Barriers and Facilitators to the Symptom Self-Management in Patients With Decompensated Cirrhosis: A Qualitative...

To systematically investigate the barriers and facilitators of symptom self-management behaviour in patients with decompensated cirrhosis.

This study adopted a qualitative descriptive design, which was reported in accordance with the Consolidated Criteria for Reporting Qualitative Research guidelines.

One-on-one, face-to-face, semi-structured interviews were conducted with 33 stakeholders, including nine patients, nine family caregivers and 15 healthcare professionals. Interview transcripts were analysed using the Capability, Opportunity, Motivation-Behaviour (COM-B) model, integrating dyadic interview analysis and qualitative content analysis.

We identified 11 barriers to symptom self-management relating to capability (poor illness perception, limited health literacy, difficulties in information acquisition and physical dysfunction); opportunity (cultural conflicts, heavy economic burden and inadequate resource support) and motivation (diminished sense of meaning in life, insufficient internal drive, delayed perception of therapeutic benefit and low self-efficacy). Conversely, we also identified eight facilitators relating to capability (progressive cognitive restructuring and adequate health literacy); opportunity (supportive environments, family cohesion and diversified information channels); and motivation (proactive adaptation, high intrinsic motivation and sustained reinforcement of therapeutic benefit).

This study identified key barriers and facilitators to symptom self-management in patients with decompensated cirrhosis, providing an evidence base for developing intervention strategies in the future.

Patients, family caregivers and healthcare professionals contributed to the study through interviews during the research process and member checks during analysis.

This clinical trial (registration number: ChiCTR2500097867) is registered in the Chinese Clinical Trial Registry as "Core symptoms and self-management among decompensated cirrhosis patients: a cross-sectional study". The trial registration link is https://www.chictr.org.cn/showproj.html?proj=252931.