关键词: 老年人, 慢性病, 多病共存, 管理困境, 质性研究, 护理

Abstract:

Objective To understand the challenges faced by elderly patients with multiple chronic conditions in community settings during the process of disease management，and to provide a basis for developing intervention strategies for managing comorbidities in the elderly. Methods A phenomenological research approach was adopted，using purposive sampling. From July to October 2024，16 elderly patients with multiple chronic conditions from 5 community service centers in Shenzhen were selected as study participants. Semi-structured in-depth interviews were conducted，and the interview data were analyzed using Colaizzi’s seven-step method. Results Totally 4 themes and 8 sub-themes were extracted，including the disorder of multi-source health information structure and environment （insufficient systematic integration of health guidance，uneven quality of knowledge under multiple information channels），the exhaustion of self-management efficacy among chronic disease patients（the coexistence of multiple diseases aggravates the burden of physical and mental symptoms；negative emotions weaken the efficacy of active management），the absence of an integrated management mechanism for multiple diseases（repeated medical visits lead to poor treatment experience；multiple medications pose potential health risks），and the lack of in-depth and dynamic social support practices（formal operation of community support systems，family support facing the dilemma of filial piety and control）. Conclusion Elderly patients with multiple chronic conditions in community settings face numerous challenges in disease management. Current chronic disease management in China primarily focuses on single diseases. It is recommended that healthcare professionals shift their perspective，improve the identification，assessment，nursing，and treatment of comorbidities in the elderly，and provide integrated chronic disease management approaches. This would enable a "one-stop" solution to the management challenges of multimorbidity in elderly patients，thereby enhancing their quality of life.

Key words: Aged, Chronic Diseases, Multimorbidity, Management Challenges, Qualitative Research, Nursing Care