Previously submitted to: JMIR Nursing (no longer under consideration since Oct 16, 2026)
Date Submitted: Oct 16, 2026
Open Peer Review Period: Oct 16, 2026 - Oct 16, 2026
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Barriers to Self-Management in Lung Transplant Recipients: A Qualitative Study Based on the COM‑B Model
ABSTRACT
Background:
Lung transplant recipients require lifelong rehabilitation, in which patient self-management is particularly crucial. However, low participation in proactive self-management is widespread and may adversely affect patient outcomes. In China’s healthcare context, research on specific barriers to self-management among lung transplant recipients remains limited.
Objective:
This study aims to employ the COM-B (Capability, Opportunity, Motivation–Behaviour) model to investigate these barriers, thereby providing a basis for developing targeted interventions to improve patient activation and support sustained self-management practices.
Methods:
A qualitative descriptive study was conducted with 18 lung transplant recipients recruited from a tertiary hospital in Shanghai, China, between November and December 2025. Semi-structured interviews were used for data collection, and inductive thematic analysis based on the COM-B model was applied for data analysis
Results:
The self-management barriers in lung transplant recipients were summarized into three themes and eight sub-themes: capability factors (lack of awareness of disease management responsibilities, and insufficient ability to acquire and integrate health information); opportunity factors (limited availability of standardized health education resources, lack of family and social support, and external pressures such as economic burdens leading to increased resource consumption); and motivation factors (prognostic disparities resulting in diminished self-efficacy, prevalence of symptom-driven passive management behaviours, and widespread negative emotions).
Conclusions:
The barriers to self-management in lung transplant recipients are complex. Nursing staff can enhance patients’ self-management capabilities by tailoring interventions to individual needs, strengthening self-management education, mobilizing diverse support systems, and stimulating patients’ subjective initiative. Clinical Trial: Not Applicable
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