A Study of the Correlation Between Vulnerability to Psychological Crisis and Self‐Disclosure in Elderly Patients With Multimorbidity: A Mixed‐Methods Study

AIM: This study examined the factors influencing psychological crisis vulnerability (PCV) in older patients with multimorbidity and identified barriers/facilitators to expressing psychological distress. This was aimed at supporting clinical interventions and ageing policies. DESIGN: A cross-sectional study. METHODS: This study was designed using explanatory sequential mixed methods. In the quantitative study, 685 older patients in the inpatient and outpatient clinics of a tertiary hospital were selected using convenience sampling, and a cross-sectional survey was conducted using the Psychological Crisis Vulnerability Scale (PVS). In the qualitative study, 14 older patients with multiple chronic diseases in the geriatric department were interviewed in depth, and the interaction mechanism between vulnerability and self-disclosure was analysed. Qualitative themes on disclosure barriers/facilitators were contextualised within the high PCV subgroups (scores ≥ 80), demonstrating how vulnerability modulates self-disclosure. RESULTS: The quantitative study showed that the PCV score of older patients with multimorbidity (69.4 ± 12.8) was significantly lower than that of the community older norm, indicating that their PCV was at the lower to middle level. Multifactorial analysis showed that residence status, economic situation, marital status, age, type of chronic disease, and hospitalisation in the preceding 6 months were the main factors affecting PCV. The qualitative study extracted hindering factors (e.g., introverted personality, family atmosphere, negative cognition, economic pressure, negative feedback, insufficient knowledge, and time weakening) and facilitating factors (e.g., perceived benefits after disclosure, a good support system, and a strong willingness to express oneself) affecting self-disclosure. CONCLUSION: PCV in older patients with multimorbidity emerges from multidimensional determinants and complex self-disclosure dynamics. IMPACT: Strategic improvements in risk assessment protocols, positive expressive behaviour cultivation, layered psychosocial support frameworks, and healthy ageing policy execution collectively enhance mental well-being and sustainable ageing trajectories. REPORTING METHOD: The study follows the STROBE guidelines. PATIENT OR PUBLIC CONTRIBUTION: Older patients from tertiary hospitals participated in this study.