"So I call myself healthy": a qualitative study on health perceptions and healthcare experiences in older adults with multimorbidity.

Abstract

An ageing population and its association with a rising prevalence of co-existing multiple chronic conditions poses increasing challenges for healthcare systems worldwide. In line with the World Health Organization ambition for societies to develop integrated care models and person-centered care, this study aimed to investigate what health means for individuals managing multiple chronic conditions and how these patients navigate a healthcare system primarily designed for single-disease management. A six-phase reflexive thematic analysis was conducted on 16 individual interviews with patients aged 67 to 87 years old in a Swedish primary care setting. Two themes were developed. Firstly, Resiliently Positioning as Non-Sick that centered on how participants employed internal strategies to position their identity on the non-sick side of a health spectrum, and secondly, Placing Yourself in the Hands of Healthcare, which focused on the mixed feelings towards interacting with healthcare. Older individuals with multiple conditions tend to identify as non-sick and strive for autonomy. Engaging with healthcare can pose a threat to both their autonomy and their non-sick identity. They desire healthcare that works holistically, focuses on health and function, and avoids stigmatizing terms like multimorbidity. We recommend that policymakers and healthcare providers integrate this understanding and support for autonomy and holistic approaches into their efforts to deliver person-centered care.