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Open Access 01-12-2021 | Care | Research

A qualitative study to investigate Swiss hospital personnel’s perceived importance of and experiences with patient’s mental–somatic multimorbidities

Authors: Nicola Julia Aebi, Seraina Caviezel, Rainer Schaefert, Gunther Meinlschmidt, Matthias Schwenkglenks, Günther Fink, Lara Riedo, Thomas Leyhe, Kaspar Wyss, SomPsyNet Consortium

Published in: BMC Psychiatry | Issue 1/2021

Abstract

Background

Mental–somatic multimorbidity in general hospital settings is associated with long hospital stays, frequent rehospitalization, and a deterioration of disease course, thus, highlighting the need for treating hospital patients more holistically. However, there are several challenges to overcome to address mental health conditions in these settings. This study investigated hospital personnel’s perceived importance of and experiences with mental–somatic multimorbidities of patients in hospital settings in Basel, Switzerland, with special consideration of the differences between physicians and nurses.

Methods

Eighteen semi-structured interviews were conducted with nurses (n = 10) and physicians (n = 8) in different hospitals located in Basel, Switzerland. An inductive approach of the framework analysis was used to develop the themes.

Results

Four themes emerged from the data analysis: 1) the relevance of mental–somatic multimorbidity within general hospitals, 2) health professionals managing their emotions towards mental health, 3) knowledge and competencies in treating patients with mental–somatic multimorbidity, and 4) interprofessional collaboration for handling mental–somatic multimorbidity in hospital settings.The mental–somatic multimorbidities in general hospital patients was found to be relevant among all hospital professionals, although the priority of mental health was higher for nurses than for physicians. This might have resulted from different working environments or in efficient interprofessional collaboration in general hospitals. Physicians and nurses both highlighted the difficulties of dealing with stigma, a lack of knowledge of mental disorders, the emphasis place on treating somatic disorders, and competing priorities and work availability, which all hindered the adequate handling of mental–somatic multimorbidity in general hospitals.

Conclusion

To support health professionals to integrate mental health into their work, proper environments within general hospitals are needed, such as private rooms in which to communicate with patients. In addition, changes in curriculums and continuing training are needed to improve the understanding of mental–somatic multimorbidities and reduce negative stereotypes. Similarly, interprofessional collaboration between health professionals needs to be strengthened to adequately identify and treat mentally multimorbid patients. A stronger focus should be placed on physicians to improve their competencies in considering patient mental health in their daily somatic treatment care.

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GBD 2019 Disease and Injuries Collaborators. Mental disorders—Level 2 cause 2020 [Available from: https://www.thelancet.com/pb-assets/Lancet/gbd/summaries/diseases/mental-disorders.pdf.

Vigo D, Thornicroft G, Atun R. Estimating the true global burden of mental illness. Lancet Psychiatry. 2016;3(2):171–8. https://doi.org/10.1016/S2215-0366(15)00505-2.CrossRefPubMed

United Nations. Transforming our world: the 2030 agenda for sustainable development. Geneva: United Nations; 2015.

Rayner L, Matcham F, Hutton J, Stringer C, Dobson J, Steer S, et al. Embedding integrated mental health assessment and management in general hospital settings: feasibility, acceptability and the prevalence of common mental disorder. Gen Hosp Psychiatry. 2014;36(3):318–24. https://doi.org/10.1016/j.genhosppsych.2013.12.004.CrossRefPubMed

Rose M, Wahl I, Crusius J, Löwe BJB-G-G. Psychische Komorbidität. 2011;54(1):83–9.

Tuch A. Somatisch-psychische Komorbidität in Schweizer Akutspitälern. Prävalenz und Inanspruchnahme. Obsan Bulletin. 2018;1/2018.

Prince M, Patel V, Saxena S, Maj M, Maselko J, Phillips MR, et al. No health without mental health. Lancet (London, England). 2007;370(9590):859–77.CrossRef

Walker J, Burke K, Wanat M, Fisher R, Fielding J, Mulick A, et al. The prevalence of depression in general hospital inpatients: a systematic review and meta-analysis of interview-based studies. Psychol Med. 2018;48(14):2285–98. https://doi.org/10.1017/S0033291718000624.CrossRefPubMed

Moayedoddin B, Rubovszky G, Mammana L, Jeannot E, Sartori M, Garin N, et al. Prevalence and clinical characteristics of the DSM IV major depression among general internal medicine patients. Eur J Intern Med. 2013;24(8):763–6. https://doi.org/10.1016/j.ejim.2013.05.016.CrossRefPubMed

10.

