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Chronic disease influences over 40 major life‐changing decisions ( MLCD s): a qualitative study in dermatology and general medicine
Author(s) -
Bhatti Z.U.,
Finlay A.Y.,
Bolton C.E.,
George L.,
Halcox J.P.,
Jones S.M.,
Ketchell R.I.,
Moore R.H.,
Salek M.S.
Publication year - 2014
Publication title -
journal of the european academy of dermatology and venereology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.655
H-Index - 107
eISSN - 1468-3083
pISSN - 0926-9959
DOI - 10.1111/jdv.12289
Subject(s) - medicine , disease , chronic disease , qualitative research , coding (social sciences) , clothing , family medicine , gerontology , social science , statistics , mathematics , archaeology , sociology , history
Background Chronic disease not only impairs patients' psycho‐social well‐being but also influences major life‐changing decisions ( MLCD s). There is little information about the types of MLCD s affected and the long‐term consequences. Objectives The aims were to identify the MLCD s influenced by chronic disease, to define ‘ MLCD ’ and to suggest support strategies for patients taking MLCD s. Methods Adult dermatology patients explained how their chronic disease had influenced MLCD s in individual interviews. Adult patients from other medical specialities gave similar information by postal survey. NVivo8 software was used for qualitative analysis of data. Themes were categorized through a coding–recoding iterative process. Results There were 308 evaluable responses (male 55.2%; mean age = 51.8 years, mean disease duration = 19 years) from the 365 (55.7%) responses to the 655 patient invitations. These were used to generate themes to conceptualize ‘ MLCD s’. The most frequently reported MLCD s in the dermatology interviews concerned career choice (66%), job (58%), choice of clothing (54%), relationships (52%), education (44%), stopping swimming (34%), moving abroad (32%), not socializing (34%), wearing make‐up (22%) and having children (22%). In the postal survey early retirement (40.6%), impact on job (29.4%), having children (24.8%), career choice (22.4%) and relationships (15.5%) were most commonly reported. The number of MLCD s reported by individuals was inversely related to age. Forty‐one affected MLCD themes were grouped into 18 MLCD categories. A definition of MLCD was developed and strategies suggested to support patients. Conclusions Chronic diseases influence a wide range of MLCD s. MLCD s are a novel domain in disease burden assessment. Clinicians' knowledge about this is important in patient management.