改善严重精神疾病患者的身体健康护理：评估患者和家属观点的定性研究。
Improvement of care for the physical health of patients with severe mental illness: a qualitative study assessing the view of patients and families.
机构信息
Pharmacotherapy and Pharmaceutical Care, University of Groningen, Antonius Deusinglaan 1, Groningen 9713 AV, The Netherlands.
出版信息
BMC Health Serv Res. 2013 Oct 21;13:426. doi: 10.1186/1472-6963-13-426.
BACKGROUND
Patients with severe mental illness (SMI) experience more physical comorbidity than the general population. Multiple factors, including inadequate seeking of healthcare and health care related factors such as lack of collaboration, underlie this undesirable situation. To improve this situation, the logistics of physical health care for patients with SMI need to be changed. We asked both patients and their families about their views on the current organization of care, and how this care could be improved.
METHODS
Group and individual interviews were conducted with patients and family of patients to explore their needs and preferences concerning the care for the physical health of patients with SMI, and to explore the shortcomings they had experienced. Using thematic analysis, responses were firstly divided into common topics, after which these topics were grouped into themes.
RESULTS
Three major themes for the improvement of the physical care of patients with SMI were found. Firstly, the reduced ability of patients with SMI to survey their own physical health interests requires health care that is tailored to these needs. Secondly, the lack of collaboration amongst mental health care professionals and general practitioners (GPs) hinders optimal care. Thirdly, concerns were expressed regarding the implementation of monitoring and supporting a healthy lifestyle. Patients with SMI welcome this implementation, but the logistics of providing this care can be improved.
CONCLUSIONS
An optimal approach for caring for the physical health of patients with SMI requires a professional approach, which is different to the routine care provided to the general public. This approach can and should be accomplished within the usual organizational structure. However, this requires tailoring of the health care to the needs of patients with SMI, as well as structural collaboration between mental health care professionals and GPs.
背景
患有严重精神疾病（SMI）的患者比一般人群经历更多的身体合并症。这种不理想的情况源于多种因素，包括寻求医疗保健不足以及缺乏协作等医疗保健相关因素。为了改善这种情况，需要改变 SMI 患者的身体健康护理的后勤工作。我们向患者及其家属询问了他们对当前护理组织的看法，以及如何改善这种护理。
方法
对患者及其家属进行了小组和个人访谈，以探讨他们对 SMI 患者身体健康护理的需求和偏好，以及他们所经历的不足之处。使用主题分析，首先将回复分为常见主题，然后将这些主题分为主题。
结果
发现改善 SMI 患者身体健康护理的三个主要主题。首先，SMI 患者自身调查身体健康兴趣的能力下降，需要针对这些需求提供医疗保健。其次，心理健康保健专业人员和全科医生（GP）之间缺乏协作，阻碍了最佳护理。第三，对实施监测和支持健康生活方式表示关注。SMI 患者欢迎这种实施，但提供这种护理的后勤工作可以得到改善。
结论
为 SMI 患者提供最佳的身体健康护理需要一种专业的方法，与为普通公众提供的常规护理不同。这种方法可以并且应该在常规组织结构内完成。但是，这需要根据患者的需求调整医疗保健，并在心理健康保健专业人员和 GP 之间建立结构性协作。
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