Physical Health Problems in Psychosis: Is It Time to Consider the Views of Family Carers?

Onwumere, Juliana; Shiers, David; Gaughran, Fiona

doi:10.3389/fpsyt.2018.00668

Cited by 6 publications

(13 citation statements)

References 39 publications

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“…Besides, carers also felt it was difficult to discuss physical health matters with service users because this may trigger conflict and they felt afraid of affecting their relationship if they reminded service users to follow some suggestions good for physical health. These communication difficulties prevented carers from providing support (Ince et al, 2019; Onwumere, Shiers, et al, 2018). The conversations required diplomacy and sensitivity to avoid conflict or ruptures in the caregiving relationship (Onwumere, Shiers, et al, 2018).…”

Section: Resultsmentioning

confidence: 99%

Experiences and views of carers regarding the physical health care of people with severe mental illness: An integrative thematic review of qualitative research

Yan

Gray

et al. 2021

Psychiatric Ment Health Nurs

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Accessible summary What is known on the subject? People with severe mental illness (SMI) have high rates of physical illnesses, and carers are core partners in managing their physical health. Qualitative research on carers' views/experiences of physical health care is limited, and there is no published systematic review that synthesizes the current evidence. What the paper adds to existing knowledge? Carers' views from seven articles were synthesised into nine themes and six subthemes describing their perceived facilitators, barriers and roles regarding the physical health care of people with SMI. Carers' voiced similar concerns to those previously identified by professionals and service users, particularly in relation to poor service access/responsiveness and communication difficulties with healthcare professionals. What are the implications for practice? Mental health nurses should be aware of the risk of diagnostic overshadowing and ensure they are both responsive and sensitive to carers concerns about the physical health of people with SMI. It is essential for mental health nurses to actively involve carers in managing physical health, especially in formulating physical healthcare plans and providing clear practical advice/information. Abstract IntroductionPeople with severe mental illness (SMI) have high rates of physical illnesses. Informal carers are core partners in addressing these issues, however research on their views/experiences is limited and there is no systematic review published on the topic. AimThis integrative thematic review explored the experiences and views of carers on physical health care in SMI by synthesizing the existing qualitative research findings. MethodsSix databases were searched from 2000 to 2021. Data were extracted and synthesised using thematic integrative analysis. The quality of included studies was assessed with the JBI Critical Appraisal Checklist. ResultsFive studies were included. Nine themes were identified conceptualising carers' perceived facilitators, barriers and roles regarding physical health care for people with SMI. DiscussionCarers felt that receiving practical help and a specialised role for mental health nurses would facilitate better physical health care. Lack of coordination/communication and poor service access/responsiveness were common barriers, often compounded by diagnostic overshadowing. Carers are involved in promoting healthy lifestyles, monitoring physical health and supporting access to services. Implications for PracticeMental health nurses should ensure they are responsive to carers' concerns and proactively support them to promote the physical health of people with SMI.

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Section: Resultsmentioning

confidence: 99%

Experiences and views of carers regarding the physical health care of people with severe mental illness: An integrative thematic review of qualitative research

Yan

Gray

et al. 2021

Psychiatric Ment Health Nurs

View full text Add to dashboard Cite

show abstract

“…Their role is often missed by research but can contribute to improvement in health status by assisting patients in their appointments and with their mobility. In addition, it should be mentioned that family carers often feel marginalized themselves by healthcare professionals, so their role needs greater acknowledgement [ 83 , 84 ].…”

Section: Discussionmentioning

confidence: 99%

Organization of Community Mental Health Services for Persons with a Severe Mental Illness and Comorbid Somatic Conditions: A Systematic Review on Somatic Outcomes and Health Related Quality of Life

Martens

Destoop

Dom

2021

IJERPH

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It is well established that persons with a severe mental illness (SMI) have a greater risk of physical comorbid conditions and premature mortality. Most studies in the field of community mental health care (CMHC) have only focused on improving cardiovascular health in people with a SMI using lifestyle approaches. Studies using organizational modifications are rather scarce. This systematic review aimed to synthesize and describe possible organizational strategies to improve physical health for persons with a SMI in CMHC. The primary outcome was Health-related Quality of Life (HR-QOL). Results suggested modest effects on quality of life and were inconsistent throughout all the included studies. Despite these findings, it appears that a more integrated approach had a positive effect on health outcomes, patient satisfaction and HR-QOL. The complexity of the processes involved in community care delivery makes it difficult to compare different models and organizational approaches. Mental health nurses were identified as possible key professionals in care organization, but no clear description of their role was found. This review could provide new insights into contributing factors for integrated care. Future research targeting the identification of the nurses’ role and facilitating factors in integrated care, in order to improve treatment and follow-up of somatic comorbidities, is recommended.

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“…Given the substantial and valued contribution that informal carers make to patient outcomes and the negative impact on their own health, 17,18,39,40 offering support to informal carers in SMI has been included in several treatment publications 41 . However, recognition of the importance of the interdependent relationship between patients and informal carers and the overlap between their caring needs as a dyad is absent.…”

Section: Implications For Practicementioning

confidence: 99%

“…Sustainable lifestyle modification and pharmacological treatments are needed to address CMR, MetS and related diseases 14 and typically rely on informal carer participation 17,18 . We argue that to understand the complex interactions that underpin the management of long‐term comorbid conditions, it is necessary to situate the experience of patients within the context of the caring dyad.…”

Section: Introductionmentioning

confidence: 99%

The experiences of the caring dyad: (Un)articulated realities of living with cardiometabolic risk, metabolic syndrome and related diseases in severe mental illness

Sud

Maidment

Bradley

et al. 2021

Health Expectations

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Background Informal carers play an important role in the care of patients with mental illness. Little is known of the relationship experience of the patient and their informal carer (caring dyad) as the context for the intersection between physical and mental health. Aim This study aimed to explore the impact of comorbid cardiometabolic risk (CMR), metabolic syndrome (MetS) and related diseases and severe mental illness (SMI) on the caring dyad. Design Between October 2018 and March 2020, we conducted 11 in‐depth semi‐structured interviews across 6 adult caring dyads, interviewing each individual separately. Setting Dyads were recruited within the United Kingdom; informal carers were nominated by the patient as a person who provided a significant amount of support. Variable Being Studied Participants were asked about the impacts of illness and caring on daily life. Data Analysis Data were analysed at the dyad level using thematic analysis, comparing and contrasting responses from each individual. Results Themes were identified: enhanced closeness, dissonance and balance within the caring dyad. Discussion and Conclusions This study uses a particular population of patients with comorbid CMR factors, MetS and related diseases and SMI and their informal carers to explore the relevance and utility of caring dyads as an analytical framework to inform practice and policy. Future interventions should consider factors impacting on dyadic relationships to formulate effective and sustainable dyadic care and treatment to improve health outcomes for both patients with SMI and their informal carers. Patient/Public Involvement In this study, patients and informal carers were participants. Topic guides were piloted with a patient and informal carer.

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Physical Health Problems in Psychosis: Is It Time to Consider the Views of Family Carers?

Cited by 6 publications

References 39 publications

Experiences and views of carers regarding the physical health care of people with severe mental illness: An integrative thematic review of qualitative research

Experiences and views of carers regarding the physical health care of people with severe mental illness: An integrative thematic review of qualitative research

Organization of Community Mental Health Services for Persons with a Severe Mental Illness and Comorbid Somatic Conditions: A Systematic Review on Somatic Outcomes and Health Related Quality of Life

The experiences of the caring dyad: (Un)articulated realities of living with cardiometabolic risk, metabolic syndrome and related diseases in severe mental illness

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