Participants described the tangible physical consequences of living with multiple chronic conditions during hospitalisation and after discharge. Physical limitations, symptom burden and functional impairments were recurrent features of their narratives. These physical challenges affected daily activities, self-management capacities and the ability to return to prior routines.
Physical experiences influenced and were influenced by emotional and social domains: symptoms could exacerbate anxiety or depressive feelings, while limited mobility or fatigue reduced opportunities for social participation and work. The source reports that many participants presented with cardiological and neurological problems, though a full diagnostic breakdown beyond that predominance was not provided in the excerpt.
Emotional and psychological responses were central to participants’ accounts of hospital stays and transitions home. Feelings ranged across anxiety, fear, frustration and hopes for recovery. Mental health was explicitly identified as a key influencing factor shaping how patients perceived care, anticipated discharge and managed life with multiple conditions.
Participants spoke about how the psychological burden modulated coping and adaptation: negative anticipations about prognosis or fragmented follow-up care could worsen distress, while supportive communication and continuity helped reduce uncertainty. The study emphasises that mental health demands specific attention during treatment and discharge planning.
Social consequences of multimorbidity were prominent in participant narratives. Chronic illness affected employment, family roles and social participation. Younger and middle-aged adults face distinct social pressures compared with older adults, including balancing work, career development and caregiving responsibilities for children or ageing relatives.
Participants described how fragmented care and lack of coordinated outpatient follow-up complicated efforts to maintain social roles and work obligations. Financial strain and altered social relationships were noted as part of the broader burden, underscoring that illness effects extend beyond the clinical setting into everyday life.
A cross-cutting theme identified in analysis was a persistent internal tension within patients’ lived experience. This tension reflected the interplay of hope and loss, striving for normality while confronting ongoing limitations, and fluctuating expectations about recovery versus acceptance of chronic impairment.
The authors report that this tension shaped experiences across physical, emotional and social levels and affected both positive and negative anticipations of illness and care. In practice, this means patients oscillated between active attempts to regain control and periods of resignation, and that these dynamics influenced responses to interventions and discharge planning.
This qualitative study used semi-structured interviews with 16 adults aged 34–64 (mean 49) living with multimorbidity and complex chronic conditions. Recruitment occurred at two Swiss university hospitals between March and July 2024 through purposive sampling; one site used an advanced practice nurse (APN) as initial contact, the other involved direct recruitment by the first author.
Inclusion criteria required adults aged 18–64 with more than two chronic illnesses and adequate German language skills; exclusions included age ≥65, moderate-to-severe cognitive impairment, decompensated psychiatric disorder, or inability to communicate. No financial compensation was provided. Interviews (20–45 minutes) were digitally recorded and transcribed verbatim. A standardised questionnaire captured sociodemographic details.
Data collection continued until code saturation (no new codes after 14 interviews), with two additional interviews conducted to confirm saturation, yielding a total sample of 16 participants (8 women, 8 men).
The research team used reflexive thematic analysis as described by Braun and Clarke. Steps included repeated transcript review, line-by-line coding, theme development, mind-mapping, and iterative refinement with six researchers participating in theme validation. MAXQDA 24 was used for data organisation.
Rigour was addressed through credibility, dependability, transferability and confirmability measures: independent coding of all 16 transcripts by two researchers, peer debriefing with researchers not involved in data collection, and detailed reporting of participants and setting. The article notes limitations: the Swiss healthcare context may affect transferability, and the participant sample predominantly included cardiological and neurological conditions, which may limit generalisability to other disease groups.
Some specific quantitative or individual outcome data beyond demographics and theme descriptions were not included in the provided source excerpt.
Findings support the need for integrated care models that move beyond disease-centred comorbidity approaches. The authors advocate coordinated, proactive care delivered by an interprofessional core team with a central coordinator to ensure continuity across sectors and reduce fragmentation.
Advanced practice nurses are highlighted as particularly well-suited to lead such models given their advanced nursing skills and knowledge. The study’s results are proposed as an evidence base to inform the role design of APNs within integrated care pathways aimed at supporting self-management, addressing mental health needs and facilitating return to daily life.
The authors recommend further research into the experiences of young and middle-aged adults with multimorbidity and complex chronic conditions to broaden understanding across diagnoses and healthcare systems. They emphasise the need to design and evaluate integrated, person-centred care interventions that address physical, psychological and social needs, extend follow-up beyond hospital discharge, and explicitly incorporate mental health support.
The excerpted source did not provide detailed intervention models, outcome metrics or participant-level diagnostic breakdowns beyond noting a predominance of cardiological and neurological conditions; these specifics were therefore not reported here.