title: What matters in "multimorbidity"? Arguably resilience and personal health experience are central to quality of life and optimizing survival.
abstract: BACKGROUND
  Much is written about "multimorbidity" as it is a difficult problem for health systems, as it reflects a complex phenomenon unique to each individual health journey and health service context. This paper proposes the adoption of 2 constructs or knowledge streams into mainstream "multimorbidity" care which are arguably most important to person-centered care-personal health perceptions and resilience.
  
  
  METHODS
  "Multimorbidity" is the manifestation of multiple nonlinear physical, psychosocial, and environmental phenomena in an individual health journey. Multimorbidity encompasses very stable states for the most part together with highly unstable phases that are difficult to manage. Averting or controlling the underlying loss of resilience in instability can be challenging without early warning signals pointing towards tipping points. Monitoring resilience and early warning signals for tipping points is new to health care. Yet what should we monitor in the complexity of multimorbidity? There are multiple and competing health service features and biometrics that can be measured. However, an expanding of literature endorses importance of simply asking a person about their self-rated health in order to provide predictions of their resilience and survival. Interoception, exemplified as self-rated health, arises from internal neurocognitive self-monitoring functions of different internal and external phenomena. Interoception is being to be recognized as predictors and barometers of resilience and survival.
  
  
  CONCLUSIONS
  Two phenomena of human systems-interoception and resilience-can guide care in the complex nature of multimorbidity in unstable health journeys and should be incorporated into clinical practice.
authors.affiliation: Department of Public Health and Primary Care, Trinity College Dublin, Dublin, Ireland.
authors.forename: Carmel Mary
authors.identifier: http://orcid.org/0000-0001-8174-7859
authors.initials: CM
authors.lastname: Martin
mesh_terms: D019468:Disease Management; D006304:Health Status; D006801:Humans; D008603:Mental Health; D000071069:Multiple Chronic Conditions / Q000453:epidemiology* / Q000523:psychology*; D018802:Patient-Centered Care / Q000458:organization & administration*; D011788:Quality of Life; D055500:Resilience, Psychological; D012720:Severity of Illness Index