Barriers to self-care in chronic obstructive pulmonary disease in China: a qualitative study

Background: Self-care is critical for improving outcomes and quality of life in patients with chronic obstructive pulmonary disease (COPD), yet substantial barriers remain. The Middle-Range Theory of Self-Care of Chronic Illness provides a framework for systematically examining these obstacles. Aim: To explore barriers to self-care among patients with COPD. Methods: A descriptive qualitative design was employed. Semi-structured interviews were conducted with COPD patients from a rehabilitation centre in China and analysed using deductive content analysis and reported in line with COREQ guidelines. Results: Sixteen patients (mean age 71.4 years; 75% male) participated. Across 3 dimensions of self-care, 7 categories and 21 subcategories were identified. In maintenance, patients reported difficulties with lifestyle modification, physical activity, and medication adherence. In monitoring, challenges included limited symptom recognition and lack of access to monitoring devices. In management, low confidence in autonomous care and reluctance to consult providers were major barriers. Conclusion: Nurses are encouraged to assess patients' existing barriers to self-care within their specific contexts and cultural backgrounds and to develop targeted, patient-centred nursing interventions aimed at strengthening self-care knowledge, motivation, and skills in clinical practice. Supportive policies are needed to promote the development of innovative self-care programmes.