District nurses' perspectives on detecting mental health problems and promoting mental health among community‐dwelling seniors with multimorbidity

Abstract

Aims and objectivesTo describe district nurses' perspectives on detecting mental health problems and promoting mental health among homebound older people with multimorbidity.BackgroundMental health problems among older people with multiple chronic conditions, that is, multimorbidity, are challenging issues. These patients' homes often serve as arenas in which district nurses can promote health. Mental health promotion must be studied in greater depth within primary care because older people with multimorbidity are particularly prone to developing poor mental health, which can go undetected and untreated.DesignA descriptive, qualitative study using semi‐structured interviews and content analysis.MethodsTwenty‐five district nurses completed individual or focus group interviews. Data were analysed using qualitative content analysis.ResultsMost district nurses stated that detecting mental health problems and promoting mental health were important tasks but that they typically focused on more practical home health care tasks. The findings revealed that district nurses focused on assessment, collaboration and social support as means of detecting mental health problems and promoting mental health.ConclusionsThe district nurses described various factors and actions that appeared to be important prerequisites for their involvement in primary mental health care. Nevertheless, there were no established goals for mental health promotion, and district nurses often seemed to depend on their collaboration with other actors. Our findings indicated that district nurses cannot bear the primary responsibility for the early detection of mental health problems and early interventions to promote mental health within this population.Relevance to clinical practiceThe findings of this study indicated that workforce training and collaboration between different care providers are important elements in the future development of this field. Early detection and early treatment of mental health‐related issues should also be stated as explicit objectives in the provision of care to community‐dwelling older people with multimorbidity.

Promoting active ageing in older people with mental disorders living in the community: An integrative review

“…However, yet older people with mental disorders' stated they preferred to consult with primary care staff rather than specialist in mental health (Lester et al, ). Lack of resources, such as guidelines or structured goals for mental health care in their settings, and lack of a structured forum for collaboration between health care providers and their patients with mental health problems were also barriers for district nurses working at the community level (Grundberg, Hansson, Hillerås, & Religa, ). One study suggested that nurses needed to develop interview techniques for assessing older people with mental health problems (Grundberg et al, ).…”

“…The review also represents the perspectives of participants, contributing to understanding the issues relating to active ageing, the service needs gaps for older people with mental health problems in rural areas, and the facilitators and barriers for working with older people in communities (Grundberg et al, 2016;Wilhelmsson & Lindberg, 2009). Participants were primary care providers including district nurses, and multidisciplinary teams in the community health services, older people living in the community, and older people with mental disorders (Goodman et al, 2011;Grundberg et al, 2014;Kim, 2009;Murray et al, 2006).…”

“…(Continues) their patients with mental health problems were also barriers for district nurses working at the community level (Grundberg, Hansson, Hillerås, & Religa, 2016). One study suggested that nurses needed to develop interview techniques for assessing older people with mental health problems (Grundberg et al, 2016). (Latorre et al, 2015).…”

Competências de enfermagem na promoção da saúde do idoso com transtorno mental [Nursing skills in the health promotion of elderly people with mental disorder] [Competencias de la enfermería en la promoción de salud al anciano con trastorno mental]

“…Dos 10 artigos selecionados [9][10][11][12][13][14][15][16][17][18] , todos publicados no período de 2014 a 2018, um é do Canadá 11 , três de países europeus (Suécia, Portugal, Espanha) 12,14,17 e seis do Brasil 9,10,13,15,16,18 . Em 2014 foram publicados dois 9,14 , em 2015 três 13,15,17 , em 2016 quatro 11,12,16,18 e apenas um em 2018 10…”

The development and pilot testing of a new instrument “Promoting Active Ageing in Older People with Mental Disorders Scale”

“…[9,11] As a result, older people with mental illness presenting to primary care settings are often not diagnosed and often go untreated. [1,[12][13][14][15] The aim of this study was to develop and test preliminary results of a new survey instrument: the "Promoting Active Ageing in Older People with Mental Disorders Scale" (PAA-MD).…”