Collins Claire, Finegan Pearse, O'Shea Marie, Larkin James, Pericin Ivana, Osborne Brian
Research Centre, Irish College of General Practitioners, Dublin, Ireland
Research Centre, Irish College of General Practitioners, Dublin, Ireland.
BMJ Open. 2021 Apr 21;11(4):e044855. doi: 10.1136/bmjopen-2020-044855.
People with enduring mental illness (EMI) have higher morbidity and mortality from chronic diseases than the general population, and this results in a significantly reduced relative life expectancy-accounted for primarily by physical illness. This gap may be partly influenced by the reduced likelihood of access to and uptake of regular physical health screening.
To establish Irish service providers' perspectives regarding the care of the physical health of people with EMI in an effort to inform future service developments aimed at improving the physical health of people with EMI.
Qualitative study of healthcare providers-general practitioners (GPs) and members of the community mental health teams-in Ireland.
GPs and mental health service providers.
Qualitative semi-structured interviews were conducted with 34 service providers. Thematic analysis was undertaken.
Participants considered that the physical health of people with EMI is not currently regularly addressed by the patient's GP or the mental health team. Factors associated with this include patient compliance with attendance, time constraints in consultations to adequately support patient self-management, communication difficulties with the patient and between primary and secondary care, and lack of clarity as to whose responsibility it is to ensure physical health is monitored. In participants' view, a barrier to improvement is the present funding approach.
The evidence from this study has the potential to form the basis for innovation and change in service delivery for people with an EMI in Ireland and internationally, specifically in countries where it is not clear who has the overall responsibility to monitor the physical health of patients with EMI. This role requires time and regular contact, and both the organisation and the funding of the health system need to support it.
患有持久性精神疾病（EMI）的人群相较于普通人群，患慢性病的发病率和死亡率更高，这导致其相对预期寿命显著缩短，主要原因是躯体疾病。这种差距可能部分受到获得和接受常规身体健康筛查的可能性降低的影响。
了解爱尔兰服务提供者对患有EMI的人群身体健康护理的看法，以便为未来旨在改善患有EMI的人群身体健康的服务发展提供信息。
对爱尔兰的医疗服务提供者——全科医生（GPs）和社区精神卫生团队成员进行定性研究。
全科医生和精神卫生服务提供者。
对34名服务提供者进行了定性半结构化访谈，并进行了主题分析。
参与者认为，患有EMI的人群的身体健康目前未得到患者的全科医生或精神卫生团队的定期关注。与此相关的因素包括患者就诊的依从性、咨询中时间有限难以充分支持患者自我管理、与患者以及初级和二级护理之间的沟通困难，以及不清楚由谁负责确保对身体健康进行监测。在参与者看来，改善的一个障碍是目前的资金投入方式。
这项研究的证据有可能为爱尔兰以及国际上患有EMI的人群的服务提供创新和变革奠定基础，特别是在不清楚谁对监测患有EMI的患者的身体健康负有总体责任的国家。这一角色需要时间和定期接触，卫生系统的组织和资金都需要为此提供支持。
