Experiences of community-dwelling older adults living with multiple chronic conditions: a qualitative study
ObjectivesThe aim of the study was to understand the experiences of living with multiple chronic conditions (MCC) from the perspective of community-living older adults with MCC.DesignA qualitative study using an interpretive description approach.SettingParticipants were recruited from southern Ontar...
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| Veröffentlicht in: | BMJ open 2019-03, Vol.9 (3), p.e023345-e023345 |
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| creator | Ploeg, Jenny Canesi, Marta D Fraser, Kimberly McAiney, Carrie Kaasalainen, Sharon Markle-Reid, Maureen Dufour, Sinead Garland Baird, Lisa Chambers, Tracey |
| description | ObjectivesThe aim of the study was to understand the experiences of living with multiple chronic conditions (MCC) from the perspective of community-living older adults with MCC.DesignA qualitative study using an interpretive description approach.SettingParticipants were recruited from southern Ontario, Canada.Participants21 community-living, older adults (≥65 years) with an average of 7.4 chronic conditions including one of diabetes, dementia or stroke.MethodsData were collected through digitally-recorded, in-depth, semi-structured in-person interviews. Interview transcripts were analysed and coded using Thorne’s interpretive description approach.ResultsFive themes were identified representing older adults' experiences of living with MCC: (a) trying to stay healthy while living with MCC, (b) depending on family caregivers for support with just about everything, (c) paying the high costs of living with MCC, (d) making healthcare decisions by proxy and (e) receiving healthcare services that do not address the complex needs of persons living with MCC.ConclusionsThe experience of living with MCC in the community was complex and multi-faceted. The need for a person-centred and family-centred approach to care in the community, which includes the coordination of health and social services that are tailored to the needs of older adults and their informal caregivers, was underscored. Such an approach would facilitate improved information-sharing and discussion of care management options between health professionals and their patients, enable older adults with MCC to actively engage in priority-setting and decision-making and may result in improved health and quality of life for older adults with MCC. |
| doi_str_mv | 10.1136/bmjopen-2018-023345 |
| format | Article |
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Interview transcripts were analysed and coded using Thorne’s interpretive description approach.ResultsFive themes were identified representing older adults' experiences of living with MCC: (a) trying to stay healthy while living with MCC, (b) depending on family caregivers for support with just about everything, (c) paying the high costs of living with MCC, (d) making healthcare decisions by proxy and (e) receiving healthcare services that do not address the complex needs of persons living with MCC.ConclusionsThe experience of living with MCC in the community was complex and multi-faceted. The need for a person-centred and family-centred approach to care in the community, which includes the coordination of health and social services that are tailored to the needs of older adults and their informal caregivers, was underscored. Such an approach would facilitate improved information-sharing and discussion of care management options between health professionals and their patients, enable older adults with MCC to actively engage in priority-setting and decision-making and may result in improved health and quality of life for older adults with MCC.</description><identifier>ISSN: 2044-6055</identifier><identifier>EISSN: 2044-6055</identifier><identifier>DOI: 10.1136/bmjopen-2018-023345</identifier><identifier>PMID: 30898800</identifier><language>eng</language><publisher>England: BMJ Publishing Group LTD</publisher><subject>Aged ; Aged, 80 and over ; Caregivers ; Chronic illnesses ; Community support ; Comorbidity ; Councils ; Data collection ; Decision Making ; Dementia ; Diabetes ; Engineering research ; Female ; Health care ; Humanities ; Humans ; Independent Living - psychology ; Interviews ; Interviews as Topic ; Male ; Medical research ; Mortality ; Multiple Chronic Conditions - psychology ; Multiple Chronic Conditions - therapy ; Older people ; Ontario ; Patient-centered care ; Patients ; Primary care ; Qualitative Research ; Quality of Health Care ; Quality of Life ; Social sciences</subject><ispartof>BMJ open, 2019-03, Vol.9 (3), p.e023345-e023345</ispartof><rights>Author(s) (or their employer(s)) 2019. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ.</rights><rights>2019 Author(s) (or their employer(s)) 2019. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ. This is an open access article distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited, appropriate credit is given, any changes made indicated, and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/ . Notwithstanding the ProQuest Terms and Conditions, you may use this content in accordance with the terms of the License.</rights><rights>Author(s) (or their employer(s)) 2019. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ. 2019</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-b472t-3d7ae7ff27326573188380ee148943b60e860d6b64ed4a3b07b0c434a066cda73</citedby><cites>FETCH-LOGICAL-b472t-3d7ae7ff27326573188380ee148943b60e860d6b64ed4a3b07b0c434a066cda73</cites><orcidid>0000-0001-8168-8449</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://bmjopen.bmj.com/content/9/3/e023345.full.pdf$$EPDF$$P50$$Gbmj$$Hfree_for_read</linktopdf><linktohtml>$$Uhttps://bmjopen.bmj.com/content/9/3/e023345.full$$EHTML$$P50$$Gbmj$$Hfree_for_read</linktohtml><link.rule.ids>230,314,723,776,780,860,881,27526,27527,27901,27902,53766,53768,77344,77375</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/30898800$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Ploeg, Jenny</creatorcontrib><creatorcontrib>Canesi, Marta</creatorcontrib><creatorcontrib>D Fraser, Kimberly</creatorcontrib><creatorcontrib>McAiney, Carrie</creatorcontrib><creatorcontrib>Kaasalainen, Sharon</creatorcontrib><creatorcontrib>Markle-Reid, Maureen</creatorcontrib><creatorcontrib>Dufour, Sinead</creatorcontrib><creatorcontrib>Garland Baird, Lisa</creatorcontrib><creatorcontrib>Chambers, Tracey</creatorcontrib><title>Experiences of community-dwelling older adults living with multiple chronic conditions: a qualitative study</title><title>BMJ open</title><addtitle>BMJ Open</addtitle><description>ObjectivesThe aim of the study was to understand the experiences of living with multiple chronic conditions (MCC) from the perspective of community-living older adults with MCC.DesignA qualitative study using an interpretive description approach.SettingParticipants were recruited from southern Ontario, Canada.Participants21 community-living, older adults (≥65 years) with an average of 7.4 chronic conditions including one of diabetes, dementia or stroke.MethodsData were collected through digitally-recorded, in-depth, semi-structured in-person interviews. Interview transcripts were analysed and coded using Thorne’s interpretive description approach.ResultsFive themes were identified representing older adults' experiences of living with MCC: (a) trying to stay healthy while living with MCC, (b) depending on family caregivers for support with just about everything, (c) paying the high costs of living with MCC, (d) making healthcare decisions by proxy and (e) receiving healthcare services that do not address the complex needs of persons living with MCC.ConclusionsThe experience of living with MCC in the community was complex and multi-faceted. The need for a person-centred and family-centred approach to care in the community, which includes the coordination of health and social services that are tailored to the needs of older adults and their informal caregivers, was underscored. Such an approach would facilitate improved information-sharing and discussion of care management options between health professionals and their patients, enable older adults with MCC to actively engage in priority-setting and decision-making and may result in improved health and quality of life for older adults with MCC.</description><subject>Aged</subject><subject>Aged, 80 and over</subject><subject>Caregivers</subject><subject>Chronic illnesses</subject><subject>Community support</subject><subject>Comorbidity</subject><subject>Councils</subject><subject>Data collection</subject><subject>Decision Making</subject><subject>Dementia</subject><subject>Diabetes</subject><subject>Engineering research</subject><subject>Female</subject><subject>Health care</subject><subject>Humanities</subject><subject>Humans</subject><subject>Independent Living - psychology</subject><subject>Interviews</subject><subject>Interviews as Topic</subject><subject>Male</subject><subject>Medical research</subject><subject>Mortality</subject><subject>Multiple Chronic Conditions - psychology</subject><subject>Multiple Chronic Conditions - therapy</subject><subject>Older people</subject><subject>Ontario</subject><subject>Patient-centered care</subject><subject>Patients</subject><subject>Primary care</subject><subject>Qualitative Research</subject><subject>Quality of Health Care</subject><subject>Quality of Life</subject><subject>Social