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Goh AMY, Westphal A, Daws T, Gascoigne-Cohen S, Hamilton B, Lautenschlager NT. A retrospective study of medical comorbidities in psychogeriatric patients. Psychogeriatrics 2016; 16:12-9. [PMID: 25737391 DOI: 10.1111/psyg.12111] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/13/2014] [Revised: 12/08/2014] [Accepted: 12/26/2014] [Indexed: 11/27/2022]
Abstract
BACKGROUND This study contributes further research into the assessment and treatment of older psychiatric patients with medical comorbidities. METHODS A retrospective file audit was conducted at the acute inpatient psychogeriatric unit of St Vincent's Aged Mental Health Service, Melbourne, in order to determine the prevalence of certain medical comorbidities and the nature of medical interventions provided for psychogeriatric inpatients. RESULTS This study, investigating 165 admissions into an acute inpatient psychogeriatric unit, highlights that psychiatric and medical comorbidities are routine in this population: the vast majority (91.5%) of all inpatients had at least one medical comorbidity. CONCLUSIONS As the population ages, psychogeriatric wards are likely to see more of the oldest-olds, who are likely to have comorbid medical illnesses. Currently, appropriate detection, investigation, and management of these illnesses are often suboptimal and can affect quality of life, increase mortality, and complicate treatment. This paper adds to the literature about the need for integrating medical and psychiatric care to create a more comprehensive strategy for treating the older person with psychiatric illness.
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Affiliation(s)
- Anita M Y Goh
- Academic Unit for Psychiatry of Old Age, Department of Psychiatry, University of Melbourne, Melbourne, Victoria, Australia.,St Vincent's Aged Mental Health Service, St Vincent's Hospital, Melbourne, Victoria, Australia.,Neuropsychiatry Unit, Melbourne Neuropsychiatry Centre, Royal Melbourne Hospital, Melbourne, Victoria, Australia
| | - Alissa Westphal
- Academic Unit for Psychiatry of Old Age, Department of Psychiatry, University of Melbourne, Melbourne, Victoria, Australia
| | - Teresa Daws
- Department of Nursing, University of Melbourne, Melbourne, Victoria, Australia
| | - Sophie Gascoigne-Cohen
- St Vincent's Aged Mental Health Service, St Vincent's Hospital, Melbourne, Victoria, Australia
| | - Bridget Hamilton
- Department of Nursing, University of Melbourne, Melbourne, Victoria, Australia.,St Vincent's Aged Mental Health Service, St Vincent's Hospital, Melbourne, Victoria, Australia
| | - Nicola T Lautenschlager
- Academic Unit for Psychiatry of Old Age, Department of Psychiatry, University of Melbourne, Melbourne, Victoria, Australia.,St Vincent's Aged Mental Health Service, St Vincent's Hospital, Melbourne, Victoria, Australia.,School of Psychiatry and Clinical Neurosciences, WA Centre for Health & Ageing, The University of Western Australia, Perth, Western Australia, Australia
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Happell B, Galletly C, Castle D, Platania-Phung C, Stanton R, Scott D, McKenna B, Millar F, Liu D, Browne M, Furness T. Scoping review of research in Australia on the co-occurrence of physical and serious mental illness and integrated care. Int J Ment Health Nurs 2015. [PMID: 26220151 DOI: 10.1111/inm.12142] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
The physical health of people with serious mental illness (SMI) has become a focal area of research. The aim of the present study was to ascertain the attention and distribution of research from within Australia on physical illness and SMI co-occurrence, and to identify gaps. A scoping review of peer-reviewed research literature from Australia, published between January 2000 and March 2014, was undertaken through an electronic literature search and coding of papers to chart trends. Four trends are highlighted: (i) an almost threefold increase in publications per year from 2000-2006 to 2007-2013; (ii) a steady release of literature reviews, especially from 2010; (iii) health-related behaviours, smoking, integrated-care programmes, and antipsychotic side-effects as the most common topics presented; and (iv) paucity of randomized, controlled trials on integrated-care models. Despite a marked increase in research attention to poorer physical health, there remains a large gap between research and the scale of the problem previously identified. More papers were descriptive or reviews, rather than evaluations of interventions. To foster more research, 12 research gaps are outlined. Addressing these gaps will facilitate the reduction of inequalities in physical health for people with SMI. Mental health nurses are well placed to lead multidisciplinary, consumer-informed research in this area.
