants and analysed using qualitative content analysis, guided by the revised Wilson-Cleary model of health-related quality of life. RESULTS The lowest health-related quality of life domain was emotional with the mean score (71.61 ± 20.6), followed by physical (78.81 ± 21.18) and heart problem (79.41 ± 18.05). There was no statistical difference in general or cardiac-specific health-related quality of life between mild, moderate or complex CHD. Qualitative findings suggested low health-related quality of life arose from a reduced capacity to contribute to family life including family income and gender. A sense of reduced marriageability and fear of dependency were important socio-cultural considerations. CONCLUSIONS CHD surgical patients in this low-income country experience poor health-related quality of life, and contributing factors differ to those reported for high-income countries. Socio-cultural understandings should underpin assessment, management and care-partnering with young adults with CHD following surgical correction.
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