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What matters in “multimorbidity”? Arguably resilience and personal health experience are central to quality of life and optimizing survival
Author(s) -
Martin Carmel Mary
Publication year - 2018
Publication title -
journal of evaluation in clinical practice
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.737
H-Index - 73
eISSN - 1365-2753
pISSN - 1356-1294
DOI - 10.1111/jep.12644
Subject(s) - health care , psychosocial , psychological resilience , interoception , context (archaeology) , resilience (materials science) , psychology , medicine , perception , social psychology , psychiatry , political science , physics , neuroscience , law , biology , thermodynamics , paleontology
Rationale Much is written about “multimorbidity” as it is a difficult problem for health systems, as it reflects a complex phenomenon unique to each individual health journey and health service context. This paper proposes the adoption of 2 constructs or knowledge streams into mainstream “multimorbidity” care which are arguably most important to person‐centered care—personal health perceptions and resilience. Analysis “Multimorbidity” is the manifestation of multiple nonlinear physical, psychosocial, and environmental phenomena in an individual health journey. Multimorbidity encompasses very stable states for the most part together with highly unstable phases that are difficult to manage. Averting or controlling the underlying loss of resilience in instability can be challenging without early warning signals pointing towards tipping points. Monitoring resilience and early warning signals for tipping points is new to health care. Yet what should we monitor in the complexity of multimorbidity? There are multiple and competing health service features and biometrics that can be measured. However, an expanding of literature endorses importance of simply asking a person about their self‐rated health in order to provide predictions of their resilience and survival. Interoception, exemplified as self‐rated health, arises from internal neurocognitive self‐monitoring functions of different internal and external phenomena. Interoception is being to be recognized as predictors and barometers of resilience and survival. Conclusions Two phenomena of human systems—interoception and resilience—can guide care in the complex nature of multimorbidity in unstable health journeys and should be incorporated into clinical practice.