Other by Chris Platania-Phung
Journal of Clinical Nursing, 2016
Aims and objectives:
To ascertain the views and experiences of mental health consumers regarding... more Aims and objectives:
To ascertain the views and experiences of mental health consumers regarding the availability and quality of care and treatment received for their physical health needs.
Background:
People diagnosed with mental illness have higher occurrence of physical health problems. Responsive health care services are crucial for prevention and management of physical health problems, and for reducing disparities in health between people diagnosed with mental illness and those who are not. There is limited research giving voice to consumer perspectives on their experiences with health care providers.
Design:
Exploratory qualitative.
Methods:
Focus group interviews with mental health consumers accessed via a consumer network group in a region of Australia (n = 31). All interview audio recordings were transcribed professionally. Interviews were thematically analysed.
Results:
The main themes were: symptomising; failure to act and alertness to prejudice. The first two themes were consumer perceptions of the actions and behaviours of health professionals, and the third describes consumer responses to these behaviours and actions. Consumers described increased risks of illness and death because of undiagnosed physical illness despite their physical health advice-seeking as the reason for the health consultation.
Conclusion:
Health care providers' non-recognition of physical health problems presents a clear example of a significant and potentially life threatening health inequity. The service provider responses described by participants suggest that mental health consumers' physical health needs may not be taken seriously.
Relevance to clinical practice:
Clinicians need to take seriously the physical health needs and concerns of people with mental illness. Nurses can play a crucial role in the prevention of diagnostic overshadowing as part of a broader direction of balancing biomedical perspectives with other approaches to health care.
Papers by Chris Platania-Phung
Mental health nursing consistently emerges as less popular than other specialties, and both servi... more Mental health nursing consistently emerges as less popular than other specialties, and both service users and mental health practitioners are affected by negative attitudes. Education is fundamental to attracting students to the field of mental health nursing. The aim of this study was to determine the impact of undergraduate mental health curricula on student attitudes to people with mental illness, and career interest in mental health nursing. A traditional mental health course was compared to a course delivered by a person with lived experience of mental illness (and mental health service use) for its impact on student attitudes and career intentions in mental health nursing (cohort 1: n = 70, cohort 2: n = 131, respectively). In both cohorts, attitudes were measured via self-report, before and after the course, and changes were investigated through within-subjects t-tests. The lived experience-led course demonstrated statistically-significant positive changes in intentions to pursue mental health nursing and a decrease in negative stereotypes, which were not observed in the traditional course. The valuable contribution of mental health nursing emerged in the traditional, but not lived-experience-led, programmes. These findings support the value of an academic with lived experience of mental health challenges in promoting attraction to mental health nursing as a career option.
BMC psychiatry, Jan 19, 2016
People with severe mental illness have poorer physical health, experience disparities in physical... more People with severe mental illness have poorer physical health, experience disparities in physical health care, and lead significantly shorter lives, compared to the general population. Routine metabolic monitoring is proposed as a method of identifying risk factors for metabolic abnormalities. Efforts to date suggest routine metabolic monitoring is both incomplete and ad-hoc, however. This present study reports on the recent implementation of a routine metabolic monitoring form at a mental health service in regional Australia. A retrospective file audit was undertaken on 721 consumers with electronic health records at the mental health service. Descriptive statistics were used to report the frequency of use of the metabolic monitoring form and the range of metabolic parameters that had been recorded. Consumers had an average age of 41.4 years (SD = 14.6), over half were male (58.4 %), and the most common psychiatric diagnosis was schizophrenia (42.3 %). The metabolic monitoring form...
