The Role of Acculturation in Self-Care Behaviours among Chinese Immigrants Living with Cardiovascular Disease: A Qualitative Study

Aims. To understand what domains of acculturation are experienced by Chinese immigrants with cardiovascular disease (CVD) in Australia and how these domains of acculturation influence their CVD self-care behaviours. Design. A qualitative descriptive design. Methods. Individual phone interviews were conducted among Chinese immigrants with CVD in Sydney, recruited from Chinese Community associations and social media. Inductive and deductive thematic analysis was employed, guided by the Middle-Range Theory of Self-Care of Chronic Illness and the conceptual model of acculturation. Results. Twenty participants, mean age 69.9 years, were interviewed. The domains of acculturation in relation to CVD self-care behaviours encompassed cultural practices, cultural values, healthcare system navigation, and new living environment. Retaining their Chinese culture and integrating into Australian culture regarding dietary practices, social networks, traditional values and family relationships served as both enablers and barriers of self-care maintenance through factors such as heart-healthy diets, physical activity, stress management and medication adherence. Many participants denied encountering difficulties to utilize primary care services, but language barriers deterred them from accessing acute services and heart-health information from mainstream sources. Some preserved beliefs and practices in Traditional Chinese Medicine may complicate their self-care maintenance (medication adherence) and self-care management (responding to acute angina episodes). Conclusion. The influence of acculturation on CVD self-care behaviours among Chinese immigrants is multifaceted and individualized. Clinicians and community health workers should assess patients’ acculturation experiences to enable culturally sensitive practices. The lack of culturally and linguistically appropriate heart health information in the community should be addressed urgently to mitigate the cardiac health disparity. Collaboration with Chinese community associations offers an opportunity for co-design and dissemination of information about Australian healthcare systems and heart health education to upskill CVD self-care practices and mitigate the health inequities experienced by Chinese immigrants.