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照顾者对共病的体验:(无法)言说的严重精神疾病患者共患心血管代谢风险、代谢综合征和相关疾病的现实。

The experiences of the caring dyad: (Un)articulated realities of living with cardiometabolic risk, metabolic syndrome and related diseases in severe mental illness.

机构信息

Aston Pharmacy School, College of Life and Health Sciences, Aston University, Birmingham, UK.

Pharmacy Department, Leicestershire Partnership NHS Trust, Bradgate Mental Health Site, Glenfield Hospital Site, Leicester, UK.

出版信息

Health Expect. 2021 Oct;24(5):1821-1832. doi: 10.1111/hex.13322. Epub 2021 Aug 2.

Abstract

BACKGROUND

Informal carers play an important role in the care of patients with mental illness. Little is known of the relationship experience of the patient and their informal carer (caring dyad) as the context for the intersection between physical and mental health.

AIM

This study aimed to explore the impact of comorbid cardiometabolic risk (CMR), metabolic syndrome (MetS) and related diseases and severe mental illness (SMI) on the caring dyad.

DESIGN

Between October 2018 and March 2020, we conducted 11 in-depth semi-structured interviews across 6 adult caring dyads, interviewing each individual separately.

SETTING

Dyads were recruited within the United Kingdom; informal carers were nominated by the patient as a person who provided a significant amount of support.

VARIABLE BEING STUDIED

Participants were asked about the impacts of illness and caring on daily life.

DATA ANALYSIS

Data were analysed at the dyad level using thematic analysis, comparing and contrasting responses from each individual.

RESULTS

Themes were identified: enhanced closeness, dissonance and balance within the caring dyad.

DISCUSSION AND CONCLUSIONS

This study uses a particular population of patients with comorbid CMR factors, MetS and related diseases and SMI and their informal carers to explore the relevance and utility of caring dyads as an analytical framework to inform practice and policy. Future interventions should consider factors impacting on dyadic relationships to formulate effective and sustainable dyadic care and treatment to improve health outcomes for both patients with SMI and their informal carers.

PATIENT/PUBLIC INVOLVEMENT: In this study, patients and informal carers were participants. Topic guides were piloted with a patient and informal carer.

摘要

背景

在精神疾病患者的护理中,非专业护理人员发挥着重要作用。对于患者及其非专业护理人员(护理二人组)的关系体验,以及其作为身心健康交叉点的背景,我们知之甚少。

目的

本研究旨在探讨共患心血管代谢风险(CMR)、代谢综合征(MetS)和相关疾病以及严重精神疾病(SMI)对护理二人组的影响。

设计

2018 年 10 月至 2020 年 3 月,我们在英国进行了 11 次深入的半结构式访谈,跨越 6 对成年护理二人组,分别对每个个体进行访谈。

设置

二人组在英国招募;非专业护理人员由患者提名,他们是提供大量支持的人。

研究变量

要求参与者描述疾病和护理对日常生活的影响。

数据分析

使用主题分析在二人组层面上分析数据,比较和对比每个个体的回答。

结果

确定了以下主题:护理二人组内的亲密感增强、不和谐和平衡。

讨论和结论

本研究使用了患有共患 CMR 因素、MetS 和相关疾病以及 SMI 的特定患者群体及其非专业护理人员,以探讨护理二人组作为一种分析框架的相关性和实用性,以告知实践和政策。未来的干预措施应考虑影响二人关系的因素,制定有效的和可持续的二人护理和治疗,以改善 SMI 患者及其非专业护理人员的健康结果。

患者/公众参与:在本研究中,患者和非专业护理人员是参与者。主题指南在一名患者和一名非专业护理人员中进行了试点。

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