Understanding experiences of and preferences for service user and carer involvement in physical health care discussions within mental health care planning

BMC Psychiatry

Research Article

Chris Gibbons¹  Nicola Small²  Helen Brooks³  Rebecca Pedley³  Karina Lovell⁴  Penny Bee⁴  Andrew Grundy⁵ 

[1] Cambridge Centre for Health Services Research, Institute of Public Health, University of Cambridge, Forvie Site, Robinson Way, CB2 0SR, Cambridge, UK;The Psychometrics Centre, Cambridge Judge Business School Executive Education, CB2 1AG, Cambridge, UK;Collaboration for Leadership in Applied Health Research and Care (CLAHRC) for Greater Manchester, Centre for Primary Care, Division of Population Health, Health Services Research and Primary Care, School of Health Sciences, Faculty of Biology, Medicine and Health, Manchester Academic Health Science Centre, University of Manchester, Williamson Building, Oxford Road, M13 9PL, Manchester, UK;Division of Nursing, Midwifery and Social Work, Faculty of Biology, Medicine and Health, University of Manchester, Jean McFarlane Building, Oxford Road, M13 9PL, Manchester, UK;Division of Nursing, Midwifery and Social Work, Faculty of Biology, Medicine and Health, University of Manchester, Jean McFarlane Building, Oxford Road, M13 9PL, Manchester, UK;Collaboration for Leadership in Applied Health Research and Care (CLAHRC) for Greater Manchester, Division of Nursing, Midwifery and Social Work, School of Health Sciences, Faculty of Biology, Medicine and Health, University of Manchester, Jean McFarlane Building, Oxford Road, M13 9PL, Manchester, UK;School of Health Sciences, Faculty of Medicine and Health Sciences, University of Nottingham, Research Office Medical School, Queen’s Medical Centre, NG7 2UH, Nottingham, UK;

关键词: Service user involvement;    Severe mental illness;    Carers;    Physical health;    Mental health services;    Care planning;    Qualitative research;    Patients’ perspectives;    Health outcomes;   

DOI  :  10.1186/s12888-017-1287-1

 received in 2016-09-23, accepted in 2017-03-27,  发布年份 2017

来源: Springer

【 摘 要 】

BackgroundPeople with severe mental illness suffer more physical comorbidity than the general population, which can require a tailored approach to physical health care discussions within mental health care planning. Although evidence pertaining to service user and carer involvement in mental health care planning is accumulating, current understanding of how physical health is prioritised within this framework is limited. Understanding stakeholder experiences of physical health discussions within mental health care planning, and the key domains that underpin this phenomena is essential to improve quality of care. Our study aimed to explore service user, carer and professional experiences of and preferences for service user and carer involvement in physical health discussions within mental health care planning, and develop a conceptual framework of effective user-led involvement in this aspect of service provision.MethodsSix focus groups and four telephone interviews were carried out with twelve service users, nine carers, three service users with a dual service user and carer role, and ten mental health professionals recruited from one mental health Trust in the United Kingdom. Data was analysed utilising a thematic approach, analysed separately for each stakeholder group, and combined to aid comparisons.ResultsNo service users or carers recalled being explicitly involved in physical health discussions within mental health care planning. Six prerequisites for effective service user and carer involvement in physical care planning were identified. Three themes confirmed general mental health care planning requirements: tailoring a collaborative working relationship, maintaining a trusting relationship with a professional, and having access to and being able to edit a living document. Three themes were novel to feeling involved in physical health care planning discussions: valuing physical health equally with mental health; experiencing coordination of care between physical-mental health professionals, and having a physical health discussion that is personalised.ConclusionsHigh quality physical health care discussions within the care planning process demands action at multiple levels. A conceptual framework is presented which provides an evidence-based foundation for service level improvement. Further work is necessary to develop a new patient reported outcome measure to enable meaningful quantification of health care quality and patient experience.

【 授权许可】

CC BY   
© The Author(s). 2017