Exploring the utility of self-determination theory in complex interventions in multimorbidity: a qualitative analysis of patient experiences of the CARE Plus intervention

McCallum, M. , Gray, C. M. , Hanlon, P. , O'Brien, R. and Mercer, S. W. (2019) Exploring the utility of self-determination theory in complex interventions in multimorbidity: a qualitative analysis of patient experiences of the CARE Plus intervention. Chronic Illness, (doi:10.1177/1742395319884106) (Early Online Publication)

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Abstract

Objectives: CARE Plus is a primary-care-based complex intervention for patients with multimorbidity living in areas of high socioeconomic deprivation. This study explores patients’ experience of the intervention and whether self-determination theory is useful to understand reported impacts. Method: Thematic analysis of semistructured interviews of 14 participants conducted during a randomised controlled trial of CARE Plus. Improvement in wellbeing in daily lives following CARE Plus was estimated from participants’ accounts of their experiences of the intervention. Findings: Participants valued the CARE Plus consultations irrespective of perceived improvements. Six participants reported changes in wellbeing that improved daily life, three reported slight improvement (not impacting daily life) and five no improvement. Evidence of satisfaction of the three major self-determination theory psychological needs – relatedness, competence and autonomy – was prominent in the accounts of those experiencing improved wellbeing in daily life; this group also spoke in ways congruent with more self-determined motivational regulation. These changes were not evident in those with little or no improvement in wellbeing. Discussion: This study suggests self-determination theory has utility in understanding the impact of CARE Plus on patients and may be a useful theory to inform development of future interventions to improve outcomes for patients with multimorbidity.

Item Type:Articles
Additional Information:This work was funded by the Chief Scientist Office of Scottish Government Health Directorates [Applied Research Programme Grant ARPG/07/1].
Status:Early Online Publication
Refereed:Yes
Glasgow Author(s) Enlighten ID:Gray, Professor Cindy and Hanlon, Dr Peter and O'Brien, Dr Rosaleen and Mercer, Professor Stewart and McCallum, Dr Marianne
Authors: McCallum, M., Gray, C. M., Hanlon, P., O'Brien, R., and Mercer, S. W.
College/School:College of Medical Veterinary and Life Sciences > Institute of Health and Wellbeing > General Practice and Primary Care
College of Medical Veterinary and Life Sciences > Institute of Health and Wellbeing > Social Scientists working in Health and Wellbeing
College of Medical Veterinary and Life Sciences > School of Medicine, Dentistry & Nursing
Journal Name:Chronic Illness
Publisher:SAGE Publications
ISSN:1742-3953
ISSN (Online):1745-9206
Published Online:01 November 2019
Copyright Holders:Copyright © The Authors 2019
First Published:First published in Chronic Illness 2019
Publisher Policy:Reproduced in accordance with the publisher copyright policy

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