People with multimorbidity: forgotten outsiders or dynamic self-managers?

Area of Science:

• Social Sciences
• Health Sciences
• Linguistics

Background:

• Multimorbidity, the co-occurrence of multiple chronic conditions, presents complex challenges in healthcare.
• Patient agency is increasingly emphasized in managing long-term health conditions.
• The role of discourse in constructing health realities requires critical examination.

Purpose of the Study:

• To analyze the discursive construction of multimorbidity within scientific literature.
• To investigate how patient agency is portrayed in scientific articles concerning multimorbidity care.
• To challenge taken-for-granted understandings of patient agency in multimorbidity.

Main Methods:

• Critical discourse analysis of 20 scientific articles on multimorbidity care.
• Application of postmodern assumptions on language and reality construction.
• Interpretation informed by agency theories and critical management studies.

Main Results:

• Identification of four distinct discourses: medical, technical, collaborative, and individual.
• The 'individual' discourse promotes patient self-management but may overemphasize agency.
• A "business-like" approach in patient care requires careful consideration of its potential restrictions.

Conclusions:

• Scientific texts reveal the power of discourse in shaping perceptions of multimorbidity and patient agency.
• Findings suggest a need for ethical considerations in developing care for patients with multiple conditions.
• Further research into political documents and professional/patient talk is recommended.