{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,4]],"date-time":"2026-09-04T16:47:11Z","timestamp":1788540431233,"version":"build-2803163510"},"reference-count":55,"publisher":"Wiley","issue":"6","license":[{"start":{"date-parts":[[2025,12,8]],"date-time":"2025-12-08T00:00:00Z","timestamp":1765152000000},"content-version":"vor","delay-in-days":7,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2025,12,1]],"date-time":"2025-12-01T00:00:00Z","timestamp":1764547200000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Health Expectations"],"published-print":{"date-parts":[[2025,12]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Effective self\u2010management is essential for improving the health outcomes of patients with type 2 diabetes mellitus (T2DM). However, many patients fail to achieve ideal self\u2010management. This qualitative study, grounded in the theory of planned behaviour (TPB), aims to explore the mechanisms underlying self\u2010management behaviours of patients with T2DM in the community, to provide insights for improve patients' self\u2010management and reduce the disease burden.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>Within the framework of the TPB, a semi\u2010structured interview guide was developed based on a literature review and expert consensus. Qualitative data were obtained from in\u2010depth interviews with 21 patients with T2DM from a community health service centre in Nanjing, Jiangsu Province. All interviews were conducted by the same interviewer to ensure consistency. Content analysis was used to identify the key factors influencing patients' self\u2010management behaviours and the underlying mechanism.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>This study systematically explained the underlying mechanisms of self\u2010management behaviours among patients with T2DM based on Ajzen's TPB, including three key levels: (1) Attitudes towards self\u2010management: shaped by both internal (e.g., self\u2010perception, perceived importance and understanding of the disease) and external factors (e.g., perceived benefits and degree of acceptance). (2) Subjective norms: influenced by both intrinsic (e.g., personal motivations) and extrinsic pressures (e.g., surrounding individuals and social groups). (3) Perceived behavioural control: determined by both inner (e.g., personal characteristics, physical and mental experience, economic resources and time management) and outer factors (e.g., environmental suitability, policy support and technical availability).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>This study provides a valuable theoretical basis and practical implications for designing effective interventions to improve self\u2010management behaviours of patients with T2DM in the community. To optimize self\u2010management behaviours of this population, a multifaceted approach is recommended, focusing on the following six key areas: improving T2DM knowledge, strengthening follow\u2010up management system, empowering patients to take an active role in their care, fostering social support network, developing their own coping skills and expanding policy support for T2DM care.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Patient or Public Contribution<\/jats:title>\n                    <jats:p>Patients with T2DM were actively involved in this study, providing essential insights and feedback throughout. Their first\u2010hand experiences contributed to the identification of sub\u2010categories and categories. Participants also reviewed and confirmed the accuracy of the interview transcripts, ensuring the reliability of the data.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/hex.70522","type":"journal-article","created":{"date-parts":[[2025,12,8]],"date-time":"2025-12-08T13:12:02Z","timestamp":1765199522000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":3,"title":["A Qualitative Study Exploring the Mechanisms Underlying Self\u2010Management Behaviours Among Community\u2010Dwelling Type 2 Diabetes Mellitus Patients in Nanjing, China"],"prefix":"10.1111","volume":"28","author":[{"given":"Jinxin","family":"Li","sequence":"first","affiliation":[{"name":"School of Nursing Nanjing Medical University Nanjing China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yue","family":"Zhang","sequence":"additional","affiliation":[{"name":"School of Public Health Nanjing Medical University Nanjing China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nan","family":"Zhao","sequence":"additional","affiliation":[{"name":"School of Nursing Nanjing Medical University Nanjing China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jianxiao","family":"Zheng","sequence":"additional","affiliation":[{"name":"School of Public Health Nanjing Medical University Nanjing China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yang","family":"Wang","sequence":"additional","affiliation":[{"name":"School of Nursing Nanjing Medical University Nanjing China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jiajia","family":"Dong","sequence":"additional","affiliation":[{"name":"School of Public Health Nanjing Medical University Nanjing China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jianwen","family":"Zhu","sequence":"additional","affiliation":[{"name":"School of Nursing Nanjing Medical University Nanjing China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jie","family":"Fu","sequence":"additional","affiliation":[{"name":"School of Public Health Nanjing Medical University Nanjing China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5896-4801","authenticated-orcid":false,"given":"Hong","family":"Fan","sequence":"additional","affiliation":[{"name":"School of Nursing Nanjing Medical University Nanjing China"},{"name":"School of Public Health Nanjing Medical University Nanjing China"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2025,12,8]]},"reference":[{"key":"e_1_2_13_2_1","first-page":"528","article-title":"Effect of Dynamic Blood Glucose Monitoring on Glucose and Lipid Metabolism and Self\u2010Management in Type 2 Diabetes Patients","volume":"36","author":"Yang D.","year":"2022","journal-title":"Chinese Nursing Research"},{"key":"e_1_2_13_3_1","doi-asserted-by":"publisher","DOI":"10.1177\/1357633X17700552"},{"key":"e_1_2_13_4_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(24)02317-1"},{"key":"e_1_2_13_5_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.diabres.2021.109119"},{"key":"e_1_2_13_6_1","unstructured":"World Health Organization \u201cDiabetes \u201d 2024 accessed January 4 2025 https:\/\/www.who.int\/news-room\/fact-sheets\/detail\/diabetes."},{"key":"e_1_2_13_7_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.lanwpc.2023.100700"},{"key":"e_1_2_13_8_1","first-page":"52","article-title":"An Investigation of Self\u2010Management Behavior With a Sample of Type 2 Diabetic Patients in the Community","volume":"12","author":"Wang X.","year":"2012","journal-title":"Chinese Nursing Management"},{"key":"e_1_2_13_9_1","unstructured":"State Council of the People's Republic of China \u201cThe Report of the 20th National Congress of the Communist Party of China \u201d 2022 https:\/\/www.gov.cn\/xinwen\/2022-10\/25\/content_5721685.htm."},{"key":"e_1_2_13_10_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jcjd.2017.11.003"},{"key":"e_1_2_13_11_1","first-page":"722","article-title":"Research Status of Health Behavior in Patients With Diabetes Mellitus","volume":"46","author":"Xuemei X.","year":"2011","journal-title":"Chinese Journal of Nursing"},{"key":"e_1_2_13_12_1","doi-asserted-by":"publisher","DOI":"10.1111\/dme.12105"},{"key":"e_1_2_13_13_1","doi-asserted-by":"publisher","DOI":"10.1037\/a0040388"},{"key":"e_1_2_13_14_1","first-page":"617","article-title":"Self\u2010Management Behaviors and Glycemic Control in Patients With Type 2 Diabetes Mellitus","volume":"49","author":"Ji J.\u2010J.","year":"2014","journal-title":"Chinese Journal of Nursing"},{"key":"e_1_2_13_15_1","first-page":"2904","article-title":"Status Quo and Influencing Factors of Self\u2010Management Behaviors in Patients With Type 2 Diabetes Mellitus","volume":"36","author":"Du J. 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