Carol E Blixen1, Stephanie Kanuch2, Adam T Perzynski2, Charles Thomas2, Neal V Dawson3, Martha Sajatovic4. 1. Center for Health Care Research and Policy, Case Western Reserve University, MetroHealth Medical Center, Cleveland, OH, USA. cxb28@cwru.edu. 2. Center for Health Care Research and Policy, Case Western Reserve University, MetroHealth Medical Center, Cleveland, OH, USA. 3. Epidemiology & Biostatistics, Center for Health Care Research and Policy, Case Western Reserve University, MetroHealth Medical Center, Cleveland, OH, USA. 4. Case Western Reserve University School of Medicine, University Hospitals Case Medical Center, Cleveland, OH, USA.
Abstract
OBJECTIVES: Individuals with serious mental illness (SMI) (major depressive disorder, bipolar disorder, schizophrenia), and diabetes (DM), face significant challenges in managing their physical and mental health. The objective of this study was to assess perceived barriers to self-management among patients with both SMI and DM in order to inform healthcare delivery practices. METHODS: We conducted 20 in-depth interviews with persons who had diagnoses of both SMI and DM. All interviews were audiotaped, transcribed verbatim, and analyzed using content analysis with an emphasis on dominant themes. RESULTS: Transcript-based analysis generated 3 major domains of barriers to disease self-management among patients with both DM and SMI: (1) personal level barriers (stress, isolation, stigma); (2) family and community level barriers (lack of support from family and friends); and (3) provider and health care system level barriers (poor relationships and communication with providers, fragmentation of care). CONCLUSIONS: Care approaches that provide social support, help in managing stress, optimize communication with providers, and reduce compartmentalization of medical and psychiatric care are needed to help these vulnerable individuals avoid health complications and premature mortality.
OBJECTIVES: Individuals with serious mental illness (SMI) (major depressive disorder, bipolar disorder, schizophrenia), and diabetes (DM), face significant challenges in managing their physical and mental health. The objective of this study was to assess perceived barriers to self-management among patients with both SMI and DM in order to inform healthcare delivery practices. METHODS: We conducted 20 in-depth interviews with persons who had diagnoses of both SMI and DM. All interviews were audiotaped, transcribed verbatim, and analyzed using content analysis with an emphasis on dominant themes. RESULTS: Transcript-based analysis generated 3 major domains of barriers to disease self-management among patients with both DM and SMI: (1) personal level barriers (stress, isolation, stigma); (2) family and community level barriers (lack of support from family and friends); and (3) provider and health care system level barriers (poor relationships and communication with providers, fragmentation of care). CONCLUSIONS: Care approaches that provide social support, help in managing stress, optimize communication with providers, and reduce compartmentalization of medical and psychiatric care are needed to help these vulnerable individuals avoid health complications and premature mortality.
Authors: Deborah M Scharf; Nicole K Eberhart; Nicole Schmidt; Christine A Vaughan; Trina Dutta; Harold Alan Pincus; M Audrey Burnam Journal: Psychiatr Serv Date: 2013-07-01 Impact factor: 3.084
Authors: Elizabeth M Stone; Lisa Nawei Chen; Gail L Daumit; Sarah Linden; Emma E McGinty Journal: J Behav Health Serv Res Date: 2019-10 Impact factor: 1.505
Authors: Awais Aftab; Chetan Bhat; Douglas Gunzler; Kristin Cassidy; Charles Thomas; Richard McCormick; Neal V Dawson; Martha Sajatovic Journal: Int J Psychiatry Med Date: 2017-12-27 Impact factor: 1.210
Authors: Benjamin G Druss; Manasvini Singh; Silke A von Esenwein; Gretl E Glick; Stephanie Tapscott; Sherry Jenkins Tucker; Cathy A Lally; Evelina W Sterling Journal: Psychiatr Serv Date: 2018-02-01 Impact factor: 3.084
Authors: Kathleen Mulligan; Hayley McBain; Frederique Lamontagne-Godwin; Jacqui Chapman; Mark Haddad; Julia Jones; Chris Flood; David Thomas; Alan Simpson Journal: Health Expect Date: 2017-03-17 Impact factor: 3.377
Authors: Judy Proudfoot; Janine Clarke; Jane Gunn; Susan Fletcher; Samineh Sanatkar; Kay Wilhelm; Lesley Campbell; Nicholas Zwar; Mark Harris; Helen Lapsley; Dusan Hadzi-Pavlovic; Helen Christensen Journal: JMIR Res Protoc Date: 2017-08-03