Finding your way to normal life: experiences of young and middle-aged adults with multimorbidity and complex chronic...

This study aimed to explore how young and middle-aged adults (aged 18-65 years) with multimorbidity and complex chronic conditions experience hospitalisation and the transition home.

In this qualitative study, semi-structured interviews were conducted. Data from the interviews were analysed using reflexive thematic analysis following Braun and Clarke (2022).

Two university hospitals in Switzerland (March to July 2024).

16 young and middle-aged adults with multimorbidity and complex chronic conditions from two university hospitals in Switzerland were selected as interview participants to gain an understanding of the experience of young and middle-aged adults with multimorbidity and complex chronic conditions within the hospital and on transition home.

Analysis of the interviews revealed four main themes that describe the experiences of younger and middle-aged adults with multimorbidity and complex chronic conditions during and after hospitalisation: experiences on a (1) physical, (2) emotional and psychological, as well as on a (3) social level and (4) the constant tension within the lived experience of illness; this constant tension in turn influenced the experiences of this patient group on a physical, emotional, psychological and social level. Conversely, these three levels influenced both the positive and negative experience of illness and the positive and negative anticipation surrounding it.

The study's findings confirm that this patient group requires integrated care, a care model that goes beyond the disease-centred comorbidity perspective of previous care models that supports coordinated proactive care by an interprofessional core team and a central coordinator and that operates within and between the different health sectors. Advanced practice nurses are particularly well-suited for a leading role within integrated care models due to their advanced nursing skills and knowledge. These results could serve as an important basis for this specific role design. The results of this study also confirm that this patient group requires a complex, holistic and person-centred approach to care to have the opportunity to return to a normal life despite massive limitations. Mental health plays a central role, as it is an important influencing factor that should be given special attention during treatment. It is essential for healthcare systems and medical professionals to understand the burden of diseases in the context of physical, financial, family and social circumstances. Further research into the experiences of young and middle-aged adults with multimorbidity and complex chronic conditions is recommended.