Review2009

Non‐psychiatric hospitalization of people with mental illness: systematic review

76 citations0/0 files storedJournal of Advanced Nursing

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Psychiatric care and mental health services Mental Health Treatment and Access Interprofessional Education and Collaboration

Abstract

AIM: This paper is a report of a literature review of the evidence regarding outcomes experienced by severely mentally ill individuals hospitalized in general medical-surgical settings for non-psychiatric conditions. BACKGROUND: Severely mentally ill individuals experience chronic medical illnesses at a rate greater than the general population. When hospitalized in non-psychiatric settings, they tend to be experienced as 'difficult' by nurses and to have longer lengths of stay. DATA SOURCES: The CINAHL and PUBMED databases were searched from 1 to 9 March 2008 to identify studies published between 1998 and 2008 investigating outcomes among people with mental illness hospitalized for non-psychiatric illness in general hospitals. METHODS: Included studies were those published in English in peer reviewed journals and investigating patient outcomes. The studies were reviewed for relevance and inclusion criteria; the methodological quality of studies was not evaluated. RESULTS: Twelve studies met inclusion criteria. All studies examining length of stay, costs of care or resource utilization showed increased measures for patients with psychiatric comorbidity. Interventions described included psychiatric liaison psychiatry and nursing, which failed to demonstrate improvement in outcomes. CONCLUSION: Nurses play a pivotal role in improving the inpatient care of this vulnerable population, but they struggle in their attempts to do so. Research to determine the best approaches to promote nurses' knowledge, positive attitudes and self-confidence in caring for patients with psychiatric comorbidity is needed. Investigation of the patient perspective on the inpatient experience might also provide insight for designing effective care processes.

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References

2015Investing in mental health 2002Medical Morbidity, Mental Illness, and Substance Use Disorders 1996Mortality and medical comorbidity among psychiatric patients: a review 1998Conducting research literature reviews 2004Prevalence, Severity, and Co-occurrence of Chronic Physical Health Problems of Persons With Serious Mental Illness 1998Mental Disorders and Access to Medical Care in the United States 1998Struggling for control: the care experiences of ‘difficult’ patients in mental health services 2005The mixed attitudes of nurse's to caring for people with mental illness in a rural general hospital

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2015Medical–Surgical Nurses' Perceptions of Psychiatric Patients: A Review of the Literature With Clinical and Practice Applications 2018General hospital health professionals’ attitudes and perceived dangerousness towards patients with comorbid mental and physical health conditions: Systematic review and meta‐analysis

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