Cascading crises, resilience and social support within the onset and development of multiple chronic conditions

Sells, Dave; Sledge, William H.; Wieland, Melissa; Walden, D. B.; Flanagan, Elizabeth; Miller, Rebecca; Davidson, Larry

doi:10.1177/1742395309104166

Cited by 63 publications

(112 citation statements)

References 25 publications

(27 reference statements)

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“…While a majority of older adults rate their perceived health, well-being and daily functional ability (indicators of successful aging) as high even in the face of chronic conditions [4,5], multimorbidity remains a major contributor to disability, deaths, and health care costs [6]. Cascading effects of multiple chronic health conditions [7] and their potentially synergetic deleterious health-related and social consequences [8,9] make co-occurrence of illness a major public health issue, for instance, increasing functional disability, social isolation and health care utilization, as well as lowering psychological well-being. The health impacts of multimorbidity are further compounded by the combination of longer life expectancies, compression of morbidity, changing lifestyles, earlier and more intensive treatment, and for many countries, larger cohorts (i.e., baby boomers) transitioning into advanced ages [10,11].…”

Section: Introductionmentioning

confidence: 99%

Multimorbidity, Health, and Aging in Canada and Australia: A Tale of Two Countries

Wister

Kendig

Mitchell

et al. 2017

Innovation in Aging

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Background: Multimorbidity has been recognized as a major public health issue, negatively affecting health-related quality of life, including physical, functional, mental, emotional, and social domains, as well as increasing health care utilization. This exploratory study examines selected health outcomes associated with multimorbidity across older age groups/cohorts and gender, comparing Canada and Australia. Methods: Data were drawn from the 2008/09 Canadian Community Health Survey and the 2009 Australian HILDA survey. Seven major chronic conditions were identical across the two data sets, and were combined into an additive measure of multimorbidity. OLS and logistic regression models were performed within age group (45-54, 55-64, 65-74, 75+) and gender to estimate associations between multimorbidity and several health-related outcomes, including: loneliness, life satisfaction, perceived health, mobility restriction, and hospital stays, adjusting for marital status, education and foreign born status. Results: Overall, country-level differences were identified for perceptions of loneliness, life satisfaction, and perceived health. Australians tended to experience a greater risk of loneliness and lower self-rated health in the face of multimorbidity than Canadians, especially among older men. Canadians tended to experience lower life satisfaction associated with multimorbidity than Australians. No country-level differences were identified for associations between multimorbidity and hospital stays or mobility limitations. Conclusions: The associations between multimorbidity and health are similar between the two countries but are variable depending on population, age group/cohort, and gender. The strongest country-level associations are for indicators of health-related quality of life, rather than health care or mobility limitation outcomes.

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Section: Introductionmentioning

confidence: 99%

Multimorbidity, Health, and Aging in Canada and Australia: A Tale of Two Countries

Wister

Kendig

Mitchell

et al. 2017

Innovation in Aging

View full text Add to dashboard Cite

show abstract

“…In contrast to the stable priorities presented above, most participants during their accounts or study periods described a more fluid scenario whereby their main condition changed over time. For a small number, this was shaped by what has been described as a "cascade of crises" (37), whereby the individual is seemingly overwhelmed by a series of health-related issues that lead to psychological and social challenges. The excerpt below highlights the practical issue of managing the finite resource of time, which is constantly reapportioned in line with new health issues arising from the participant's multiple conditions: "It's not been a straightforward thing for me.…”

Section: Resultsmentioning

confidence: 99%

Patient Priorities in Osteoarthritis and Comorbid Conditions: A Secondary Analysis of Qualitative Data

Cheraghi-Sohi

Bower

Kennedy

et al. 2013

Arthritis Care & Research

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Objective. A lack of agreement between clinician and patient priorities can impact the clinician-patient relationship, treatment concordance, and potential health outcomes. Studies have suggested that patients with osteoarthritis (OA) may prioritize comorbidities over their OA, but as yet no explicit systematic exploration of OA patients' priorities in relation to comorbidities exists. This study aims to explore how patients prioritize their OA among their conditions, which factors underlie this prioritization, and whether and why these priorities change over time.

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“…Families tend to prioritize the treatment of illnesses based on the degree of pain experienced and evidence of physical deterioration that interferes with quality of life. [29][30][31] Sells et al 30 label this behavior a virtual cascade of crises (p. 95). For these high-cholesterol patients, the nonexistence of symptoms is positively associated with the evaluation of high cholesterol as nothing to be truly concerned.…”

Section: What If Either-or Both-and According To Whom?mentioning

confidence: 99%

If my cholesterol is…then I foresee…: patient accounts of uncertainty

Drummond

2017

Qual Res Med Healthc

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The author examines the talk of patients with high cholesterol as they discuss their experiences of adding a statin to their treatment regimen. The primary objective was to understand patients' expectations of statins, and their beliefs and feelings as they continued or discontinued use, and to better understand why adherence to a statin regimen is particularly low. While numerous studies report reasons for nonadherence, few apply theory to provide plausible explanations. Analysis of the focus group data revealed three major themes. First, patients do not view high cholesterol as serious in light of other major health problems like diabetes and cancer within the household. Second, patients believe statins are effective in lowering cholesterol but risky. Third, many patients do not understand how high levels of cholesterol are produced in the body and how statins interrupt that process. Problematic integration theory is used to explain the uncertainty patients experience when given a diagnosis of high cholesterol, the use of statins to control it, and the quality of information received about both cholesterol and statins.

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Cascading crises, resilience and social support within the onset and development of multiple chronic conditions

Cited by 63 publications

References 25 publications

Multimorbidity, Health, and Aging in Canada and Australia: A Tale of Two Countries

Multimorbidity, Health, and Aging in Canada and Australia: A Tale of Two Countries

Patient Priorities in Osteoarthritis and Comorbid Conditions: A Secondary Analysis of Qualitative Data

If my cholesterol is…then I foresee…: patient accounts of uncertainty

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