School of Psychology, Faculty of Science and Information Technology, The University of Newcastle, University Drive, Callaghan, NSW, 2308, Australia.
Hunter Medical Research Institute, Clinical Research Centre, Lot 1 Kookaburra Circuit, New Lambton Heights, NSW, 2305, Australia.
BMC Public Health. 2018 Mar 27;18(1):416. doi: 10.1186/s12889-018-5314-z.
People with a mental illness experience greater chronic disease morbidity and mortality, and associated reduced life expectancy, compared to those without such an illness. A higher prevalence of chronic disease risk behaviours (inadequate nutrition, inadequate physical activity, tobacco smoking, and harmful alcohol consumption) is experienced by this population. Family carers have the potential to support change in such behaviours among those they care for with a mental illness. This study aimed to explore family carers': 1) experiences in addressing the chronic disease risk behaviours of their family members; 2) existing barriers to addressing such behaviours; and 3) perceptions of potential strategies to assist them to provide risk behaviour change support.
A qualitative study of four focus groups (n = 31), using a semi-structured interview schedule, was conducted with carers of people with a mental illness in New South Wales, Australia from January 2015 to February 2016. An inductive thematic analysis was employed to explore the experience of carers in addressing the chronic disease risk behaviours.
Two main themes were identified in family carers' report of their experiences: firstly, that health behaviours were salient concerns for carers and that they were engaged in providing support, and secondly that they perceived a bidirectional relationship between health behaviours and mental well-being. Key barriers to addressing behaviours were: a need to attend to carers' own well-being; defensiveness on behalf of the family member; and not residing with their family member; with other behaviour-specific barriers also identified. Discussion around strategies which would assist carers in providing support for health risk behaviours identified a need for improved communication and collaboration between carers and health services accessed by their family members.
Additional support from general and mental health services accessed by family members is desired to assist carers to address the barriers to providing behaviour change support. Carers have the potential to support and extend health service interventions aimed at improving the chronic disease risk behaviours of people with a mental illness but may require additional information, and collaboration from services. Further research is needed to explore these constructs in a large representative sample.
与没有精神疾病的人相比，精神疾病患者患有更多的慢性疾病，死亡率更高，预期寿命更短。这类人群更容易出现慢性疾病风险行为（营养不足、身体活动不足、吸烟和有害饮酒）。家庭成员有潜力支持他们所照顾的精神疾病患者改变这些行为。本研究旨在探讨家庭照顾者：1）应对其家庭成员慢性疾病风险行为的经验；2）应对这些行为的现有障碍；3）对可能有助于他们提供风险行为改变支持的策略的看法。
2015 年 1 月至 2016 年 2 月，在澳大利亚新南威尔士州，对 31 名有精神疾病患者的家庭照顾者进行了四项焦点小组（n=31）的定性研究，使用半结构式访谈方案。采用归纳主题分析方法探讨照顾者应对慢性疾病风险行为的经验。
家庭照顾者在报告其经验时确定了两个主要主题：首先，健康行为是照顾者关注的重要问题，他们提供支持；其次，他们认为健康行为和心理健康之间存在双向关系。解决行为问题的主要障碍包括：照顾者自身健康的需要；家庭成员的防御性；不与家庭成员同住；还确定了其他特定行为的障碍。围绕有助于照顾者为健康风险行为提供支持的策略的讨论，需要改善照顾者与其家庭成员所使用的医疗保健服务之间的沟通和协作。
家庭成员所使用的一般医疗和精神健康服务需要提供更多支持，以帮助照顾者解决提供行为改变支持的障碍。照顾者有潜力支持和扩展旨在改善精神疾病患者慢性疾病风险行为的健康服务干预措施，但可能需要额外的信息和服务协作。需要进一步研究来探索这些结构在大的代表性样本中的情况。
