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Anteayer Journal of Advanced Nursing

Navigating Prediabetes in a Foreign Country: A Qualitative Study of Self‐Management Experiences Among Chinese‐Speaking Immigrants in Australia

ABSTRACT

Aim

Chinese-speaking immigrants in Australia have a higher risk of type 2 diabetes and face more barriers to accessing quality healthcare compared to non-culturally and linguistically diverse populations. This study aimed to explore the self-management experiences of Chinese-speaking Australians with self-reported lived experience of prediabetes following immigration.

Design

Qualitative study.

Methods

Semi-structured interviews were conducted with 10 purposively selected Australian Chinese-speaking immigrants aged over 40 years. Data collection was undertaken in Perth, Western Australia between April and August 2024. Data were analysed using reflexive thematic analysis.

Results

Three themes are presented in this paper: (1) An acculturation journey: Reshaping cultural identity and social connections in immigrant lives, (2) Embodying prediabetes: Cognitive reconstruction and emotional adaptation in the transition to the patient role and (3) Decision-behaviour dynamics: Mapping agency and adaptiveness in self-management processes. Participants demonstrated dynamic adjustment through the processes of self-awareness, adaptive behaviours, self-reflection and self-attribution of health outcomes.

Conclusion

Chinese-speaking Australians navigating prediabetes following immigration underwent a complex process of reconstruction across cognitive, cultural and psychological domains. Prediabetes self-management was shaped by cultural values, acculturation, dietary preferences, emotional resilience, local and distant social networks and resource availability. These findings underscore the importance of empowering both individuals and communities through evidence-based and culturally appropriate strategies.

Implications and Impact

Participants experienced profound transformations in their cultural adaptation, prediabetes cognition, social support networks and emotional–psychological landscape. Future interventions must address identified barriers (e.g., cooking burden, comorbidities, stress), facilitators (e.g., leisure travel, family support), motivations (e.g., cultural heritage, health risk perception) and challenges (e.g., knowledge–behaviour gap, digital health information) that shape self-management behaviours. A community empowerment approach, utilising evidence-based content, flexible delivery formats and existing cultural networks, should be adopted to offer promising pathways for prediabetes health education.

Reporting Method

The study adhered to the Consolidated Criteria for Reporting Qualitative Research guidelines.

Patient or Public Contribution

Limited patient and public involvement was incorporated, with two community representatives providing feedback on interview questions and recruitment strategies.

Development and Psychometric Testing of a Low Extremity Lymphedema Risk Management Behaviours Questionnaire for Patients With Gynecologic Cancer

ABSTRACT

Background

Lower extremity lymphedema (LEL) is a debilitating complication for patients with gynecologic cancer. A series of strategies have been recommended to mitigate the risk of LEL and improve patient outcomes; however, investigation into LEL risk management behaviours in this population is limited, and the absence of reliable and valid tools is an important reason.

Aims

To develop and evaluate the psychometric properties of the lower extremity lymphedema risk management behaviours questionnaire (LELRMBQ) for Chinese patients with gynaecologic cancer.

Design

This was a methodological study.

Methods

Initial items were generated using a literature review. The initial LELRMBQ was refined, and its content validity was evaluated by conducting two rounds of expert consultation and a pilot study. Psychometric testing of 389 participants recruited by convenience sampling was conducted from December 2022 to June 2023. Exploratory factor analysis (EFA; subsample 1, N = 158) and confirmatory factor analysis (CFA; subsample 2, N = 231) were performed separately to determine the multi-dimensional structure of the questionnaire. Known-group validity, internal consistency reliability, and test–retest reliability were also evaluated.

Results

A total of 25 items with satisfactory content validity were included in psychometric testing. The EFA identified a four-factor structure, comprising 18 items, which explained 74.49% of the total variance. The CFA supported this structure with acceptable fit indices. Known-group validity was partially supported by significant differences in total LELRMBQ scores among groups with different education levels, residence, cancer type, and LEL awareness. Internal consistency and temporal stability were acceptable.

Conclusions

The 18-item LELRMBQ demonstrated sufficient reliability and validity as a tool for measuring LEL risk management behaviours in patients with gynaecologic cancer.

Implications for the Profession and/or Patient Care

The LELRMBQ has potential applicability in assessing LEL risk management behaviours, identifying gaps in educational practices, tailoring effective interventions, and evaluating intervention effectiveness.

Reporting Method

This manuscript followed the STROBE guidelines.

Patient or Public Contribution

Patients with gynecologic cancer participated in this study and provided the data through the survey.

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