1
|
Owens J, Lovell K, Brown A, Bee P. Parity of esteem and systems thinking: a theory informed qualitative inductive thematic analysis. BMC Psychiatry 2022; 22:650. [PMID: 36261819 PMCID: PMC9583593 DOI: 10.1186/s12888-022-04299-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/11/2022] [Accepted: 10/10/2022] [Indexed: 12/01/2022] Open
Abstract
BACKGROUND Parity of Esteem (PoE) is about equality between mental and physical health but is a term lacking definition and clarity. The complexity of the field of mental health and the conversations around PoE add to its opacity. Therefore, the aim of this study is to use systems thinking to explore the strengths and challenges of using PoE. METHODS This is a secondary analysis of descriptive qualitative data, from 27 qualitative interviews, utilising the World Health Organisation (WHO) system domains as a framework for the inductive thematic analysis. RESULTS Examining the current strengths and challenges of systems in mental and physical healthcare using the WHO domains and macro, meso and micro levels, identifies specific actions to redress inequity between mental and physical health provision. CONCLUSION The evidence suggests that moving PoE from rhetoric towards reality requires new configurations with a systems orientation, which uses macro, meso and micro levels to analyse and understand the complexity of relations within and between domain levels and reorienting funding, training and measurement. This requires embedding new competencies, infrastructures and practices within an effective learning healthcare system.
Collapse
Affiliation(s)
- Janine Owens
- National Institute for Health and Care Research Applied Research Collaboration Greater Manchester (NIHRARC GM), Faculty of Biology, Medicine and Health, The University of Manchester, Oxford Road, Manchester, M13 9PL, England.
| | - Karina Lovell
- National Institute for Health and Care Research Applied Research Collaboration Greater Manchester (NIHRARC GM), Faculty of Biology, Medicine and Health, The University of Manchester, Oxford Road, Manchester, M13 9PL, England
| | - Abigail Brown
- National Institute for Health and Care Research Applied Research Collaboration Greater Manchester (NIHRARC GM), Faculty of Biology, Medicine and Health, The University of Manchester, Oxford Road, Manchester, M13 9PL, England
| | - Penny Bee
- National Institute for Health and Care Research Applied Research Collaboration Greater Manchester (NIHRARC GM), Faculty of Biology, Medicine and Health, The University of Manchester, Oxford Road, Manchester, M13 9PL, England
| |
Collapse
|
2
|
Improving the Physical Health of Psychiatric Hospital Residents: An Evaluation of an Obesity Education Program for Mental Health Professionals. Healthcare (Basel) 2022; 10:healthcare10101851. [PMID: 36292296 PMCID: PMC9601487 DOI: 10.3390/healthcare10101851] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/21/2022] [Revised: 09/06/2022] [Accepted: 09/19/2022] [Indexed: 11/19/2022] Open
Abstract
Background: People living with mental health disorders are at increased risk for developing obesity due to poor diet, physical inactivity, and antipsychotic medications. In the United States, the obesity rate is 36% in the general population and more than 50% for people living with mental health disorders. Although mental health clinicians concentrate on managing psychiatric disorders, they seldom recognize the gradual increase in body mass index of their patients. The result is a disconnection between the clinical management of psychiatric disorders and the medical management of obesity. Purpose: This study assessed the effectiveness of an evidence-based education program for improving the obesity management practices of mental health clinicians caring for residents at a state psychiatric hospital. Methods: This was a quasi-experimental study design with a pretest and posttest evaluation. Convenience sampling was used to recruit mental health professionals, or clinicians, at a large psychiatric hospital in the Southern region of the United States. Data was collected with the Advising and Treating Overweight and Obese Patient questionnaire (17 items). Data analysis included descriptive and inferential statistics. The findings were reported in accordance with the TREND and GREET guidelines. Results: The education program was completed by 50 MHCs. The pretest indicated that 76% of MHCs were not involved in helping obese residents manage their weight, but the posttest indicated 90% were involved. There was a significant increase in MHC knowledge about obesity management and reported actions 90-days after the program. MHCs were unable to arrange follow-up visits for residents, a task not directly within their control. Conclusions: Mental health clinicians reported increased knowledge and improved clinical practice after an education program. Because the outcomes were reported at 90-days after the program, further research needs to evaluate the longitudinal impact of this type of program, where the reported behaviors are correlated to process and clinical outcome measures for obesity.
Collapse
|
3
|
Bhandari P, Paswan B. Lifestyle Behaviours and Mental Health Outcomes of Elderly: Modification of Socio-Economic and Physical Health Effects. AGEING INTERNATIONAL 2020. [DOI: 10.1007/s12126-020-09371-0] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
|
4
|
Samuriwo R, Hannigan B. Wounds in mental health care: The archetype of a ‘wicked problem of many hands’ that needs to be addressed? INTERNATIONAL JOURNAL OF MENTAL HEALTH 2019. [DOI: 10.1080/00207411.2019.1706702] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Affiliation(s)
- Ray Samuriwo
- School of Healthcare Sciences, Cardiff University, Cardiff, United Kingdom
- Wales Centre for Evidence Based Care, Cardiff University, Cardiff, United Kingdom
| | - Ben Hannigan
- School of Healthcare Sciences, Cardiff University, Cardiff, United Kingdom
| |
Collapse
|
5
|
Vancampfort D, Watkins A, Ward PB, Probst M, De Hert M, Van Damme T, Mugisha J. Barriers, attitudes, confidence, and knowledge of nurses regarding metabolic health screening and intervention in people with mental illness: a pilot study from Uganda. Afr Health Sci 2019; 19:2546-2554. [PMID: 32127827 PMCID: PMC7040261 DOI: 10.4314/ahs.v19i3.30] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
Background People with mental illness are at an increased risk for developing cardio-metabolic disorders. Routine screening following pharmacotherapy is however unacceptably low in sub-Saharan African countries with less than 1% adequately screened. It is unknown whether this is due to a lack of adequate competences. Objectives The aim of this pilot study was to assess the barriers, attitudes, confidence, and knowledge of nurses regarding metabolic health, prevention and treatment in Uganda. Methods Twenty-eight nurses (39% female, 30.9±6.9 years) completed the Metabolic — Barriers, Confidence, Attitudes and Knowledge Questionnaire and the physical activity prescription rate item of the Exercise in Mental Illness Questionnaire. Results More than 75% had a positive attitude towards metabolic screening and intervention and more than 50% were confident in providing smoking cessation advice, and physical activity and nutritional counseling. However, 57% stated that their heavy workload prevented them from doing health screening and promotion activities. There was a negative correlation (ρ=-0.54, P=0.003) between the frequency of physical activity prescription and the perception of the inability of patients to change. Conclusion The present findings suggest that nurses are generally supportive of metabolic health screening and intervention but their high workload prevents them from implementing metabolic health interventions.
