The lived experience of severe mental illness and long-term conditions: a qualitative exploration of service user, carer, and healthcare professional perspectives on self-managing co-existing mental and physical conditions.
Long-term conditions
Mental health
Multimorbidity
Qualitative research
Self-management
Severe mental illness
Journal
BMC psychiatry
ISSN: 1471-244X
Titre abrégé: BMC Psychiatry
Pays: England
ID NLM: 100968559
Informations de publication
Date de publication:
19 07 2022
19 07 2022
Historique:
received:
20
04
2022
accepted:
30
06
2022
entrez:
19
7
2022
pubmed:
20
7
2022
medline:
22
7
2022
Statut:
epublish
Résumé
People with severe mental illness (SMI), such as schizophrenia, have higher rates of physical long-term conditions (LTCs), poorer health outcomes, and shorter life expectancy compared with the general population. Previous research exploring SMI and diabetes highlights that people with SMI experience barriers to self-management, a key component of care in long-term conditions; however, this has not been investigated in the context of other LTCs. The aim of this study was to explore the lived experience of co-existing SMI and LTCs for service users, carers, and healthcare professionals. A qualitative study with people with SMI and LTCs, their carers, and healthcare professionals, using semi-structured interviews, focused observations, and focus groups across the UK. Forty-one interviews and five focus groups were conducted between December 2018 and April 2019. Transcripts were coded by two authors and analysed thematically. Three themes were identified, 1) the precarious nature of living with SMI, 2) the circularity of life with SMI and LTCs, and 3) the constellation of support for self-management. People with co-existing SMI and LTCs often experience substantial difficulties with self-management of their health due to the competing demands of their psychiatric symptoms and treatment, social circumstances, and access to support. Multiple long-term conditions add to the burden of self-management. Social support, alongside person-centred professional care, is a key facilitator for managing health. An integrated approach to both mental and physical healthcare was suggested to meet service user and carer needs. The demands of living with SMI present a substantial barrier to self-management for multiple co-existing LTCs. It is important that people with SMI can access person-centred, tailored support for their LTCs that takes into consideration individual circumstances and priorities.
Sections du résumé
BACKGROUND
People with severe mental illness (SMI), such as schizophrenia, have higher rates of physical long-term conditions (LTCs), poorer health outcomes, and shorter life expectancy compared with the general population. Previous research exploring SMI and diabetes highlights that people with SMI experience barriers to self-management, a key component of care in long-term conditions; however, this has not been investigated in the context of other LTCs. The aim of this study was to explore the lived experience of co-existing SMI and LTCs for service users, carers, and healthcare professionals.
METHODS
A qualitative study with people with SMI and LTCs, their carers, and healthcare professionals, using semi-structured interviews, focused observations, and focus groups across the UK. Forty-one interviews and five focus groups were conducted between December 2018 and April 2019. Transcripts were coded by two authors and analysed thematically.
RESULTS
Three themes were identified, 1) the precarious nature of living with SMI, 2) the circularity of life with SMI and LTCs, and 3) the constellation of support for self-management. People with co-existing SMI and LTCs often experience substantial difficulties with self-management of their health due to the competing demands of their psychiatric symptoms and treatment, social circumstances, and access to support. Multiple long-term conditions add to the burden of self-management. Social support, alongside person-centred professional care, is a key facilitator for managing health. An integrated approach to both mental and physical healthcare was suggested to meet service user and carer needs.
CONCLUSION
The demands of living with SMI present a substantial barrier to self-management for multiple co-existing LTCs. It is important that people with SMI can access person-centred, tailored support for their LTCs that takes into consideration individual circumstances and priorities.
Identifiants
pubmed: 35850709
doi: 10.1186/s12888-022-04117-5
pii: 10.1186/s12888-022-04117-5
pmc: PMC9295434
doi:
Types de publication
Journal Article
Research Support, Non-U.S. Gov't
Langues
eng
Sous-ensembles de citation
IM
Pagination
479Informations de copyright
© 2022. The Author(s).
Références
J Affect Disord. 2019 Mar 1;246:320-326
pubmed: 30594874
Innov Clin Neurosci. 2011 Oct;8(10):14-8
pubmed: 22132366
Epidemiol Psichiatr Soc. 2008 Jan-Mar;17(1):14-9
pubmed: 18444452
Psychosom Med. 2016 Apr;78(3):263-70
pubmed: 27111458
BMC Fam Pract. 2015 Nov 24;16:171
pubmed: 26597934
Lancet Psychiatry. 2015 May;2(5):465-476
pubmed: 26360289
Community Ment Health J. 2013 Apr;49(2):207-12
pubmed: 23054155
Br J Psychiatry. 2010 Oct;197(4):272-7
pubmed: 20884949
Br J Psychiatry. 2010 Feb;196(2):116-21
pubmed: 20118455
PLoS One. 2012;7(5):e36468
pubmed: 22615769
BJPsych Adv. 2018 Sep;24(5):319-333
pubmed: 30174829
BMC Med. 2016 Jun 22;14(1):88
pubmed: 27328975
Lancet Psychiatry. 2015 May;2(5):431-451
pubmed: 26360287
Psychol Med. 2015 Jan;45(1):11-27
pubmed: 24569086
Eur Psychiatry. 2009 Sep;24(6):412-24
pubmed: 19682863
Psychiatry Res. 2014 Jan 30;215(1):39-45
pubmed: 24113124
PLoS One. 2014 Nov 04;9(11):e111682
pubmed: 25369130
Cochrane Database Syst Rev. 2016 Apr 27;4:CD011361
pubmed: 27120555
BMC Psychiatry. 2017 Apr 13;17(1):138
pubmed: 28407746
Psychol Med. 2020 Jan;50(2):293-302
pubmed: 30744718
Eur Psychiatry. 2012 Jan;27(1):33-42
pubmed: 21570814
Ann Behav Med. 2019 Jul 17;53(8):693-707
pubmed: 30304386
Soc Work Public Health. 2014;29(6):581-93
pubmed: 25144699
PLoS One. 2021 Oct 26;16(10):e0258937
pubmed: 34699536
J Psychiatr Ment Health Nurs. 2019 Nov;26(9-10):347-357
pubmed: 31287193
J Psychiatr Ment Health Nurs. 2014 Jun;21(5):414-22
pubmed: 23829198
Diabet Med. 2021 Jul;38(7):e14562
pubmed: 33772867
Br J Psychiatry. 2015 Nov;207(5):450-7
pubmed: 26294369
Acta Psychiatr Scand. 2015 Aug;132(2):86-96
pubmed: 25976975
Health Technol Assess. 2018 Nov;22(65):1-160
pubmed: 30499443
Psychol Med. 2016 Oct;46(14):2869-2881
pubmed: 27502153
BMJ Open. 2015 Dec 15;5(12):e009010
pubmed: 26671955
Soc Sci Med. 2007 Sep;65(5):934-45
pubmed: 17521790
Am J Public Health. 2013 May;103(5):777-80
pubmed: 23488489
Issues Ment Health Nurs. 2012 Mar;33(3):172-80
pubmed: 22364429
Am J Public Health. 2014 Aug;104(8):e25-31
pubmed: 24922170
Front Psychiatry. 2021 Aug 18;12:723962
pubmed: 34489764
PLoS One. 2015 Aug 28;10(8):e0136603
pubmed: 26317516
Lancet Psychiatry. 2020 Jan;7(1):64-77
pubmed: 31860457
BMJ. 2008 Mar 1;336(7642):491-5
pubmed: 18276664
J Adv Nurs. 2013 Nov;69(11):2514-24
pubmed: 23621276