Mental health consumers' with medical co‐morbidity experience of the transition through tertiary medical services to primary care

Cranwell, Kathryn; Polacsek, Meg; McCann, Terence V.

doi:10.1111/inm.12174

Cited by 13 publications

(9 citation statements)

References 31 publications

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“…The interviews were semi-structured and explored both the positive and negative aspects of the participant’s surgical experience and “journey” commencing from pre-operative consultation to hospital discharge and follow-up. The interview schedule is outlined in Table 1 and was initially derived from several sources [ 17 , 18 ], and then refined by the authors with expertise in both psychiatry and surgery, following consultation with colleagues and a consensus meeting. Participants received a $50 supermarket voucher at the completion of their interview in recognition of their contribution.…”

Section: Methodsmentioning

confidence: 99%

“…What is unknown at the patient level, is how the surgical experience of these patients from their own perspective might influence surgical outcomes and their SMI. Whilst such experience of care has been investigated within primary and general tertiary medical care settings, and incorporates themes of access difficulties, communication challenges, exclusion from decision making and a need for holistic care [ 17 , 18 ], no evidence can be found within the surgical context specifically. This lack of understanding is detrimental to providing surgical services that are truly patient centred and responsive to their needs.…”

Section: Introductionmentioning

confidence: 99%

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Surgical experience for patients with serious mental illness: a qualitative study

et al. 2021

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Background People with serious mental illness (SMI) have significantly worse surgical outcomes compared to the general population. There are many contributing factors to this complex issue, however consideration of the surgical experience from the patient’s own perspective has never been undertaken. This lack of understanding prevents the provision of truly patient centred care and may limit the impact of potential improvement initiatives. Therefore this study aims to describe and better understand the surgical experience from the perspective of patients with SMI. Methods Within this qualitative study, semi-structured, audio-recorded interviews were conducted between August 2019 – June 2020, with 10 consenting participants with SMI who had surgery in the previous 2 years. A thematic analysis approach was used to explore both the positive and negative aspects of the participant’s surgical experience commencing from pre-operative consultation to hospital discharge and follow-up. Results Four main themes and related subthemes emerged including i) the perceived lack of mental ill health recognition, ii) highly variable patient and clinician interactions, iii) the impact of healthcare services, and iv) strategies for improvement. Conclusion Surgical patients with SMI want to be treated like everyone else whilst still having their mental ill health acknowledged and proactively managed despite this rarely occurring, which is valuable information for all surgical teams to consider and learn from. Participants were able to describe several readily implementable strategies to potentially improve their care and overall surgical experience, and as such highlight considerable opportunities for these to be tested and evaluated for this underserved patient group.

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Section: Methodsmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Surgical experience for patients with serious mental illness: a qualitative study

et al. 2021

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“…The findings provided four main themes that reflected their experience of the transition: 1. accessing tertiary medical hospital services was difficult and time-consuming, 2. contrasting experiences of clinician engagement and support, 3. lack of continuity of care between tertiary medical and primary care services, and 4. Mental Health Hospital Admission Reduction Program (MH HARP) (an augmented care program to reduce the number of emergency department re-presentations by service users with medical co-morbidity) clinicians facilitated service users’ transition [ 24 ]. Clinician focus group discussion and individual interviews.…”

Section: Introductionmentioning

confidence: 99%

Improving mental health service users’ with medical co-morbidity transition between tertiary medical hospital and primary care services: a qualitative study

Cranwell

Polacsek

McCann

2016

BMC Health Serv Res

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BackgroundMental health service users have high rates of medical co-morbidity but frequently experience problems accessing and transitioning between tertiary medical and primary care services. The aim of this study was to identify ways to improve service users’ with medical co-morbidity care and experience during their transition between tertiary medical hospitals and primary care services.MethodExperience-based co-design (EBCD) qualitative study incorporating a focus group discussion. The study took place in a large tertiary medical service, incorporating three medical hospitals, and primary care services, in Melbourne, Australia. A purposive sample of service users and their caregivers and tertiary medical and primary care clinicians participated in the focus group discussion, in August 2014. A semi-structured interview guide was used to inform data collection. A thematic analysis of the data was undertaken.ResultsThirteen participants took part in the focus group interview, comprising 5 service users, 2 caregivers and 6 clinicians. Five themes were abstracted from the data, illustrating participants’ perspectives about factors that facilitated (clinicians’ expertise, engagement and accessibility enhancing transition) and presented as barriers (improving access pathways; enhancing communication and continuity of care; improving clinicians’ attitudes; and increasing caregiver participation) to service users’ progress through tertiary medical and primary care services. A sixth theme, enhancing service users’ transition, incorporated three strategies to enhance their transition through tertiary medical and primary care services.ConclusionEBCD is a useful approach to collaboratively develop strategies to improve service users’ with medical co-morbidity and their caregivers’ transition between tertiary medical and primary care services. A whole-of-service approach, incorporating policy development and implementation, change of practice philosophy, professional development education and support for clinicians, and acceptance of the need for caregiver participation, is required to improve service users’ transition.

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“…Additionally, there is a need to involve both consumers and exercise practitioners in planning and codeveloping interventions which take account of barriers and enablers for participating, and maintaining, engagement to ensure interventions are appropriate (Cranwell, Polacsek, & McCann, 2016;Happell et al, 2016). These interventions also need to address the known gap between an expressed interest in exercise and actual participation in physical activities (Ussher, Stanbury, Cheeseman, & Faulkner, 2007).…”

mentioning

confidence: 99%

Codesigned recommendations for increasing engagement in structured physical activity for people with serious mental health problems in Australia

Wheeler

Roennfeldt

Slattery

et al. 2018

Health Soc Care Community

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People with mental health problems are at higher risk of physical health comorbidities and early mortality. A key risk factor for poor health outcomes is a lack of regular physical activity. Mental health services have typically responded by focusing on screening and promoting lifestyle programmes within secondary care mental health settings. The aim of this study was to better understand the barriers and enablers for Australian mental health consumers to participate in physical activity or exercise programmes from the perspectives of consumers and exercise practitioners. Interviews with 15 consumers experiencing serious mental health problems and five exercise practitioners were undertaken, followed by two focus groups (involving eight consumers and two exercise practitioners) to gain consensus on themes from the interviews, and codesign a set of recommendations for services to support and increase the engagement of mental health consumers in regular community-based exercise. Barriers that impacted on engagement in physical activity included: lack of social support, insufficient knowledge and information, difficulties with work/life balance, impact of physical and mental health issues, fear and lack of confidence, and financial cost. Enablers or motivators assisting engagement in community-based physical activity programmes included: social support, access to person-centred individualised exercise options, connection and a sense of belonging, and access to information and education. Recommendations and a checklist were developed to assist services to increase the involvement of mental health consumers in community-based exercise and to ensure that exercise practitioners and their employing organisations are adequately equipped to work with this population.

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Mental health consumers' with medical co‐morbidity experience of the transition through tertiary medical services to primary care

Cited by 13 publications

References 31 publications

Surgical experience for patients with serious mental illness: a qualitative study

Surgical experience for patients with serious mental illness: a qualitative study

Improving mental health service users’ with medical co-morbidity transition between tertiary medical hospital and primary care services: a qualitative study

Codesigned recommendations for increasing engagement in structured physical activity for people with serious mental health problems in Australia

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