Facilitators and barriers to self-management among patients with maintenance hemodialysis in central China: a qualitative study

Abstract

Objective: This study aimed to explore the facilitative and obstructive factors of self-management in patients undergoing maintenance hemodialysis to provide a reference for improving patient self-management in China. Methods: Qualitative description was adopted as a suitable methodological. approach to characterize the phenomena of self-management experiences in patients undergoing maintenance hemodialysis. This qualitative study collected data via semi-structured interviews conducted with 18 maintenance hemodialysis patients in Henan Province, China, during the period from January 1 to February 28, 2025. Qualitative analysis of the recorded interviews was conducted to generate themes. Results: Based on the Social Ecological Model, this study summarized the facilitators and barriers to self-management among patients receiving maintenance hemodialysis, and identified a total of 10 themes across five levels: individual, interpersonal, organizational, community, and social. Conclusion: Maintenance hemodialysis patients' self-management is a systemic issue; single-level interventions fail to fundamentally improve outcomes. Based on the Social Ecological Model, it is imperative to establish a multidimensional collaborative intervention system covering individual, interpersonal, organizational, community, and social levels to comprehensively enhance their self-management capacity.