Collapse
Affiliation(s)
- Davy Vancampfort
- KU Leuven — University of Leuven, Department of Rehabilitation Sciences, Leuven, Belgium
- KU Leuven — University of Leuven, University Psychiatric Center KU Leuven, Kortenberg, Belgium
| | - Andrew Watkins
- Keeping the Body in Mind Program, The Bondi Centre, South Eastern Sydney Local Health District, Sydney, NSW, Australia
- Faculty of Health, University of Technology Sydney, Sydney, Australia
| | - Philip B Ward
- School of Psychiatry, University of New South Wales, Sydney, Australia
- Schizophrenia Research Unit, Ingham Institute for Applied Medical Research, Liverpool, Australia
| | - Michel Probst
- KU Leuven — University of Leuven, Department of Rehabilitation Sciences, Leuven, Belgium
| | - Marc De Hert
- KU Leuven — University of Leuven, University Psychiatric Center KU Leuven, Kortenberg, Belgium
| | - Tine Van Damme
- KU Leuven — University of Leuven, Department of Rehabilitation Sciences, Leuven, Belgium
| | - James Mugisha
- Kyambogo University, Kampala, Uganda
- Butabika National Referral and Mental Health Hospital, Kampala, Uganda
| |
Collapse
|
6
|
Shpigelman CN, HaGani N. The impact of disability type and visibility on self-concept and body image: Implications for mental health nursing. J Psychiatr Ment Health Nurs 2019; 26:77-86. [PMID: 30793457 DOI: 10.1111/jpm.12513] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/26/2018] [Revised: 01/30/2019] [Accepted: 02/18/2019] [Indexed: 11/30/2022]
Abstract
WHAT IS KNOWN ON THE SUBJECT?: Physical appearance, as in the case of individuals with physical disabilities who use a cane, walker or wheelchair, also influence others' reactions and as a result, may lead to one's negative or positive feelings and thoughts. A disability that is not observable by others, as in the case of individuals with psychiatric disabilities (mental illnesses), may also have a negative impact on one's feelings and thoughts, due to stigma associated with psychiatric disabilities. To date, research has mainly focused on the way persons with a noticeable type of disability think about themselves. It is also important to evaluate the impact of disability type on ones' feelings and thoughts, and compare persons with visible and invisible disabilities. WHAT THE PAPER ADDS TO EXISTING KNOWLEDGE?: We asked 119 adults (over the age of 18 years) with different types of disabilities to complete a set of questionnaires and found that those who had a disability that was not observable by others (a psychiatric disability) felt more negative about themselves and their body than those who had a disability that was observable by others (a physical disability). The study extends the current knowledge on the impact of disability type and its visibility on the way persons with disabilities think about themselves. WHAT ARE THE IMPLICATIONS FOR PRACTICE?: The findings suggest that healthcare services should be modified to address the psychological needs of people with different types of disability. Mental health nurses should identify practices in the community that will improve the feelings and thoughts of consumers with disabilities, and especially those who cope with a psychiatric disability. Abstract Introduction Individuals with disabilities often face stigma and discrimination, which may negatively affect their self-concept. To date, research has mainly focused on the psychological implications of living with a noticeable physical disability. Less attention has been given to individuals with invisible psychiatric disabilities as a stigmatized subgroup in the disability community. Aim To evaluate the impact of disability type and its visibility on the self-concept and body image. Method A cross-sectional quantitative study design was implemented to compare the self-concept and body image of individuals with visible physical disabilities and individuals with invisible psychiatric disabilities (n = 119). Pearson correlations, ANOVA and multiple linear regression models were performed. Results Individuals with invisible psychiatric disabilities reported lower levels of self-concept and body image compared to individuals with visible physical disabilities. Gender, family status and the severity level of the disability were found to be associated with self-concept and body image. Discussion The study extends the current knowledge by showing that disability visibility might play a protective role for persons with physical disabilities compared to persons with psychiatric disabilities. Implications for Practice Mental health nurses should apply practices to enhance the self-concept and body image of consumers with invisible psychiatric disabilities.
Collapse
Affiliation(s)
- Carmit-Noa Shpigelman
- Department of Community Mental Health, Faculty of Social Welfare and Health Sciences, University of Haifa, Haifa, Israel
| | - Neta HaGani
- School of Social Work, Faculty of Social Welfare and Health Sciences, University of Haifa, Haifa, Israel
| |
Collapse
|
7
|
Çelik Ince S, Partlak Günüşen N. The views and habits of the individuals with mental illness about physical activity and nutrition. Perspect Psychiatr Care 2018; 54:586-595. [PMID: 29733428 DOI: 10.1111/ppc.12289] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/11/2018] [Revised: 04/04/2018] [Accepted: 04/14/2018] [Indexed: 11/30/2022] Open
Abstract
PURPOSE The aim of this study is to determine the views and habits of the individuals with mental illness on physical activities and nutrition behaviors. DESIGN AND METHODS This study was carried out descriptive qualitative method. The sample of the study consisted of 15 individuals with mental illness. The data were collected with Socio-Demographic Information Form and Semi-Structured Interview Form and analyzed by content analysis. FINDINGS Four main themes emerged as the result of the analysis of the data. These themes are the barriers, facilitators, habits, and the needs. PRACTICE IMPLICATIONS Mental health nurses should be aware of the barriers of individuals with mental illness. It is recommended that mental health nurses make interventions to encourage patients to have physical activity and healthy eating.
