Self-Management Experiences and Challenges in Patients with Metabolic Dysfunction-associated Steatotic Liver Disease: A Qualitative Study Guided by Pender’s Health Promotion Model

Haojie Hao, Danyang Guo, Yidan Quan, Han Fei, Jiayin Xu, Wei Zhang

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¹ School of Public Health and Nursing, Hangzhou Normal University, Hangzhou 311121, Zhejiang, China,

² Department of Nursing, Sichuan Provincial People’ s Hospital, Chengdu 610072, Sichuan, China,

³ Clinical Trial Unit, Hangzhou Normal University Affiliated Hospital, Hangzhou 310015, Zhejiang, China,

JCNR 2026 , 10(3), 181–192; https://doi.org/10.26689/jcnr.v10i3.13748

© 2026 by the Authors. Licensee Whioce Publishing, Singapore. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution 4.0 International License ( https://creativecommons.org/licenses/by/4.0/ )

Abstract

Objective: The study aims to explore experiences of patients with metabolic dysfunction–associated steatotic liver disease (MASLD) in self-management, identify the challenges they encountered and their needs during the self-management process. Methods: This qualitative study was conducted at an integrated tertiary hospital between March and May 2025. Semi-structured interviews with 15 participants were analyzed using Colaizzi’s seven-step method, and the resulting themes were mapped onto the constructs of the Pender health promotion model (HPM). Result: Three themes and nine sub-themes were mapped onto the HPM as challenges and obstacles in the self-management process of patients with MASLD. The themes encompass individual characteristics and negative experiences (personal factors and previous experiences with weight loss and rebound), cognitive and emotional deficits in self-management behaviors (insufficient recognition of the benefits of self-management, lack of interpersonal and situational support, negative emotional impact related to behavior, and low self-efficacy), and temporary needs and compromises with hobbies (unhealthy dietary preferences and long-term dietary habits, behavioral compromises in social situations, and temporary needs conflicting with healthy behaviors). Conclusion: Healthcare professionals should comprehensively assess the individual characteristics of patients with MASLD and provide personalized dietary and exercise management tailored to their lifestyle and behavioral preferences, while also paying close attention to their psychological and emotional well-being. Addressing patients’ behavioral, psychological, and social needs enhance the feasibility and sustainability of lifestyle changes, thereby promoting more effective and long-term self-management.

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