{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,15]],"date-time":"2026-07-15T07:10:11Z","timestamp":1784099411174,"version":"3.55.0"},"reference-count":28,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2026,7,15]],"date-time":"2026-07-15T00:00:00Z","timestamp":1784073600000},"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>Background<\/jats:title>\n                    <jats:p>Metabolic dysfunction-associated steatotic liver disease is a prevalent chronic liver disease globally. Postmenopausal women may face a higher risk of developing this disease due to the metabolic changes related to menopausal transition. Although lifestyle adjustments remain the core of the care process, sustained self-management often remains highly challenging. This study, based on the theory of active health, aims to explore the self-management experience of postmenopausal women and the supportive needs.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>A descriptive qualitative design was employed. From August to October 2025, we recruited 16 postmenopausal MASLD patients from a tertiary Grade A hospital in Nanjing. Semi-structured, face-to-face interviews were conducted. Data were independently analyzed by two researchers using thematic analysis.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Sixteen postmenopausal women with MASLD were interviewed. Five themes were generated: (1) Inadequate awareness of MASLD risk; (2) obstacles under the physical and mental burden related to menopause; (3) gaps in the support system; (4) bidirectional effects of emotional experiences on self-management; (5) active health seeking and self-motivation.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Self-management in postmenopausal women with MASLD is shaped by interacting cognitive, physical, emotional, and family factors, while many retain modifiable motivation and initiative. These findings provide valuable implications for development of future interventions targeting this population.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.3389\/fpubh.2026.1828862","type":"journal-article","created":{"date-parts":[[2026,7,15]],"date-time":"2026-07-15T06:43:39Z","timestamp":1784097819000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":0,"title":["A qualitative study on the self-management experience and needs of postmenopausal patients with metabolic dysfunction-associated steatotic liver disease from the perspective of active health"],"prefix":"10.3389","volume":"14","author":[{"given":"Yuying","family":"Yang","sequence":"first","affiliation":[{"name":"School of Nursing, Nanjing Medical University","place":["Nanjing, China"]},{"name":"Department of Nursing, Nanjing BenQ Medical Center, The Affiliated BenQ Hospital of Nanjing Medical University","place":["Nanjing, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jinjin","family":"Cao","sequence":"additional","affiliation":[{"name":"Department of Nursing, Nanjing BenQ Medical Center, The Affiliated BenQ Hospital of Nanjing Medical University","place":["Nanjing, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lu","family":"Zhang","sequence":"additional","affiliation":[{"name":"School of Nursing, Nanjing Medical University","place":["Nanjing, China"]},{"name":"Department of Nursing, Nanjing BenQ Medical Center, The Affiliated BenQ Hospital of Nanjing Medical University","place":["Nanjing, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jing","family":"Liu","sequence":"additional","affiliation":[{"name":"Department of Nursing, Nanjing BenQ Medical Center, The Affiliated BenQ Hospital of Nanjing Medical University","place":["Nanjing, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mei","family":"Li","sequence":"additional","affiliation":[{"name":"International Medical Services, Nanjing BenQ Medical Center, The Affiliated BenQ Hospital of Nanjing Medical University","place":["Nanjing, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1965","published-online":{"date-parts":[[2026,7,15]]},"reference":[{"key":"ref1","doi-asserted-by":"publisher","first-page":"944","DOI":"10.1016\/S2468-1253(24)00193-6","article-title":"Natural history and progression of metabolic dysfunction-associated steatotic liver disease","volume":"9","author":"Hagstr\u00f6m","year":"2024","journal-title":"Lancet Gastroenterol