The self-reinforcing cycle under dual constraints—a study of the behavioral logic of urban empty-nest older adults substituting self-medication for formal medical treatment
Bibliographic Data
| ID | 22083544 |
|---|---|
| Authors | Ji Wu (0000-0002-3417-635X, Harbin University), Yi Liu (0000-0001-7733-3290, Harbin University, corresponding author), Yuanyuan Liu (0000-0002-2216-2954, Harbin Engineering University), Siwen Li (0000-0003-0784-134X, Harbin Engineering University) |
| Year | 2026 |
| Volume | 14 |
| Pages | 1701771-1701771 |
| Publication date | 2026-03-05 |
| Peer Reviewed | Yes |
| Open Access | Yes |
| Type | ARTICLE |
| Venue | Frontiers in Public Health (JOURNAL) |
| Journal identifiers | ISSN: 2296-2565 • E-ISSN: 2296-2565 |
| Publisher | Frontiers Media SA (PUBLISHER • CH) |
| DOI | 10.3389/fpubh.2026.1701771 |
| PMID | 41869611 |
| OpenAlex | W7133707982 |
| Language | EN |
| References cited | 31 |
Introduction: Against the stark backdrop of China's rapidly aging population and the high prevalence of chronic diseases among the older adults, urban empty-nesters face a dual challenge stemming from inadequate intergenerational support and heightened health vulnerability. A deeper understanding of their illness coping behavior is therefore critically needed. Methods: This study employs grounded theory methodology, conducting in-depth interviews with 25 empty-nest older adults in H City. A total of 290,000 words of interview texts were collected to generate a theoretical model, systematically revealing the individual cognitive framework and dynamic mechanisms of health behaviors within this group. Results: The study reveals a "dual constraints-trigger mechanism-self-reinforcing cycle" logic underpinning the health coping strategies of empty-nest elders: (1) At the precondition level, insufficient intergenerational support and self-perceived burden constitute structural dual constraints; (2) The trigger mechanism is activated by illness experience and self-diagnosed health anxiety, which interact and amplify each other through lay explanatory models of illness, thereby directly driving behavioral decisions; (3) The behavioral pathway follows a self-reinforcing sequence of "self-medication → consulting community networks for medication advice → seeking medical treatment," further exacerbated by structural contradictions within the healthcare system; (4) Outcomes form a closed loop, in which these health management practices not only conclude the current coping cycle but also often initiate new health issues, restarting the entire cycle. Discussion: The findings indicate that the behavior of "substituting self-medication for formal medical treatment" essentially functions as a survival strategy among the older adults under structural constraints. This strategy allows them to maintain autonomy through self-reliant narratives and achieve social adaptation via peer group-based mutual support. The study offers a theoretical pathway that integrates structural reflection with subjective care, contributing meaningfully to the development of healthy aging policies
Cognition · Disease · Grounded theory · Health care · Medical advice · Population · Population ageing · Underpinning · Chronic Disease Management Strategies · Health disparities and outcomes · Intergenerational Family Dynamics and Caregiving
| Citation velocity | historical |
|---|---|
| Highly cited | No |