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严重精神疾病患者对身体保健的态度:一项患者和精神科临床医生定性访谈研究。

Attitudes to physical healthcare in severe mental illness; a patient and mental health clinician qualitative interview study.

机构信息

Foundation Year 3 Physical Health Care, Department of Psychiatry, University of Oxford, Oxford, UK.

Oxford Health NHS Foundation Trust, Oxford, UK.

出版信息

BMC Fam Pract. 2020 Nov 27;21(1):243. doi: 10.1186/s12875-020-01316-5.

Abstract

BACKGROUND

People with severe mental illness experience physical health significantly worse than the general population. Physical health monitoring is shared between primary care and secondary mental healthcare services, though there is debate whether mental health teams should provide more physical healthcare. The views of mental health clinicians and patients with mental illness towards physical healthcare provision are unclear.

AIMS

To explore the attitudes of Community Mental Health Team (CMHT) clinicians and patients experiencing severe mental illness towards physical healthcare and its provision.

DESIGN AND SETTING

Qualitative study in a CMHT setting.

METHODS

Interviews were carried out with CMHT clinicians and patients with severe mental illness. Data were collected using semi-structured interviews and analysed using thematic analysis.

RESULTS

There were 14 patients and 15 clinicians recruited. Patients varied in their awareness of the association between physical and mental health, but were engaged in physical health monitoring. Clinicians were aware of the importance of physical healthcare but reported barriers to provision, including lack of training, resource constraints and uncertainty in their role. There was no consensus in either group regarding how physical healthcare should be provided, with diverse attitudes expressed for why CMHTs should and shouldn't provide more physical healthcare.

CONCLUSIONS

Increasing physical healthcare provision from mental health teams requires healthcare-related barriers be addressed, but it remains unclear whether CMHT clinicians or patients believe this to be a solution.

摘要

背景

患有严重精神疾病的人经历的身体健康状况明显不如一般人群。身体健康监测由初级保健和二级精神卫生保健服务共同负责,尽管人们对于精神卫生团队是否应该提供更多的身体健康护理存在争议。精神卫生临床医生和患有精神疾病的患者对身体保健服务的看法尚不清楚。

目的

探讨社区精神卫生团队(CMHT)的临床医生和患有严重精神疾病的患者对身体保健以及其提供的态度。

设计和设置

在 CMHT 环境中进行的定性研究。

方法

对 CMHT 临床医生和患有严重精神疾病的患者进行了访谈。使用半结构化访谈收集数据,并使用主题分析进行分析。

结果

共招募了 14 名患者和 15 名临床医生。患者对身心健康之间的关联的认识程度不同,但都参与了身体健康监测。临床医生意识到身体健康护理的重要性,但报告了提供服务的障碍,包括缺乏培训、资源限制和角色不确定。在两组中,对于如何提供身体保健服务都没有达成共识,对于 CMHT 应该或不应该提供更多的身体保健服务,表达了不同的态度。

结论

增加精神卫生团队提供的身体保健服务需要解决与医疗保健相关的障碍,但尚不清楚 CMHT 临床医生或患者是否认为这是一种解决方案。

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