Collapse
Affiliation(s)
- Sevecen Çelik Ince
- Faculty of Nursing, Psychiatric Nursing Department, Dokuz Eylul University, Izmir, Turkey
| | | |
Collapse
|
8
|
Erginer DK, Günüşen NP. Determination of physical health status and healthy lifestyle behaviors of individuals with mental illness. Perspect Psychiatr Care 2018; 54:371-379. [PMID: 29473170 DOI: 10.1111/ppc.12261] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/25/2017] [Revised: 12/01/2017] [Accepted: 01/15/2018] [Indexed: 11/30/2022] Open
Abstract
PURPOSE The aim of this study is to determine the physical health status and healthy lifestyle behaviors of individuals with mental illness. DESIGN AND METHODS A descriptive research design was used. The sample of the study consisted of 115 individuals with mental illness. The Health Lifestyle Behaviors Scale II was used to assess the healthy lifestyle behaviors of the participants. FINDINGS Of the individuals, 49.6% were found to have metabolic syndrome. Individuals with mental illness obtained the lowest score from the physical activity dimension of the scale. PRACTICE IMPLICATIONS Individuals with mental illness need to receive education and support, especially in terms of nutrition and exercise.
Collapse
|
9
|
Physical Health Care for People with Severe Mental Illness: the Attitudes, Practices, and Training Needs of Nurses in Three Asian Countries. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2018; 15:ijerph15020343. [PMID: 29462859 PMCID: PMC5858412 DOI: 10.3390/ijerph15020343] [Citation(s) in RCA: 28] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 01/08/2018] [Revised: 02/02/2018] [Accepted: 02/12/2018] [Indexed: 11/18/2022]
Abstract
People with severe mental illness (SMI) have considerable unmet physical health needs and an increased risk of early mortality. This cross-sectional survey utilized the Physical Health Attitude Scale (PHASe) to examine the attitudes, practices, and training needs of nurses towards physical health care of people with SMI in three Asian countries (Hong Kong, Japan, Qatar). Cross-country differences were explored and linear regression was used to investigate if nurses’ attitudes and confidence were associated with their level of involvement in physical health care. A total of 481 questionnaires were returned. Hong Kong nurses were less involved in physical health care than those from Japan and Qatar. Nurses’ attitudes and confidence were significant predictors of their participation in managing physical health. Compared with western countries, more nurses in this study felt that mental illness was a barrier to improving physical health. Three-quarters reported that they needed additional training in promoting cardiometabolic health. The perceived need for additional training in physical health care was held by Mental Health Nurses (MHN) irrespective of their type of nursing registration and nationality. Nurse educators and service providers should reconsider the physical health care training requirements of nurses working in mental health settings in order to improve the physical health of people with SMI.
Collapse
|
10
|
Ehrlich C, Chester P, Kisely S, Crompton D, Kendall E. Making sense of self-care practices at the intersection of severe mental illness and physical health-An Australian study. HEALTH & SOCIAL CARE IN THE COMMUNITY 2018; 26:e47-e55. [PMID: 28685496 DOI: 10.1111/hsc.12473] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 06/12/2017] [Indexed: 06/07/2023]
Abstract
The poor physical health of people who experience severe mental illness (SMI) is an important public health issue that has been acknowledged, yet not properly addressed. People who live with SMI perform a myriad of complex tasks in order to take care of their physical health, while receiving unpredictable levels of support and assistance from health professionals. In this qualitative study, we aimed to uncover the kinds of work people with SMI do in order to look after their physical health. In a metropolitan area in Queensland, Australia, 32 people with lived experience of SMI participated in semi-structured, face-to-face interviews. Data were digitally recorded, transcribed verbatim and open coded. They were then themed using a constant comparative process. We found that people with SMI were engaged in a "rhythm of life with illness" that consisted of relatively short, acute and chaotic cycles of mental and physical illness, accompanied by much longer mental and physical illness recovery cycles. Participants engaged in three specific types of health-related work to manage these cycles: discovery work (and the associated role of the health professional); sense-making work to meaningfully interpret health and illness; and embedding work to become engaged self-managers of illness and producers of health. We discuss how varying levels of support from health professionals impact consumers' self-management of their physical and mental health; how health professionals influence consumers' experience of treatment burden; and implications for practice.
Collapse
Affiliation(s)
- Carolyn Ehrlich
- School of Human Services and Social Work, Griffith University, Meadowbrook, Queensland, Australia
- Hopkins Centre, Menzies Health Institute, Griffith University, Meadowbrook, Queensland, Australia
| | - Polly Chester
- School of Human Services and Social Work, Griffith University, Meadowbrook, Queensland, Australia
- Hopkins Centre, Menzies Health Institute, Griffith University, Meadowbrook, Queensland, Australia
| | - Steve Kisely
- School of Medicine, The University of Queensland, Woolloongabba, Queensland, Australia
| | - David Crompton
- School of Human Services and Social Work, Griffith University, Meadowbrook, Queensland, Australia
- Hopkins Centre, Menzies Health Institute, Griffith University, Meadowbrook, Queensland, Australia
- Metro South Addiction and Mental Health Services, Upper Mount Gravatt, Queensland, Australia
| | - Elizabeth Kendall
- School of Human Services and Social Work, Griffith University, Meadowbrook, Queensland, Australia
- Hopkins Centre, Menzies Health Institute, Griffith University, Meadowbrook, Queensland, Australia
| |
Collapse
|
11
|
Watkins A, Rosenbaum S, Ward PB, Patching J, Denney-Wilson E, Stein-Parbury J. The Validity and Reliability Characteristics of the M-BACK Questionnaire to Assess the Barriers, Attitudes, Confidence, and Knowledge of Mental Health Staff Regarding Metabolic Health of Mental Health Service Users. Front Public Health 2017; 5:321. [PMID: 29312914 PMCID: PMC5732257 DOI: 10.3389/fpubh.2017.00321] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/20/2017] [Accepted: 11/14/2017] [Indexed: 12/22/2022] Open
Abstract
Background Addressing the burden of poor physical health and the subsequent gap in life expectancy experienced by people with mental illness is a major priority in mental health services. To equip mental health staff with the competence to deliver evidence-based interventions, targeted staff training regarding metabolic health is required. In order to evaluate the effectiveness of staff training regarding metabolic health, we aimed to develop a succinct measure to determine the barriers, attitudes, confidence, and knowledge of health practitioners through the development and test–retest reliability of the Metabolic-Barriers, Attitudes, Confidence, and Knowledge Questionnaire (M-BACK). Methods The M-BACK questionnaire was developed to evaluate the impact of specialized training in metabolic health care for mental health nurses. Content of the M-BACK was developed from a literature review and refined by an expert review panel and validated via a piloting process. To determine the test–retest reliability of the M-BACK, 31 nursing students recruited from the University of Notre Dame, Sydney completed the questionnaire on two separate occasions, 7 days apart. Intraclass correlation coefficients (ICCs) were calculated for the total score, as well as each of the four domains. Results Pilot testing was undertaken with a sample of 106 mental health nurses with a mean age 48.2, ranging from 24 to 63 years of age, who participated in six training courses. Questionnaire development resulted in a 16-item instrument, with each item is scored on a five-point Likert scale ranging from “strongly disagree” to “strongly agree.” Test–retest reliability of the M-BACK was completed by 30 of 31 nursing students recruited, ICCs ranged from 0.62 to 0.96. Conclusion The M-BACK is a reliable measure of the key elements of practitioner perceptions of barriers, and their knowledge, attitudes, and confidence regarding metabolic monitoring in people with mental illness. It can be used to assess the effectiveness of interventions aimed at increasing uptake of metabolic monitoring, a key component of programs to reduce the life expectancy gap in people living with severe mental illness.
