Prioritizing social identities: Patients’ perspective on living with multimorbidity

Abstract

Objective: This article explores experiences of people with multimorbidity, and attempts to advance understandings of the complexity of living with multimorbidity outside the medical encounter in a social identity theoretical framework. Method: This is a qualitative study using individual semi-structured interviews among nine persons living with multimorbidity. The interviews are analysed inductively according to thematic content analysis. Results: The emerging themes are: 1) Impact on daily life, 2) Professional life and 3) Capacity for handling multimorbidity. People with multimorbidity experience physical limitations and psychological distress, which limits their ability to maintain social relations and affiliation to the labour market. Accordingly, they are challenged in their ability to retain a sense of normal everyday life, which is mediated by their capacity for handling multimorbidity. Discussion: Multimorbidity may compromise various social identities. The complexity of living with multimorbidity is increased by an aspiration to maintain valued social identities in order to preserve a coherent sense of self and a normal everyday life. This study suggests an increased focus on individual priorities and values outside the medical encounter, and argues in favour of recognizing the conflicts that people experience as they try to balance multimorbidity with other important aspects of their daily lives.

Everyday Lives of Middle-Aged Persons with Multimorbidity: A Mixed Methods Systematic Review

“…Others reported that their illnesses had negatively affected their family relationships or led to the break-up of their marriages. These findings were also confirmed by Cheng et al [ 27 ], Morgan et al [ 41 ] and Sand et al [ 51 ].…”

“…In Noël et al [ 45 ], the most frequently mentioned effects of multimorbidity on physical functioning were decreased mobility, physical limitations, pain and fatigue. Such physical limitations were also mentioned by some of the participants with multimorbidity in Sand et al [ 51 ]. In Cheng et al [ 27 ] the most common and serious issues reported by Chinese adults were physical limitations associated with their multiple chronic conditions.…”

“…All included studies had clear research questions and collected data that addressed the research questions. The 13 qualitative studies [ 27 , 41 , 45 , 46 , 47 , 49 , 51 , 55 , 57 , 60 , 61 , 63 , 64 ] had a low RoB. The quality of the 30 quantitative studies [ 24 , 25 , 26 , 28 , 29 , 30 , 31 , 33 , 34 , 35 , 36 , 37 , 38 , 39 , 40 , 42 , 43 , 44 , 48 , 50 , 52 , 53 , 54 , 56 , 58 , 59 , 62 , 65 , 66 , 67 ] varied, with 26 studies [ 24 , 25 , 28 , 29 , 30 , 31 , 33 , 34 , 35 , 36 , …”

“…Four studies described the impact the participants’ multiple illnesses and associated physical limitations had on their everyday lives [ 41 , 45 , 51 , 69 ]. In Noël et al [ 45 ], the most frequently mentioned effects of multimorbidity on physical functioning were decreased mobility, physical limitations, pain and fatigue.…”

“…Eighteen studies [ 25 , 26 , 27 , 31 , 33 , 41 , 43 , 45 , 47 , 48 , 51 , 52 , 54 , 55 , 59 , 63 , 65 , 67 ] explored psychosocial functioning in middle-aged persons with multimorbidity.…”