Coping with multimorbidity in old age--a qualitative study.
BACKGROUND
Comparatively few studies address the problems related to multimorbidity. This is surprising, since multimorbidity is a particular challenge for both general practitioners and patients. This study focuses on the latter, analyzing the way patients aged 65-85 cope with multimorbidity.


METHODS
19 narrative in-depth interviews with multimorbid patients were conducted. The data was analysed using grounded theory. Of the 19 interviewed patients 13 were female and 6 male. Mean age was 75 years. Participating patients showed a relatively homogeneous socio-economic status. Patients were recruited from the German city of Hamburg and the state of North Rhine-Westphalia.


RESULTS
Despite suffering from multimorbidity, interviewees held positive attitudes towards life: At the social level, patients tried to preserve their autonomy to the most possible extent. At the emotional level, interviewees oscillated between anxiety and strength - having, however, a positive approach to life. At the practical level, patients aimed at keeping their diseases under control. The patients tended to be critical in regards to medication.


CONCLUSIONS
These findings might have implications for the treatment of multimorbid patients in primary care and further research: The generally presumed passivity of older individuals towards medical treatment, which can be found in literature, is not evident among our sample of older patients. In future, treatment of these patients might take their potential for pro-active cooperation more strongly into account than it is currently the case.
Institute of General Practice, Universitätsmedizin Rostock, Doberaner Str, 142, Rostock, 18057, Germany. christin.loeffler@med.uni-rostock.de
Christin
C
Löffler
Hanna
H
Kaduszkiewicz
Carl-Otto
CO
Stolzenbach
Waldemar
W
Streich
Angela
A
Fuchs
Hendrik
H
van den Bussche
Friederike
F
Stolper
Attila
A
Altiner
D000203:Activities of Daily Living / Q000523:psychology*; D000223:Adaptation, Psychological; D000368:Aged; D000369:Aged, 80 and over; D000375:Aging / Q000502:physiology / Q000523:psychology*; D002908:Chronic Disease / Q000523:psychology* / Q000628:therapy; D015897:Comorbidity; D005191:Family Characteristics; D005260:Female; D005858:Germany; D015438:Health Behavior; D006801:Humans; D007407:Interviews as Topic; D008297:Male; D033262:Narration; D010342:Patient Acceptance of Health Care / Q000523:psychology; D026684:Personal Autonomy; D036301:Qualitative Research; D012648:Self Care / Q000379:methods / Q000523:psychology; D012923:Social Class