1
|
Bellass S, Lister J, Kitchen CEW, Kramer L, Alderson SL, Doran T, Gilbody S, Han L, Hewitt C, Holt RIG, Jacobs R, Prady SL, Shiers D, Siddiqi N, Taylor J. Living with diabetes alongside a severe mental illness: A qualitative exploration with people with severe mental illness, family members and healthcare staff. Diabet Med 2021; 38:e14562. [PMID: 33772867 DOI: 10.1111/dme.14562] [Citation(s) in RCA: 19] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/09/2020] [Revised: 02/24/2021] [Accepted: 03/24/2021] [Indexed: 01/01/2023]
Abstract
AIMS Diabetes is two to three times more prevalent in people with severe mental illness, yet little is known about the challenges of managing both conditions from the perspectives of people living with the co-morbidity, their family members or healthcare staff. Our aim was to understand these challenges and to explore the circumstances that influence access to and receipt of diabetes care for people with severe mental illness. METHODS Framework analysis of qualitative semi-structured interviews with people with severe mental illness and diabetes, family members, and staff from UK primary care, mental health and diabetes services, selected using a maximum variation sampling strategy between April and December 2018. RESULTS In all, 39 adults with severe mental illness and diabetes (3 with type 1 diabetes and 36 with type 2 diabetes), nine family members and 30 healthcare staff participated. Five themes were identified: (a) Severe mental illness governs everyday life including diabetes management; (b) mood influences capacity and motivation for diabetes self-management; (c) cumulative burden of managing multiple physical conditions; (d) interacting conditions and overlapping symptoms and (e) support for everyday challenges. People living with the co-morbidity and their family members emphasised the importance of receiving support for the everyday challenges that impact diabetes management, and identified barriers to accessing this from healthcare providers. CONCLUSIONS More intensive support for diabetes management is needed when people's severe mental illness (including symptoms of depression) or physical health deteriorates. Interventions that help people, including healthcare staff, distinguish between symptoms of diabetes and severe mental illness are also needed.
Collapse
Affiliation(s)
- Sue Bellass
- Department of Health Sciences, University of York, Heslington, York, UK
| | - Jennie Lister
- Department of Health Sciences, University of York, Heslington, York, UK
| | | | - Lyndsey Kramer
- Department of Sociology, Wentworth College, University of York, Heslington, York, UK
| | | | - Tim Doran
- Department of Health Sciences, University of York, Heslington, York, UK
| | - Simon Gilbody
- Department of Health Sciences, University of York, Heslington, York, UK
| | - Lu Han
- Department of Health Sciences, University of York, Heslington, York, UK
| | - Catherine Hewitt
- Department of Health Sciences, University of York, Heslington, York, UK
| | - Richard Ian Gregory Holt
- Faculty of Medicine/Southampton National Institute for Health Research Biomedical Research Centre, University Hospital Southampton NHS Foundation Trust, Southampton General Hospital, University of Southampton, Southampton, UK
| | - Rowena Jacobs
- Centre for Health Economics, University of York, York, UK
| | | | - David Shiers
- Division of Psychology and Mental Health/Greater, Manchester Mental Health NHS Trust/Primary Care and Health Sciences (Keele University), University of Manchester, Manchester, UK
| | - Najma Siddiqi
- Department of Health Sciences, University of York, Heslington, York, UK
- Bradford District Care NHS Foundation Trust, Shipley, Bradford, UK
- Hull York Medical School, University of York, Heslington, York, UK
| | - Johanna Taylor
- Department of Health Sciences, University of York, Heslington, York, UK
| |
Collapse
|