Improving kidney care for people with severe mental health difficulties: a thematic analysis of twenty-two healthcare providers’ perspectives

Frontiers in Public Health

Public Health

Peter Conlon¹  Claire Carswell²  Aoife Smith³  Kate Bramham⁴  Clodagh Cogley⁵  Jessica Bramham⁵  Paul D’Alton⁶  John Holian⁷ 

[1] Beaumont Hospital, Dublin, Ireland;Department of Health Sciences, University of York, York, United Kingdom;School of Nursing and Midwifery, Queen’s University Belfast, Belfast, Northern Ireland, United Kingdom;Irish Kidney Association, Dublin, Ireland;King’s College London, London, United Kingdom;School of Psychology, University College Dublin, Dublin, Ireland;School of Psychology, University College Dublin, Dublin, Ireland;St Vincent’s University Hospital, Dublin, Ireland;St Vincent’s University Hospital, Dublin, Ireland;

关键词: kidney disease;    mental health;    mental illness;    health inequities;    schizophrenia;    dialysis;    transplantation;    kidney failure;   

DOI  :  10.3389/fpubh.2023.1225102

 received in 2023-05-18, accepted in 2023-06-08,  发布年份 2023

来源: Frontiers

【 摘 要 】

IntroductionPeople with severe mental health difficulties (SMHDs) and concurrent kidney disease have less access to quality kidney care and worse clinical outcomes. Our research investigates the barriers and facilitators to effective kidney care for people with SMHDs, and how care might be improved for this underserved population.MethodsWe conducted semi-structured interviews with twenty-two physical (n = 14) and mental (n = 8) healthcare professionals with experience working with people with SMHDs and concurrent kidney disease. Interview data were analysed and interpreted using reflexive thematic analysis.ResultsFour themes were generated from the data: 1. “It’s about understanding their limitations and challenges, without limiting their rights” describes how some people with SMHDs need additional support when accessing kidney care due to challenges with their mental state, motivation, cognitive difficulties, or mistrust of the healthcare system. 2. “There are people falling through the cracks” describes how the separation of physical and mental healthcare, combined with under-resourcing and understaffing, results in poorer outcomes for people with SMHDs. 3. “Psychiatry is a black spot in our continuing medical education” describes how many renal healthcare providers have limited confidence in their understanding of mental health and their ability to provide care for people with SMHDs. 4. “When they present to a busy emergency department with a problem, the staff tend to go ‘…psych patient”” describes how stigma towards people with SMHDs can negatively impact quality of care.ConclusionHealthcare professionals accounts’ describe how people with SMHDs and kidney disease can have favourable outcomes if they have appropriate hospital, community and social supports. Findings indicate that effective management of kidney disease for people with SMHDs requires integrated physical and mental health care, which takes an individualised “whole person” approach to addressing the interaction between kidney disease and mental health.

【 授权许可】

Unknown   
Copyright © 2023 Cogley, Carswell, Bramham, Bramham, Smith, Holian, Conlon and D’Alton.