Evidence map›Paper›PMID 40038223›Full record

ArticleJournal of general internal medicine2026

Perceived Connections Between Personal Values and Health in High-Risk Patients with Multimorbidity: A Qualitative Study.

Linnaea Schuttner, Jonathan Staloff, Mariah Theis, James D Ralston, Ann-Marie Rosland, Karin Nelson, Laura Coyle, Scott Hagan, Tamara Schult, Traci Solt and 2 more

Abstract read
In one paragraph

Article in Journal of general internal medicine, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

0numbers the graph read from it
0cells of the map it votes in
0citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

0 citing papers in PubMed.

No citing paper in PubMed yet.

4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

12 authors.

Linnaea SchuttnerSeattle-Denver Center of Innovation, Health Services Research, VA Puget Sound Health Care System, Seattle, WA, USA. linnaea.schuttner@va.gov.ORCID 0000-0003-2289-0684
Jonathan StaloffSeattle-Denver Center of Innovation, Health Services Research, VA Puget Sound Health Care System, Seattle, WA, USA.
Mariah TheisSeattle-Denver Center of Innovation, Health Services Research, VA Puget Sound Health Care System, Seattle, WA, USA.
James D RalstonKaiser Permanente Washington Health Research Institute, Seattle, WA, USA.
Ann-Marie RoslandVA Center for Health Equity Research and Promotion, VA Pittsburgh Healthcare System, Pittsburgh, PA, USA.
Karin NelsonSeattle-Denver Center of Innovation, Health Services Research, VA Puget Sound Health Care System, Seattle, WA, USA.
Laura CoyleOffice of Primary Care, Veterans Health Administration, Washington, DC, USA.
Scott HaganDepartment of Medicine, University of Washington, Seattle, WA, USA.
Tamara SchultOffice of Patient Centered Care and Cultural Transformation, Veterans Health Administration, Washington, DC, USA.
Traci SoltOffice of Primary Care, Veterans Health Administration, Washington, DC, USA.
Katherine RitcheyGeriatrics Research, Education and Clinical Center, VA Puget Sound Health Care System, Seattle, WA, USA.
George SayreSeattle-Denver Center of Innovation, Health Services Research, VA Puget Sound Health Care System, Seattle, WA, USA.

Funding

Health Services Research and Development K2HX003462HSRD VA IK2 HX003462
6 · The paper itself

Abstract

backgroundAligned with increasing organizational and policy focus on whole person care, particularly for patients with multimorbidity, health systems are operationalizing how to assess what patients find meaningful in life for personalized health planning. Few studies have examined how patients with multimorbidity at high risk of adverse events perceive connections between what is most important in life (i.e., personal values) and health, healthcare, and healthcare decisions. This knowledge is critical to optimizing how, when, and under what circumstances the topics are addressed in healthcare settings.

objectiveTo understand how high-risk patients with multimorbidity perceive connections between personal values and health, healthcare, and healthcare decisions.

designQualitative study.

participantsPatients ≥ 75th percentile risk of hospitalization or mortality using a validated prediction score, with ≥ 2 diagnoses among depression, hypertension, chronic kidney disease, or diabetes, engaged in Veterans Health Administration primary care. APPROACH: Individual semi-structured telephone interview, analyzed with content analysis. KEY

resultsPatients (N=27) averaged 68 years old; 17 (63%) were male. Three main themes emerged: (1) personal values were rarely discussed in healthcare settings or reflected in healthcare decision-making, sometimes given perceived lower relevance by patients; (2) when personal values were perceived as affecting health decisions, it was within specific contexts or circumstances (e.g., deciding on surgery); (3) eliciting personal values in healthcare settings could have positive or negative consequences, related to conditions of disclosure and resultant action taken in the care plan, and not all patients wanted to disclose values.

conclusionsIn this study, high-risk patients with multimorbidity reported rarely discussing values in healthcare settings, and if so, only perceived relevant connections between values and health in specific contexts. While some participants felt sharing values benefitted care, not all felt comfortable with disclosure. Patient preferences for eliciting and incorporating values are relevant to integrating patient personal values in healthcare settings.

Indexed as

MultimorbiditySocial ValuesAgedAged, 80 and overDecision MakingFemaleHumansMaleMiddle AgedQualitative ResearchUnited StatesMultimorbidityPatient-centered carePersonal valuesQualitative researchVeterans

Identifiers

PMID40038223
PMCPMC12960877

What OpenQuestion holds

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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.