Abstract
Background Older adults with multiple chronic somatic diseases are challenged by mental comorbidities and social environmental changes resulting in complex bio-psychosocial healthcare needs. Comparatively few studies have addressed the coping strategies and resources of this highly vulnerable group. This study used the INTERMED interview method as a basis to investigate the resources of home-dwelling older adults with complex health care needs. Methods Following a randomized controlled trial this qualitative study analyzed detailed notes taken by a trained psychosomatic doctor during 24 interventional supportive counseling home visits. The randomized controlled trial participants were recruited from the ESTHER cohort study, a population-based study of older adults conducted in the state of Saarland, Southwest Germany. Patients with complex health care needs identified with the INTERMED interview received the supportive counseling home visit intervention, which followed the principles of narrative-based medicine and explored the personal resources of the participants. Notes from 24 supportive counseling home visits were analyzed using thematic content analysis. Results The qualitative analysis from 24 home visits identified 387 single codes, from which two main categories and 14 subcategories were derived. Participants with complex health care needs named currently available present resources and personal/long-lasting resources representing the main categories. Eight main categories were derived within the field of currently available resources that were deemed helpful to cope with the actual situation. Personal/long-lasting resources comprise statements that reflect personal experiential and attitudinal resources gained through socialization and internalization of interpersonal experiences. Conclusion The highly vulnerable group of complex patients reported many social, personal and structural resources that play significant roles in helping them to deal with their current situation. Home care professionals need skills to recognize and use the many different potential resources each client is able to access, which could enhance their well-being.
Psychosocial resources in middle-aged and older adults with complex health care needs: results of a qualitative study
