Barriers to self-management behaviours among young adults living with type 2 diabetes mellitus in China: a directed qualitative content analysis

Chun Ni Heng¹Xiao-Xia Ma¹Na Zhang^1*Yi Cui²Na Liu²Na Zhang^1*Wei Jiang^1*

• ¹Tangdu Hospital, Air Force Medical University, Xi'an, China
• ²Air Force Medical University, Xi'an, Shaanxi Province, China

Introduction and objective: Type 2 diabetes mellitus (T2DM) is increasingly common among young adults, often accompanied by high rates of comorbidity and severe complications. A key component of managing T2DM in young adults is the promotion of positive health behaviours, such as maintaining a healthy diet and engaging in regular physical activity. However, achieving these changes can often be challenging. In this study, we aimed to explore potential barriers to self-management behaviours among young Chinese patients with T2DM. Methods: From August to October 2024, we purposively recruited 16 young participants from a tertiary hospital in Shaanxi Province in northwest of China to participate in face-to-face semi-structured interviews. Participants were queried about their self-management behaviours and obstacles encountered. The transcribed data were analyzed using directed qualitative content analysis, guided by the Capability, Opportunity, Motivation as determinants of Behaviour (COM-B) theory. Results: We identified three domains that hinder healthy behaviours in young adults, including capability (lack of scientific knowledge about self-management and limitations of physical fitness and disease symptoms); motivation (insufficient perceived threat, low self-efficacy, habits and preferences, stigma, and negative emotions); and opportunity (role conflicts, work burden, lack of family support, interpersonal barriers, and external environmental obstacles). Conclusions: A range of barriers affects self-management behaviours in young patients with T2DM. It is essential for healthcare professionals to offer accurate and scientifically based information about T2DM through diverse channels and to enhance the support of family and social networks. Furthermore, developing personalized and actionable management plans tailored to this patient group is crucial for effectively managing blood glucose.