Navigating life and health care. A qualitative study of the lived experience of complex multimorbidity in Denmark
Anne Grøndahl Poulsen, Mia Fredens, Stina Lou, Nasrin Tayyari Dehbarez, Camilla Palmhøj Nielsen, Lotte Groth JensenAbstract
Aim:
This study aimed to explore how individuals with complex multimorbidity perceive and experience the management of their health in everyday life and healthcare encounters.
Background:
Patients with two or more health conditions may be challenging for general practitioners (GPs) who must provide adequate treatment(-s) in a healthcare system structured mainly around single-disease models. For patients, the lived experience of this multimorbidity can be demanding, as it often involves managing multiple appointments, medications, and medical advice alongside everyday life. This situation may be particularly challenging for patients who live with multiple physical and mental health conditions.
Methods:
Semi-structured individual interviews with eight individuals with complex multimorbidity living in Denmark. Analysis was guided by thematic analysis.
Findings:
The analysis resulted in two main themes. First, ‘Multiple diagnoses – not multimorbidity’ describes how the participants did not expect overall continuity across diagnoses but appreciated recognition of the cumulative burden of multimorbidity. They expected continuity within each speciality and developed agentic strategies to achieve this. Some were successful; others were not. Second, ‘Managing treatment and illness in everyday life’ describes how the participants navigated tensions between medical recommendations and personal priorities as they deliberately pursued valued activities at the expense of their long- or short-term health. A professional lifeline, was a significant support for the participant. This person was often the GP. These findings underscore the active role of patients and the GP’s role in recognizing their resources to develop patient-centred care that is responsive to and realistic for the individual patient.