Ni Mhaolain AM, Butler JS, Magill PF, Wood AE, Sheehan J. The increased need for liaison psychiatry in surgical patients due to the high prevalence of undiagnosed anxiety and depression. Ir J Med Sci. 2008;177(3):211–5. https://doi.org/10.1007/s11845-008-0124-4.CrossRefPubMed

11.

Rentsch D, Dumont P, Borgacci S, Carballeira Y. deTonnac N, Archinard M, et al. prevalence and treatment of depression in a hospital department of internal medicine. Gen Hosp Psychiatry. 2007;29(1):25–31. https://doi.org/10.1016/j.genhosppsych.2006.08.008.CrossRefPubMed

12.

Topitz A, Benda N, Saumer G, Friedrich F, König D, Soulier N, et al. Prävalenz und Erkennen der Depression an nicht-psychiatrischen Krankenhausabteilungen neuropsychiatrie 2015;29(2):63–70.

13.

Uhlenbusch N, Löwe B, Härter M, Schramm C, Weiler-Normann C, Depping MK. Depression and anxiety in patients with different rare chronic diseases: a cross-sectional study. PLoS One. 2019;14(2):e0211343. https://doi.org/10.1371/journal.pone.0211343.CrossRefPubMedPubMedCentral

14.

Walker J, Hansen CH, Martin P, Symeonides S, Ramessur R, Murray G, et al. Prevalence, associations, and adequacy of treatment of major depression in patients with cancer: a cross-sectional analysis of routinely collected clinical data. Lancet Psychiatry. 2014;1(5):343–50. https://doi.org/10.1016/S2215-0366(14)70313-X.CrossRefPubMed

15.

Schlapbach M, Ruflin R. Koordinierte Versorgung für psychisch erkrankte Personen an der Schnittstelle "Akutsomatik - Psychiatrie resp. psychiatrische Klinik" - Situationsanalyse und Handlungsbedarf: Schlussbericht. Socialdesign AG im Auftrag des Bundesamtes für Gesundheit (BAG), Bern. 2017.

16.

Rettke H, Petry H, von Känel R, Jordan K-D, Ernst J. Patientinnen und Patienten mit psychiatrischen Komorbiditäten im Akutspital. Pflege. 2020;33(2):85–91. https://doi.org/10.1024/1012-5302/a000718.CrossRefPubMed

17.

Patel V, Saxena S, Lund C, Thornicroft G, Baingana F, Bolton P, et al. The Lancet commission on global mental health and sustainable development. Lancet. 2018;392(10157):1553–98. https://doi.org/10.1016/S0140-6736(18)31612-X.CrossRefPubMed

18.

Wittchen HU, Jacobi F, Rehm J, Gustavsson A, Svensson M, Jönsson B, et al. The size and burden of mental disorders and other disorders of the brain in Europe 2010. Eur Neuropsychopharmacol. 2011;21(9):655–79. https://doi.org/10.1016/j.euroneuro.2011.07.018.CrossRefPubMed

19.

Giandinoto JA, Edward KL. Challenges in acute care of people with co-morbid mental illness. Br J Nurs. 2014;23(13):728–32. https://doi.org/10.12968/bjon.2014.23.13.728.CrossRefPubMed

20.

Henderson C, Noblett J, Parke H, Clement S, Caffrey A, Gale-Grant O, et al. Mental health-related stigma in health care and mental health-care settings. Lancet Psychiatry. 2014;1(6):467–82. https://doi.org/10.1016/S2215-0366(14)00023-6.CrossRefPubMed

21.

Hughes B, Fitzpatrick JJ. Nurse-physician collaboration in an acute care community hospital. J Interprof Care. 2010;24(6):625–32. https://doi.org/10.3109/13561820903550804.CrossRefPubMed

22.

Matthys E, Remmen R, Van Bogaert P. An overview of systematic reviews on the collaboration between physicians and nurses and the impact on patient outcomes: what can we learn in primary care? BMC Fam Pract. 2017;18(1):110. https://doi.org/10.1186/s12875-017-0698-x.CrossRefPubMedPubMedCentral

23.

