title: Older adults' perception of chronic illness management in South Korea.
abstract: OBJECTIVE
  Despite the recent emphasis on a patient-centered chronic care model, few studies have investigated its use in older adults in South Korea. We explored how older Korean adults perceive and cope with their chronic illness.
  
  
  METHODS
  We conducted focus group interviews in Seoul, Korea in January 2010. Focus groups were formed by disease type (hypertension and type 2 diabetes) and gender using purposive sampling. Inclusion criteria were patients aged 60 and over who had been diagnosed with diabetes or hypertension and received care at a community health center for at least six months prior to participation. Interview data were analyzed through descriptive content analysis.
  
  
  RESULTS
  Among personal factors, most participants felt overwhelmed when they received their diagnosis. However, with time and control of their acute symptoms using medication, their worry diminished and participants tended to denying being identified as a patient or sick person. Among socio-familial factors, participants reported experiencing stigma with their chronic illness and feeling it was a symbol of weakness. Instead of modifying their lifestyles, which might interfere with their social relationships, they resorted to only following their medicine regime prescribed by their doctor. Participants also reported feeling that their doctor only prescribed medications and acted in an authoritative and threatening manner to induce and reinforce participants' compliance with treatment.
  
  
  CONCLUSIONS
  For successful patient-centered management of chronic illnesses, supportive environments that include family, friends, and healthcare providers should be established.
  
  
  
  Despite the recent emphasis on a patient-centered chronic care model, few studies have investigated its use in older adults in South Korea. We explored how older Korean adults perceive and cope with their chronic illness.
  
  
  
  We conducted focus group interviews in Seoul, Korea in January 2010. Focus groups were formed by disease type (hypertension and type 2 diabetes) and gender using purposive sampling. Inclusion criteria were patients aged 60 and over who had been diagnosed with diabetes or hypertension and received care at a community health center for at least six months prior to participation. Interview data were analyzed through descriptive content analysis.
  
  
  
  Among personal factors, most participants felt overwhelmed when they received their diagnosis. However, with time and control of their acute symptoms using medication, their worry diminished and participants tended to denying being identified as a patient or sick person. Among socio-familial factors, participants reported experiencing stigma with their chronic illness and feeling it was a symbol of weakness. Instead of modifying their lifestyles, which might interfere with their social relationships, they resorted to only following their medicine regime prescribed by their doctor. Participants also reported feeling that their doctor only prescribed medications and acted in an authoritative and threatening manner to induce and reinforce participants’ compliance with treatment.
  
  
  
  For successful patient-centered management of chronic illnesses, supportive environments that include family, friends, and healthcare providers should be established.
authors.affiliation: Department of Public Administration, College of Social Sciences, Ewha Womans University, Seoul, Korea.
authors.forename: Minah
authors.initials: M
authors.lastname: Kang
authors.affiliation: Health Services Research Center, Hallym University, Seoul, Korea.
authors.forename: Jaiyong
authors.initials: J
authors.lastname: Kim
authors.affiliation: Health Services Research Center, Hallym University, Seoul, Korea ; Department of Social and Preventive Medicine, Hallym University College of Medicine, Chuncheon, Korea.
authors.forename: Sang-Soo
authors.initials: SS
authors.lastname: Bae
authors.affiliation: Health Services Research Center, Hallym University, Seoul, Korea ; Department of Social and Preventive Medicine, Hallym University College of Medicine, Chuncheon, Korea.
authors.forename: Yong-Jun
authors.initials: YJ
authors.lastname: Choi
authors.affiliation: Division of Nursing, Hallym University, Chuncheon, Korea.
authors.forename: Dong-Soo
authors.initials: DS
authors.lastname: Shin
mesh_terms: D000368:Aged; D002908:Chronic Disease; D003151:Community Health Centers; D003924:Diabetes Mellitus, Type 2 / Q000175:diagnosis*; D019468:Disease Management; D005260:Female; D017144:Focus Groups; D006801:Humans; D006973:Hypertension / Q000175:diagnosis*; D007407:Interviews as Topic; D008019:Life Style; D008297:Male; D008875:Middle Aged; D010465:Perception; D056910:Republic of Korea; D012944:Social Support
keywords: Chronic disease; Elders; Perception