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Patient capacity and constraints in the experience of chronic disease: a qualitative systematic review and thematic synthesis

Patient capacity and constraints in the experience of chronic disease: a qualitative systematic review and thematic synthesis
Patient capacity and constraints in the experience of chronic disease: a qualitative systematic review and thematic synthesis
Background: life and healthcare demand work from patients, more so from patients living with multimorbidity. Patients must respond by mobilizing available abilities and resources, their so-called capacity. We sought to summarize accounts of challenges that reduce patient capacity to access or use healthcare or to enact self-care while carrying out their lives.

Methods: we conducted a systematic review and synthesis of the qualitative literature published since 2000 identifying from MEDLINE, EMBASE, Psychinfo, and CINAHL and retrieving selected abstracts for full text assessment for inclusion. After assessing their methodological rigor, we coded their results using a thematic synthesis approach.

Results: the 110 reports selected, when synthesized, showed that patient capacity is an accomplishment of interaction with (1) the process of rewriting their biographies and making meaningful lives in the face of chronic condition(s); (2) the mobilization of resources; (3) healthcare and self-care tasks, particularly, the cognitive, emotional, and experiential results of accomplishing these tasks despite competing priorities; (4) their social networks; and (5) their environment, particularly when they encountered kindness or empathy about their condition and a feasible treatment plan.

Conclusion: patient capacity is a complex and dynamic construct that exceeds “resources” alone. Additional work needs to translate this emerging theory into useful practice for which we propose a clinical mnemonic (BREWS) and the ICAN Discussion Aid
1471-2296
Boehmer, Kasey R.
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Gionfriddo, Michael R.
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Rodriguez-Gutierrez, Rene
c1d31404-8283-44ca-b0da-366a38bacc1a
Dabrh, Abd Moain Abu
aa19862c-c33f-4a06-9845-ab48ac0ee210
Leppin, Aaron L.
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Hargraves, Ian
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May, Carl
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Shippee, Nathan D.
b30cc75a-bd72-4ba4-924b-6e00a7ea5abf
Castaneda-Guarderas, Ana
af10573c-5a0d-4811-bcac-9904c0b0f5cd
Palacios, Claudia Zeballos
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Bora, Pavithra
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Erwin, Patricia
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Montori, Victor M.
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Boehmer, Kasey R.
e9d029a7-c14e-4861-9dd9-7dcb84f02e6a
Gionfriddo, Michael R.
1e49ed42-ea79-4569-bc29-1d66113b7c68
Rodriguez-Gutierrez, Rene
c1d31404-8283-44ca-b0da-366a38bacc1a
Dabrh, Abd Moain Abu
aa19862c-c33f-4a06-9845-ab48ac0ee210
Leppin, Aaron L.
cbde8d90-0720-49ee-9bc4-116f8ccd95fe
Hargraves, Ian
19580c06-d152-4ee5-922b-bf393b1431d4
May, Carl
17697f8d-98f6-40d3-9cc0-022f04009ae4
Shippee, Nathan D.
b30cc75a-bd72-4ba4-924b-6e00a7ea5abf
Castaneda-Guarderas, Ana
af10573c-5a0d-4811-bcac-9904c0b0f5cd
Palacios, Claudia Zeballos
866bd952-0783-4cde-b082-661d6e7fef70
Bora, Pavithra
16d9a813-0c7a-4a35-ae3e-001fc60d053c
Erwin, Patricia
cdd0f69f-5cfb-4844-b9f8-60da013d972e
Montori, Victor M.
a5f37c36-7f57-4a70-8975-f11d9c63b87e

Boehmer, Kasey R., Gionfriddo, Michael R., Rodriguez-Gutierrez, Rene, Dabrh, Abd Moain Abu, Leppin, Aaron L., Hargraves, Ian, May, Carl, Shippee, Nathan D., Castaneda-Guarderas, Ana, Palacios, Claudia Zeballos, Bora, Pavithra, Erwin, Patricia and Montori, Victor M. (2016) Patient capacity and constraints in the experience of chronic disease: a qualitative systematic review and thematic synthesis. BMC Family Practice, 17 (127). (doi:10.1186/s12875-016-0525-9).

Record type: Article

Abstract

Background: life and healthcare demand work from patients, more so from patients living with multimorbidity. Patients must respond by mobilizing available abilities and resources, their so-called capacity. We sought to summarize accounts of challenges that reduce patient capacity to access or use healthcare or to enact self-care while carrying out their lives.

Methods: we conducted a systematic review and synthesis of the qualitative literature published since 2000 identifying from MEDLINE, EMBASE, Psychinfo, and CINAHL and retrieving selected abstracts for full text assessment for inclusion. After assessing their methodological rigor, we coded their results using a thematic synthesis approach.

Results: the 110 reports selected, when synthesized, showed that patient capacity is an accomplishment of interaction with (1) the process of rewriting their biographies and making meaningful lives in the face of chronic condition(s); (2) the mobilization of resources; (3) healthcare and self-care tasks, particularly, the cognitive, emotional, and experiential results of accomplishing these tasks despite competing priorities; (4) their social networks; and (5) their environment, particularly when they encountered kindness or empathy about their condition and a feasible treatment plan.

Conclusion: patient capacity is a complex and dynamic construct that exceeds “resources” alone. Additional work needs to translate this emerging theory into useful practice for which we propose a clinical mnemonic (BREWS) and the ICAN Discussion Aid

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Accepted/In Press date: 25 August 2016
e-pub ahead of print date: 1 September 2016
Published date: 1 September 2016
Organisations: Faculty of Health Sciences

Identifiers

Local EPrints ID: 400730
URI: https://eprints.soton.ac.uk/id/eprint/400730
ISSN: 1471-2296
PURE UUID: e272baa6-61df-4bc0-bbd8-004263c5e612
ORCID for Carl May: ORCID iD orcid.org/0000-0002-0451-2690

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Date deposited: 23 Sep 2016 12:54
Last modified: 06 Jun 2018 12:33

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Contributors

Author: Kasey R. Boehmer
Author: Michael R. Gionfriddo
Author: Rene Rodriguez-Gutierrez
Author: Abd Moain Abu Dabrh
Author: Aaron L. Leppin
Author: Ian Hargraves
Author: Carl May ORCID iD
Author: Nathan D. Shippee
Author: Ana Castaneda-Guarderas
Author: Claudia Zeballos Palacios
Author: Pavithra Bora
Author: Patricia Erwin
Author: Victor M. Montori

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