Family involvement to support cardiovascular self-management care for people with severe mental illness: a systematic review

BackgroundSelf-management is intended to empower individuals in their recovery by providing the skills and confidence they need to take active steps in recognising and managing their own health problems. Evidence supports such interventions in a range of long-term physical health conditions, but a recent systematic synthesis is not available for people with severe mental health problems.AimsTo evaluate the effectiveness of self-management interventions for adults with severe mental illness (SMI).MethodA systematic review of randomised controlled trials was conducted. A meta-analysis of symptomatic, relapse, recovery, functioning and quality of life outcomes was conducted, using RevMan.ResultsA total of 37 trials were included with 5790 participants. From the meta-analysis, self-management interventions conferred benefits in terms of reducing symptoms and length of admission, and improving functioning and quality of life both at the end of treatment and at follow-up. Overall the effect size was small to medium. The evidence for self-management interventions on readmissions was mixed. However, self-management did have a significant effect compared with control on subjective measures of recovery such as hope and empowerment at follow-up, and self-rated recovery and self-efficacy at both time points.ConclusionThere is evidence that the provision of self-management interventions alongside standard care improves outcomes for people with SMI. Self-management interventions should form part of the standard package of care provided to people with SMI and should be prioritised in guidelines: research on best methods of implementing such interventions in routine practice is needed.Declaration of interestsNone.

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Self-Management Support Needs From the Perspectives of Persons With Severe Mental Illness: A Systematic Review and Thematic Synthesis of Qualitative Research

Journal of the American Psychiatric Nurses Association ◽

10.1177/1078390319877953 ◽

2019 ◽

Vol 26 (5) ◽

pp. 464-482 ◽

Cited By ~ 2

Author(s):

Titus A. A. Beentjes ◽

Betsie G. I. van Gaal ◽

Theo van Achterberg ◽

Peter J. J. Goossens

Keyword(s):

Systematic Review ◽

Mental Illness ◽

Severe Mental Illness ◽

Essential Element ◽

Self Management ◽

Support Needs ◽

Management Support ◽

Thematic Synthesis ◽

Management Interventions ◽

Important Others

BACKGROUND: The development of de-hospitalization policies in mental health has resulted in a growing emphasis on self-management. In the chronic care model, self-management support is an essential element. Because of the episodic nature of severe mental illness (SMI) and its high relapse rates, we assume that the extent of self-management support needs of individuals with an SMI is considerable. However, a clear overview of the nature of the self-management support needs of persons with SMI is missing. AIMS: This study aimed to identify self-management support needs from the perspective of individuals with SMI. METHOD: A systematic review was conducted using the method of thematic synthesis of qualitative studies. After searching the databases MEDLINE, PsycINFO, CINAHL, and EMBASE, we screened the papers for the eligibility criteria: individuals with an SMI, adequately representing the voice of persons with SMI and describing their self-management support needs. Thirty-one papers were included. RESULTS: The main findings showed that participants in the studies described the need for informational support, emotional support, acknowledgment, encouragement, and guidance to make sense of their illness experiences, ease suffering, obtain validation and recognition, execute self-management tasks, and be led through unfamiliar territory. CONCLUSION: The perspectives of persons with SMI can provide a road map for constructing a self-management support intervention for persons with SMI. Important others have an essential role in fulfilling support needs. Independently managing an SMI is difficult. Therefore, it is preferable to let important others participate in self-management interventions and to introduce peer support.

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Are diabetes self-management programmes for the general diabetes population effective for people with severe mental illness?: a systematic review

BMC Psychiatry ◽

10.1186/s12888-020-02779-7 ◽

2020 ◽

Vol 20 (1) ◽

Author(s):

Anne Coxon ◽

Hayley McBain ◽

Neli Pavlova ◽

Hannah Rowlands ◽

Kathleen Mulligan

Keyword(s):

Systematic Review ◽

Mental Illness ◽

Severe Mental Illness ◽

Self Management

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Identifying the minimal important difference in patient-reported outcome measures in the field of people with severe mental illness: a pre–post-analysis of the Illness Management and Recovery Programme

Quality of Life Research ◽

10.1007/s11136-021-02779-4 ◽

2021 ◽

Author(s):

Titus A. A. Beentjes ◽

Steven Teerenstra ◽

Hester Vermeulen ◽

Peter J. J. Goossens ◽

Maria W. G. Nijhuis-van der Sanden ◽

...

