Abstract:

Objective To explore the dilemmas and causes of self-management behavior maintenance in patients with type 2 diabetes mellitus（T2DM），and to provide a basis for developing continuous self-management intervention strategies. Methods A descriptive qualitative study guided by the ego depletion theory was conducted. Using purposive sampling，18 T2DM inpatients were recruited from the endocrinology department of a tertiary hospital in Zhengzhou，Henan Province，between February and April 2025. Semi-structured interviews were conducted，and the data were analyzed using conventional content analysis. Results A total of 3 themes and 10 sub-themes were identified，namely the antecedents of behavioral depletion（long-term accumulation of multiple management tasks，conflict of social roles，dysfunctional social support，biased perception of disease risks），the process of behavioral depletion （conflict between impulsive attitudes and management standards，imbalance between negative emotions and rational decision-making，gap between behavioral intention and implementation），and the aftereffects of behavioral depletion （impulsive decision-making，accumulation of negative emotions，self-indulgence）. Conclusion The difficulty in sustaining self-management behaviors among T2DM patients results from the continuous depletion of self-regulatory resources due to multifaceted factors，leading to ego depletion. Nursing professionals should prioritize monitoring the impact of resource depletion on patients and implement timely resource replenishment and recovery strategies. This approach is essential for supporting patients in maintaining optimal behavioral states and enhancing the sustainability of self-management practices.

Key words: Type 2 Diabetes Mellitus, Self-Management Behavior, Ego Depletion, Self-Control, Qualitative Research, Nursing Care

摘要：

目的 探讨2型糖尿病患者自我管理行为维持的困境及成因，为制订持续性的自我管理干预方案提供依据。 方法 基于自我损耗理论，应用描述性质性研究方法，采用目的抽样法，于2025年2—4月选取河南省郑州市某三级甲等综合医院内分泌科住院的18例2型糖尿病患者作为研究对象，进行半结构式访谈，采用传统内容分析法进行资料分析。 结果 共归纳出行为损耗前因（长期多重管理任务叠加、社会角色冲突、社会支持失调、疾病风险认知偏差）、行为损耗过程（冲动态度与管理标准的冲突、负性情绪与理性决策的失衡、行为意向与行为执行的差距）、行为损耗后效（冲动性决策、负性情绪积聚、自我放纵）3个主题及10个亚主题。 结论 2型糖尿病患者自我管理行为维持困难是多因素持续消耗控制资源、引发自我损耗的结果，护理人员应密切关注资源损耗对患者的影响，及时采取资源补充及恢复策略，帮助其维持良好的行为状态，提高自我管理行为的可持续性。

关键词: 2型糖尿病, 自我管理行为, 自我损耗, 自我控制, 质性研究, 护理