Barriers to home-based self-management in hospitalized patients with type 2 diabetes: a qualitative descriptive content analysis guided by protection motivation theory

Effective self-management is essential for glycemic control in type 2 diabetes. However, many patients experience self-management failure prior to hospitalization. This study aimed to explore the barriers to home-based self-management among hospitalized Chinese patients and interpret these barriers using Protection Motivation Theory (PMT).

A descriptive qualitative research design was employed. From December 2025 to February 2026, semi-structured interviews were conducted with 19 patients with type 2 diabetes recruited through purposive sampling from a tertiary hospital in Northeast China. Data were analyzed using Graneheim and Lundman’s qualitative content analysis approach. The study was reported following the COREQ guidelines.

Systematic content analysis of 19 interview transcripts yielded 319 initial codes derived from condensed meaning units identified through repeated reading of raw data. Following Graneheim and Lundman’s method, these codes were organized into 19 subcategories nested within 6 main categories at the manifest content level. Subsequent interpretive analysis, guided by Protection Motivation Theory (PMT), mapped these inductively derived categories to latent-level theoretical dimensions, elucidating the underlying psychosocial and cultural mechanisms driving self-management failure.

Failure in home-based self-management results from complex cognitive, psychosocial, and environmental barriers. Future nursing interventions should prioritize nurse-led transitional care models and culturally tailored health education to enhance patients’ self-efficacy and risk perception.

Not applicable.