Barriers and Facilitators of Patient Activation in old patients with cancer in China：a descriptive qualitative Research Based on the Ecological Systems Theory

Within 24 hours of the interview’s conclusion, the researcher transcribed the audio recordings into text, marking non-verbal information at corresponding points in the transcript and compiling the interviewee’s general information. The same data is independently analyzed and coded by two researchers to ensure its completeness and accuracy, then the results compared to summarize the themes. This study employs a methodology that integrates theoretical and data-driven approaches, utilizing Ecological Systems Theory as the foundational framework for thematic identification while allowing for the emergence of data-derived themes to ensure comprehensive analysis. The thematic analysis adheres to Braun and Clarke’s qualitative analysis procedures, commencing with the verification of transcription accuracy and repeated readings to familiarize with the content. The first researcher conducted preliminary coding on a portion of the text based on the theoretical framework, while the remaining text was coded according to data-generated themes. The themes underwent rigorous scrutiny to ensure internal consistency and mutual distinctiveness. Subsequently, a coding manual was developed, and a second researcher with a psychology background independently coded 30% of the text based on this manual. Any coding discrepancies were resolved through discussion and consensus-building. A summary of the data analysis process is presented in Table 2.