Journal of mental health (Abingdon, England), Jan 22, 2016
Shortened life expectancy of people with mental illness is now widely known and the focus of rese... more Shortened life expectancy of people with mental illness is now widely known and the focus of research and policy activity. To date, research has primarily reflected perspectives of health professionals with limited attention to the views and opinions of those most closely affected. The voice of carers is particularly minimal, despite policy stipulating carer participation is required for mental health services. To present views and opinions of carers regarding physical health of the people they care for. Qualitative exploratory. Two focus groups and one individual interview were conducted with 13 people identifying as carers of a person with mental illness. Research was conducted in the Australian Capital Territory. Data analysis was based on the thematic framework of Braun and Clarke. Two main themes were interaction between physical and mental health; and, carers' own physical and mental health. Participants described the impact of mental illness and its treatments on physical...
International Journal of Mental Health Nursing, 2016
People with mental illness have a significantly lower life expectancy and higher rates of chronic... more People with mental illness have a significantly lower life expectancy and higher rates of chronic physical illnesses than the general population. Health care system reform to improve access and quality is greatly needed to address this inequity. The inclusion of consumers of mental health services as co-investigators in research is likely to enhance service reform. In light of this, the current paper reviews mental health consumer focussed research conducted to date, addressing the neglect of physical health in mental health care and initiatives with the aim of improving physical health care. The international literature on physical healthcare in the context of mental health services was searched for articles, including mental health consumers in research roles, via Medline, CINAHL and Google Scholar, in October 2015. Four studies where mental health consumers participated as researchers were identified. Three studies involved qualitative research on barriers and facilitators to physical health care access, and a fourth study on developing technologies for more effective communication between GPs and patients. This review found that participatory mental health consumer research in physical health care reform has only become visible in the academic literature in 2015. Heightened consideration of mental health consumer participation in research is required by health care providers and researchers. Mental health nurses can provide leadership in increasing mental health consumer research on integrated care directed towards reducing the health gap between people with and without mental illness.
Issues in mental health nursing, Jan 10, 2016
Metabolic syndrome is more prevalent in people with serious mental illness, compared to the gener... more Metabolic syndrome is more prevalent in people with serious mental illness, compared to the general population. The main purpose of this study was to determine the extent electronic metabolic monitoring forms were being completed in a regional mental health service and the extent to which diagnoses of metabolic syndrome could be made using the data available. A retrospective file audit of 721 electronic mental health consumer records was undertaken. Metabolic monitoring data were recorded for 261 (36%) consumers, of which 57 (21.8%) met the clinical criteria for metabolic syndrome, 61 (23.4%) did not meet clinical criteria, and diagnoses could not be made for 143 (54.8%) consumers due to missing data. The limited use of electronic health records may inhibit the detection of risk factors for the diagnosis of metabolic syndrome.
International journal of mental health nursing, Jan 14, 2016
The physical health of people diagnosed with a mental illness is significantly poorer in comparis... more The physical health of people diagnosed with a mental illness is significantly poorer in comparison with the general population. Awareness of this health disparity is increasing; however, strategies to address the problem are limited. Carers play an important role in the physical health care of people with mental illness, particularly in facilitating navigation of and advocating in the health care system. A specialist physical health nurse consultant position has been suggested as a way to address the physical health care disparity and limited research available suggests that positive outcomes are possible. In the present study, a qualitative exploratory research project was undertaken, involving in-depth interviews with people identifying as mental health carers. Two focus groups and one individual interview were conducted involving a total of 13 carers. The resulting data were analyzed thematically. Views and opinions about the proposed physical health nurse consultant (PHNC) posi...
International Journal of Mental Health Nursing, 2016
The life expectancy of people living with mental illness is significantly shorter than that of th... more The life expectancy of people living with mental illness is significantly shorter than that of the rest of the population. Despite the profound impact of physical health issues on both quality of life and life expectancy, the perspectives of mental health consumers have yet to be thoroughly explored. Furthermore, research has focused far more on describing barriers than on identifying solutions. This paper reports on findings from a qualitative exploratory research study, with the aim to examine the potential role of a specialist nurse with advanced physical health-care skills. Focus groups were conducted with 31 consumers. Data were analysed thematically. The concept of a role like this was supported; however, participants stressed: (i) the importance of integration between health professionals and various components of the health-care system; and (ii) the need for culture change for nurses to work from a less medically-dominated approach. Previous research literature suggests that a nursing position dedicated to physical health care and coordination might produce positive outcomes for mental health consumers. The findings from the current research project emphasize the need for consumers to be identified as key stakeholders in a solution-focused approach to improved physical health care for mental health consumers.
