Analysis of barriers and facilitators to patient activation among patients with infectious keratitis from a social ecosystems theory perspective: a qualitative study in the Chinese context.
4 affiliations
- 1School of Ophthalmology and Optometry, Wenzhou Medical University, Wenzhou, Zhejiang, China.
- 2School of Nursing, Wenzhou Medical University, Wenzhou, Zhejiang, China.
- 3School of Medical Humanities and Management, Wenzhou Medical University, Wenzhou, Zhejiang, China.
- 4National Clinical Research Center for Ocular Diseases, Eye Hospital, Wenzhou Medical University, Wenzhou, Zhejiang, China.
Abstract
Background
Infectious keratitis is one of the leading causes of visual impairment and blindness, placing a significant burden on global public health. Its treatment and favorable prognosis depend heavily on patients' knowledge, skills, and confidence in managing their own health. Nevertheless, qualitative investigations into patient activation among individuals with infectious keratitis within the Chinese cultural context remain scarce. Additionally, research examining this issue through the lens of social ecosystem theory is notably lacking.Objective
This study aims to identify the facilitators and barriers to patient activation among patients with infectious keratitis in China using a qualitative approach to provide a theoretical basis for developing systematic, multilevel intervention strategies.Methods
This study employed a descriptive qualitative research design. Using purposive sampling, 15 patients with infectious keratitis were recruited from a tertiary eye hospital in Zhejiang Province, China, between July and September 2025. Semi-structured interviews were conducted, and the interview data were analyzed using qualitative content analysis with NVivo 12.Results
Based on social ecosystems theory, the analysis identified three main categories at the micro, meso, and macro levels: (1) microsystem -perceptions and behavioral adaptation challenges under disease impact; (2) mesosystem-support and tension in patient interactions with family and providers; (3) macrosystem-challenges and needs in building social networks.Conclusions
Patient activation in infectious keratitis is constrained by individual, family, healthcare, and social factors across the micro, meso, and macro levels. Future interventions need to incorporate both facilitators and barriers by strengthening patient education, family support, patient-provider communication, and coordination of social resources to enhance patient activation and improve clinical outcomes.
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BibTeX
@article{yu2026analysis,
title = {{Analysis of barriers and facilitators to patient activation among patients with infectious keratitis from a social ecosystems theory perspective: a qualitative study in the Chinese context.}},
author = {Huanle Yu and Jiating Wang and Rui Zhou and Xiao Wang and Yuyang Li and Xintian Wang and Jing Wang and Ziling Song and Xi Zhang and Xiaoqiong Huang},
journal = {Frontiers in public health},
year = {2026},
month = oct,
doi = {10.3389/fpubh.2026.1881288},
url = {https://europepmc.org/article/MED/42909004},
note = {CC BY},
}
RIS
TY - JOUR
TI - Analysis of barriers and facilitators to patient activation among patients with infectious keratitis from a social ecosystems theory perspective: a qualitative study in the Chinese context.
AU - Huanle Yu
AU - Jiating Wang
AU - Rui Zhou
AU - Xiao Wang
AU - Yuyang Li
AU - Xintian Wang
AU - Jing Wang
AU - Ziling Song
AU - Xi Zhang
AU - Xiaoqiong Huang
PY - 2026
DA - 2026/10/07
JO - Frontiers in public health
DO - 10.3389/fpubh.2026.1881288
UR - https://europepmc.org/article/MED/42909004
AB - Background Infectious keratitis is one of the leading causes of visual impairment and blindness, placing a significant burden on global public health. Its treatment and favorable prognosis depend heavily on patients' knowledge, skills, and confidence in managing their own health. Nevertheless, qualitative investigations into patient activation among individuals with infectious keratitis within the Chinese cultural context remain scarce. Additionally, research examining this issue through the lens of social ecosystem theory is notably lacking.Objective This study aims to identify the facilitators and barriers to patient activation among patients with infectious keratitis in China using a qualitative approach to provide a theoretical basis for developing systematic, multilevel intervention strategies.Methods This study employed a descriptive qualitative research design. Using purposive sampling, 15 patients with infectious keratitis were recruited from a tertiary eye hospital in Zhejiang Province, China, between July and September 2025. Semi-structured interviews were conducted, and the interview data were analyzed using qualitative content analysis with NVivo 12.Results Based on social ecosystems theory, the analysis identified three main categories at the micro, meso, and macro levels: (1) microsystem -perceptions and behavioral adaptation challenges under disease impact; (2) mesosystem-support and tension in patient interactions with family and providers; (3) macrosystem-challenges and needs in building social networks.Conclusions Patient activation in infectious keratitis is constrained by individual, family, healthcare, and social factors across the micro, meso, and macro levels. Future interventions need to incorporate both facilitators and barriers by strengthening patient education, family support, patient-provider communication, and coordination of social resources to enhance patient activation and improve clinical outcomes.
SN - 2296-2565
ER -