{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,5]],"date-time":"2026-03-05T06:40:53Z","timestamp":1772692853537,"version":"3.50.1"},"reference-count":42,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2026,3,5]],"date-time":"2026-03-05T00:00:00Z","timestamp":1772668800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Public Health"],"abstract":"<jats:sec>\n                    <jats:title>Introduction<\/jats:title>\n                    <jats:p>Against the stark backdrop of China\u2019s rapidly aging population and the high prevalence of chronic diseases among the older adults, urban empty-nesters face a dual challenge stemming from inadequate intergenerational support and heightened health vulnerability. A deeper understanding of their illness coping behavior is therefore critically needed.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>This study employs grounded theory methodology, conducting in-depth interviews with 25 empty-nest older adults in H City. A total of 290,000 words of interview texts were collected to generate a theoretical model, systematically revealing the individual cognitive framework and dynamic mechanisms of health behaviors within this group.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>The study reveals a \u201cdual constraints\u2013trigger mechanism\u2013self-reinforcing cycle\u201d logic underpinning the health coping strategies of empty-nest elders: (1) At the precondition level, insufficient intergenerational support and self-perceived burden constitute structural dual constraints; (2) The trigger mechanism is activated by illness experience and self-diagnosed health anxiety, which interact and amplify each other through lay explanatory models of illness, thereby directly driving behavioral decisions; (3) The behavioral pathway follows a self-reinforcing sequence of \u201cself-medication\u202f\u2192\u202fconsulting community networks for medication advice\u202f\u2192\u202fseeking medical treatment,\u201d further exacerbated by structural contradictions within the healthcare system; (4) Outcomes form a closed loop, in which these health management practices not only conclude the current coping cycle but also often initiate new health issues, restarting the entire cycle.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Discussion<\/jats:title>\n                    <jats:p>The findings indicate that the behavior of \u201csubstituting self-medication for formal medical treatment\u201d essentially functions as a survival strategy among the older adults under structural constraints. This strategy allows them to maintain autonomy through self-reliant narratives and achieve social adaptation via peer group-based mutual support. The study offers a theoretical pathway that integrates structural reflection with subjective care, contributing meaningfully to the development of healthy aging policies.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.3389\/fpubh.2026.1701771","type":"journal-article","created":{"date-parts":[[2026,3,5]],"date-time":"2026-03-05T05:25:35Z","timestamp":1772688335000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":0,"title":["The self-reinforcing cycle under dual constraints\u2014a study of the behavioral logic of urban empty-nest older adults substituting self-medication for formal medical treatment"],"prefix":"10.3389","volume":"14","author":[{"given":"Ji","family":"Wu","sequence":"first","affiliation":[{"name":"School of Humanities and Social Sciences, Harbin Engineering University","place":["Harbin, China"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yuanyuan","family":"Liu","sequence":"additional","affiliation":[{"name":"School of Humanities and Social Sciences, Harbin Engineering University","place":["Harbin, China"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Siwen","family":"Li","sequence":"additional","affiliation":[{"name":"School of Humanities and Social Sciences, Harbin Engineering University","place":["Harbin, China"]}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1965","published-online":{"date-parts":[[2026,3,5]]},"reference":[{"key":"ref1","first-page":"14","article-title":"The impact of internet use on the health of the elderly","volume":"5","author":"Zhao","year":"2020","journal-title":"Chin J Popul Sci"},{"key":"ref2","doi-asserted-by":"publisher","first-page":"31","DOI":"10.3969\/j.issn.1004-129X.2012.03.004","article-title":"Life quality of urban empty-nested 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