Self-management experiences of patients with hypertriglyceridemia-induced acute pancreatitis and coexisting diabetes mellitus: a qualitative study

In patients with hypertriglyceridemia-induced acute pancreatitis (HTG-AP) and coexisting diabetes mellitus (DM), effective post-discharge care depends on simultaneous glycaemic and lipid management, alongside diet, medication, exercise, monitoring, and recurrence prevention. Yet, existing studies have largely addressed acute management and near-term endpoints, with little attention to how these patients interpret risk or maintain self-management in daily life. We adopted the Health Action Process Approach (HAPA) for its motivational-volitional phase distinction, which provides a structured lens to investigate how behavioural intentions are translated into action plans, enacted, and sustained in this high-risk group. A Husserlian descriptive phenomenological study was conducted, with the Health Action Process Approach used as a sensitising framework during the interpretive stage. Twenty patients with HTG-AP and coexisting DM were purposively recruited from two hospitals in eastern China between November 2025 and January 2026. We collected data through face-to-face semi-structured interviews, which were audio-recorded and transcribed verbatim. Data collection and preliminary analysis were carried out simultaneously. Saturation was judged to have been reached after the 20th formal interview, when no new codes, categories or themes were identified and the existing themes showed no further substantive development. The transcripts were organised using NVivo 15.0 and subjected to Colaizzi’s seven-step analytical framework. Twenty participants (aged 22–59 years; 15 men) comprised three groups: DM first diagnosed during the index hospitalisation with first-episode HTG-AP ( n = 6), pre-existing DM with first-episode HTG-AP ( n = 3), and pre-existing DM with recurrent HTG-AP ( n = 11). Three themes and 14 subthemes were identified: divergent risk perceptions; barriers and facilitators in translating intention into action; and long-term confidence amid persistent challenges. First-episode participants described acute threat and limited practical experience, whereas recurrent participants reported heterogeneous risk perceptions, accumulated knowledge and reduced self-efficacy. Long-term maintenance was constrained by contextual and psychological barriers. Self-management support may be more useful when tailored to disease trajectory and risk-perception pattern. Nurses can link risk communication to individualised action and coping plans, address emotional responses to recurrence, involve family members and coordinate multidisciplinary transitional follow-up.