Abstract: Objective: To explore the real-life experiences of self-management in patients with thyroid-associated ophthalmopathy and to provide a reference for developing effective self-management intervention programs. Methods: A descriptive qualitative study was conducted. From November to December 2024, 16 inpatients with thyroid-associated ophthalmopathy were recruited from the ophthalmology ward of a tertiary grade A general hospital in Kunming, Yunnan Province, and participated in semi-structured interviews. The interview guide was developed based on the Capability, Opportunity, Motivation-Behavior (COM-B) model, relevant literature, and expert consultation. Data were analyzed and themes were extracted using the Colaizzi's 7-step analysis method within the phenomenological research approach. Results: Three themes and eight sub-themes were identified, including specifically capability factors (insufficient ability to acquire and integrate health information, reduced self-management execution due to impaired physical function), opportunity factors (insufficient accessibility and standardization of medical resources, intertwined fragile social support networks and stigma, inadequate public environmental adaptability exacerbating daily life difficulties), and motivation factors (disease adaptation motivation influenced by therapeutic uncertainty, behavior adjustments driven by image management needs, prominent symptom-oriented passive management behaviors). Conclusion: The barriers to self-management behaviors in patients with thyroid-associated ophthalmopathy are multifaceted. Nurses can help improve patients' self-management abilities by strengthening self-management knowledge education, providing self-management skills training, and mobilizing social support systems based on individual patient needs.

Key words: Thyroid-associated ophthalmopathy, Self-management, Qualitative research, Capability, Opportunity, and Motivation-Behavior model, Nursing

摘要： 目的：了解甲状腺相关眼病患者自我管理的真实体验，为构建有效的自我管理干预方案提供参考。方法：采用描述性质性研究方法，于 2024 年 11 月至 12 月选取云南省昆明市某三级甲等综合医院眼科病区住院治疗的 16 例甲状腺相关眼病住院患者进行半结构式访谈，基于能力、机会、动机-行为（COM-B）模型及相关文献、专家咨询制订半结构式访谈提纲，采用现象学研究中的 Colaizzi 7 步分析法剖析提炼主题。结果：共归纳出 3 个主题 8 个亚主题，即能力因素（健康信息获取与整合能力不足、躯体功能受限削弱自我管理执行力）、机会因素（医疗资源可及性与规范性不足、社会支持网络脆弱与病耻感交织、公共环境适配性不足加剧生活障碍）和动机因素（疾病适应动机受疗效不确定性影响、形象管理需求驱动行为调整、症状导向的被动管理行为显著）。 结论：甲状腺相关眼病患者的自我管理行为障碍因素较为复杂，护理人员可基于患者需求，通过加强自我管理知识教育、自我管理技能培训及调动社会支持系统，帮助患者提高自我管理能力。

关键词: 甲状腺相关眼病, 自我管理, 质性研究, 能力、机会、动机-行为（COM-B）模型, 护理