TY - JOUR
T1 - Exploring the facilitators, barriers, and strategies for self-management in adults living with severe mental illness, with and without long-term conditions
T2 - A qualitative evidence synthesis
AU - Balogun-Katung, Abisola
AU - Carswell, Claire
AU - Brown, Jennifer V. E.
AU - Coventry, Peter
AU - Ajjan, Ramzi
AU - Alderson, Sarah
AU - Bellass, Sue
AU - Boehnke, Jan R.
AU - Holt, Richard
AU - Jacobs, Rowena
AU - Kellar, Ian
AU - Kitchen, Charlotte
AU - Lister, Jennie
AU - Peckham, Emily
AU - Shiers, David
AU - Siddiqi, Najma
AU - Wright, Judy
AU - Young, Ben
AU - Taylor, Jo
N1 - Funding Information:
This paper reports work undertaken as part of the DIAMONDS programme, which is funded by the National Institute for Health Research under its Programme Grants for Applied Research (project number RP-PG-1016-20003). Peter Coventry is part funded by the UK Research and Innovation Closing the Gap Network+ [ES/ S004459/1].
Publisher Copyright:
© 2021 Balogun-Katung et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.
PY - 2021/10/26
Y1 - 2021/10/26
N2 - Background: People living with severe mental illness (SMI) have a reduced life expectancy by around 15–20 years, in part due to higher rates of long-term conditions (LTCs) such as diabetes and heart disease. Evidence suggests that people with SMI experience difficulties managing their physical health. Little is known, however, about the barriers, facilitators and strategies for self-management of LTCs for people with SMI. Aim To systematically review and synthesise the qualitative evidence exploring facilitators, barriers and strategies for self-management of physical health in adults with SMI, both with and without long-term conditions.Methods: CINAHL, Conference Proceedings Citation Index- Science, HMIC, Medline, NICE Evidence and PsycInfo were searched to identify qualitative studies that explored barriers, facilitators and strategies for self-management in adults with SMI (with or without co-morbid LTCs). Articles were screened independently by two independent reviewers. Eligible studies were purposively sampled for synthesis according to the richness and relevance of data, and thematically synthesised.Results: Seventy-four articles met the inclusion criteria for the review; 25 articles, reporting findings from 21 studies, were included in the synthesis. Seven studies focused on co-morbid LTC self-management for people with SMI, with the remaining articles exploring self-management in general. Six analytic themes and 28 sub-themes were identified from the synthesis. The themes included: the burden of SMI; living with co-morbidities; beliefs and attitudes about self-management; support from others for self-management; social and environmental factors; and routine, structure and planning.Conclusions: The synthesis identified a range of barriers and facilitators to self-management, including the burden of living with SMI, social support, attitudes towards self-management and access to resources. To adequately support people with SMI with co-morbid LTCs, healthcare professionals need to account for how barriers and facilitators to self-management are influenced by SMI, and meet the unique needs of this population.
AB - Background: People living with severe mental illness (SMI) have a reduced life expectancy by around 15–20 years, in part due to higher rates of long-term conditions (LTCs) such as diabetes and heart disease. Evidence suggests that people with SMI experience difficulties managing their physical health. Little is known, however, about the barriers, facilitators and strategies for self-management of LTCs for people with SMI. Aim To systematically review and synthesise the qualitative evidence exploring facilitators, barriers and strategies for self-management of physical health in adults with SMI, both with and without long-term conditions.Methods: CINAHL, Conference Proceedings Citation Index- Science, HMIC, Medline, NICE Evidence and PsycInfo were searched to identify qualitative studies that explored barriers, facilitators and strategies for self-management in adults with SMI (with or without co-morbid LTCs). Articles were screened independently by two independent reviewers. Eligible studies were purposively sampled for synthesis according to the richness and relevance of data, and thematically synthesised.Results: Seventy-four articles met the inclusion criteria for the review; 25 articles, reporting findings from 21 studies, were included in the synthesis. Seven studies focused on co-morbid LTC self-management for people with SMI, with the remaining articles exploring self-management in general. Six analytic themes and 28 sub-themes were identified from the synthesis. The themes included: the burden of SMI; living with co-morbidities; beliefs and attitudes about self-management; support from others for self-management; social and environmental factors; and routine, structure and planning.Conclusions: The synthesis identified a range of barriers and facilitators to self-management, including the burden of living with SMI, social support, attitudes towards self-management and access to resources. To adequately support people with SMI with co-morbid LTCs, healthcare professionals need to account for how barriers and facilitators to self-management are influenced by SMI, and meet the unique needs of this population.
UR - http://www.scopus.com/inward/record.url?scp=85117894177&partnerID=8YFLogxK
U2 - 10.1371/journal.pone.0258937
DO - 10.1371/journal.pone.0258937
M3 - Article
C2 - 34699536
AN - SCOPUS:85117894177
SN - 1932-6203
VL - 16
JO - PLoS ONE
JF - PLoS ONE
IS - 10
M1 - e0258937
ER -