Concept Analysis of Health-related Hardiness in Older People with Multiple Diseases Using a Hybrid Model

Background and purpose: Patients with hardiness personality could better control the psychological distress induced by multiple diseases. The present study aimed to clarify the concept of health related hardiness in older individuals with multiple diseases. Materials and methods: A hybrid method was used to analyze the concept of health related hardiness. This model consists of theoretical review, field work, and final analysis. After first phase, nine older people with multiple diseases were selected via purposive sampling from Ramsar Imam Sajjad Hospital and Tonekabon Shahid Rajaee Hospital and interviewed in autumn-winter 2019-2020. In third phase, information from the theoretical phase was combined with the fieldwork phase, and the concept of health related hardiness was clarified. Results: Health-related hardiness in older individuals with multiple diseases means that they could achieve the expected health-related outcomes (successful control of the disease, reduced disease burden, and adaptation to disease) by purposeful management of health-related stressors, simultaneous management of several diseases, and personality traits such as stubbornness, patience, tolerance, and having cognitive abilities. Meanwhile, family and social supports, as facilitators, are of great benefit in reducing physical and psychological pressures induced by diseases burden. Conclusion: The health-related hardiness model could be applied in further studies and used to implement promotion protocols in older people with multiple diseases and development of health-related hardiness scales.