Digital Illness Narratives of Young Chinese Adults With Diabetes on RedNote: Qualitative Narrative Analysis

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Abstract
Background: Chronic illness disrupts everyday routines, social roles, and sense of self, particularly among young individuals undergoing identity formation. With the expansion of digital media, social platforms have become key sites where patients narrate illness experiences, negotiate stigma, and seek support. However, such processes remain underexplored in non-Western, collectivist contexts. Objective: This study examines how young Chinese individuals with diabetes construct illness narratives and negotiate identity in digital environments. Methods: This study uses a narrative analysis approach, combining inductive thematic coding with culturally and critically informed interpretation. A total of 303 narrative posts were collected from RedNote, a Chinese social media platform characterized by diary-like user-generated content. The dataset includes both text-based and video-based posts, capturing longitudinal and first-person accounts of living with diabetes. Results: In total, 4 distinct narrative types were identified. The chaos narrative captures experiences of cognitive dissonance, emotional breakdown, and disruption of daily routines following diagnosis, often accompanied by guilt toward family members and anxiety over future uncertainty. The stigma narrative reflects social withdrawal, concealment of illness, and perceived discrimination in intimate relationships and employment contexts, highlighting the role of externally imposed social judgment. The resilience narrative illustrates processes of self-acceptance, disciplined self-management, and the integration of illness into everyday life through routinized practices such as blood glucose monitoring and dietary regulation. The solidarity narrative emphasizes the importance of familial care and digitally mediated peer support, where users exchange practical knowledge, emotional encouragement, and collective identity markers, transforming isolation into shared experience. Across these narratives, illness is not only experienced as disruption but also actively reinterpreted through culturally embedded values such as familial responsibility and collective belonging. Conclusions: This study advances illness narrative research by demonstrating how digital platforms mediate culturally specific forms of meaning-making among young patients with chronic illness. It extends the concept of biographical disruption by conceptualizing it as a dynamic and relational process shaped by digital storytelling, familial expectations, and peer interaction. The findings highlight the importance of culturally sensitive and platform-aware approaches to health communication and digital patient support.

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