Hepatol"},{"key":"ref2","doi-asserted-by":"publisher","first-page":"5640","DOI":"10.3390\/ijms25115640","article-title":"Metabolic dysfunction-associated Steatotic liver disease: from pathogenesis to current therapeutic options","volume":"25","author":"Portincasa","year":"2024","journal-title":"Int J Mol Sci"},{"key":"ref3","doi-asserted-by":"publisher","first-page":"1542","DOI":"10.1016\/j.jhep.2023.06.003","article-title":"A multisociety Delphi consensus statement on new fatty liver disease nomenclature","volume":"79","author":"Rinella","year":"2023","journal-title":"J Hepatol"},{"key":"ref4","doi-asserted-by":"publisher","first-page":"17455057251376883","DOI":"10.1177\/17455057251376883","article-title":"Relationship between MASLD and women's health: a review","volume":"21","author":"Jancova","year":"2025","journal-title":"Womens Health (Lond)"},{"key":"ref5","doi-asserted-by":"publisher","first-page":"1457","DOI":"10.1002\/hep.30626","article-title":"Sex differences in nonalcoholic fatty liver disease: state of the art and identification of research gaps","volume":"70","author":"Lonardo","year":"2019","journal-title":"Hepatology"},{"key":"ref6","doi-asserted-by":"publisher","first-page":"348","DOI":"10.1097\/gme.0000000000002133","article-title":"Menopause is associated with increased prevalence of nonalcoholic fatty liver disease: a systematic review and meta-analysis","volume":"30","author":"Jaroenlapnopparat","year":"2023","journal-title":"Menopause"},{"key":"ref7","doi-asserted-by":"publisher","first-page":"1237845","DOI":"10.3389\/fphar.2023.1237845","article-title":"Protective effect of phytoestrogens on nonalcoholic fatty liver disease in postmenopausal women","volume":"14","author":"Zhao","year":"2023","journal-title":"Front Pharmacol"},{"key":"ref8","first-page":"431","article-title":"The mediating effect of social support on the relationship between self-management and quality of life in patients with non-alcoholic fatty liver disease","volume":"41","author":"Li","year":"2024","journal-title":"Chin J Soc Med"},{"key":"ref9","doi-asserted-by":"publisher","first-page":"e078333","DOI":"10.1136\/bmjopen-2023-078333","article-title":"Self-management behaviours in adults with non-alcoholic fatty liver disease: a cross-sectional survey from China","volume":"14","author":"Zhou","year":"2024","journal-title":"BMJ Open"},{"key":"ref10","first-page":"24","article-title":"Concept analysis of proactive health in patients with chronic diseases","volume":"24","author":"Liu","year":"2026","journal-title":"Chin Gen Pract Nurs"},{"key":"ref11","doi-asserted-by":"publisher","first-page":"1995","DOI":"10.16766\/j.cnki.issn.1674-4152.004277","article-title":"Discussion on the theory and practice framework of proactive health under the healthy China strategy","volume":"23","author":"Bai","year":"2025","journal-title":"Chin Gen Pract Nurs."},{"key":"ref12","doi-asserted-by":"publisher","first-page":"355","DOI":"10.1111\/hex.13665","article-title":"Barriers and enabling factors in weight management of patients with nonalcoholic fatty liver disease: a qualitative study using the COM-B model of behaviour","volume":"26","author":"Gu","year":"2023","journal-title":"Health Expect"},{"key":"ref13","doi-asserted-by":"publisher","first-page":"334","DOI":"10.1002\/1098-240X(200008)23:4<334::AID-NUR9>3.0.CO;2-G","article-title":"Whatever happened to qualitative description?","volume":"23","author":"Sandelowski","year":"2000","journal-title":"Res Nurs Health"},{"key":"ref14","doi-asserted-by":"publisher","first-page":"349","DOI":"10.1093\/intqhc\/mzm042","article-title":"Consolidated criteria for reporting qualitative research (COREQ): a 32-item checklist for interviews and focus groups","volume":"19","author":"Tong","year":"2007","journal-title":"Int J Qual Health Care"},{"key":"ref15","doi-asserted-by":"publisher","first-page":"77","DOI":"10.1191\/1478088706qp063oa","article-title":"Using thematic analysis in psychology","volume":"3","author":"Braun","year":"2006","journal-title":"Qual Res Psychol"},{"key":"ref16","doi-asserted-by":"publisher","first-page":"e000634","DOI":"10.1136\/bmjgast-2021-000634","article-title":"Patient disease knowledge, attitudes and behaviours related to non-alcoholic fatty liver disease: a qualitative study","volume":"8","author":"Tincopa","year":"2021","journal-title":"BMJ Open