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.
WHITE J., GRAY R. & JONES M. (2009) Journal of Psychiatric and Mental Health Nursing16, 493-498 The development of the serious mental illness physical Health Improvement ProfilePeople with serious mental illness (SMI), such as schizophrenia and bipolar disorder, are more likely to suffer from a range of long-term physical conditions including diabetes and cardiovascular disease. Consequently they will die 10-15 years earlier than the general population. Health services have failed to address this major health inequality because of a lack of consensus about the type and frequency of monitoring people with SMI require and a lack of knowledge and skills in the mental health workforce. We developed the SMI physical Health Improvement Profile to help mental health nurses profile the physical health of the SMI patients they work with and direct them towards the evidence base interventions available to address identified health problems.
This paper describes the development of an adherence therapy intervention in schizophrenia and synthesizes the results to date of a collaborative international programme of research. Sticking to treatment is essential to control symptoms and prevent relapse, but as with other long-term conditions, medication adherence is poor. Adherence therapy seeks to facilitate a process of shared decision making, where both parties work towards agreed goals. Central is the theory that when patients make shared choices with a professional they are more likely to stick with them because they are personally owned and meaningful. The results of adherence therapy trials that seek to test this theory are mixed. Outcomes of trials might have been be affected by the point in the patient's illness cycle when therapy was delivered and by sampling bias. Authors of trials of medication management and alliance training packages that aim to equip mental health workers with adherence therapy competencies show considerable promise in improving clinical outcomes. Helping patients manage their medication is central to the work of mental health nurses. We argue that the potential benefits to patients are such that there is sufficient evidence to recommend that all mental health nurses receive medication management training.
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.
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