A Journey Map of Health Behaviour Decision-Making Among Patients with Type 2 Diabetes Mellitus Who are Repeatedly Hospitalized: A Longitudinal Qualitative Study.
5 affiliations
- 1Acupuncture Department, Shenzhen Hospital (Futian) of Guangzhou University of Chinese Medicine, Shenzhen, People's Republic of China.
- 2The Sixth Clinical Medical College of Guangzhou University of Traditional Chinese Medicine, Shenzhen, People's Republic of China.
- 3Department of Orthopedics, Shenzhen Hospital (Futian) of Guangzhou University of Chinese Medicine, Shenzhen, People's Republic of China.
- 4Endocrinology Department, Shenzhen Hospital (Futian) of Guangzhou University of Chinese Medicine, Shenzhen, People's Republic of China.
- 5Nephrology Department, Shenzhen Hospital (Futian) of Guangzhou University of Chinese Medicine, Shenzhen, People's Republic of China.
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.
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BibTeX
@article{mao2026journey,
title = {{A Journey Map of Health Behaviour Decision-Making Among Patients with Type 2 Diabetes Mellitus Who are Repeatedly Hospitalized: A Longitudinal Qualitative Study.}},
author = {Huan Mao and Min Zhang and Wenxia Hu and Weiling Yang and Bixia Yuan and Ting Li and Yuxuan Lu and Weiwei Chen and Mujun Liu},
journal = {Journal of multidisciplinary healthcare},
year = {2026},
month = nov,
doi = {10.2147/jmdh.s646999},
url = {https://europepmc.org/article/MED/42999637},
note = {CC BY-NC},
}
RIS
TY - JOUR
TI - A Journey Map of Health Behaviour Decision-Making Among Patients with Type 2 Diabetes Mellitus Who are Repeatedly Hospitalized: A Longitudinal Qualitative Study.
AU - Huan Mao
AU - Min Zhang
AU - Wenxia Hu
AU - Weiling Yang
AU - Bixia Yuan
AU - Ting Li
AU - Yuxuan Lu
AU - Weiwei Chen
AU - Mujun Liu
PY - 2026
DA - 2026/11/03
JO - Journal of multidisciplinary healthcare
DO - 10.2147/jmdh.s646999
UR - https://europepmc.org/article/MED/42999637
AB - 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.
SN - 1178-2390
ER -