Self-management of health dilemmas among Chinese distant-water fishing vessel crew: a descriptive qualitative study based on Orem's self-care theory.

BACKGROUND

Distant-water fishing is one of the world's most hazardous occupations, characterized by extreme isolation from medical facilities, prolonged voyages, and high-intensity labor. Despite documented risks, qualitative evidence on how Chinese crew members manage their health during extended voyages remains scarce.

OBJECTIVE

This study explored health self-management dilemmas among Chinese distant-water fishing vessel crew members, guided by Orem's Self-Care Theory.

METHODS

A descriptive qualitative design was employed. Purposive and maximum variation sampling recruited 19 crew members from squid-jigging vessels in Zhoushan, China (February-June 2026). Face-to-face semi-structured interviews were conducted in private spaces. Data were analyzed using thematic analysis with NVivo 15.0.

RESULTS

Three themes emerged: (1) inadequate distant-water medical resources (lack of professional care, insufficient supplies, transport delays, hierarchical pressure blocking help-seeking); (2) high-intensity operations (disrupted work-rest cycles, chronic exhaustion, monotonous isolated life with emotional distress, willingness to manage health yet constrained by conditions); and (3) weak interpersonal support (utilitarian peer relationships, formalized family support with "reporting good news while concealing bad news"). Structural conditions shaped crew members' health management practices and limited available options.

CONCLUSION

Health self-management dilemmas are structurally rooted, produced by inadequate medical resources, hazardous working conditions, and functionally decomposed support systems. Recommendations include independent medical reporting channels, enforced work-rest protections, accessible medication guidance, enhanced first-aid capacity, and telemedical services via satellite communication.