Managing Patients with Diabetes Mellitus and Mental Health Problems

Prim Health Care Res Dev

2012

A qualitative, explorative design was used, collecting data through semi-structured interviews with 12 MHCS working in psychosis outpatient care in Sweden. Data were analysed with qualitative content analysis. Findings Three categories emerged and provide a deeper understanding of how staff were aware of the risks of type 2 diabetes among their patients and therefore performed lifestyle interventions to promote these. Nevertheless, they lacked knowledge of diabetes care and simultaneously felt a lack of training among diabetes nurses to adapt diabetes care to suit persons with cognitive dysfunctions. Patients who were overconfident in their ability to manage diabetes care reported to have experienced most difficulties. Cooperation among those involved in these persons' health was considered necessary. Implications Diabetes care for persons with psychosis could improve if knowledge of type 2 diabetes was increased among MHCS and training in how to adapt diabetes care to persons with cognitive dysfunctions was enlarged among diabetes nurses. A challenge for nurses is to see how the care of different illnesses and support given by the family and others affect the persons total life situation and health. Healthcare plans and cooperation among all those involved in these persons' health is necessary for this.

Section: Introductionmentioning

confidence: 99%

Mental healthcare staff's knowledge and experiences of diabetes care for persons with psychosis – a qualitative interview study

Prim Health Care Res Dev

2012

“…The importance of organizing care with consideration for difficulties found among persons with psychosis was identified in 10 of the reviewed studies (Warren et al . 2001, Brar et al .…”

Section: Resultsmentioning

confidence: 99%

“…2007, Fagiolini et al . 2008, Llorca 2008). These include difficulties in adherence to treatment, inability to manage self‐care programmes, difficulties negotiating appointments, referrals and follow‐up care (Warren et al . 2001, Brar et al .…”

Section: Resultsmentioning

confidence: 99%

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Organizing care for persons with psychotic disorders and risk of or existing diabetes mellitus type 2

Psychiatric Ment Health Nurs

Hjelm

2012

This literature review aimed to explore previous knowledge about specific care requirements for persons with psychotic disorders and risk of or existing type 2 diabetes. Sixteen qualitative and quantitative studies in the area were identified and summarized. The studies together indicate that mental health nurses play an important role in motivating people to perform diabetes care as they are often known to and trusted by the patients. A holistic approach to the person's health, with close follow-ups by psychiatric care and cooperation with diabetes care, may have benefits for the person with diabetes. Screening for and treating psychotic symptoms is an important task for the mental health nurse, as these symptoms drain energy from the person and prevent diabetes self-care. Lifestyle and diabetes education needs to be practical, adapted to the individual and focused on maintaining a healthy diet, regular exercise, changing smoking habits and preventing diabetes complications. Treatment with antipsychotic drugs increases the need for follow-ups of glycaemic control.

“…Previous studies indicate that with shared‐care systems (Van Bruggen et al . 2007) or with care being team based with excellent coordination and communication between specialists, the person and their family are more likely to have good outcomes (Warren et al . 2001).…”

Section: Discussionmentioning

confidence: 99%

Community health‐care staff's experiences of support to prevent type 2 diabetes among people with psychosis: An interview study with health staff

Int J Mental Health Nurs

Hjelm

2012

The aim of the study was to describe mental health staff experiences of giving support to prevent type 2 diabetes mellitus (DM) among people with psychosis in community psychiatry. A qualitative interview study with a purposeful sample of 12 community health staff was conducted. Data were analysed using qualitative content analysis. The results show how staff reported continuously supporting people with psychosis to adapt to healthy lifestyles, but stated that support is not given until after a person becomes overweight or is diagnosed with type 2 DM. Support was described as a never-ending process of motivation facing many reverses. Individually-adapted support given in practical situations was perceived as most successful. Cooperation between health-care organizations was seen as essential, but inadequate. Limitations in income and social network, and easy access to fast food and alcohol, were seen as obstacles to support. The results indicate that community health staff are in a position to make a considerable impact in motivating and supporting healthy lifestyle changes in practical situations in daily life among people with psychosis. This study raises awareness of how community health staff's support can be useful when developing nursing skills and health-care plans for people with psychosis.