Supplementary file 1_Self-management of health dilemmas among Chinese distant-water fishing vessel crew: a descriptive qualitative study based on Orem’s self-care theory.docx

Despite documented risks, qualitative evidence on how Chinese crew members manage their health during extended voyages remains scarce.</p>Objective<p>This study explored health self-management dilemmas among Chinese distant-water fishing vessel crew members, guided by Orem’s Self-Care Theory.</p>Methods<p>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.</p>Results<p>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”).