Journal article 888 views 84 downloads
End-of-life care for people with severe mental illness: mixed methods systematic review and thematic synthesis of published case studies (the MENLOC study)
,
Deborah Edwards ,
Sally Anstey ,
Paul Gill ,
Mala Mann ,
Alan Meudell ,
Ben Hannigan
BMJ Open, Volume: 12, Issue: 2, Start page: e053223
Swansea University Author:
Michael Coffey
-
PDF | Version of Record
© Author(s) (or their employer(s)) 2022. This is an open access article distributed in accordance with the Creative Commons Attribution 4.0 Unported (CC BY 4.0) license
Download (664.96KB)
DOI (Published version): 10.1136/bmjopen-2021-053223
Abstract
Objectives People with severe mental illness (SMI) have significant comorbidities and reduced life expectancy. The objective of the review reported in this paper was to synthesise material from case studies relating to the organisation, provision and receipt of care for people with SMI who have an e...
| Published in: | BMJ Open |
|---|---|
| ISSN: | 2044-6055 2044-6055 |
| Published: |
BMJ
2022
|
| Online Access: |
Check full text
|
| URI: | https://cronfa.swan.ac.uk/Record/cronfa59446 |
| Tags: |
Add Tag
No Tags, Be the first to tag this record!
|
| Abstract: |
Objectives People with severe mental illness (SMI) have significant comorbidities and reduced life expectancy. The objective of the review reported in this paper was to synthesise material from case studies relating to the organisation, provision and receipt of care for people with SMI who have an end-of-life (EoL) diagnosis.Design Systematic review and thematic synthesis.Data sources MEDLINE, PsycINFO, EMBASE, HMIC, AMED, CINAHL, CENTRAL, ASSIA, DARE and Web of Science from inception to December 2019. Supplementary searching for additional material including grey literature along with 62 organisational websites.Results Of the 11 904 citations retrieved, 42 papers reporting 51 case studies were identified and are reported here. Twenty-five of the forty-two case study papers met seven, or more quality criteria, with eight meeting half or less. Attributes of case study subjects included that just over half were men, had a mean age of 55 years, psychotic illnesses dominated and the EoL condition was in most cases a cancer. Analysis generated themes as follows diagnostic delay and overshadowing, decision capacity and dilemmas, medical futility, individuals and their networks, care provision.Conclusions In the absence of high-quality intervention studies, this evidence synthesis indicates that cross disciplinary care is supported within the context of established therapeutic relationships. Attention to potential delay and diagnostic overshadowing is required in care provision. The values and preferences of individuals with severe mental illness experiencing an end-of-life condition should be recognised. |
|---|---|
| College: |
Faculty of Medicine, Health and Life Sciences |
| Funders: |
This work was supported by the National Institute for Health Research (NIHR) Health Services and Delivery Research programme, grant number HS&DR 17/100/15 |
| Issue: |
2 |
| Start Page: |
e053223 |