From risk perception to action: A qualitative study of self-management in hematopoietic stem cell transplant patients

A descriptive qualitative study was conducted to explore risk perception, self-management challenges, and coping strategies among Chinese hematopoietic stem cell transplantation (HSCT) patients, using the Health Action Process Approach (HAPA) as the guiding framework. Purposive sampling, based on the principle of information power, was employed to recruit 20 HSCT patients from a hospital in south-central China between May and August 2024. The HAPA model informed the development of semi-structured interview questions, and the data were analyzed using a combination of thematic analysis and framework analysis. The findings indicate that both risk perception and self-efficacy play a critical role in motivating patient engagement in self-management. Main barriers to self-management included difficulties in symptom control, lifestyle modification, psychological adjustment, and healthcare-related financial burdens. Effective coping strategies reported by participants involved the use of digital tools, seeking professional medical advice, maintaining self-management journals, and drawing on family and social support networks. In clinical practice, healthcare professionals may capitalize on the heightened risk perception and self-efficacy during the peri-transplant period to promote the transition from risk perception to actionable self-management behaviors. In contrast, during the early post-discharge phase, when both risk perception and self-efficacy tend to decline, tailored support systems and resource allocation are helpful for maintaining the transition from risk perception to self-management action.