Gastroenterol"},{"key":"ref17","doi-asserted-by":"publisher","first-page":"799","DOI":"10.46234\/ccdcw2022.156","article-title":"Proactive health: an imperative to achieve the goal of healthy China","volume":"4","author":"Liu","year":"2022","journal-title":"China CDC Wkly"},{"key":"ref18","doi-asserted-by":"publisher","first-page":"1251","DOI":"10.1186\/s12912-025-03922-z","article-title":"Patterns of proactive health behaviors and associated factors among middle-aged and older women in China: a latent class analysis","volume":"24","author":"Lei","year":"2025","journal-title":"BMC Nurs"},{"key":"ref19","doi-asserted-by":"publisher","first-page":"876","DOI":"10.1093\/heapol\/czaf047","article-title":"Enhancing health system efficiency in China: considering the interaction between use of primary care and the demand for secondary and tertiary care","volume":"40","author":"Jing","year":"2025","journal-title":"Health Policy Plan"},{"key":"ref20","doi-asserted-by":"publisher","first-page":"1445","DOI":"10.2174\/1871530323666221028154159","article-title":"Hepatologists\u2019 awareness and knowledge of NAFLD and the familiarity with renaming NAFLD to MAFLD","volume":"24","author":"Alem","year":"2024","journal-title":"Endocr Metab Immune Disord Drug Targets"},{"key":"ref21","doi-asserted-by":"publisher","first-page":"1895","DOI":"10.2147\/RMHP.S523169","article-title":"Exploring factors influencing dietary management in Chinese chronic kidney disease patients based on the COM-B model: a qualitative study","volume":"18","author":"Zhang","year":"2025","journal-title":"Risk Manag Healthc Policy"},{"key":"ref22","doi-asserted-by":"publisher","first-page":"1919","DOI":"10.1111\/jan.15237","article-title":"Factors affecting reductions in dietary salt consumption in people of Chinese descent: an integrative review","volume":"78","author":"Chan","year":"2022","journal-title":"J Adv Nurs"},{"key":"ref23","doi-asserted-by":"publisher","first-page":"336","DOI":"10.1186\/s12889-022-12566-6","article-title":"Gender differences in the relationships between housework and metabolic markers: a longitudinal cohort study in China","volume":"22","author":"Wang","year":"2022","journal-title":"BMC Public Health"},{"key":"ref24","doi-asserted-by":"publisher","first-page":"280","DOI":"10.1002\/hpm.2904","article-title":"The implications of childcare on grandparents\u2019 health self-management in a Chinese elderly population","volume":"35","author":"Wang","year":"2020","journal-title":"Int J Health Plann Manag"},{"key":"ref25","doi-asserted-by":"publisher","first-page":"106","DOI":"10.1016\/j.socscimed.2018.05.047","article-title":"Physical and mental health of Chinese grandparents caring for grandchildren and great-grandparents","volume":"229","author":"Xu","year":"2019","journal-title":"Soc Sci Med"},{"key":"ref26","doi-asserted-by":"publisher","first-page":"1729","DOI":"10.1016\/j.cgh.2025.08.040","article-title":"Menopause may partially explain age-related increased risk of MASLD fibrosis: a causal mediation analysis","volume":"24","author":"Sokale","year":"2025","journal-title":"Clin Gastroenterol Hepatol"},{"key":"ref27","doi-asserted-by":"publisher","first-page":"1697","DOI":"10.3390\/biomedicines9111697","article-title":"Non-alcoholic fatty liver disease (NAFLD) and potential links to depression, anxiety, and chronic stress","volume":"9","author":"Shea","year":"2021","journal-title":"Biomedicine"},{"key":"ref28","doi-asserted-by":"publisher","first-page":"759","DOI":"10.1080\/17474124.2021.1914587","article-title":"Liver-spleen axis in nonalcoholic fatty liver disease","volume":"15","author":"Tarantino","year":"2021","journal-title":"Expert Rev Gastroenterol Hepatol"}],"container-title":["Frontiers in Public Health"],"original-title":[],"link":[{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fpubh.2026.1828862\/full","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,7,15]],"date-time":"2026-07-15T06:43:40Z","timestamp":1784097820000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fpubh.2026.1828862\/full"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,7,15]]},"references-count":28,"alternative-id":["10.3389\/fpubh.2026.1828862"],"URL":"https:\/\/doi.org\/10.3389\/fpubh.2026.1828862","relation":{},"ISSN":["2296-2565"],"issn-type":[{"value":"2296-2565","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,7,15]]},"article-number":"1828862"}}