A mixed analysis approach to elucidate the multiple chronic condition experience of English- and Spanish-speaking older adults

Abstract

Background

Having multiple chronic conditions (MCCs) is the most common health condition in older adults. The management of each condition presents many challenges. A key factor in patients’ ability to manage their own health care is their level of health literacy.

Purpose

The purpose of this mixed analysis study was to elucidate the experience of older adults living with MCCs and identify associations among the experiences to determine targets for future mobile health (mHealth) interventions focused on MCCs and health literacy.

Participants and methods

Using the Abilities, Skills, and Knowledge Model as a framework, semi-structured interviews were completed with 25 older adults in English and Spanish. Interviews were analyzed using inductive thematic analysis and hierarchical cluster analysis.

Results

The main themes from these results included 1) Reflections of chronic disease; 2) Emotional aspects of chronic disease; 3) Physical barriers to well-being; 4) Quality-of-care factors; and 5) Cognitive strategies for self-management. Qualitative results highlighted the importance of a multi-targeted approach to chronic disease self-management (CDSM). Cluster analysis identified associations within the qualitative data, revealing the importance of the subthemes related to coping with pain and the impact of the patient–provider relationship on treatment adherence.

Conclusion

Results support the utility of mHealth interventions to improve health literacy and promote CDSM.

Keywords:

• multimorbidity
• mHealth
• self-management
• qualitative
• cluster analysis
• treatment adherence

Acknowledgments

This study was supported by grants from the US National Heart, Lung, and Blood Institute (R56HL096578 05A1) and the National Institute on Minority Health and Health Disparities (RO1MD010368). The funders had no role in the design of the study, in the collection, analyses, or interpretation of data, in the writing of the manuscript, and in the decision to publish the results.

Disclosure

Dr Raymond L Ownby reports grants from the US National Institute on Minority Health and Health Disparities, during the conduct of the study, and another from Enalan Communications, Inc., outside the submitted work. In addition, Dr Ownby has a provisional patent application pending. The other authors report no conflicts of interest in this work.