Collapse
Affiliation(s)
- Andrew Watkins
- Keeping the Body in Mind Program, The Bondi Centre, South Eastern Sydney Local Health District, Sydney, NSW, Australia.,Faculty of Health, University of Technology Sydney, Sydney, NSW, Australia
| | - Simon Rosenbaum
- School of Psychiatry, University of New South Wales, Sydney, NSW, Australia
| | - Philip B Ward
- School of Psychiatry, University of New South Wales, Sydney, NSW, Australia.,Schizophrenia Research Unit, Ingham Institute for Applied Medical Research, Liverpool, NSW, Australia
| | - Joanna Patching
- School of Nursing, University of Notre Dame, Sydney, NSW, Australia
| | | | - Jane Stein-Parbury
- Faculty of Health, University of Technology Sydney, Sydney, NSW, Australia
| |
Collapse
|
12
|
Bahorik AL, Satre DD, Kline-Simon AH, Weisner CM, Campbell CI. Serious mental illness and medical comorbidities: Findings from an integrated health care system. J Psychosom Res 2017; 100:35-45. [PMID: 28789791 PMCID: PMC5576509 DOI: 10.1016/j.jpsychores.2017.07.004] [Citation(s) in RCA: 48] [Impact Index Per Article: 6.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/03/2017] [Revised: 05/22/2017] [Accepted: 07/06/2017] [Indexed: 11/19/2022]
Abstract
OBJECTIVE To examine the odds associated with having medical comorbidities among patients with serious mental illness (SMI) in a large integrated health system. METHOD In a secondary analysis of electronic health record data, this study identified 25,090 patients with an ICD-9 SMI diagnosis of bipolar disorder (n=20,308) or schizophrenia (n=4782) and 25,090 controls who did not have a SMI, matched on age, gender, and medical home facility. Conditional logistic regressions compared the odds associated with having nine medical comorbidity categories and fifteen chronic or serious conditions among patients with SMI versus controls. RESULTS Results showed having a SMI was associated with significantly higher odds of each medical comorbidity examined (p's<0.001), except no evidence of a significant association was found between having schizophrenia and musculoskeletal diseases. A similar pattern was found regarding the chronic or severe conditions, where having schizophrenia or bipolar was associated with >1.5 times the odds of each condition (p's<0.001). CONCLUSIONS In an integrated health system where patients may have fewer barriers to care, SMI patients are likely to present for treatment with a range of medical comorbidities, including chronic and severe conditions. SMI patients may need outreach strategies focused on disease prevention, screening and early diagnosis, and treatment to address medical comorbidities and associated poor health outcomes.
Collapse
Affiliation(s)
- Amber L Bahorik
- Department of Psychiatry, 401 Parnassus Avenue, University of California, San Francisco, CA 94143, USA; Division of Research, Kaiser Permanente Northern California, 2000 Broadway, Oakland, CA 94612, USA.
| | - Derek D Satre
- Department of Psychiatry, 401 Parnassus Avenue, University of California, San Francisco, CA 94143, USA; Division of Research, Kaiser Permanente Northern California, 2000 Broadway, Oakland, CA 94612, USA
| | - Andrea H Kline-Simon
- Division of Research, Kaiser Permanente Northern California, 2000 Broadway, Oakland, CA 94612, USA
| | - Constance M Weisner
- Department of Psychiatry, 401 Parnassus Avenue, University of California, San Francisco, CA 94143, USA; Division of Research, Kaiser Permanente Northern California, 2000 Broadway, Oakland, CA 94612, USA
| | - Cynthia I Campbell
- Department of Psychiatry, 401 Parnassus Avenue, University of California, San Francisco, CA 94143, USA; Division of Research, Kaiser Permanente Northern California, 2000 Broadway, Oakland, CA 94612, USA
| |
Collapse
|
13
|
Bressington D, Mui J, Wells H, Chien WT, Lam C, White J, Gray R. Refocusing on physical health: Community psychiatric nurses' perceptions of using enhanced health checks for people with severe mental illness. Int J Ment Health Nurs 2016; 25:214-24. [PMID: 26857108 DOI: 10.1111/inm.12195] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/02/2015] [Revised: 09/23/2015] [Accepted: 10/11/2015] [Indexed: 11/30/2022]
Abstract
In the present qualitative, descriptive study, we explored Hong Kong community psychiatric nurses' (CPN) perceptions of using comprehensive physical health checks for service users diagnosed with severe mental illness (SMI). Research interviews were conducted with a purposive sample of 11 CPN in order to explore their perceptions about the use of the Health Improvement Profile (HIP) over a 1-year period. Interview data were analysed using inductive thematic analysis. The analysis revealed that the majority of CPN appreciated the comprehensive focus on the physical health of their clients and reported positive changes in their clinical practice. Many of them observed an increase in the motivation of their clients to improve their physical health, and also noted observable benefits in service users' well-being. The use of the HIP also helped the CPN identify implementation barriers, and highlighted areas of the tool that required modifications to suit the local cultural and clinical context. To our knowledge, this is the first study conducted in an Asian mental health service that explores nurses' views about using comprehensive health checks for people with SMI. The findings suggest that such approaches are viewed as being acceptable, feasible, and potentially beneficial in the community mental health setting.
