Barriers to self-management among patients with permanent pacemakers: a qualitative exploration from the perspective of physicians and nurses

Permanent pacemaker patients’ self-management is vital for quality of life, but most have low self-management ability. While prior research has reported self-management barriers, none analyze them from physicians’ and nurses’ perspectives. This study aimed to determine the barriers to self-management among patients with permanent pacemaker implantation from the perspectives of physicians and nurses in a tertiary hospital in Yunnan, China. A qualitative descriptive research design was adopted in this study, with the Self-Management Theory and the Behavior Change Wheel Theory as the theoretical frameworks. The study population comprised physicians and nurses engaged in work related to permanent pacemaker implantation in the Cardiology Department of a tertiary hospital in Yunnan Province. Data were collected through semi-structured interviews. Purposive sampling was adopted in accordance with the inclusion criteria: (1) having worked in the ward for more than one year with work experience related to pacemaker implantation; (2) holding an intermediate or higher professional title, or having participated in relevant specialized training; (3) being willing to actively participate and cooperate. The sample size was determined after data saturation was confirmed via group discussions, and a total of 11 physicians and nurses were finally included. Qualitative content analysis was used for data analysis in this study. The barriers to self-management among patients who had permanent pacemaker implantation, as identified from physicians and nurses, were as follows: self-monitoring capability, cognitive capability, help-seeking ability, memory ability, hospital-residence distance, family support and companionship, living habits, self-management attitude, and emotional regulation capability. This study identifies key barriers to self-management in patients with permanent pacemakers, providing insights for targeted interventions. For example, healthcare teams can establish community follow-ups, multi-level support systems, and patient-centered care. Meanwhile, it is also necessary to address patients’ postoperative needs and establish an open communication platform involving multiple stakeholders. All these are crucial for optimizing management, promoting recovery, and improving overall health.