Nienke T. Y. G. van der Voort, PhD, Inholland University of Applied Sciences, Amsterdam, the Netherlands / Saxion University of Applied Sciences, Deventer, The Netherlands.
Nikki C. Klaessen, MSc, Avans, University of Applied Science, Den Bosch, The Netherlands.
J Am Psychiatr Nurses Assoc. 2024 Jan-Feb;30(1):141-148. doi: 10.1177/10783903221085596. Epub 2022 Apr 20.
The life expectancy of patients with severe mental illness (SMI) is estimated to be 20 to 30 years shorter than in the general population due to avoidable physical illnesses. This gap is widening. Health care professionals' performance with regard to physical health and lifestyle appears to be suboptimal.
The purpose of this study is to formulate recommendations to enhance physical care for patients with an SMI.
A generic descriptive qualitative study was conducted. Fifteen mental health nurses (MHNs) working in community mental health care in the Netherlands were interviewed. Thematic analysis of the data was performed.
Most MHNs perceived physical screening and lifestyle interventions to be an important part of their professional role. However, they recognize discrepancy between their perception and actual practice. Most MHNs focus in particular on the psychiatric illness and its consequences for daily living, and they defined the provision of physical health care as a secondary concern. Participants described building a therapeutic relationship as a crucial, however, difficult part of the process of working on physical health promotion. Many MHNs tend to formulate goals and necessary behavioral changes on behalf of their patients, rather than helping them formulate their own goals and activities for themselves.
Building a good therapeutic relationship with patients and supporting patients in defining their own lifestyle goals can enhance nursing physical care. Support by other team members (such as NPs) and managers is needed. In training and education for professionals, the lessons learned in this study should be included.
由于可避免的身体疾病，严重精神疾病 (SMI) 患者的预期寿命比一般人群短 20 到 30 年。这一差距正在扩大。医疗保健专业人员在身体健康和生活方式方面的表现似乎并不理想。
本研究旨在制定建议，以加强对 SMI 患者的身体护理。
进行了一项通用描述性定性研究。采访了荷兰社区精神卫生保健机构的 15 名精神科护士 (MHN)。对数据进行了主题分析。
大多数 MHN 认为身体筛查和生活方式干预是其专业角色的重要组成部分。然而，他们认识到自己的看法和实际做法之间存在差距。大多数 MHN 特别关注精神疾病及其对日常生活的影响，他们将提供身体健康护理定义为次要关注点。参与者将建立治疗关系描述为促进身体健康促进过程的关键部分，但也很困难。许多 MHN 倾向于代表患者制定目标和必要的行为改变，而不是帮助他们为自己制定目标和活动。
与患者建立良好的治疗关系并支持患者定义自己的生活方式目标可以增强护理的身体护理。需要其他团队成员（如 NPs）和经理的支持。在专业人员的培训和教育中，应包括本研究中吸取的教训。
