Care Experiences and Well-being of Asian Immigrant Cancer Survivors Living in Countries of the Western World Ranked as Very High on the Human Development Index: A Systematic Review of International Evidence.

OBJECTIVE: Cultural diversity is a defining feature of very high Human Development Index countries of the Western world. Asian immigrants represent a growing demographic in these countries and are a vulnerable group at risk of experiencing health disparities, including individuals surviving cancer. We synthesized available research evidence to evaluate the unmet needs, cancer care experience and factors affecting health-related quality of life of Asian immigrant cancer survivors living in countries in the Western world ranked as very high Human Development Index. METHODS: This systematic review is reported in accordance with Preferred Reporting Item for Systematic Reviews and Meta-Analyses guidelines. Three electronic databases (MEDLINE, EMBASE, and CINAHL) were systematically searched in September 2023 and again in May 2024 to identify research studies of any design. Predefined inclusion criteria were applied, and findings from the included studies were synthesized narratively. RESULTS: Of 515 records identified, 31 studies met the inclusion criteria: 19 qualitative, 10 quantitative, and two mixed-methods studies. Thirty studies reported on samples of Chinese origin (25 studies with exclusive focus on Chinese immigrants). Six studies reported on samples of Arab origin (one study with exclusive focus on Arab immigrants). Frequently reported unmet needs for both Chinese and Arab immigrants included access to high-quality information, psychological and social support services, and professional interpreter services. Communication with healthcare professionals was often reported as problematic. Psychological burden was commonly reported and negatively affected health-related quality of life in both groups. Cultural beliefs strongly influenced cancer experiences, particularly among Chinese immigrants, who often reported experiencing stigma. CONCLUSION: While our findings apply predominantly to Chinese and Arab immigrant cancer survivors, it is evident that wealthy living environments and well-developed healthcare systems/services are not panacea. Addressing the unique needs of immigrant cancer survivors, as well as barriers experienced in accessing supportive cancer care in the host country is essential to promoting equitable cancer care. Improving accessibility, navigation, and health literacy are key strategies to optimize outcomes for these populations, together with a need to re-shape supportive care approaches to suit cultural norms and preferences. IMPLICATIONS FOR NURSING PRACTICE: To promote equity, nurses are required to demonstrate cultural sensitivity and proactive awareness of how immigrant status might influence how cancer as a personal and family illness can be experienced. Nurses should carefully assess the specific needs of immigrant cancer survivors and enable bespoke navigation within the health care system and in the community to effectively respond to these needs.