The gap between mental health nurses’ perceptions on their role in somatic screening and lifestyle coaching for patients with a severe mental illness and their perceived actual practice: a qualitative study

Abstract

Background: Patients with a severe mental illness (SMI) have very high morbidity and mortality rates. It is estimated that patients with SMI have a life expectancy that is 20-30 years shorter than the general population. The majority of these premature deaths can be attributed to natural causes such as cardiovascular disease, respiratory diseases and certain types of cancer, all preventable and manageable diseases. Multiple factors contribute to this shortened life expectancy, such as symptoms of the mental disorder, lifestyle factors, poverty, lack of participation in society, side effects of medication as well as limited access to medical care. Several interventions and guidelines have been developed to promote somatic screening and lifestyle coaching in patients with SMI. Mental health nurses (MHN) have an important role in performing these interventions. However, it is unclear how mental health nurses perceive their role with respect to somatic screening and lifestyle coaching. Aims: To describe how MHN perceive their role concerning somatic screening and lifestyle coaching for patients with SMI and how this affects their practice. Method: A descriptive qualitative design was applied. Fifteen MHN working in a FACT-team were interviewed. Thematic analysis was performed. Results: The majority of nurses who were interviewed perceive somatic screening and lifestyle intervention as a part of their role. However, there appears to be a gap between the role they perceive and actual practice. Factors influencing the perceived ability of executing this role were identified. Being able to connect with the patient seemed a crucial factor in this process. Conclusion and implications of key findings: Nurses perceive barriers in executing their role in somatic screening and lifestyle interventions. Nursing education should focus on knowledge and skills concerning healthy lifestyle and establishing a connection with the patient