Reeves S, Pelone F, Harrison R, Goldman J, Zwarenstein M. Interprofessional collaboration to improve professional practice and healthcare outcomes. Cochrane Database of Systematic Reviews [Internet]. 2017; (6). Available from: https://doi.org//10.1002/14651858.CD000072.pub3.

24.

Lipowski ZJ. Consultation-liaison psychiatry in general hospital. Compr Psychiatry. 1971;12(5):461–5. https://doi.org/10.1016/0010-440X(71)90086-1.CrossRefPubMed

25.

Huyse FJ, Herzog T, Lobo A, Malt UF, Opmeer BC, Stein B, et al. Consultation-liaison psychiatric service delivery: results from a European study. Gen Hosp Psychiatry. 2001;23(3):124–32. https://doi.org/10.1016/S0163-8343(01)00139-6.CrossRefPubMed

26.

Innes K, Morphet J, O'Brien AP, Munro I. Caring for the mental illness patient in emergency departments--an exploration of the issues from a healthcare provider perspective. J Clin Nurs. 2014;23(13–14):2003–11. https://doi.org/10.1111/jocn.12437.CrossRefPubMed

27.

SomPsyNet - Prevention of Psychosocial Distress Consequences in Somatic Medicine: a Model for Collaborative Care (Clinicaltrials.gov Identifier NCT04269005) [Internet]. [Available from: https://ClinicalTrials.gov/show/NCT04269005.

28.

Universitäre Altersklinik FELIX PLATTER. Jahresbericht 2019 2020 [Available from: https://www.felixplatter.ch/dam/felixplatter/assets/pdf/Jahresberichte/Jahresbericht_2019_Universitaere_Altersmedizin_FELIX_PLATTER.pdf.

29.

Universitätsspital Basel. Jahresbericht 2019 2020 [Available from: https://jahresbericht.unispital-basel.ch/2019.

30.

Bethesda Spital AG. Geschäftsbericht 2019 2020 [Available from: https://bethesda-spital.ch/ueber-uns/geschaeftsbericht-bethesda-spital.html.

31.

QSR International Pty Ltd. NVivo qualitative data analysis software. Version 12. 2018.

32.

Gale NK, Heath G, Cameron E, Rashid S, Redwood S. Using the framework method for the analysis of qualitative data in multi-disciplinary health research. BMC Med Res Methodol. 2013;13(1):117. https://doi.org/10.1186/1471-2288-13-117.CrossRefPubMedPubMedCentral

33.

Tong A, Sainsbury P, Craig J. Consolidated criteria for reporting qualitative research (COREQ): a 32-item checklist for interviews and focus groups. Int J Qual Health Care. 2007;19(6):349–57. https://doi.org/10.1093/intqhc/mzm042.CrossRef

34.

Canuto A, Gkinis G, DiGiorgio S, Arpone F, Herrmann FR, Weber K. Agreement between physicians and liaison psychiatrists on depression in old age patients of a general hospital: influence of symptom severity, age and personality. Aging Ment Health. 2016;20(10):1092–8. https://doi.org/10.1080/13607863.2015.1063103.CrossRefPubMed

35.

Cepoiu M, McCusker J, Cole MG, Sewitch M, Belzile E, Ciampi A. Recognition of depression by non-psychiatric physicians--a systematic literature review and meta-analysis. J Gen Intern Med. 2008;23(1):25–36. https://doi.org/10.1007/s11606-007-0428-5.CrossRefPubMed

36.

Härter M, Woll S, Reuter K, Wunsch A, Bengel J. Recognition of psychiatric disorders in musculoskeletal and cardiovascular rehabilitation patients. Arch Phys Med Rehabil. 2004;85(7):1192–7. https://doi.org/10.1016/j.apmr.2003.08.106.CrossRefPubMed

37.

Wancata J, Windhaber J, Bach M, Meise U. Recognition of psychiatric disorders in nonpsychiatric hospital wards. J Psychosom Res. 2000;48(2):149–55. https://doi.org/10.1016/S0022-3999(99)00098-7.CrossRefPubMed

38.

Chen KY, Evans R, Larkins S. Why are hospital doctors not referring to consultation-liaison psychiatry? - a systemic review. BMC Psychiatry. 2016;16(1):390. https://doi.org/10.1186/s12888-016-1100-6.CrossRefPubMedPubMedCentral

39.

