Centre for Health Services Research, School of Health Sciences, City, University of London, London, UK.
East London NHS Foundation Trust, London, UK.
Health Expect. 2017 Oct;20(5):1020-1030. doi: 10.1111/hex.12543. Epub 2017 Mar 17.
People with diabetes and severe mental illness (SMI) experience poorer outcomes than those with diabetes alone. To improve outcomes, it is necessary to understand the difficulties that people with SMI experience in managing their diabetes.
To identify barriers and enablers to effective diabetes self-management experienced by people with SMI and type 2 diabetes.
Qualitative methodology using semi-structured interviews was employed. Development of the interview topic guide and analysis of the transcripts were informed by the Theoretical Domains Framework for behaviour change, which consists of fourteen theoretical domains that have been found to influence behaviour.
Fourteen people with SMI and type 2 diabetes took part in the study. Participants considered diabetes self-management to be important, were aware of the risks of poor diabetes control but struggled to follow recommended advice, particularly if their mental health was poor. Support from family and health professionals was considered an important enabler of diabetes self-management.
New approaches are required to support diabetes self-management in people with SMI. This study identified some of the important domains that may be targeted in new interventions.
患有糖尿病和严重精神疾病（SMI）的人比仅患有糖尿病的人预后更差。为了改善预后，有必要了解 SMI 患者在管理糖尿病方面所面临的困难。
确定患有 SMI 和 2 型糖尿病的人在有效自我管理糖尿病方面所面临的障碍和促进因素。
采用定性方法，使用半结构式访谈。访谈主题指南的制定和转录本的分析均基于行为改变的理论领域框架，该框架包含已发现会影响行为的 14 个理论领域。
14 名患有 SMI 和 2 型糖尿病的患者参与了研究。参与者认为自我管理糖尿病很重要，他们意识到控制不佳的风险，但难以遵循建议，尤其是在他们的心理健康状况不佳的情况下。家庭和卫生专业人员的支持被认为是糖尿病自我管理的一个重要促进因素。
需要新的方法来支持 SMI 患者的自我管理。本研究确定了一些可能成为新干预措施目标的重要领域。
