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.

Background: 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. Methods: 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. Results: 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. Conclusion: 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.