Combining diabetes and mental health care: An ethnographic exploration of user involvement in combined care
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Combining diabetes and mental health care : An ethnographic exploration of user involvement in combined care. / Zabell, Vicki; Arnfred, Sidse Marie; Rønne, Sabrina Trappaud; Berring, Lene Lauge; Lerbæk, Birgitte; Jørgensen, Rikke.
I: Journal of Clinical Nursing, Bind 32, Nr. 17-18, 2023, s. 6622-6633.Publikation: Bidrag til tidsskrift › Tidsskriftartikel › Forskning › fagfællebedømt
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TY - JOUR
T1 - Combining diabetes and mental health care
T2 - An ethnographic exploration of user involvement in combined care
AU - Zabell, Vicki
AU - Arnfred, Sidse Marie
AU - Rønne, Sabrina Trappaud
AU - Berring, Lene Lauge
AU - Lerbæk, Birgitte
AU - Jørgensen, Rikke
PY - 2023
Y1 - 2023
N2 - PurposeTo explore and describe the enactment of user involvement and combined care in a Danish clinic that aimed at providing integrated diabetes and mental health care. DesignAn ethnographic study. Data Sources and MethodsData consisted of field notes from 96 hours of participant observations and field notes from 32 informal conversations with healthcare providers, users and relatives as well as 12 semistructured interviews with users. Data were analysed using a thematic analysis. This study reports to the SRQR guidelines. ResultsTreatment was not combined as intended if only one healthcare provider handled the consultations. Here, the healthcare providers' focus was often on their own area of expertise-either mental health or diabetes. If more than one healthcare provider handled consultations, the consultations were often divided between them, focussing on one condition at the time. Healthcare providers noted, that learning from peer colleagues was a way to increase the possibility for combined care. Furthermore, combined care was highly dependent on the healthcare providers' ability to involve users' illness experiences in their own care planning. Here, a high level of user involvement increased the levels of combined care during consultations. ConclusionThis study set out to explore and describe user involvement and combined care in a specialised diabetes and mental health outpatient clinic. Combined care is complexed and requires that healthcare providers are well-equipped to manage the complexity of delivering care for people with both conditions. The degree of combined care was linked with the healthcare providers' ability to involve users and their knowledge on the condition outside there are of expertise. Relevance to Clinical PracticeA peer-learning environment in combination with clinical guidelines and joint display could support healthcare providers in involving users in own care and when delivering care outside their area of expertise. Public contributionNo patient or public contribution. Due to the COVID-19 pandemic, the original user council withdraw their consent to participate due to health-related worries and anxiety concerning the pandemic. The user council consisted of three members diagnosed with diabetes and severe mental illness. They were invited to participate in physical meetings, phone or online meetings. Presenting findings from the study to the study participants were also hindered by the second lockdown. This influenced the possibility for data triangulation.
AB - PurposeTo explore and describe the enactment of user involvement and combined care in a Danish clinic that aimed at providing integrated diabetes and mental health care. DesignAn ethnographic study. Data Sources and MethodsData consisted of field notes from 96 hours of participant observations and field notes from 32 informal conversations with healthcare providers, users and relatives as well as 12 semistructured interviews with users. Data were analysed using a thematic analysis. This study reports to the SRQR guidelines. ResultsTreatment was not combined as intended if only one healthcare provider handled the consultations. Here, the healthcare providers' focus was often on their own area of expertise-either mental health or diabetes. If more than one healthcare provider handled consultations, the consultations were often divided between them, focussing on one condition at the time. Healthcare providers noted, that learning from peer colleagues was a way to increase the possibility for combined care. Furthermore, combined care was highly dependent on the healthcare providers' ability to involve users' illness experiences in their own care planning. Here, a high level of user involvement increased the levels of combined care during consultations. ConclusionThis study set out to explore and describe user involvement and combined care in a specialised diabetes and mental health outpatient clinic. Combined care is complexed and requires that healthcare providers are well-equipped to manage the complexity of delivering care for people with both conditions. The degree of combined care was linked with the healthcare providers' ability to involve users and their knowledge on the condition outside there are of expertise. Relevance to Clinical PracticeA peer-learning environment in combination with clinical guidelines and joint display could support healthcare providers in involving users in own care and when delivering care outside their area of expertise. Public contributionNo patient or public contribution. Due to the COVID-19 pandemic, the original user council withdraw their consent to participate due to health-related worries and anxiety concerning the pandemic. The user council consisted of three members diagnosed with diabetes and severe mental illness. They were invited to participate in physical meetings, phone or online meetings. Presenting findings from the study to the study participants were also hindered by the second lockdown. This influenced the possibility for data triangulation.
KW - combined care
KW - co-morbid illness
KW - diabetes care
KW - mental health care
KW - psychiatric disorders
KW - support needs
KW - type 1 diabetes
KW - type 2 diabetes
KW - ILLNESS
U2 - 10.1111/jocn.16703
DO - 10.1111/jocn.16703
M3 - Journal article
C2 - 37166281
VL - 32
SP - 6622
EP - 6633
JO - Journal of Clinical Nursing
JF - Journal of Clinical Nursing
SN - 0962-1067
IS - 17-18
ER -
ID: 347812516