The trajectory of health behavior in Chinese rural older adults with chronic diseases: A qualitative study

To explore health management trajectories in rural older adults with chronic diseases, examining behavioral evolution and identifying transition triggers across disease stages.

Face-to-face, semi-structured interviews with 39 Chinese rural older adults were analyzed thematically.

Findings reveal three behavioral stages: (1) Early self-management, where patients rationalize symptoms and attempt independent control; (2) Medical assistance-seeking, involving multi-facility consultations for diagnosis/treatment optimization; (3) Active treatment cessation, prioritizing symptom alleviation and functional preservation. Transitions between stages are driven by symptom control efficacy.

Results demonstrate that health behaviors that differ from biomedical recommendations may reflect patients' own contextual logic and lived priorities. The study highlights the need to differentiate older adults' pragmatic health reasoning from biomedical perspectives in chronic care interventions.