Sharda L, Baker J, Cahill J. A mixed methods study of the healthcare received by patients diagnosed with a personality disorder on acute general hospital wards. J Adv Nurs. 2021;77(4):2002–11. https://doi.org/10.1111/jan.14797.CrossRefPubMed

40.

Foye U, Simpson A, Reynolds L. “Somebody else’s business”: the challenge of caring for patients with mental health problems on medical and surgical wards. J Psychiatr Ment Health Nurs. 2020;27(4):406–16. https://doi.org/10.1111/jpm.12596.CrossRefPubMed

41.

Giandinoto JA, Stephenson J, Edward KL. General hospital health professionals' attitudes and perceived dangerousness towards patients with comorbid mental and physical health conditions: systematic review and meta-analysis. Int J Ment Health Nurs. 2018;27(3):942–55. https://doi.org/10.1111/inm.12433.CrossRefPubMed

42.

Giandinoto J-A, K-l E. The phenomenon of co-morbid physical and mental illness in acute medical care: the lived experience of Australian health professionals. BMC Research Notes. 2015;8(1):295. https://doi.org/10.1186/s13104-015-1264-z.CrossRefPubMedPubMedCentral

43.

Knaak S, Mantler E, Szeto A. Mental illness-related stigma in healthcare: barriers to access and care and evidence-based solutions. Healthcare Manag Forum. 2017;30(2):111–6. https://doi.org/10.1177/0840470416679413.CrossRef

44.

Casanova J, Day K, Dorpat D, Hendricks B, Theis L, Wiesman S. Nurse-physician work relations and role expectations. J Nurs Adm. 2007;37(2):68–70. https://doi.org/10.1097/00005110-200702000-00007.CrossRefPubMed

45.

Fißler M, Quante A. Psychiatric liaison consultations of patients without psychiatric illness in a general hospital in Germany: a retrospective analysis. Wien Med Wochenschr. 2015;165(21–22):436–44. https://doi.org/10.1007/s10354-015-0384-3.CrossRefPubMed

46.

Martin JS, Ummenhofer W, Manser T, Spirig R. Interprofessional collaboration among nurses and physicians: making a difference in patient outcome. Swiss Med Wkly. 2010;140:w13062.PubMed

47.

House S, Havens D. Nurses' and Physicians' perceptions of nurse-physician collaboration: a systematic review. J Nurs Adm. 2017;47(3):165–71. https://doi.org/10.1097/NNA.0000000000000460.CrossRefPubMed

48.

Tan TC, Zhou H, Kelly M. Nurse-physician communication - an integrated review. J Clin Nurs. 2017;26(23–24):3974–89. https://doi.org/10.1111/jocn.13832.CrossRefPubMed

49.

Tang CJ, Chan SW, Zhou WT, Liaw SY. Collaboration between hospital physicians and nurses: an integrated literature review. Int Nurs Rev. 2013;60(3):291–302. https://doi.org/10.1111/inr.12034.CrossRefPubMed

50.

Jasmin K, Walker A, Guthrie E, Trigwell P, Quirk A, Hewison J, et al. Integrated liaison psychiatry services in England: a qualitative study of the views of liaison practitioners and acute hospital staffs from four distinctly different kinds of liaison service. BMC Health Serv Res. 2019;19(1):522. https://doi.org/10.1186/s12913-019-4356-y.CrossRefPubMedPubMedCentral

Title: A qualitative study to investigate Swiss hospital personnel’s perceived importance of and experiences with patient’s mental–somatic multimorbidities
Authors: Nicola Julia Aebi
Seraina Caviezel
Rainer Schaefert
Gunther Meinlschmidt
Matthias Schwenkglenks
Günther Fink
Lara Riedo
Thomas Leyhe
Kaspar Wyss
SomPsyNet Consortium
Publication date: 01-12-2021
Publisher: BioMed Central
Keyword: Care
Published in: BMC Psychiatry / Issue 1/2021
Electronic ISSN: 1471-244X
DOI: https://doi.org/10.1186/s12888-021-03353-5

Keynote webinar | Spotlight on medication adherence

Springer Medicine

A qualitative study to investigate Swiss hospital personnel’s perceived importance of and experiences with patient’s mental–somatic multimorbidities

Abstract

Background

Methods

Results

Conclusion

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

Background

Methods

Results

Conclusion

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