sciences</subject><issn>2044-6055</issn><issn>2044-6055</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2019</creationdate><recordtype>article</recordtype><sourceid>9YT</sourceid><sourceid>ACMMV</sourceid><sourceid>EIF</sourceid><sourceid>BENPR</sourceid><recordid>eNqNkU9r3DAQxU1paEKaTxAogl56cap_luUeCiWkSSHQS3IWsjTOamtLjiRvst--WnYb0p6qi8To9x4z86rqnOALQpj43E_rMIOvKSayxpQx3rypTijmvBa4ad6-eh9XZymtcTm86ZqGvquOGZadlBifVL-unmeIDryBhMKATJimxbu8re0TjKPzDyiMFiLSdhlzQqPb7GpPLq_QVCpuHgGZVQzemSL21mUXfPqCNHpc9Oiyzm4DKOXFbt9XR4MeE5wd7tPq_vvV3eVNffvz-sflt9u65y3NNbOthnYYaMuoaFpGpGQSAxAuO856gUEKbEUvOFiuWY_bHhvOuMZCGKtbdlp93fvOSz-BNeBz1KOao5t03Kqgnfr7x7uVeggbJXjbUNYVg08HgxgeF0hZTS6Zsg7tISxJUdKJAhIiCvrxH3QdlujLeDuqQKLtaKHYnjIxpBRheGmGYLXLUx3yVLs81T7Povrweo4XzZ_0CnCxB4r6vxx_A3aHrkE</recordid><startdate>20190320</startdate><enddate>20190320</enddate><creator>Ploeg, Jenny</creator><creator>Canesi, Marta</creator><creator>D Fraser, Kimberly</creator><creator>McAiney, Carrie</creator><creator>Kaasalainen, Sharon</creator><creator>Markle-Reid, Maureen</creator><creator>Dufour, Sinead</creator><creator>Garland Baird, Lisa</creator><creator>Chambers, Tracey</creator><general>BMJ Publishing Group LTD</general><general>BMJ Publishing Group</general><scope>9YT</scope><scope>ACMMV</scope><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>3V.</scope><scope>7RV</scope><scope>7X7</scope><scope>7XB</scope><scope>88E</scope><scope>88G</scope><scope>8FI</scope><scope>8FJ</scope><scope>8FK</scope><scope>ABUWG</scope><scope>AFKRA</scope><scope>AZQEC</scope><scope>BENPR</scope><scope>BTHHO</scope><scope>CCPQU</scope><scope>DWQXO</scope><scope>FYUFA</scope><scope>GHDGH</scope><scope>GNUQQ</scope><scope>K9-</scope><scope>K9.</scope><scope>KB0</scope><scope>M0R</scope><scope>M0S</scope><scope>M1P</scope><scope>M2M</scope><scope>NAPCQ</scope><scope>PIMPY</scope><scope>PQEST</scope><scope>PQQKQ</scope><scope>PQUKI</scope><scope>PRINS</scope><scope>PSYQQ</scope><scope>Q9U</scope><scope>7X8</scope><scope>5PM</scope><orcidid>https://orcid.org/0000-0001-8168-8449</orcidid></search><sort><creationdate>20190320</creationdate><title>Experiences of community-dwelling older adults living with multiple chronic conditions: a qualitative study</title><author>Ploeg, Jenny ; Canesi, Marta ; D Fraser, Kimberly ; McAiney, Carrie ; Kaasalainen, Sharon ; Markle-Reid, Maureen ; Dufour, Sinead ; Garland Baird, Lisa ; Chambers, Tracey</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-b472t-3d7ae7ff27326573188380ee148943b60e860d6b64ed4a3b07b0c434a066cda73</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2019</creationdate><topic>Aged</topic><topic>Aged, 80 and over</topic><topic>Caregivers</topic><topic>Chronic illnesses</topic><topic>Community support</topic><topic>Comorbidity</topic><topic>Councils</topic><topic>Data collection</topic><topic>Decision Making</topic><topic>Dementia</topic><topic>Diabetes</topic><topic>Engineering research</topic><topic>Female</topic><topic>Health care</topic><topic>Humanities</topic><topic>Humans</topic><topic>Independent Living - psychology</topic><topic>Interviews</topic><topic>Interviews as Topic</topic><topic>Male</topic><topic>Medical research</topic><topic>Mortality</topic><topic>Multiple Chronic Conditions - psychology</topic><topic>Multiple Chronic Conditions - therapy</topic><topic>Older people</topic><topic>Ontario</topic><topic>Patient-centered care</topic><topic>Patients</topic><topic>Primary care</topic><topic>Qualitative Research</topic><topic>Quality of Health Care</topic><topic>Quality of Life</topic><topic>Social sciences</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Ploeg, Jenny</creatorcontrib><creatorcontrib>Canesi, Marta</creatorcontrib><creatorcontrib>D Fraser, Kimberly</creatorcontrib><creatorcontrib>McAiney, Carrie</creatorcontrib><creatorcontrib>Kaasalainen, Sharon</creatorcontrib><creatorcontrib>Markle-Reid, Maureen</creatorcontrib><creatorcontrib>Dufour, Sinead</creatorcontrib><creatorcontrib>Garland Baird, Lisa</creatorcontrib><creatorcontrib>Chambers, Tracey</creatorcontrib><collection>BMJ Open Access Journals</collection><collection>BMJ Journals:Open Access</collection><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>ProQuest Central (Corporate)</collection><collection>Nursing & Allied Health Database</collection><collection>Health & Medical Collection</collection><collection>ProQuest Central (purchase pre-March 2016)</collection><collection>Medical Database (Alumni Edition)</collection><collection>Psychology Database (Alumni)</collection><collection>Hospital Premium Collection</collection><collection>Hospital Premium Collection (Alumni Edition)</collection><collection>ProQuest Central (Alumni) (purchase pre-March 2016)</collection><collection>ProQuest Central (Alumni Edition)</collection><collection>ProQuest