University of Kentucky, Lexington, KY, USA.
Qual Health Res. 2011 May;21(5):601-11. doi: 10.1177/1049732310395779. Epub 2011 Jan 24.
Approximately three fourths of middle-aged and older adults have at least two simultaneously occurring chronic conditions ("multiple morbidity," or MM), a trend expected to increase dramatically throughout the world. Rural residents, who tend to have fewer personal and health resources, are more likely to experience MM. To improve our understanding of the ways in which vulnerable, rural residents in the United States experience and manage MM, we interviewed 20 rural Appalachian residents with MM. We identified the following themes: (a) MM has multifaceted challenges and is viewed as more than the sum of its parts; (b) numerous challenges exist to optimal MM self-management, particularly in a rural, underresourced context; however, (c) participants described strategic methods of managing MM, including prioritizing certain conditions and management strategies and drawing heavily on assistance from informal and formal sources.
大约四分之三的中年和老年人同时患有至少两种慢性疾病（“多种合并症”，或 MM），这种趋势预计在全球范围内将大幅增加。农村居民往往个人和健康资源较少，更有可能经历 MM。为了更好地了解美国弱势农村居民经历和管理 MM 的方式，我们采访了 20 名患有 MM 的美国阿巴拉契亚农村居民。我们确定了以下主题：(a) MM 具有多方面的挑战，被视为不仅仅是其各部分的总和；(b) 最佳 MM 自我管理存在许多挑战，特别是在农村资源不足的情况下；但是，(c) 参与者描述了管理 MM 的策略性方法，包括优先考虑某些疾病和管理策略，并大量依赖非正式和正式来源的帮助。
