Self-management barriers in recurrent acute pancreatitis: a qualitative study from the health belief model perspective.

Objective: To explore the self-management barriers and their underlying mechanisms in patients with recurrent acute pancreatitis (RAP) based on the health belief model, and to provide a basis for developing systematic intervention strategies. Methods: A convenience sampling method was used to select 24 patients with RAP admitted to the Affiliated Hospital of Zunyi Medical University from December 2024 to April 2025. Using the health belief model (HBM) as the theoretical framework, semi-structured interviews were conducted to collect data. The Colaizzi seven-step content analysis method was employed to code, summarize, and extract themes from the interview transcripts. Results: The mean age of the patients was 47.25 ± 13.74 years. Among them, 14 were male (58.33%) and 10 were female (41.67%). Three core themes and six sub-themes were identified. Theme 1, Perceived Threat, included two sub-themes: perceived susceptibility and perceived severity. Patients generally underestimated the recurrence risk and exhibited a sense of luck, while simultaneously bearing multiple pressures from the consequences of recurrence. Theme 2, Behavioral Evaluation, included perceived benefits and perceived barriers. Although patients recognized the importance of behavior change and formed initial beliefs, they encountered multiple real-world obstacles such as financial burden, work pressure, and social barriers during the translation of knowledge into action, resulting in the core dilemma of the "knowing-doing gap." Theme 3, Behavioral Enablers, included cues to action and self-efficacy. Patients' health behaviors were mostly triggered by isolated physical symptom signals without systematic triggering mechanisms. Their self-efficacy showed dynamic fluctuations, which directly affected the sustainability and stability of behavior change. Conclusion: The self-management dilemmas of patients with recurrent acute pancreatitis run through the three core components of the HBM, manifesting as coexistence of a sense of luck and multiple pressures, the knowing-doing gap, lack of cues, and fluctuating efficacy. It is recommended to design systematic and individualized self-management support programs by strengthening continuous risk perception, reducing behavioral barriers, enhancing self-efficacy, building support systems, and establishing proactive cues to action.