Collapse
Affiliation(s)
| | - Jolene Mui
- Castle Peak Hospital, Tuen Mun, New Territories, Hong Kong
| | - Harvey Wells
- School of Nursing, Kingston University and St George's, University of London, London
| | - Wai Tong Chien
- School of Nursing, The Hong Kong Polytechnic University, Hung Hom
| | - Claire Lam
- School of Nursing, The Hong Kong Polytechnic University, Hung Hom
| | - Jacquie White
- Department of Nursing, University of Hull, Yorkshire, UK
| | - Richard Gray
- Department of Nursing Research and Education, Hamad Medical Corporation, Doha, Qatar.,School of Nursing and Midwifery, The University of South Australia, Whyalla, South Australia, Australia
| |
Collapse
|
14
|
Goh AMY, Westphal A, Daws T, Gascoigne-Cohen S, Hamilton B, Lautenschlager NT. A retrospective study of medical comorbidities in psychogeriatric patients. Psychogeriatrics 2016; 16:12-9. [PMID: 25737391 DOI: 10.1111/psyg.12111] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/13/2014] [Revised: 12/08/2014] [Accepted: 12/26/2014] [Indexed: 11/27/2022]
Abstract
BACKGROUND This study contributes further research into the assessment and treatment of older psychiatric patients with medical comorbidities. METHODS A retrospective file audit was conducted at the acute inpatient psychogeriatric unit of St Vincent's Aged Mental Health Service, Melbourne, in order to determine the prevalence of certain medical comorbidities and the nature of medical interventions provided for psychogeriatric inpatients. RESULTS This study, investigating 165 admissions into an acute inpatient psychogeriatric unit, highlights that psychiatric and medical comorbidities are routine in this population: the vast majority (91.5%) of all inpatients had at least one medical comorbidity. CONCLUSIONS As the population ages, psychogeriatric wards are likely to see more of the oldest-olds, who are likely to have comorbid medical illnesses. Currently, appropriate detection, investigation, and management of these illnesses are often suboptimal and can affect quality of life, increase mortality, and complicate treatment. This paper adds to the literature about the need for integrating medical and psychiatric care to create a more comprehensive strategy for treating the older person with psychiatric illness.
Collapse
Affiliation(s)
- Anita M Y Goh
- Academic Unit for Psychiatry of Old Age, Department of Psychiatry, University of Melbourne, Melbourne, Victoria, Australia.,St Vincent's Aged Mental Health Service, St Vincent's Hospital, Melbourne, Victoria, Australia.,Neuropsychiatry Unit, Melbourne Neuropsychiatry Centre, Royal Melbourne Hospital, Melbourne, Victoria, Australia
| | - Alissa Westphal
- Academic Unit for Psychiatry of Old Age, Department of Psychiatry, University of Melbourne, Melbourne, Victoria, Australia
| | - Teresa Daws
- Department of Nursing, University of Melbourne, Melbourne, Victoria, Australia
| | - Sophie Gascoigne-Cohen
- St Vincent's Aged Mental Health Service, St Vincent's Hospital, Melbourne, Victoria, Australia
| | - Bridget Hamilton
- Department of Nursing, University of Melbourne, Melbourne, Victoria, Australia.,St Vincent's Aged Mental Health Service, St Vincent's Hospital, Melbourne, Victoria, Australia
| | - Nicola T Lautenschlager
- Academic Unit for Psychiatry of Old Age, Department of Psychiatry, University of Melbourne, Melbourne, Victoria, Australia.,St Vincent's Aged Mental Health Service, St Vincent's Hospital, Melbourne, Victoria, Australia.,School of Psychiatry and Clinical Neurosciences, WA Centre for Health & Ageing, The University of Western Australia, Perth, Western Australia, Australia
| |
Collapse
|
15
|
Martin CT. The value of physical examination in mental health nursing. Nurse Educ Pract 2015; 17:91-6. [PMID: 26643656 DOI: 10.1016/j.nepr.2015.11.001] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/03/2014] [Revised: 10/29/2015] [Accepted: 11/03/2015] [Indexed: 11/19/2022]
Abstract
This article explores the use of a physical examination assignment in a mental health general nursing clinical placement course that addresses the poor physical health of people with mental illness and the barriers traditionally impeding health care provision for this population. A descriptive qualitative approach utilizes inductive content analysis to investigate 145 student survey responses. The assignment assists student nurses in understanding that physical and mental well-being are intrinsically linked. Students report increased comfort performing a physical examination on patients with mental illness post assignment. Students' initial bias towards this population was minimized post the clinical assignment. Poor physical health is common among people with mental health problems. Many view the provision of care as a major public health issue. Nurses are the front line caregivers of mental health service consumers and are well positioned to assess their physical needs. Their assessment may be the first step in recognizing health care issues in this population.
Collapse
Affiliation(s)
- Carolyn T Martin
- School of Nursing, California State University, Stanislaus, One University Circle, Turlock, CA 95382, USA.
| |
Collapse
|
16
|
Mortality of people suffering from mental illness: a study of a cohort of patients hospitalised in psychiatry in the north of France. Soc Psychiatry Psychiatr Epidemiol 2015; 50:269-77. [PMID: 25028200 DOI: 10.1007/s00127-014-0913-1] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/27/2013] [Accepted: 05/30/2014] [Indexed: 10/25/2022]
Abstract
BACKGROUND The mortality of people suffering from psychiatric illnesses is far higher than that of the general population, all categories of diagnosis combined; mortality statistics can be used as an index of quality of care. The aim of this study was to assess the all-cause mortality in psychiatric patients covering all diagnostic groups. METHODS The living or deceased status of 4,417 patients of majority age hospitalised in a public mental health establishment between 2004 and 2007 were requested from French National Institute for Statistics and Economic Studies on 1st January 2011. The cause of death of those people who had died was obtained from French National Institute for Health and Medical Research and comparative standardized mortality ratios (SMR) were established from the population in a region of northern France of the same age in 2006. RESULTS The study population was made up of 54% men and 46% women, median age 41 and 45 years old, respectively. Four hundred and seventy-three people died during the period studied. The SMR were 421 for men (95% CI 378-470) and 330 for women (95% CI 281-388). The highest SMRs were found in patients aged 35-54, with a 20-time higher mortality risk than the general population of the same age. CONCLUSION Our study confirms the considerably higher mortality in psychiatric patients than in general population, particularly in mean age and mostly due to an unnatural cause.
