{
  "abstract": "Health behaviour decision-making is central to type 2 diabetes mellitus management, but remains complex and context dependent after repeated hospitalisations. Research has focused on health behaviours and associated factors, overlooking patient-centred decision-making across care stages and limiting stage-specific decision support and continuity-of-care strategies. A longitudinal qualitative study was conducted in mainland China, with data collected from October 2025 to March 2026. 16 patients with type 2 diabetes mellitus who had experienced repeated hospitalisations were included and participated in repeated semi-structured interviews across three stages: pre-admission (T1), hospitalisation (T2), and home management (T3). Interviews were conducted on the second day of hospitalisation, one day before discharge, and three months after discharge. The interviews explored decision-making behaviours, support needs, emotional experiences, and pain points. Longitudinal analysis involved within-participant comparison across the three care stages, followed by cross-case synthesis to identify recurrent and divergent patterns of change. The findings were then integrated into a time-based visual journey map of health behaviour decision-making. Four stage-specific trajectories were synthesised from the longitudinal interview data within four dimensions initially identified through preliminary patient observations: (1) behavioural transition from preference-driven care-seeking decisions to structured treatment adherence and fragile self-management; (2) evolving support needs from seeking trusted decision anchors to seeking structured empowerment and transition preparation, and finally to seeking continuous and accessible out-of-hospital support; (3) emotional evolution from self-blame after initially neglecting the illness, to fragile stability, and ultimately to acceptance and coexistence with the disease under long-term burden; and (4) phase-specifc pain points, including decision-making impeded by multiple information dilemmas before admission, insufficient motivation for sustained self-management during hospitalisation, and support discontinuity with practical burdens during home management. This study extends the application of patient journey mapping to understanding health behaviour decision-making among patients with T2DM who experience repeated hospitalisations. By identifying critical disruptions in decision-making, unmet needs, and barriers to sustained management, the journey map offers actionable insights for designing stage-specific, patient-centred decision-support and continuity-of-care interventions, with particular relevance to nurse-led clinical practice.",
  "abstract_shown": true,
  "affiliations": [
    "Acupuncture Department, Shenzhen Hospital (Futian) of Guangzhou University of Chinese Medicine, Shenzhen, People's Republic of China.",
    "The Sixth Clinical Medical College of Guangzhou University of Traditional Chinese Medicine, Shenzhen, People's Republic of China.",
    "Department of Orthopedics, Shenzhen Hospital (Futian) of Guangzhou University of Chinese Medicine, Shenzhen, People's Republic of China.",
    "Endocrinology Department, Shenzhen Hospital (Futian) of Guangzhou University of Chinese Medicine, Shenzhen, People's Republic of China.",
    "Nephrology Department, Shenzhen Hospital (Futian) of Guangzhou University of Chinese Medicine, Shenzhen, People's Republic of China."
  ],
  "article_type": "research article",
  "arxiv": null,
  "author_total": 9,
  "authors": [
    {
      "affs": [
        0,
        1
      ],
      "name": "Huan Mao"
    },
    {
      "affs": [
        0,
        1
      ],
      "name": "Min Zhang",
      "orcid": "0009-0006-7378-3941"
    },
    {
      "affs": [
        0,
        1
      ],
      "name": "Wenxia Hu"
    },
    {
      "affs": [
        1
      ],
      "name": "Weiling Yang"
    },
    {
      "affs": [
        2
      ],
      "name": "Bixia Yuan"
    },
    {
      "affs": [
        3
      ],
      "name": "Ting Li"
    },
    {
      "affs": [
        1
      ],
      "name": "Yuxuan Lu"
    },
    {
      "affs": [
        4
      ],
      "name": "Weiwei Chen"
    },
    {
      "affs": [
        0
      ],
      "name": "Mujun Liu",
      "orcid": "0009-0009-1454-7713"
    }
  ],
  "bibtex": "https://research.draconitic.com/paper/8qn0rqj16g2dd.bib",
  "cited_by": 0,
  "doi": "10.2147/jmdh.s646999",
  "fulltext_url": "https://europepmc.org/articles/PMC13744248",
  "id": "8qn0rqj16g2dd",
  "issns": [
    "1178-2390"
  ],
  "landing_url": "https://europepmc.org/article/MED/42999637",
  "language": "eng",
  "licence": "CC-BY-NC",
  "licence_label": "CC BY-NC",
  "licence_source": "article",
  "licence_url": "https://creativecommons.org/licenses/by-nc/4.0/",
  "metadata_licence": null,
  "native_subjects": [
    [
      "openalex",
      "2712|Diabetes Management and Education"
    ]
  ],
  "openalex": "W7225159379",
  "pdf_url": "https://europepmc.org/articles/PMC13744248?pdf=render",
  "pmcid": "PMC13744248",
  "pmid": "42999637",
  "published": "2026-11-03",
  "publisher": null,
  "ris": "https://research.draconitic.com/paper/8qn0rqj16g2dd.ris",
  "sources": [
    {
      "first_seen": "2026-11-09T15:20:34Z",
      "native_id": "MED:42999637",
      "source": "europepmc",
      "url": "https://europepmc.org/article/MED/42999637"
    }
  ],
  "subjects": [
    {
      "field": "medicine",
      "origin": "openalex:2712|Diabetes Management and Education",
      "subfield": "endocrinology-metabolism"
    }
  ],
  "title": "A Journey Map of Health Behaviour Decision-Making Among Patients with Type 2 Diabetes Mellitus Who are Repeatedly Hospitalized: A Longitudinal Qualitative Study.",
  "title_text": "A Journey Map of Health Behaviour Decision-Making Among Patients with Type 2 Diabetes Mellitus Who are Repeatedly Hospitalized: A Longitudinal Qualitative Study.",
  "type": "peer-reviewed",
  "updated_at": "2026-11-09T15:20:34Z",
  "url": "https://research.draconitic.com/paper/8qn0rqj16g2dd",
  "venue": "Journal of multidisciplinary healthcare",
  "versions": []
}