Title |
Barriers to effective diabetes management – a survey of people with severe mental illness
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Published in |
BMC Psychiatry, June 2018
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DOI | 10.1186/s12888-018-1744-5 |
Pubmed ID | |
Authors |
Kathleen Mulligan, Hayley McBain, Frederique Lamontagne-Godwin, Jacqui Chapman, Chris Flood, Mark Haddad, Julia Jones, Alan Simpson |
Abstract |
People with severe mental illnesses (SMI) such as schizophrenia and bipolar disorder have an increased risk of developing type 2 diabetes and have poorer health outcomes than those with diabetes alone. To maintain good diabetes control, people with diabetes are advised to engage in several self-management behaviours. The aim of this study was to identify barriers or enablers of diabetes self-management experienced by people with SMI. Adults with type 2 diabetes and SMI were recruited through UK National Health Service organisations and mental health and diabetes charities. Participants completed an anonymous survey consisting of: Summary of Diabetes Self-Care Activities (SDSCA); CORE-10 measure of psychological distress; a measure of barriers and enablers of diabetes self-management based on the Theoretical Domains Framework; Diabetes UK care survey on receipt of 14 essential aspects of diabetes healthcare. To identify the strongest explanatory variables of SDSCA outcomes, significant variables (p < .05) identified from univariate analyses were entered into multiple regressions. Most of the 77 participants had bipolar disorder (42%) or schizophrenia (36%). They received a mean of 7.6 (SD 3.0) diabetes healthcare essentials. Only 28.6% had developed a diabetes care plan with their health professional and only 40% reported receiving specialist psychological support. Engagement in self-management activities was variable. Participants reported taking medication on 6.1 (SD 2.0) days in the previous week but other behaviours were less frequent: general diet 4.1 (2.3) days; specific diet 3.6 (1.8) days, taking exercise 2.4 (2.1) days and checking feet on 1.7 (1.8) days. Smoking prevalence was 44%. Participants reported finding regular exercise and following a healthy diet particularly difficult. Factors associated with diabetes self-management included: the level of diabetes healthcare and support received; emotional wellbeing; priority given to diabetes; perceived ability to manage diabetes or establish a routine to do so; and perceived consequences of diabetes self-management. Several aspects of diabetes healthcare and self-management are suboptimal in people with SMI. There is a need to improve diabetes self-management support for this population by integrating diabetes action plans into care planning and providing adequate psychological support to help people with SMI manage their diabetes. |
X Demographics
Geographical breakdown
Country | Count | As % |
---|---|---|
United Kingdom | 20 | 51% |
Australia | 2 | 5% |
United States | 1 | 3% |
New Zealand | 1 | 3% |
Unknown | 15 | 38% |
Demographic breakdown
Type | Count | As % |
---|---|---|
Members of the public | 17 | 44% |
Practitioners (doctors, other healthcare professionals) | 13 | 33% |
Scientists | 9 | 23% |
Mendeley readers
Geographical breakdown
Country | Count | As % |
---|---|---|
Unknown | 226 | 100% |
Demographic breakdown
Readers by professional status | Count | As % |
---|---|---|
Student > Master | 39 | 17% |
Student > Bachelor | 29 | 13% |
Student > Ph. D. Student | 19 | 8% |
Researcher | 17 | 8% |
Student > Doctoral Student | 13 | 6% |
Other | 32 | 14% |
Unknown | 77 | 34% |
Readers by discipline | Count | As % |
---|---|---|
Nursing and Health Professions | 43 | 19% |
Psychology | 32 | 14% |
Medicine and Dentistry | 28 | 12% |
Social Sciences | 13 | 6% |
Sports and Recreations | 5 | 2% |
Other | 19 | 8% |
Unknown | 86 | 38% |