title: Striving for control: cognitive, self-care, and faith strategies employed by vulnerable black and white older adults with multiple chronic conditions.
abstract: The average older adult reaches age 65 with at least two chronic, co-occurring illnesses, or multiple morbidities (MM). We currently lack critical information about the specific strategies older adults use to attempt to control these MM. To increase our understanding of how older adults attempt to manage these MM and retain control of their health, in-depth interviews were conducted with 41 Black and White middle aged and older men and women with MM. We were particularly interested in representing the experience of those groups more vulnerable to adverse health outcomes due to greater disease prevalence and low income. During in-depth interviews, we asked open-ended questions on life and health history and open-ended and semi-structured questions about self-care for multiple morbidities. Participants expressed a strong desire to remain in control of their health; to do so they employed a wide range of strategies including cognitive structuring techniques (being health vigilant, normalizing, resignation/relinquishing control, and social comparison), self-care activities (emphasizing diet, exercise, medication taking, modifying existing activities, going to the doctor), and faith orientations (prayer as a constructive support strategy, gaining strength from God, church as a central part of life). With the exception of faith orientations, there were no race/ethnicity differences in the strategies participants use. Future studies should expand on this knowledge by exploring the contextual, cultural, and psychological backdrop and characteristics that shape the use of these coping strategies.
authors.affiliation: Cancer Prevention Fellow, National Cancer Institute and Master of Public Health Student, Harvard School of Public Health, 677 Huntington Avenue, Boston, MA 02115, USA. cleach@hsph.harvard.edu
authors.forename: Corinne R
authors.initials: CR
authors.lastname: Leach
authors.forename: Nancy E
authors.initials: NE
authors.lastname: Schoenberg
mesh_terms: D001741:Black or African American; D000368:Aged; D000369:Aged, 80 and over; D002908:Chronic Disease / Q000208:ethnology* / Q000523:psychology; D003071:Cognition; D015897:Comorbidity; D005260:Female; D006801:Humans; D007407:Interviews as Topic; D008297:Male; D008875:Middle Aged; D012648:Self Care; D029181:Spirituality; D014481:United States; D035862:Vulnerable Populations; D044465:White People