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Advanced serious illness, multimorbidity, and multibeneficence: The role of communication
Author(s) -
Cohn Jeffrey
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.12706
Subject(s) - conversation , multimorbidity , psychological intervention , pathological , medicine , focus (optics) , scale (ratio) , psychology , psychiatry , communication , pathology , comorbidity , physics , optics , quantum mechanics
Abstract Sturmberg et al write about multimorbidity as “several diagnosable diseases within the same individual.”[1][Sturmberg JP, 2017] They posit that this syndrome is the result of multiple interconnected disturbances reflecting scale‐free, fractal signs of pathology ranging from biochemical/hormonal alterations at one end of a spectrum to community and societal ills at the other. In this commentary, I will be focusing on 3 perspectives: 1) a preterminal phase of multimorbidity that is indicative of that loss of reparative or even homeokinetic properties, known by some as “advanced serious illness”[2][, ]; 2) the manifestations of advanced serious illness multimorbidity that, using the same networks that connect into the patient, are signs of this syndrome at the levels of the immediate family/friend social network, the broader community, and society at large; and 3) the potential for these same networks that transmit pathological forces to convey the positive effects of therapeutic interventions in a scale‐free manner, with a focus on how conversation can lead to what I'm calling “multibeneficence.”