Managing Complexity: Black Older Adults With Multimorbidity.
Managing Complexity: Black Older Adults With Multimorbidity.
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管理复杂性：患有多种疾病的黑人老年人。
DOI：
10.1093/geront/gnad066
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发表时间：
2024
期刊：
影响因子：
--
通讯作者：
Cutchin,MalcolmP
中科院分区：
文献类型：
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作者：
Fritz,Heather;Chase,Sage;Morgan,Lauren;Cutchin,MalcolmP
背景和目的与白色老年人相比，黑人老年人有更高的多功能障碍率，并且获得的多功能障碍支持更少。然而，人们对患有多发性硬化症的黑人老年人的经历知之甚少，这些经历可能是这些差异的核心，也是干预措施和改善对这一人群护理的核心。在这项研究中，我们的目的是概念化的multimorphism管理（MM）的经验为黑人老年aduls.Research设计和MethodsAs一个更大的研究的一部分，黑人老年人的multimorphism和医生的同情心，我们进行了深入的定性访谈，30名黑人老年人生活在美国中西部的一个大城市，年龄在65岁及以上的自我报告的multimorphism。我们使用扎根理论分析，提炼出一个核心概念范畴，以及组件域和dimensions.Results“管理复杂性”出现的核心范畴来描述我们的样本MM。管理复杂性包括“社会背景”、“日常物流”、“护理时间”和“护理角色”等领域。讨论和implicationsWe讨论如何管理复杂性是不同于病人的复杂性，以及它是如何与累积的不平等和不稳定性。研究结果对围绕提供者教育和同情心的干预以及对患有MM的黑人老年人的授权具有潜在的影响。
Background and ObjectivesBlack older adults have higher rates of multimorbidity and receive less effective multimorbidity support than their white counterparts. Yet little is known about the experiences of Black older adults with multimorbidity that may be at the heart of those disparities and which are central to interventions and improving care for this population. In this study, we aimed to conceptualize the multimorbidity management (MM) experience for Black older adults.Research Design and MethodsAs part of a larger study on Black older adults’ multimorbidity and physician empathy, we conducted in-depth qualitative interviews with 30 Black older adults living in a large midwestern city in the United States aged 65 years and older with self-reported multimorbidity. We used grounded theory analysis to distill findings into a core conceptual category as well as component domains and dimensions.Results“Managing complexity” emerged as the core category to describe MM in our sample. Managing complexity included domains of “social context,” “daily logistics,” “care time,” and “care roles.”Discussion and ImplicationsWe discuss how managing complexity is distinct from patient complexity and how it is related to cumulative inequality and precarity. Study findings have potential implications for intervention around provider education and empathy as well as for enabling agency of Black older adults with MM.