Categorizing the Effect of Comorbidity:: A Qualitative Study of Individuals' Experiences in a Low-Vision Rehabilitation Program

• Autores: Heather E. Whitson, Karen Steinhauser, Natalie Ammarell, Diane Whitaker, Scott W. Cousins, Deidra Ansah, Linda L. Sanders, Harvey J. Cohen
• Localización: Journal of the American Geriatrics Society, ISSN 0002-8614, Vol. 59, Nº. 10, 2011, págs. 1802-1809
• Idioma: inglés
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• Resumen

  • Objectives: To identify generalizable ways that comorbidity affects older adults� experiences in a health service program directed toward an index condition and to develop a framework to assist clinicians in approaching comorbidity in the design, delivery, and evaluation of such interventions.

    Design: A qualitative data content analysis of interview transcripts to identify themes related to comorbidity.

    Setting: An outpatient low-vision rehabilitation program for macular disease.

    Participants: In 2007/08, 98 individuals undergoing low-vision rehabilitation and their companions provided 624 semistructured interviews that elicited perceptions about barriers and facilitators of successful program participation.

    Results: The interviews revealed five broad themes about comorbidity: (i) �good days, bad days,� reflecting participants� fluctuating health status during the program because of concurrent medical problems; (ii) �communication barriers.� which were sometimes due to participant impairments and sometimes situational; (iii) �overwhelmed,� which encompassed pragmatic and emotional concerns of participants and caregivers; (iv) �delays,� which referred to the tendency of comorbidities to delay progress in the program and to confer added inconvenience during lengthy appointments; and (v) value of companion involvement in overcoming some barriers imposed by comorbid conditions.

    Conclusion: This study provides a taxonomy and conceptual framework for understanding consequences of comorbidity in the experience of individuals receiving a health service. If confirmed in individuals receiving interventions for other index diseases, the framework suggests actionable items to improve care and facilitate research involving older adults.