The physical health nurse consultant role: a consumer, carer, and health professional perspective

Tracy Tabvuma

doi:10.25918/thesis.516

People diagnosed with a mental illness (hereon referred to as consumers) experience adverse physical health outcomes such as higher morbidity and premature mortality compared to the general population. More specifically, the life expectancy of consumers diagnosed with psychotic disorders is up to 30 years shorter compared to the general public, primarily due to physical health comorbidities. Despite initiatives purposefully designed to address these inequities, physical health disparities still persist for consumers. In 2018, the National Health and Medical Research Council (NHMRC) funded a Randomised Controlled Trial entitled Improving the cardiometabolic health of people with psychosis: The Physical Health Nurse Consultant Service. The intervention sought to redress consumers’ physical health disparities by dedicating a specialist mental health nursing position to deliver and coordinate integrated mental and physical healthcare alongside routine care. Randomised Controlled Trials are typically quantitative in nature. However, integrating qualitative methods alongside quantitative findings can deepen our understanding of intervention effects. Therefore, consistent with national recommendations to involve consumers and carers in service evaluation, a qualitative inquiry was implemented. Through a series of five related papers published in high quality peer-reviewed journals, the thesis explores the views and experiences of consumers, carers, and healthcare professionals regarding the Physical Health Nurse Consultant service and its implementation. Manuscript one, an integrative review, conveyed consumers’ insights into the barriers and enablers of physical healthcare and interventions, and advocacy for co-production. Manuscript two highlighted consumer perspectives and experiences regarding therapeutic partnerships with the Physical Health Nurse Consultant. Manuscript three highlighted consumers’ perceptions of collaborative physical healthcare processes aligning with goal-setting theory to facilitate co-development and implementation of their health goals and goal types. Manuscript four provided insights into carers’ preference for adopting a supporting role in physical healthcare because of perceived credibility, trustworthiness and benefits of the Physical Health Nurse Consultant. Lastly, manuscript five illustrated healthcare professionals’ perception that the Physical Health Nurse Consultant role effectively integrated physical and mental healthcare as part of a multidisciplinary response. The findings from this thesis strongly demonstrate consumers, carers and healthcare professionals’ support for the continuation of the PHNC role and its integration into routine practice. The research provides nuanced implications for policy, practice, and research regarding contextualisation, implementation and evaluation for future iterations of the role.

The physical health nurse consultant role: a consumer, carer, and health professional perspective

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The physical health nurse consultant role: a consumer, carer, and health professional perspective

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