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Published in: BMC Primary Care 1/2016

Open Access 01-12-2016 | Research article

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

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

Published in: BMC Primary Care | Issue 1/2016

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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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Metadata
Title
Patient capacity and constraints in the experience of chronic disease: a qualitative systematic review and thematic synthesis
Authors
Kasey R. Boehmer
Michael R. Gionfriddo
Rene Rodriguez-Gutierrez
Abd Moain Abu Dabrh
Aaron L. Leppin
Ian Hargraves
Carl R. May
Nathan D. Shippee
Ana Castaneda-Guarderas
Claudia Zeballos Palacios
Pavithra Bora
Patricia Erwin
Victor M. Montori
Publication date
01-12-2016
Publisher
BioMed Central
Published in
BMC Primary Care / Issue 1/2016
Electronic ISSN: 2731-4553
DOI
https://doi.org/10.1186/s12875-016-0525-9

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