Siddiqui, Muhammad Faraz ORCID: https://orcid.org/0000-0002-2253-3911
(2024)
Self-management of physical-mental multimorbidity: perspectives and experiences of people with diabetes and depression, and healthcare providers in Pakistan.
PhD thesis, University of York.
Abstract
Background: Multimorbidity is a growing concern in South Asia. There is a need to support self-management among people with physical-mental multimorbidity. However, current knowledge of self-management practices and perspectives is limited. In this thesis, the aim was to develop a better understanding of self-management in physical-mental multimorbidity in a South Asian setting - Pakistan.
Methods: Three research studies were conducted. First, a systematic review was conducted to identify the determinants of NCD self-management in South Asia (objective 1). This was followed by two primary studies conducted in Pakistan. One was a qualitative phenomenological study which explored how people live with and manage physical-mental multimorbidity (objective 2). The other was an exploratory qualitative study which explored healthcare providers’ perspectives and experiences of self-management support in physical-mental multimorbidity (objective 3).
Results: The systematic review identified a range of individual, interpersonal and socio-cultural determinants which were linked to self-management behaviours. The phenomenological study documented the wide-ranging effects of physical-mental multimorbidity, the use of medication, behavioural modification and coping strategies to self-manage, and the challenges faced by individuals in managing complex symptoms and mood/behavioural changes. Discussions with healthcare providers found that self-management support interactions are largely disease-centred, with limited use of behavioural strategies and collaborative approaches. Patient and health-system related factors were also identified as barriers in the provision of self-management support.
Conclusion: This thesis highlights the need for interventions to reduce barriers to self-management, empower individuals with physical-mental multimorbidity to self-manage their illnesses, and strengthen healthcare services to meet the demands of physical-mental multimorbidity. There is a need to further strengthen the existing evidence, and adapt and test culturally appropriate self-management support interventions for people living physical-mental multimorbidity in Pakistan.
Metadata
Supervisors: | Catherine, Hewitt and Najma, Siddiqi and Hannah, Jennings |
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Keywords: | multimorbidity; self-management; phenomenology |
Awarding institution: | University of York |
Academic Units: | The University of York > Health Sciences (York) |
Depositing User: | Dr Muhammad Faraz Siddiqui |
Date Deposited: | 23 May 2025 10:40 |
Last Modified: | 23 May 2025 10:40 |
Open Archives Initiative ID (OAI ID): | oai:etheses.whiterose.ac.uk:36607 |
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