Qualitative study on the psychological and behavioral adaptation process of patients with impaired awareness of hypoglycemia

ObjectiveTo explore the psychological and behavioral adaptation process of patients with impaired awareness of hypoglycemia(IAH) regarding their lack of symptom perception,identify key stage characteristics,and to construct an adaptation model to provide a theoretical basis for formulating intervention strategies.MethodsUsing purposive sampling method,semi-structured interviews were conducted with 18 hospitalized patients with impaired awareness of hypoglycemia in a tertiary grade A hospital in Tianjin from May to June 2025.NVivo 15.0 software was employed for coding and analyzing the interview data.Grounded theory was used to construct a relational model of psychological and behavioral adaptation in patients with impaired awareness of hypoglycemia.ResultsThe symptom perception characteristics of patients with impaired awareness of hypoglycemia manifested in three types:complete loss of perception,highered perception threshold,and static situational perception loss.The psychological and behavioral adaptation process exhibited dynamic changes through different stages(confusion,conflict,negativity,and reconstruction),encompassing five psychological patterns(ignorance and indifference,confusion and helplessness,fear and anxiety,passive acceptance,and regular adaptation) and six behavioral patterns(lack of strategy,contradictory compensation,inert avoidance,strict monitoring,technology-driven,and experience-driven),with phenomena of leapfrogging and regression between stages.ConclusionsPatients with impaired awareness of hypoglycemia exhibit staged psychological adaptation and behavioral compensation patterns under the state of symptom perception loss.This finding provides a theoretical basis for the development of clinical intervention strategies.