Background Multimorbidity, the co-existence of multiple health conditions in an individual, is a significant Public Health challenge. However, it has no consensus definition or measure, and its determinants and outcomes are not fully understood. Resilience may be a mechanism by which the experience of multimorbidity can be improved but there has been little study of this. Aim To define and measure the prevalence of multimorbidity and resilience to multimorbidity, to assess the role of mental health and childhood socio-economic status (SES) and to investigate the long-term outcomes. Objectives 1. To determine how multimorbidity and resilience to multimorbidity should be defined and measured in Public Health research 2. To assess the prevalence of multimorbidity and resilience to multimorbidity using the measures identified in objective one 3. To assess the role of mental health conditions and childhood SES in the occurrence of multimorbidity and resilience to multimorbidity 4. To assess the impact of multimorbidity and resilience to multimorbidity on long-term outcomes Method Systematic reviews of the literature were conducted to address objective one. The analysis of two contrasting study populations was used to address objectives two to four. These were the Australian cross-sectional Diamond study and the Aberdeen Children of the 1950s cohort study. Results Multimorbidity was defined as the presence of two or more conditions and was measured by patient self-report and healthcare administrative data. Resilience was the presence of good self-reported outcomes despite multimorbidity. Multimorbidity prevalence ranged from 3% to 38%. Mental health conditions led to an increased burden of multimorbidity and a reduced prevalence of resilience. Childhood SES and other SES factors were associated with multimorbidity. Childhood SES and other SES factors were associated with multimorbidity. Multimorbidity was associated with poorer outcomes. Conclusion The findings in this thesis can be used to improve consensus approaches to studying multimorbidity and resilience, and to develop interventions to tackle these.
| Identifer | oai:union.ndltd.org:bl.uk/oai:ethos.bl.uk:752685 |
| Date | January 2018 |
| Creators | Johnston, Marjorie C. |
| Contributors | Crilly, Mike ; Black, Corri ; Prescott, Gordon ; Mercer, Stewart |
| Publisher | University of Aberdeen |
| Source Sets | Ethos UK |
| Detected Language | English |
| Type | Electronic Thesis or Dissertation |
| Source | http://digitool.abdn.ac.uk:80/webclient/DeliveryManager?pid=238333 |
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