"I want to take the power back": An interpretative phenomenological analysis of self-management in coexisting physical and mental long-term conditions
- 1School of Health Sciences, University of Southampton, Southampton, United Kingdom
- 2NIHR ARC Wessex, Southampton, United Kingdom
Abstract
Introduction: Individuals living with both physical and mental health conditions face compounding barriers to self-management. These challenges arise from complex care needs, interactions between long-term conditions symptoms and inequalities resulting in a high treatment burden. While previous research on coexisting conditions has largely focused on those with severe mental illness, there remains an important gap in understanding the factors that help or hinder self-management among adults living with coexisting physical and common mental health conditions (anxiety/depression) in the community. Objective: This study aims to explore the facilitators and barriers to self-management for adults living with a physical long-term condition and coexisting anxiety or depression in the community. Methods: A qualitative study with in-depth semi-structured interviews was conducted between May and August 2025. Eight adults living with coexisting physical and mental health conditions in the UK participated. Interview data was recorded, transcribed and analysed using Interpretative Phenomenological Analysis. Results: Three main themes were generated; (1) Moving beyond sink or swim: scaffolding support to self-manage (2) Self-managing: a choice or systemic exclusion (3) Unseen struggles: learning to live with my long-term conditions. Participants described the complex, often unsupported reality of self-managing coexisting long-term conditions, where many felt forced to integrate self-management into their lives due to systemic gaps and negative interactions with healthcare professional. Their experiences demonstrated an apparent hinderance to self-management, with age, condition visibility and identity struggles creating compounding barriers. Therefore, a holistic scaffolded support approach promoting integrated care was suggested to meet both their health and social needs. Conclusions: Our study provides insight into self-management facilitators and barriers among adults living with coexisting physical-mental health long-term conditions, highlighting substantial barriers to self-management and the need for person-centred, flexible, integrated support. The findings emphasise the need for new care models reflecting evolving presentations and domains of coexisting conditions.
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BibTeX
@article{lodwick2026want,
title = {{"I want to take the power back": An interpretative phenomenological analysis of self-management in coexisting physical and mental long-term conditions}},
author = {Catherine Lodwick and Leire Ambrosio and Mari Carmen Portillo},
journal = {PLOS One},
year = {2026},
month = sep,
doi = {10.1371/journal.pone.0359157},
url = {https://doi.org/10.1371/journal.pone.0359157},
note = {CC BY 4.0},
}
RIS
TY - JOUR
TI - "I want to take the power back": An interpretative phenomenological analysis of self-management in coexisting physical and mental long-term conditions
AU - Catherine Lodwick
AU - Leire Ambrosio
AU - Mari Carmen Portillo
PY - 2026
DA - 2026/09/25
JO - PLOS One
DO - 10.1371/journal.pone.0359157
UR - https://doi.org/10.1371/journal.pone.0359157
AB - Introduction: Individuals living with both physical and mental health conditions face compounding barriers to self-management. These challenges arise from complex care needs, interactions between long-term conditions symptoms and inequalities resulting in a high treatment burden. While previous research on coexisting conditions has largely focused on those with severe mental illness, there remains an important gap in understanding the factors that help or hinder self-management among adults living with coexisting physical and common mental health conditions (anxiety/depression) in the community. Objective: This study aims to explore the facilitators and barriers to self-management for adults living with a physical long-term condition and coexisting anxiety or depression in the community. Methods: A qualitative study with in-depth semi-structured interviews was conducted between May and August 2025. Eight adults living with coexisting physical and mental health conditions in the UK participated. Interview data was recorded, transcribed and analysed using Interpretative Phenomenological Analysis. Results: Three main themes were generated; (1) Moving beyond sink or swim: scaffolding support to self-manage (2) Self-managing: a choice or systemic exclusion (3) Unseen struggles: learning to live with my long-term conditions. Participants described the complex, often unsupported reality of self-managing coexisting long-term conditions, where many felt forced to integrate self-management into their lives due to systemic gaps and negative interactions with healthcare professional. Their experiences demonstrated an apparent hinderance to self-management, with age, condition visibility and identity struggles creating compounding barriers. Therefore, a holistic scaffolded support approach promoting integrated care was suggested to meet both their health and social needs. Conclusions: Our study provides insight into self-management facilitators and barriers among adults living with coexisting physical-mental health long-term conditions, highlighting substantial barriers to self-management and the need for person-centred, flexible, integrated support. The findings emphasise the need for new care models reflecting evolving presentations and domains of coexisting conditions.
SN - 1932-6203
ER -