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Affiliation(s)
- Brenda Happell
- Synergy, Nursing and Midwifery Research Centre, University of Canberra and ACT Health, Canberra Hospital, ACT, Canberra, Australia
| | - Cherrie Galletly
- The Adelaide Clinic, Adelaide, South Australia, Australia.,School of Medicine, University of Adelaide, Adelaide, South Australia, Australia
| | - David Castle
- St Vincent's Hospital, Melbourne, Victoria, Australia.,School of Medicine, University of Melbourne, Melbourne, Victoria, Australia
| | - Chris Platania-Phung
- Synergy, Nursing and Midwifery Research Centre, University of Canberra and ACT Health, Canberra Hospital, ACT, Canberra, Australia
| | - Robert Stanton
- Central Queensland University, Central Queensland University, School of Human Health and Social Sciences, Bundaberg, Queensland, Australia
| | - David Scott
- Central Queensland University, School of Medical and Applied Sciences, Melbourne, Victoria, Australia
| | - Brian McKenna
- School of Nursing, Midwifery and Paramedicine, Australian Catholic University, Melbourne, Victoria, Australia.,NorthWestern Mental Health, Melbourne, Victoria, Australia
| | | | - Dennis Liu
- Northern Mental Health Service, Salisbury, South Australia, Australia
| | - Matthew Browne
- Central Queensland University, Central Queensland University, School of Human Health and Social Sciences, Bundaberg, Queensland, Australia
| | - Trentham Furness
- School of Nursing, Midwifery and Paramedicine, Australian Catholic University, Melbourne, Victoria, Australia.,NorthWestern Mental Health, Melbourne, Victoria, Australia
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Happell B, Platania-Phung C, Scott D. A systematic review of nurse physical healthcare for consumers utilizing mental health services. J Psychiatr Ment Health Nurs 2014; 21:11-22. [PMID: 23419025 DOI: 10.1111/jpm.12041] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 01/07/2013] [Indexed: 11/29/2022]
Abstract
People with serious mental illness have higher rates of physical illness and are more likely to experience premature death than the general population. Nurse-led strategies to improve physical healthcare in mental healthcare services could potentially reduce these inequalities. However the extent of nurse involvement in physical healthcare (such as physical risk screening, health education and care co-ordination) in mental health settings is not known. A systematic review was conducted on nurse-led physical healthcare reported for consumers with serious mental illness (SMI) in mental health services, and their benefits. Electronic literature bases (CINAHL, Proquest, PsychINFO and Web of Science) were systematically searched, in conjunction with a manual search of literature reviews on physical healthcare in mental health services. Articles were included if they: (a) were published in the last 10 years; (b) were English language; (c) involved physical healthcare of adult consumers receiving mental healthcare services; and (d) reported nurse involvement in physical healthcare. Forty articles were included in the review. The distribution of types of care were: health education (47%), screening and/or monitoring (33.3%), care co-ordination and management (33.3%), lifestyle programme delivery (30.5%), follow-up actions to screening results (25%) and registers and data administration (5.5%). Overall, the evaluation of nurse-based physical healthcare is in early stages. Thus far, they appear to have positive implications for consumers with SMI.
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Affiliation(s)
- B Happell
- Centre for Mental Health Nursing Innovation, Institute for Health and Social Science Research, Rockhampton, Qld, Australia; School of Nursing and Midwifery, Central Queensland University, Rockhampton, Qld, Australia
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Happell B, Platania-Phung C, Scott D. Proposed nurse-led initiatives in improving physical health of people with serious mental illness: a survey of nurses in mental health. J Clin Nurs 2013; 23:1018-29. [PMID: 24606393 DOI: 10.1111/jocn.12371] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/23/2013] [Indexed: 12/19/2022]
Abstract
AIMS AND OBJECTIVES To identify nurse perceptions on the potential value of general and specific nursing approaches to improving physical health outcomes of people with serious mental illness. BACKGROUND People diagnosed with serious mental illnesses experience heightened rates of physical illnesses and can be supported better via healthcare system prevention and management. Nurses working in mental health are a critical part of a system-wide approach to improving physical health care, but there is little known on their views on specific approaches within Australia (e.g. screening for risks, stigma reduction). DESIGN A national, cross-sectional and nonrandom survey study delivered online. METHODS Members of the Australian College of Mental Health Nurses (n = 643), representing nurses employed in mental healthcare services across Australia (71·6% from public mental health services). Participants were asked to rate the potential of nine nurse-based strategies for improving physical health (options: 'yes', 'no', 'not sure') and the potential value of 10 nursing and general strategies for improving physical health (rating from 'negative value' to 'significant value'). RESULTS There was a high endorsement of all nine nurse-based strategies for physical health (e.g. lifestyle programmes, screening, linking services), although there was less support for reducing antipsychotics or advocating for fewer side effects. Participants mainly viewed all strategies as of moderate to significant value, with the most promising value attached to colocation of primary and mental care services, lifestyle programmes and improving primary care services (reduce stigma, train GPs). CONCLUSIONS Australian nurses working in mental health services view a range of nurse-based strategies for improving physical healthcare services and standards as important. RELEVANCE TO CLINICAL PRACTICE Nurses collectively need to work with consumers, health agencies and the general public to further define how to organise and implement physical health integration strategies, towards more comprehensive health care of people with serious mental illness.
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Affiliation(s)
- Brenda Happell
- Institute for Health and Social Science Research, Engaged Research Chair in Mental Health Nursing, Centre for Mental Health Nursing Innovation, School of Nursing and Midwifery, Central Queensland University, Rockhampton, Queensland, Australia
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Happell B, Platania-Phung C, Gray R, Hardy S, Lambert T, McAllister M, Davies C. A role for mental health nursing in the physical health care of consumers with severe mental illness. J Psychiatr Ment Health Nurs 2011; 18:706-11. [PMID: 21896113 DOI: 10.1111/j.1365-2850.2010.01666.x] [Citation(s) in RCA: 42] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/23/2022]
Abstract
There is extensive international evidence that people with severe mental illness have a lower standard of physical health than the general population. This leads to higher morbidity and mortality rates. Many of the causes for this poor physical health are modifiable. Yet the physical needs of this consumer group are neglected by healthcare systems in Australia, and elsewhere. While medical specialists are clearly integral to remedying this, nurses are well placed to play a key role in focused prevention and early intervention in the physical well-being of consumers with mental health problems. This paper outlines the specifics on how mental health nurses can be sensitized, prepared and empowered to help turn this serious health issue around. In particular, mental health nurses could be trained in and then utilize a new physical health check and response system in the UK (called the Health Improvement Profile) if adapted for use within Australia. This profile will be briefly introduced, and then its value to improving health care discussed.
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Affiliation(s)
- B Happell
- Institute for Health and Social Science Research and School of Nursing and Midwifery, CQ University Australia, Rockhampton, QLD, Australia.
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