Social networks of patients with multimorbidity: a qualitative study of patients’ and supporters’ views

Abstract

INTRODUCTION Multimorbidity impacts on patients' health and wellbeing, but relationships experienced within social networks can support people to live well. AIM This study sought to elicit the views of New Zealanders with multimorbidity about their social networks and the views of their nominated supporters. METHODS Ten patients with multimorbidity and their nominated supporters each independently recorded their views of the patient's social network on a five-concentric-circle template, indicating supporting role and importance to each patient. Sets of patients' and nominated supporters' templates were compared followed by comparing matched pairs of patient-supporter templates. Nominated supporters' views about the patients' networks and why they were nominated were collated. RESULTS Three patients nominated family members as supporters and seven nominated health professionals. Nominated family members identified a greater range of supporters than nominated health professionals. Nominated family members perceived that they played an integral role, whereas health professionals were less comfortable viewing relationships with patients in this way. Family members were not surprised to be nominated as supporters, and some described a considerable burden of care. Health professionals described themselves as coordinators of support and having positive relationships with patients. DISCUSSION Patients with multimorbidity have rich and diverse social networks. They view partners, family and health professionals as providing significant support. Family members are more aware of their role and have a deeper understanding of other network members than health professionals. Further research is needed on the use of social networks in clinical practice to support the health and wellbeing of those with multimorbidity.

General practice and patients’ views of the social networks of patients with multimorbidity

“…29 CoCPs can also include student-learners who join temporarily in pursuit of their education. 18,21,30 Social network researchers often use mapping tools for people to record their supporters, including patients with long-term conditions or multimorbidity. 8,9,12,16 Mapping tools typically include a template with concentric circles indicating the relative importance of supporters to the person, who is in the centre.…”

“…16 Some social networks include general practice and other health professionals. 17,18 These networks are akin to Communities of Clinical Practice (CoCP), whereby a group of people, both professional and lay, commit to providing support for particular patients. 11,[19][20][21] General practice teams believe they are the health-care anchor to coordinate care for patients with long-term conditions.…”

The social networks of New Zealand patients with multimorbidity and the work of those nominated as their ‘significant supporters’: An exploratory study

“…Using a five-concentric-circle social network mapping template (modified from E & B Wenger-Trayner (Wenger-Trayner & Wenger-Trayner, 2015)), patients, together with students, mapped their social network and recorded their relative importance to the patient by recording proximity of each to the centre of the circle. These results are presented elsewhere (McKinlay, McDonald, Darlow, & Perry, 2017).…”

The longitudinal association of multimorbidity on loneliness and network size: Findings from a population‐based study

“…For instance, in a study by Hawkley et al, it was concluded that particularly the quality of relationships is a key determinant of loneliness. 42 The study showed that patients with multimorbidity have a rich and diverse social network; however, some of the nominated supporters are not aware of their important role that may indicate a rather one-sided relationship and a possible negative perception of one's own social network. 41 Further explanation for the results of this study might be provided by a qualitative study from New Zealand.…”

“…The authors stated that health professionals either underestimated their importance in their patient's social network or did not want to be too important to the patient. 42 The study showed that patients with multimorbidity have a rich and diverse social network; however, some of the nominated supporters are not aware of their important role that may indicate a rather one-sided relationship and a possible negative perception of one's own social network. This insight might explain why the onset of multimorbidity leads to an increased social network but also increased loneliness.…”