Exploring the facilitators, barriers, and strategies for self-management in adults living with severe mental illness, with and without long-term conditions: A qualitative evidence synthesis.
Exploring the facilitators, barriers, and strategies for self-management in adults living with severe mental illness, with and without long-term conditions: A qualitative evidence synthesis.
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DOI：
10.1371/journal.pone.0258937
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发表时间：
2021
期刊：
影响因子：
3.7
通讯作者：
DIAMONDS research team
中科院分区：
文献类型：
--
作者：
Balogun-Katung A;Carswell C;Brown JVE;Coventry P;Ajjan R;Alderson S;Bellass S;Boehnke JR;Holt R;Jacobs R;Kellar I;Kitchen C;Lister J;Peckham E;Shiers D;Siddiqi N;Wright J;Young B;Taylor J;DIAMONDS research team
患有严重精神疾病（SMI）的人的预期寿命减少了大约15-20年，部分原因是糖尿病和心脏病等长期疾病（LTCs）的发病率较高。有证据表明，重度精神障碍患者在管理自己的身体健康方面存在困难。然而，对于重度精神分裂症患者LTCs自我管理的障碍、促进因素和策略，我们知之甚少。系统地审查和综合定性证据，探讨重度精神障碍成人身体健康自我管理的促进因素、障碍和策略，包括有和没有长期条件。检索了CINAHL、会议论文集引文索引-科学、HMIC、Medline、NICE Evidence和PsycInfo，以确定探讨SMI成人（伴有或不伴有LTCs）自我管理障碍、促进因素和策略的定性研究。文章由两名独立审稿人独立筛选。根据数据的丰富性和相关性，有目的地对符合条件的研究进行抽样综合，并按主题进行综合。74篇文章符合纳入标准；25篇文章，报告了21项研究的结果，被纳入了综合研究。七项研究聚焦于重度精神障碍患者共病LTC自我管理，其余文章则探讨一般的自我管理。从综合中确定了6个分析主题和28个副主题。主题包括：重度精神障碍患者的负担；与合并症共存；关于自我管理的信念和态度；在自我管理方面得到他人的支持；社会和环境因素；还有常规，结构和计划。综合报告确定了自我管理的一系列障碍和促进因素，包括重度精神障碍患者的生活负担、社会支持、对自我管理的态度和获得资源的机会。为了充分支持患有重度精神障碍并合并ltc的患者，医疗保健专业人员需要考虑自我管理的障碍和促进因素如何受到重度精神障碍的影响，并满足这一人群的独特需求。
People living with severe mental illness (SMI) have a reduced life expectancy by around 15–20 years, in part due to higher rates of long-term conditions (LTCs) such as diabetes and heart disease. Evidence suggests that people with SMI experience difficulties managing their physical health. Little is known, however, about the barriers, facilitators and strategies for self-management of LTCs for people with SMI. To systematically review and synthesise the qualitative evidence exploring facilitators, barriers and strategies for self-management of physical health in adults with SMI, both with and without long-term conditions. CINAHL, Conference Proceedings Citation Index- Science, HMIC, Medline, NICE Evidence and PsycInfo were searched to identify qualitative studies that explored barriers, facilitators and strategies for self-management in adults with SMI (with or without co-morbid LTCs). Articles were screened independently by two independent reviewers. Eligible studies were purposively sampled for synthesis according to the richness and relevance of data, and thematically synthesised. Seventy-four articles met the inclusion criteria for the review; 25 articles, reporting findings from 21 studies, were included in the synthesis. Seven studies focused on co-morbid LTC self-management for people with SMI, with the remaining articles exploring self-management in general. Six analytic themes and 28 sub-themes were identified from the synthesis. The themes included: the burden of SMI; living with co-morbidities; beliefs and attitudes about self-management; support from others for self-management; social and environmental factors; and routine, structure and planning. The synthesis identified a range of barriers and facilitators to self-management, including the burden of living with SMI, social support, attitudes towards self-management and access to resources. To adequately support people with SMI with co-morbid LTCs, healthcare professionals need to account for how barriers and facilitators to self-management are influenced by SMI, and meet the unique needs of this population.
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