ArticleInternational journal of nursing sciences2026
Pathways to self-management among older adults with multimorbidity in rural China: A fuzzy-set qualitative comparative analysis.
Article in International journal of nursing sciences, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
Objectives: This study aimed to investigate how individual, problem-related, and environmental factors interact to influence self-management behaviours among rural older adults with multimorbidity in China, to inform more context-sensitive interventions. Methods: A cross-sectional study was conducted in 9 healthcare facilities across Zhejiang Province, China, from July 2022 to May 2023, involving 487 rural older adults with multimorbidity via convenience sampling, who had been diagnosed with 2 or more chronic conditions. Data were collected through questionnaires and electronic health records to assess self-efficacy, psychological resilience, physical symptoms, the Charlson Comorbidity Index, social support, and resource accessibility. Fuzzy-set qualitative comparative analysis was employed to explore the complex, non-linear interactions between contextual factors, ultimately determining the sufficient conditions for self-management behaviours. Results: Correlation analyses revealed positive associations between self-management behaviours and self-efficacy, psychological resilience, social support, and resource accessibility ( Conclusions: Self-management among rural older adults with multimorbidity is shaped by complex, context-dependent interactions. Effective interventions should prioritize enhancing self-efficacy, expanding access to resources, and tailoring strategies to distinct contextual profiles. The study also demonstrates the utility of fuzzy-set qualitative comparative analysis for advancing context-sensitive healthcare solutions.
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