PMID- 29449295
OWN - NLM
STAT- MEDLINE
DCOM- 20180822
LR  - 20190202
IS  - 2044-6055 (Electronic)
IS  - 2044-6055 (Linking)
VI  - 8
IP  - 2
DP  - 2018 Feb 15
TI  - Management of type 2 diabetes mellitus in people with severe mental illness: an 
      online cross-sectional survey of healthcare professionals.
PG  - e019400
LID - 10.1136/bmjopen-2017-019400 [doi]
LID - e019400
AB  - OBJECTIVES: To establish healthcare professionals' (HCPs) views about clinical 
      roles, and the barriers and enablers to delivery of diabetes care for people with 
      severe mental illness (SMI). DESIGN: Cross-sectional, postal and online survey. 
      SETTING: Trusts within the National Health Service, mental health and diabetes 
      charities, and professional bodies. PARTICIPANTS: HCPs who care for people with 
      type 2 diabetes mellitus (T2DM) and/or SMI in the UK. PRIMARY AND SECONDARY 
      OUTCOME MEASURES: The barriers, enablers and experiences of delivering T2DM care 
      for people with SMI, informed by the Theoretical Domains Framework. RESULTS: 
      Respondents were 273 HCPs, primarily mental health nurses (33.7%) and 
      psychiatrists (32.2%). Only 25% of respondents had received training in managing 
      T2DM in people with SMI. Univariate analysis found that mental health 
      professionals felt responsible for significantly fewer recommended diabetes care 
      standards than physical health professionals (P<0.001). For those seeing diabetes 
      care as part of their role, the significant barriers to its delivery in the 
      multiple regression analyses were a lack of knowledge (P=0.003); a need for 
      training in communication and negotiation skills (P=0.04); a lack of optimism 
      about the health of their clients (P=0.04) and their ability to manage T2DM in 
      people with SMI (P=0.003); the threat of being disciplined (P=0.02); fear of 
      working with people with a mental health condition (P=0.01); a lack of service 
      user engagement (P=0.006); and a need for incentives (P=0.04). The significant 
      enablers were an understanding of the need to tailor treatments (P=0.04) and 
      goals (P=0.02) for people with SMI. CONCLUSIONS: This survey indicates that 
      despite current guidelines, diabetes care in mental health settings remains 
      peripheral. Even when diabetes care is perceived as part of an HCP's role, 
      various individual and organisational barriers to delivering recommended T2DM 
      care standards to people with SMI are experienced.
CI  - (c) Article author(s) (or their employer(s) unless otherwise stated in the text of 
      the article) 2018. All rights reserved. No commercial use is permitted unless 
      otherwise expressly granted.
FAU - McBain, Hayley
AU  - McBain H
AD  - School of Health Sciences, University of London, London, UK.
FAU - Lamontagne-Godwin, Frederique
AU  - Lamontagne-Godwin F
AD  - College of Nursing, Midwifery and Healthcare, University of West London, London, 
      UK.
FAU - Haddad, Mark
AU  - Haddad M
AD  - School of Health Sciences, University of London, London, UK.
FAU - Simpson, Alan
AU  - Simpson A
AD  - School of Health Sciences, University of London, London, UK.
AD  - Newham Centre for Mental Health, East London NHS Foundation Trust, London, UK.
FAU - Chapman, Jacqui
AU  - Chapman J
AD  - Diabetes Specialist Nursing Service, East London NHS Foundation Trust, London.
AD  - Diabetes Specialist Nursing Service, East London NHS Foundation Trust.
FAU - Jones, Julia
AU  - Jones J
AD  - Centre for Research in Primary and Community Care (CRIPACC), University of 
      Hertfordshire, Hatfield, UK.
FAU - Flood, Chris
AU  - Flood C
AD  - School of Health Sciences, University of London, London, UK.
AD  - Community Health Newham, East London NHS Foundation Trust, London, UK.
FAU - Mulligan, Kathleen
AU  - Mulligan K
AD  - School of Health Sciences, University of London, London, UK.
LA  - eng
PT  - Journal Article
PT  - Research Support, Non-U.S. Gov't
DEP - 20180215
PL  - England
TA  - BMJ Open
JT  - BMJ open
JID - 101552874
SB  - IM
EIN - BMJ Open. 2018 May 5;8(5):. PMID: 31329768
MH  - Adult
MH  - *Attitude of Health Personnel
MH  - Clinical Competence
MH  - Communication
MH  - Cross-Sectional Studies
MH  - Delivery of Health Care
MH  - Diabetes Mellitus, Type 2/complications/*therapy
MH  - Fear
MH  - Female
MH  - Health Care Surveys
MH  - Health Services Needs and Demand
MH  - Humans
MH  - Male
MH  - Mental Disorders/*complications
MH  - Nurses
MH  - Optimism
MH  - *Patient Care
MH  - *Professional Role
MH  - *Psychiatric Nursing
MH  - *Psychiatry
MH  - Self Efficacy
MH  - Severity of Illness Index
MH  - Surveys and Questionnaires
MH  - United Kingdom
PMC - PMC5829882
OTO - NOTNLM
OT  - General Diabetes
OT  - Mental Health
OT  - Quality In Health Care
COIS- Competing interests: None declared.
EDAT- 2018/02/17 06:00
MHDA- 2018/08/23 06:00
PMCR- 2018/02/15
CRDT- 2018/02/17 06:00
PHST- 2018/02/17 06:00 [entrez]
PHST- 2018/02/17 06:00 [pubmed]
PHST- 2018/08/23 06:00 [medline]
PHST- 2018/02/15 00:00 [pmc-release]
AID - bmjopen-2017-019400 [pii]
AID - 10.1136/bmjopen-2017-019400 [doi]
PST - epublish
SO  - BMJ Open. 2018 Feb 15;8(2):e019400. doi: 10.1136/bmjopen-2017-019400.