Developing a health values framework for patients with cardiovascular-kidney-metabolic syndrome: a qualitative exploration through the lens of social determinants of health

Abstract

Despite global calls for the advancement of patient-centered care, care planning often remains poorly aligned with patients’ lived social contexts and core values. This study aimed to understand what matters most to patients with cardiovascular-kidney-metabolic (CKM) syndrome and to develop a CKM-specific health values framework informed by a Social Determinants of Health (SDOH) perspective. This qualitative study employed semi-structured interviews with patients diagnosed with CKM syndrome at a tertiary hospital in Hangzhou, Zhejiang Province, China. Thematic analysis was conducted using a combination of deductive and inductive approaches. A total of 29 eligible CKM patients participated in the study. Informed by the SDOH framework, the CKM health values framework identified ten domains that participants regarded as essential to their health and well-being. These domains were grouped into three value orientations: five individual-oriented domains, including Preserving Physical and Cognitive Function, Psychological Well-being and Meaning, Informed Engagement in Health Management, Quality-Longevity Trade-off, and Financial and Insurance Security; one interpersonal-oriented domains, including Social Connectedness and Belonging; and two community-oriented domains, including Responsive and Coordinated Healthcare and Health-supportive Living Environment. The CKM health values framework, informed by an SDOH perspective, provides a conceptual and practical basis for eliciting patient-centered values that are often overlooked in routine clinical care. These findings may inform the development of conversational aids, decision-support tools, and patient-centered personalized care plans that better reflect patients’ lived experiences, social contexts, and health priorities. Not applicable.