Central UK/Ireland</collection><collection>ProQuest Central Essentials</collection><collection>ProQuest Central</collection><collection>BMJ Journals</collection><collection>ProQuest One Community College</collection><collection>ProQuest Central Korea</collection><collection>Health Research Premium Collection</collection><collection>Health Research Premium Collection (Alumni)</collection><collection>ProQuest Central Student</collection><collection>Consumer Health Database (Alumni Edition)</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>Nursing & Allied Health Database (Alumni Edition)</collection><collection>Consumer Health Database</collection><collection>Health & Medical Collection (Alumni Edition)</collection><collection>Medical Database</collection><collection>ProQuest Psychology</collection><collection>Nursing & Allied Health Premium</collection><collection>Publicly Available Content Database</collection><collection>ProQuest One Academic Eastern Edition (DO NOT USE)</collection><collection>ProQuest One Academic</collection><collection>ProQuest One Academic UKI Edition</collection><collection>ProQuest Central China</collection><collection>ProQuest One Psychology</collection><collection>ProQuest Central Basic</collection><collection>MEDLINE - Academic</collection><collection>PubMed Central (Full Participant titles)</collection><jtitle>BMJ open</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Ploeg, Jenny</au><au>Canesi, Marta</au><au>D Fraser, Kimberly</au><au>McAiney, Carrie</au><au>Kaasalainen, Sharon</au><au>Markle-Reid, Maureen</au><au>Dufour, Sinead</au><au>Garland Baird, Lisa</au><au>Chambers, Tracey</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Experiences of community-dwelling older adults living with multiple chronic conditions: a qualitative study</atitle><jtitle>BMJ open</jtitle><addtitle>BMJ Open</addtitle><date>2019-03-20</date><risdate>2019</risdate><volume>9</volume><issue>3</issue><spage>e023345</spage><epage>e023345</epage><pages>e023345-e023345</pages><issn>2044-6055</issn><eissn>2044-6055</eissn><abstract>ObjectivesThe aim of the study was to understand the experiences of living with multiple chronic conditions (MCC) from the perspective of community-living older adults with MCC.DesignA qualitative study using an interpretive description approach.SettingParticipants were recruited from southern Ontario, Canada.Participants21 community-living, older adults (≥65 years) with an average of 7.4 chronic conditions including one of diabetes, dementia or stroke.MethodsData were collected through digitally-recorded, in-depth, semi-structured in-person interviews. Interview transcripts were analysed and coded using Thorne’s interpretive description approach.ResultsFive themes were identified representing older adults' experiences of living with MCC: (a) trying to stay healthy while living with MCC, (b) depending on family caregivers for support with just about everything, (c) paying the high costs of living with MCC, (d) making healthcare decisions by proxy and (e) receiving healthcare services that do not address the complex needs of persons living with MCC.ConclusionsThe experience of living with MCC in the community was complex and multi-faceted. The need for a person-centred and family-centred approach to care in the community, which includes the coordination of health and social services that are tailored to the needs of older adults and their informal caregivers, was underscored. Such an approach would facilitate improved information-sharing and discussion of care management options between health professionals and their patients, enable older adults with MCC to actively engage in priority-setting and decision-making and may result in improved health and quality of life for older adults with MCC.</abstract><cop>England</cop><pub>BMJ Publishing Group LTD</pub><pmid>30898800</pmid><doi>10.1136/bmjopen-2018-023345</doi><orcidid>https://orcid.org/0000-0001-8168-8449</orcidid><oa>free_for_read</oa></addata></record> |
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| subjects | Aged Aged, 80 and over Caregivers Chronic illnesses Community support Comorbidity Councils Data collection Decision Making Dementia Diabetes Engineering research Female Health care Humanities Humans Independent Living - psychology Interviews Interviews as Topic Male Medical research Mortality Multiple Chronic Conditions - psychology Multiple Chronic Conditions - therapy Older people Ontario Patient-centered care Patients Primary care Qualitative Research Quality of Health Care Quality of Life Social sciences |
| title | Experiences of community-dwelling older adults living with multiple chronic conditions: a qualitative study |
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