Exploring health-related challenges among older adults: a qualitative study

Population ageing in Iran is accelerating, yet qualitative evidence on older adults’ experiences of health-related challenges remains limited. This study explored older adults’ perceptions and experiences of health-related challenges in later life to inform comprehensive care and age-friendly health policies. This qualitative study was conducted in Hamadan, western Iran, from June 2024 to February 2025. Older adults attending day care centers were recruited using purposive sampling with maximum variation. Data were analyzed using inductive conventional qualitative content analysis. Saturation was assessed through a two-step process in which code saturation was considered to have been achieved at the 13th interview, and meaning saturation was subsequently appraised iteratively across three additional interviews to evaluate whether the emerging categories captured adequate conceptual depth and nuance. The study followed the COREQ checklist. Sixteen older adults participated. Four categories and nine subcategories were identified: (1) Identity and existential challenges in older adulthood (threats to dignity and social worth; mortality awareness and end-of-life concerns); (2) Social and structural challenges (loneliness and erosion of social ties; feeling powerless along the service-seeking pathway; role strain and family tensions); (3) Physical and functional challenges (managing chronic illness and treatment burden; functional weariness and vulnerability); and (4) Economic challenges (financial burden of health care; everyday economic insecurity). Older adults in this study described health challenges as a multidimensional experience involving threats to dignity, social isolation, physical limitations, and economic insecurity. These context-specific findings suggest the importance of person-centered nursing care that addresses both clinical needs and everyday vulnerabilities. Further multicenter and mixed-methods research is needed to examine the extent of these challenges across diverse settings and to inform the development and evaluation of context-sensitive support interventions. Not applicable.