ArticleJournal of advanced nursing2026
Double Burdens and Double Resilience: Dynamic Interactions in Older Couples Living With Multimorbidity.
Article in Journal of advanced nursing, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Authors and funding
5 authors.
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Abstract
aimsTo explore the lived experiences and daily interactions of older couples living with multimorbidity.
designA descriptive-interpretive qualitative study based on a generic interpretive description framework.
methodsA total of 20 dyads were recruited using a purposive sampling strategy, and 24 semi-structured in-depth interviews were conducted between May 2023 and January 2025. Reflexive thematic analysis was used to analyse data.
resultsFour overarching themes were generated: (1) dynamic relationship structures; (2) diverse interaction patterns; (3) double burdens; and (4) double resilience. Dynamic relationship structures occurred in dyadic and triadic forms. Diverse interaction patterns involved independence, interdependence and dependence. Double burdens manifested as physical toll, financial hardship, emotional contagion and perceptual misalignment, whereas double resilience was reflected in the nudge effect, emotional resonance and promotion of family ownership of health.
conclusionThis study adopted a dyadic perspective to explore the experiences and interactions of older couples living with multimorbidity. The caring dynamics and blurred roles of patient and care partner deviate from the traditional unidirectional, linear model of 'one person caring for the other'. Formal or informal caregiving support from third parties, as well as the nudge effect and emotional resonance between spouses, may help orient older couples as they navigate the challenges associated with multimorbidity. IMPLICATIONS FOR THE PROFESSION: Our findings indicate that community nurses can play a proactive role in identifying older couples living with multimorbidity through routine care attendance and assessments, enabling early recognition of health management needs. Geriatric nurses can leverage insights into couples' interaction patterns to tailor more effective care plans at different stages of illness, monitor emerging risks and identify optimal timing for third-party support. By facilitating a responsive triadic network, nurses can help ensure continuous and sustainable health care. REPORTING
methodAdhered to SRQR guidelines for qualitative research. PATIENT OR PUBLIC INVOLVEMENT: This study did not include patient or public involvement in its design, conduct, or reporting.
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