Collapse
|
17
|
Hemingway S, Clifton A, Stephenson J, Edward KL. Facilitating knowledge of mental health nurses to undertake physical health interventions: a pre-test/post-test evaluation. J Nurs Manag 2014; 22:383-93. [DOI: 10.1111/jonm.12220] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/08/2014] [Indexed: 11/30/2022]
Affiliation(s)
- Steve Hemingway
- School of Human and Health Sciences; Centre for Health and Social Care Research; University of Huddersfield; Queensgate Huddersfield UK
| | - Andrew Clifton
- School of Human and Health Sciences; Centre for Health and Social Care Research; University of Huddersfield; Queensgate Huddersfield UK
| | - John Stephenson
- School of Human and Health Sciences; Centre for Health and Social Care Research; University of Huddersfield; Queensgate Huddersfield UK
| | - Karen-Leigh Edward
- Faculty of Health Sciences; Australian Catholic University; Melbourne Vic. Australia
- Nursing Research Unit; St Vincent's Private Hospital; Melbourne Vic. Australia
| |
Collapse
|
18
|
Hemingway S, Trotter F, Stephenson J, Holdich P. Diabetes: increasing the knowledge base of mental health nurses. ACTA ACUST UNITED AC 2014; 22:991-2, 994-6. [PMID: 24067307 DOI: 10.12968/bjon.2013.22.17.991] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
Abstract
Physical health assessment for people with a serious mental illness (SMI) has been a neglected issue, with all the evidence showing that mental health nurses (MHNs) and associated practitioners need to develop such skills. The University of Huddersfield and South West Yorkshire Partnership Foundation Trust collaborated in a Physical Skills Project with the aim of facilitating knowledge and skills for MHNs. The development of the education and training workshop is presented. The results of a pre- and post-test evaluation of diabetes, evaluation of the workshop and, finally, implications for practice with regard to transferable knowledge and skill, are discussed.
Collapse
|
19
|
Abstract
The objective was to consider the feasibility of food diaries as a method of understanding the dietary behaviour of people with schizophrenia. Examination of the food diaries completed in 1 week by eight patients with schizophrenia. All the patients were successful in completing the task. Examination of the food diaries revealed that: eating fruit and vegetables was largely absent; there was very little variety in most of the patients' diets; patients relied heavily on convenience food and ready meals for their main meal; as a rule patients followed an ordered mealtime routine; generally patients did not drink enough fluid; they were not big treat eaters; only one patient recorded drinking any alcohol; overall there appeared to be poor diet literacy in our small sample. The results show that on the whole, people with schizophrenia have a poor diet. This could be due to a combination of financial difficulty, lack of skills in food preparation, lack of motivation to prepare food or ignorance of what constitutes a healthy diet. The fact that they all managed to complete the task is perhaps evidence of motivation to improve their health and demonstrates the utility of food diaries in educating this population.
Collapse
Affiliation(s)
- S Hardy
- The Northampton Physical Health and Well-Being Project, UK.
| | | |
Collapse
|
20
|
Happell B, Scott D, Platania-Phung C. Provision of preventive services for cancer and infectious diseases among individuals with serious mental illness. Arch Psychiatr Nurs 2012; 26:192-201. [PMID: 22633581 DOI: 10.1016/j.apnu.2011.09.002] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/07/2011] [Revised: 08/15/2011] [Accepted: 09/02/2011] [Indexed: 11/26/2022]
Abstract
Individuals living with serious mental illness (SMI) have increased mortality chiefly because of a higher prevalence of chronic disorders, including some cancers and infectious diseases. Although increased prevalence of these disorders may be attributable to lifestyle and risk behaviors, there is evidence that they may not be appropriately addressed by health professionals. We conducted a review of the literature describing preventive services for cancer and infectious diseases provided to individuals with SMI. Most studies demonstrated a 20%-30% reduced likelihood of breast, cervical, and colorectal cancer screening, or immunizations for influenza and pneumonia, in patients with SMI compared with those without SMI. This is most common in those with the most severe forms of SMI. HIV and hepatitis were more commonly screened for in people with SMI than the general population, likely because of the increased risk for these disorders within this group, but there were still substantial proportions of individuals with SMI who had never received a screening, or had not received a recent screening, for these disorders. The mental health nursing profession has an opportunity to address the disparity in care for cancer and infectious diseases, as well as other physical disorders, experienced by mental health consumers. With systemic support and ongoing education, mental health nurses may be capable of conducting or recommending screening for disorders and providing lifestyle advice. These practices may help to reduce the increased prevalence of chronic disease in SMI populations.
Collapse
Affiliation(s)
- Brenda Happell
- Institute for Health and Social Science Research, and School of Nursing and Midwifery, and CQUniversity Australia, Rockhampton, Queensland, Australia.
| | | | | |
Collapse
|
21
|
Blythe J, White J. Role of the mental health nurse towards physical health care in serious mental illness: an integrative review of 10 years of UK literature. Int J Ment Health Nurs 2012; 21:193-201. [PMID: 22533326 DOI: 10.1111/j.1447-0349.2011.00792.x] [Citation(s) in RCA: 83] [Impact Index Per Article: 6.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
People with serious mental illness have significantly poorer physical health compared to the general population. Mental health nurses are in a prime position to help reduce unacceptable death in this population. A literature search was undertaken to identify the role of the mental health nurse in regards to physical health care, intervention, and attaining the necessary knowledge to address the physical health needs of people in the UK with serious mental illness. Of 254 papers identified, nine met the inclusion criteria. An integrative literature review found that mental health nurses are not routinely supported by physical health-care education and training, with many expressing role ambiguity. Inpatient setting correlated to a less positive role attitude; poor primary-secondary care interface communication compounded the problem of this vulnerable population having their physical health needs identified and met.