Keyword(s):

Mental Illness ◽

Severe Mental Illness ◽

Minimal Important Difference ◽

Patient Reported Outcome Measures ◽

Patient Reported Outcome ◽

Self Management ◽

Illness Management ◽

Meaningful Change ◽

Illness Management And Recovery ◽

Patient Reported

Abstract Purpose Complementary interventions for persons with severe mental illness (SMI) focus on both personal recovery and illness self-management. This paper aimed to identify the patient-reported outcome measures (PROMs) associated with the most relevant and meaningful change in persons with SMI who attended the Illness Management and Recovery Programme (IMR). Methods The effect of the IMR was measured with PROMs concerning recovery, illness self-management, burden of symptoms and quality of life (QoL). From the QoL measures, an anchor was chosen based on the most statistically significant correlations with the PROMs. Then, we estimated the minimal important difference (MID) for all PROMs using an anchor-based method supported by distribution-based methods. The PROM with the highest outcome for effect score divided by MID (the effect/MID index) was considered to be a measure of the most relevant and meaningful change. Results All PROMs showed significant pre–post-effects. The QoL measure ‘General Health Perception (Rand-GHP)’ was identified as the anchor. Based on the anchor method, the Mental Health Recovery Measure (MHRM) showed the highest effect/MID index, which was supported by the distribution-based methods. Because of the modifying gender covariate, we stratified the MID calculations. In most MIDs, the MHRM showed the highest effect/MID indexes. Conclusion Taking into account the low sample size and the gender covariate, we conclude that the MHRM was capable of showing the most relevant and meaningful change as a result of the IMR in persons with SMI.

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The experiences of family caregivers of people with severe mental illness in the Middle East: A systematic review and meta-synthesis of qualitative data

PLoS ONE ◽

10.1371/journal.pone.0254351 ◽

2021 ◽

Vol 16 (7) ◽

pp. e0254351

Author(s):

Aisha Hamed Alyafei ◽

Taghrid Alqunaibet ◽

Hassan Mansour ◽

Afia Ali ◽

Jo Billings

Keyword(s):

Systematic Review ◽

Mental Illness ◽

Middle East ◽

Severe Mental Illness ◽

Family Caregivers ◽

Critical Role ◽

Geographical Area ◽

Well Being ◽

Negative Consequences ◽

Middle East Countries

Background There is a wealth of literature exploring the experiences of family caregivers of people with severe mental illness (SMI) in western countries, however, this topic has been neglected in the Middle East, despite families being the main source of caregiving in this context. The purpose of this review was to conduct a systematic review and qualitative meta-synthesis to explore the experiences of family caregivers living in countries in the Middle East caring for a relative with severe mental illness. Methods A systematic review and meta-synthesis were conducted, to comprehensively gain a thorough and detailed overview of what is known about family caregivers’ experiences from published qualitative research in the Middle East geographical area from inception to May 2021. The review protocol was pre-registered with PROSPERO (Ref: CRD42020165519). Results The review identified twelve qualitative studies that explored caregivers’ experiences of caring for relatives with SMI in Middle East countries. Family caregivers’ experiences were captured under seven overarching themes. The participants across all studies reported negative consequences of providing care, increased burden and emotional distress. Many experienced issues with family/marital relationships and stigmatizing attitudes and behaviours from their communities. Caregivers expressed the need for increased support which was perceived to have a critical role in improving family caregivers’ experiences. Conclusions The meta-synthesis revealed many challenges and issues that affect caregivers of people with SMI in the Middle East. Family caregivers experienced distress and burden, and reported significant impact on their psychological well-being. Their experiences highlight the urgent need to provide more support for family caregivers in Middle East countries.

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