Aston University, Birmingham, United Kingdom.
Leicestershire Partnership NHS Trust, Leicester, United Kingdom.
BMC Psychiatry. 2024 Jun 6;24(1):426. doi: 10.1186/s12888-024-05864-3.
People with severe mental illness (SMI) such as schizophrenia and bipolar disorder are at a substantially higher risk of premature death in that they die between 10 and 20 years earlier than the general population. Cardiovascular disease (CVD) and diabetes are the main potentially avoidable contributors to early death. Research that explores the experiences of people with SMI highlights their struggles in engaging with health professionals and accessing effective and timely interventions for physical health conditions. A consequence of such struggles to navigate and access physical healthcare results in many people with SMI relying heavily on support provided by informal carers (e.g., family members, close friends). Despite this, the experiences of informal carers, and the roles they undertake in relation to supporting the physical health and psychotropic medication use of people with SMI, remains under-researched.
To explore the impacts of providing care for physical health in severe mental illness on informal carers.
Thematic analysis of semi-structured interviews with eight informal carers of people with SMI in United Kingdom (UK) national health services.
Informal carers played an active part in the management of the patient's conditions and shared their illness experience. Involvement of informal carers was both emotional and practical and informal carers' own lives were affected in ways that were sometimes deeply profound. Informal carers were involved in both 'looking after' the patient from the perspective of doing practical tasks such as collecting dispensed medication from a community pharmacy (caring for) and managing feelings and emotions (caring about).
Providing care for the physical health of someone with SMI can be understood as having two dimensions - 'caring for' and 'caring about'. The findings suggest a bidirectional relationship between these two dimensions, and both have a cost for the informal carer. With appropriate support informal carers could be more actively involved at all stages of care without increasing their burden. This should be with an awareness that carers may minimise the information they share about their own needs and impacts of their role to spare the person they care and themselves any distress.
患有严重精神疾病（SMI）的人群，如精神分裂症和双相情感障碍患者，过早死亡的风险明显更高，他们的死亡时间比普通人群早 10 至 20 年。心血管疾病（CVD）和糖尿病是导致早逝的主要潜在可避免因素。研究表明，患有 SMI 的人在与健康专业人员接触以及获得有效的、及时的身体健康状况干预措施方面存在困难。这种在导航和获得身体保健方面的困难导致许多患有 SMI 的人严重依赖非正式照顾者（例如，家庭成员、亲密朋友）提供的支持。尽管如此，非正式照顾者的经历以及他们在支持患有 SMI 的人的身体健康和精神药物使用方面所承担的角色，仍然没有得到充分研究。
探讨为严重精神疾病患者提供身体健康护理对非正式照顾者的影响。
对英国国家卫生服务体系中 8 名患有 SMI 的非正式照顾者的半结构化访谈进行主题分析。
非正式照顾者在管理患者病情方面发挥了积极作用，并分享了他们的疾病经历。非正式照顾者的参与既是情感上的，也是实际的，他们的生活受到了深刻的影响。非正式照顾者不仅参与从实际任务（如从社区药房收取配药）照顾患者的角度，还参与管理患者的感受和情绪（关心患者）。
为患有 SMI 的人提供身体健康护理可以理解为具有两个维度——“照顾”和“关心”。研究结果表明这两个维度之间存在双向关系，而且对非正式照顾者来说都有代价。通过适当的支持，非正式照顾者可以在护理的所有阶段更积极地参与，而不会增加他们的负担。这应该意识到，照顾者可能会尽量减少他们分享的有关自己需求和角色影响的信息，以免给他们照顾的人或自己带来任何痛苦。