Collapse
Affiliation(s)
- Jeanette Blythe
- School Nursing Team, Weelsby View Health Centre, Grimsby, UK.
| | | |
Collapse
|
22
|
Happell B, Scott D, Platania-Phung C, Nankivell J. Should we or shouldn't we? Mental health nurses' views on physical health care of mental health consumers. Int J Ment Health Nurs 2012; 21:202-10. [PMID: 22533327 DOI: 10.1111/j.1447-0349.2011.00799.x] [Citation(s) in RCA: 89] [Impact Index Per Article: 7.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/16/2023]
Abstract
People diagnosed with a mental illness experience poorer physical health than the general population. Nurses have been identified for their potential role in addressing physical health needs of consumers of mental health services. This paper reports on preliminary findings of a qualitative study on health-care services for physical and mental health in a regional area in Australia. A key purpose of the study was to explore the perceptions of nurses working in mental health settings of their physical care with consumers. A qualitative, exploratory approach was undertaken. Semi-structured focus groups were conducted with 38 nurses from one mental health service. Nurse participants described a common co-occurrence of physical problems and mental illness and expressed the importance of health-care services to treatment and prevention. Participants expressed divergent views on nurses' capacity to contribute to better health-care processes.
Collapse
Affiliation(s)
- Brenda Happell
- Institute for Health and Social Science Research, and School of Nursing and Midwifery, Central Queensland University Australia, Bruce Highway, Rockhampton, Queensland, Australia.
| | | | | | | |
Collapse
|
23
|
Happell B, Platania-Phung C, Scott D. Placing physical activity in mental health care: a leadership role for mental health nurses. Int J Ment Health Nurs 2011; 20:310-8. [PMID: 21896121 DOI: 10.1111/j.1447-0349.2010.00732.x] [Citation(s) in RCA: 65] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
The wide-ranging benefits of physical activity for consumers with mental illness are acknowledged within the mental health nursing field; however, this is not commonly translated to practice. The primary aim of this paper is to argue that mental health nurses are well positioned to, and should, provide leadership in promoting physical activity to improve the quality of care for people with mental illness. Topics addressed in this paper include the relationship between physical activity and both physical and mental health, the views and experiences of consumers with physical activity, the efficacy of physical activity interventions, the attitudes of nurses to physical activity as a component of care, barriers to a physical activity focus in care for mental illness, and the role of mental health nurses in promoting physical activity. There is a clear and important relationship between physical activity and mental health. Mental health nurses are well positioned to encourage and assist consumers to engage in physical activity, although they might lack the educational preparation to perform this role effectively.
Collapse
Affiliation(s)
- Brenda Happell
- Institute for Health and Social Science Research, School of Nursing and Midwifery, CQUniversity Australia, Rockhampton, Queensland.
| | | | | |
Collapse
|
24
|
Happell B, Platania-Phung C, Gray R, Hardy S, Lambert T, McAllister M, Davies C. A role for mental health nursing in the physical health care of consumers with severe mental illness. J Psychiatr Ment Health Nurs 2011; 18:706-11. [PMID: 21896113 DOI: 10.1111/j.1365-2850.2010.01666.x] [Citation(s) in RCA: 42] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/23/2022]
Abstract
There is extensive international evidence that people with severe mental illness have a lower standard of physical health than the general population. This leads to higher morbidity and mortality rates. Many of the causes for this poor physical health are modifiable. Yet the physical needs of this consumer group are neglected by healthcare systems in Australia, and elsewhere. While medical specialists are clearly integral to remedying this, nurses are well placed to play a key role in focused prevention and early intervention in the physical well-being of consumers with mental health problems. This paper outlines the specifics on how mental health nurses can be sensitized, prepared and empowered to help turn this serious health issue around. In particular, mental health nurses could be trained in and then utilize a new physical health check and response system in the UK (called the Health Improvement Profile) if adapted for use within Australia. This profile will be briefly introduced, and then its value to improving health care discussed.
Collapse
Affiliation(s)
- B Happell
- Institute for Health and Social Science Research and School of Nursing and Midwifery, CQ University Australia, Rockhampton, QLD, Australia.
| | | | | | | | | | | | | |
Collapse
|
25
|
Hardy S, White J, Deane K, Gray R. Educating healthcare professionals to act on the physical health needs of people with serious mental illness: a systematic search for evidence. J Psychiatr Ment Health Nurs 2011; 18:721-7. [PMID: 21896115 DOI: 10.1111/j.1365-2850.2011.01722.x] [Citation(s) in RCA: 45] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/09/2023]
Abstract
Healthcare professionals in primary and secondary care should monitor the physical health of people with serious mental illness, yet in practice this does not appear to be a routine intervention. Our objective is to develop evidence-based training for healthcare professionals to enable them all to offer better physical care to this population. We performed a systematic search with the aim of evaluating the current evidence of the efficacy of education interventions. Search terms covered Severe Mental Illness, Physical Health and Education. The search yielded 147 papers, of which none were eligible for inclusion. A number of studies were excluded from this review as although there was an implicit education package provided to healthcare professionals, no information was reported on the outcomes of this education with regard to healthcare professionals' knowledge, attitudes and behaviours. The only information that these studies provided was patient-specific outcomes. It is vital that researchers start to publish details of healthcare professional education and their outcomes in physical health and serious mental illness research.
Collapse
Affiliation(s)
- S Hardy
- PhyHWell Project, Northamptonshire teaching PCT, Norwich, UK.
| | | | | | | |
Collapse
|
26
|
Life expectancy at birth for people with serious mental illness and other major disorders from a secondary mental health care case register in London. PLoS One 2011; 6:e19590. [PMID: 21611123 PMCID: PMC3097201 DOI: 10.1371/journal.pone.0019590] [Citation(s) in RCA: 420] [Impact Index Per Article: 32.3] [Reference Citation Analysis] [Abstract] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/24/2011] [Accepted: 04/01/2011] [Indexed: 11/19/2022] Open
Abstract
OBJECTIVE Despite improving healthcare, the gap in mortality between people with serious mental illness (SMI) and general population persists, especially for younger age groups. The electronic database from a large and comprehensive secondary mental healthcare provider in London was utilized to assess the impact of SMI diagnoses on life expectancy at birth. METHOD People who were diagnosed with SMI (schizophrenia, schizoaffective disorder, bipolar disorder), substance use disorder, and depressive episode/disorder before the end of 2009 and under active review by the South London and Maudsley NHS Foundation Trust (SLAM) in southeast London during 2007-09 comprised the sample, retrieved by the SLAM Case Register Interactive Search (CRIS) system. We estimated life expectancy at birth for people with SMI and each diagnosis, from national mortality returns between 2007-09, using a life table method. RESULTS A total of 31,719 eligible people, aged 15 years or older, with SMI were analyzed. Among them, 1,370 died during 2007-09. Compared to national figures, all disorders were associated with substantially lower life expectancy: 8.0 to 14.6 life years lost for men and 9.8 to 17.5 life years lost for women. Highest reductions were found for men with schizophrenia (14.6 years lost) and women with schizoaffective disorders (17.5 years lost). CONCLUSION The impact of serious mental illness on life expectancy is marked and generally higher than similarly calculated impacts of well-recognised adverse exposures such as smoking, diabetes and obesity. Strategies to identify and prevent causes of premature death are urgently required.
