Prioritizing illness: Lessons in selfmanaging multiple chronic diseases

Abstract

Chronic disease management strategies are typically based on single disease models, yet patients often need to manage multiple conditions. This study uses the concepts of "chronic illness trajectory" and "biographical disruption" to examine how patients self-manage multiple chronic conditions and especially how they prioritize their conditions. Fifty-three people with multiple chronic illnesses participated in one of six focus groups. The results suggest that people who were disrupted tended to be younger than 60, lived on their own, cared for other family members, or encountered other barriers. Many people anticipated subsequent illnesses because of their age and prior experience with illness. Their reasons for prioritizing a particular illness included: (1) the unpredictable nature of the disease; (2) the condition could not be controlled by medication; and (3) the condition set off other health problems. Social context played a key role in shaping patients' biography and chronic illness trajectory. © Canadian Journal of Sociology.