Timing of onset and self-management of multiple chronic conditions: A qualitative examination taking a lifespan perspective

Abstract

Objectives Over two-thirds of older individuals live with multiple chronic conditions, yet chronic diseases are often studied in silos. Taking a lifespan approach to understanding the development of multiple chronic conditions in the older population helps to further elucidate opportunities for targeted interventions that address the complexities of multiple chronic conditions. Methods Semi-structured interviews were conducted with 38 older adults (age 64+) diagnosed with at least two chronic health conditions. Content analysis was used to build understanding of how older adults discuss the timing of diagnoses and subsequent self-management of multiple chronic conditions. Results Findings highlight the complex process by which illnesses unfold in the context of individuals' lives and the subsequent engagement and/or disengagement in self-management behaviors. Two primary themes were evident regarding timing of illnesses: illnesses were experienced within the context of social life events and/or health events, and illnesses were not predominantly seen as connected to one another by patients. Self-management behaviors were described in response to onset of each illness. Discussion Findings provide insight into how older adults understand their experience of multiple chronic conditions and change in self-management behaviors over time. In order for practitioners to ignite behavioral changes, a person's history and life experiences must be considered.

Challenges Experienced by Older People During the Initial Months of the COVID-19 Pandemic

“…Specifically, quantitative questions can provide systematic descriptive statistics to reference, while the analysis of open-ended data can help to build a ground-up perspective of the individual's lived experiences, by reducing researcher bias. Such methodologies have been applied to more fully understand the impact of stressors on older adults when providing caregiving (Gaugler et al, 2018), managing chronic illnesses (Jason & Reed, 2015;Heid et al, 2018;Liddy, Blazkho, & Mill, 2014), or in response to a disaster (Heid, Schug, Cartwright, & Pruchno, 2017;Henderson, Roberto, & Kamo, 2010;King et al, 2015;Langan & Palmer, 2012;Miller & Brockie, 2015).…”