Collapse
|
27
|
Scott D, Happell B. The high prevalence of poor physical health and unhealthy lifestyle behaviours in individuals with severe mental illness. Issues Ment Health Nurs 2011; 32:589-97. [PMID: 21859410 DOI: 10.3109/01612840.2011.569846] [Citation(s) in RCA: 275] [Impact Index Per Article: 21.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
Recent mental health care policy has addressed the need for health care professionals to consider the physical health of consumers. Mental health nurses are particularly well-placed for this role. To provide mental health nurses with practical information, this narrative review summarises evidence from recent research on the physical health of individuals with Serious Mental Illness (SMI). In those with SMI, the international prevalence of obesity, the metabolic syndrome, diabetes mellitus, symptoms of cardiovascular disease, and respiratory disease all exceed that of the general population by at least two times, and HIV prevalence may be increased by as much as eight times. This increased prevalence of chronic disease may be largely responsible for an increased risk of death of up to five times, resulting in as much as 30 years of potential life lost. Of particular concern, the recent evidence suggests that for physical health and increased mortality, the gap between individuals with SMI and the general population is worsening. Unhealthy lifestyle behaviours undoubtedly play a role in the development of poor physical health and chronic disease, and the present review indicates that low physical activity, poor diet, smoking, alcohol and substance abuse, and risky sexual behaviour are common in individuals with SMI. This narrative review demonstrates that the prevalence of poor physical health and health behaviours in people with SMI far exceed that observed in the general population, and reinforces the urgent need for mental health nurses to address physical health concerns in patients.
Collapse
Affiliation(s)
- David Scott
- CQUniversity Australia, Institute for Health and Social Science Research and School of Nursing and Midwifery, Rockhampton, Queensland, Australia
| | | |
Collapse
|
28
|
Hardy S, Gray R. Adapting the severe mental illness physical Health Improvement Profile for use in primary care. Int J Ment Health Nurs 2010; 19:350-5. [PMID: 20887609 DOI: 10.1111/j.1447-0349.2010.00686.x] [Citation(s) in RCA: 38] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
People with severe mental illness (SMI) have a higher incidence of long-term physical conditions, including diabetes and cardiovascular disease. This can dramatically reduce their life expectancy. In the UK, it is the duty of health-care professionals in primary care to monitor the physical health of this group of people. However, these professionals have been given no specific training in order to do this effectively. The Northampton Physical Health and Well-Being Project has been developed in order to reduce the mortality of people with SMI, improve their physical and emotional health, and increase their support network. We have adapted the Health Improvement Profile (a tool to help mental health nurses profile the physical health of people with SMI) for use in primary care by creating a manual and website and will provide bespoke training in its use to the health-care professionals.
Collapse
Affiliation(s)
- Sheila Hardy
- The Northampton Physical Health and Well-Being Project, Faculty of Health, University of East Anglia, Norwich, UK.
| | | |
Collapse
|
29
|
Happell B, Palmer C. The Mental Health Nurse Incentive Program: the benefits from a client perspective. Issues Ment Health Nurs 2010; 31:646-53. [PMID: 20854037 DOI: 10.3109/01612840.2010.488784] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
It is now acknowledged that a substantial proportion of the Australian population will experience a mental health condition at some time during their lives. Only a small proportion will access care and treatment for these conditions, and those who do are more likely to access general medical practitioners than specialist mental health providers. The Mental Health Nurse Incentive Program (MHNIP) was introduced by the Commonwealth Government to enhance access to mental health care by engaging mental health nurses in collaboration with general practitioners and private psychiatrists. The aim of the current study was to explore the experiences and opinions of clients utilising these services. A qualitative exploratory approach involving in-depth semi-structured interviews was utilised to enhance understanding of the client perspective. Interviews were conducted with 14 clients. Data were analysed using NVivo to assist with the identification of major themes. The findings revealed the major themes to be: initial reactions; a comfortable setting; flexibility; holistic care; and affordable care. These findings suggest that clients perceive the MHNIP as a valuable intervention that met the mental health needs of clients to a greater extent than had previously been possible.
Collapse
Affiliation(s)
- Brenda Happell
- Central Queensland University Australia, Institute of Health and Social Science Research and School of Nursing and Midwifery, Rockhampton, Australia.
| | | |
Collapse
|
30
|
MacNeela P, Morris R, Scott A, Treacy MP, Hyde A. Seen as core: a Delphi consensus study of essential elements of mental health nursing care in Ireland. Arch Psychiatr Nurs 2010; 24:339-48. [PMID: 20851325 DOI: 10.1016/j.apnu.2010.02.001] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/18/2009] [Revised: 01/24/2010] [Accepted: 02/03/2010] [Indexed: 12/11/2022]
Abstract
Continued ambiguity about the scope of mental health nursing is harmful to the discipline's identity and to patients' interests. Using a Delphi survey design, consensus was achieved on a set of 70 items representing core elements of mental health nursing among a sample of 150 mental health nurses working in Ireland. Items achieving consensus in Round 3 of the survey were composed of 28 clinical phenomena (framed as client problems), 18 direct and 12 indirect nursing interventions, and 12 nursing-sensitive outcomes of care. Mental health nurses accepted responsibility across a broad range of outcomes apart from those linked to physical care, the one domain of care rejected by participants. The findings portray mental health nursing as a psychosocial enterprise, encompassing both phenomenological and diagnosis-related elements.
Collapse
|