Workload-capacity imbalances and their impact on self-management complexity in patients with multimorbidity: a multicenter cross-sectional study

• Published in: Annals of medicine (Helsinki) 2025-12, Vol.57 (1), p.2451195
• Main Authors: Zhao, Binyu, Fu, Yujia, Wu, Jingjie, Xue, Erxu, Lai, Chuyang, Chen, Dandan, Wu, Qiwei, Yu, Jianing, Wu, Qiaoyu, Ye, Zhihong, Shao, Jing
• Format: Article
• Language: English
• Subjects: Adult; Aged; capacity; China - epidemiology; Cross-Sectional Studies; cumulative complexity model; Female; Humans; Male; Middle Aged; Multimorbidity; Primary Care; Self-Management; Surveys and Questionnaires; Workload; Workload - statistics & numerical data
• ISSN: 0785-3890; 1365-2060; 1365-2060
• DOI: 10.1080/07853890.2025.2451195

Multimorbidity is increasing globally, emphasizing the need for effective self-management strategies. The Cumulative Complexity Model (CuCoM) offers a unique perspective on understanding self-management based on workload and capacity. This study aims to validate the CuCoM in multimorbid patients and identify tailored predictors of self-management. This multicenter cross-sectional survey recruited 1920 multimorbid patients in five primary health centres and four hospitals in China. The questionnaire assessed workload (drug intake, doctor visits and follow-up, disruption in life, and health problems), capacity (social, environmental, financial, physical, and psychological), and self-management. Data were analyzed using latent profile analysis, chi-square, multivariate linear regression, and network analysis. d Patients were classified into four profiles: low workload-low capacity (10.2%), high workload-low capacity (7.5%), low workload-high capacity (64.6%), and high workload-high capacity (17.7%). Patients with low workload and high capacity exhibited better self-management (β = 0.271,