Related Experiment Videos
Rethinking Symptom Fluctuation in Multimorbidity: A Dynamic Systems Framework From Primary Care
1Rokkasho Medical Center, Japan Association for Development of Community Medicine (JADECOM), Kamikita, Aomori, Japan.
Journal of Evaluation in Clinical Practice
|July 27, 2026
Summary
Symptom fluctuation in multimorbidity is reframed as a dynamic systems phenomenon, not direct disease output. This perspective aids clinicians in managing variability and supporting patient stability in primary care.
Area of Science:
- Complex Systems Science
- Primary Care Medicine
- Clinical Phenomenology
Background:
- Symptom fluctuation is common in multimorbidity but poorly explained by disease-centered models.
- Conventional frameworks fail to account for daily variability in symptoms like fatigue and dyspnea.
Purpose of the Study:
- To propose a dynamic systems framework for understanding symptom fluctuation in multimorbidity.
- To reframe symptom variability as an emergent property of interacting physiological systems.
Main Methods:
- Conceptual framework development integrating clinical observation and theoretical insights.
- Utilizing dynamic systems theory to model symptom expression.
- Considering the influence of everyday life conditions on physiological system configurations.
Main Results:
- Symptom expression emerges from dynamic configurations of interacting physiological systems.
- Variability is an emergent property of system interactions near physiological stability limits.
- Everyday conditions (sleep, activity, nutrition) continuously shape system configurations and physical reserve.
Conclusions:
- A dynamic systems perspective reconceptualizes symptom fluctuation in multimorbidity.
- Understanding symptoms as dynamic expressions aids clinical interpretation and care strategies.
- This approach supports primary care focused on maintaining system stability and functional reserve.
Related Concept Videos
01:15Methods of Documentation VI: Case Management Model
The case management model is a multidisciplinary approach that involves healthcare professionals from diverse disciplines, such as physicians, nurses, therapists, social workers, and pharmacists, working collaboratively to address the various needs of patients. Each healthcare professional brings unique expertise and perspectives, contributing to a more comprehensive understanding of the patient's condition and tailoring treatment plans accordingly.
For example, a patient with a chronic illness...
For example, a patient with a chronic illness...
01:18Models of Health Promotion and Illness Prevention II
The person's health status fluctuates continually, varying from being in good health to becoming ill and returning to being healthy. To understand the concept of illness prevention, there are two models. First, the health-illness continuum model is a graphic representation of an individual's wellness. It states that a person is considered healthy in the absence of physical disease and the presence of good emotional health.
The agent-host-environment model states that disease results from...
The agent-host-environment model states that disease results from...
01:18Factors Affecting Illness
When a person's physical, emotional, intellectual, social development or spiritual functioning is compromised, this deviation from a healthy normal state is called illness. Illness creates stress that in turn harms individuals. Irritation, anger, denial, hopelessness, and fear are behavioral and emotional changes an individual experiences in the phases of illness. A variety of factors influence a person's health and well-being.
For instance, risk factors are connected to illness, disability,...
For instance, risk factors are connected to illness, disability,...
01:21Dimensions of Health and Illness
The factors influencing the health-illness continuum can be internal or external and may or may not be under conscious control. They are related to the following eight human dimensions, and each dimension is interrelated to one other.
01:17Classification of Illness
The meaning of illness is individualized to each person who experiences an alteration in health. In contrast, disease is a medical term indicating a pathological change in the structure and function of the body or mind. It is a condition that has specific symptoms and boundaries.
An illness is a response to a disease in which the person's level of functioning is changed compared with a previous level. The general classification of illness includes acute and chronic.
Acute illness is severe and...
An illness is a response to a disease in which the person's level of functioning is changed compared with a previous level. The general classification of illness includes acute and chronic.
Acute illness is severe and...
01:26Methods of Documentation II: POMR
The Problem-Oriented Medical Record (POMR) revolutionized medical record-keeping by introducing a systematic approach focusing on the patient's problems rather than merely listing symptoms. Dr. Lawrence Weed's introduction of this method in the 1960s marked a significant advancement in medical documentation. The POMR framework consists of four key components: the database, problem list, plan of care, and progress notes.