Issues in Mental Health Nursing, 2015
Recovery-oriented services are a goal for policy and practice in the Australian mental health ser... more Recovery-oriented services are a goal for policy and practice in the Australian mental health service system. Evidence-based reform requires an instrument to measure knowledge of recovery concepts. The Recovery Knowledge Inventory (RKI) was designed for this purpose, however, its suitability and validity for student health professionals has not been evaluated. The purpose of the current article is to report the psychometric features of the RKI for measuring nursing students' views on recovery. The RKI, a self-report measure, consists of four scales: (I) Roles and Responsibilities, (II) Non-Linearity of the Recovery Process, (III) Roles of Self-Definition and Peers, and (IV) Expectations Regarding Recovery. Confirmatory and exploratory factor analyses of the baseline data (n = 167) were applied to assess validity and reliability. Exploratory factor analyses generally replicated the item structure suggested by the three main scales, however more stringent analyses (confirmatory factor analysis) did not provide strong support for convergent validity. A refined RKI with 16 items had internal reliabilities of α = .75 for Roles and Responsibilities, α = .49 for Roles of Self-Definition and Peers, and α = .72, for Recovery as Non-Linear Process. If the RKI is to be applied to nursing student populations, the conceptual underpinning of the instrument needs to be reworked, and new items should be generated to evaluate and improve scale validity and reliability.
Journal of Clinical Nursing, 2015
To explore factors impacting on the feasibility of academic and educator roles for consumers of m... more To explore factors impacting on the feasibility of academic and educator roles for consumers of mental health services. The supports required to facilitate these roles from the perspectives of mental health nurse academics and consumer educators/academics will also be explored. Involving consumers in the education of health professionals is becoming more common. Frequently this strategy is viewed as important to influence the attitudes of health professionals towards consumer participation in mental health services. There remains a paucity of research about these roles and the factors which promote and support their feasibility. Qualitative exploratory. In-depth telephone interviews were undertaken with 34 nurse academics and 12 consumer educators or academics. Participants included nurse academics coordinating undergraduate and postgraduate mental health subjects, and consumer academics and educators involved in teaching mental health nursing components. Interviews were 20 - 45 minutes in duration. Data were analysed thematically. Four subthemes were identified under the broad theme of feasibility and support: Reliability, support, vulnerability and seen to be griping. Significant barriers were identified by nurses and consumers to effective consumer involvement, largely reflecting the impact of mental health challenges. Despite this, there was little evidence of structured support being available to enhance the viability of these positions. Involving consumers in the education of health professionals through teaching, curriculum development, assessment and evaluation, is likely to enhance consumer participation in mental health services and ultimately improve service delivery. This involvement needs to be genuine to be effective. Consumers are often viewed as unreliable, vulnerable and using education to voice their own negative experiences. These issues and lack of support provided pose major barriers to successful roles, strategies to overcome barriers and maximise the effectiveness of roles require investigation and implementation.
Issues in Mental Health Nursing, 2015
People with serious mental illness (SMI) have increased risk of cardiovascular disease and premat... more People with serious mental illness (SMI) have increased risk of cardiovascular disease and premature death, yet research on nurse-provided health promotion in mental health services remains under-developed. This paper informs efforts to improve the nursing role in physical health of consumers with SMI by establishing what nurse perceptions and background influence their care. Members of the Australian College of Mental Health Nursing were invited to participate in an online survey on their views on physical health care in mental health services. Survey questions included: (a) nurse-consumer collaboration in preventative care and (b) sub-sections of the Robson and Haddad Physical Health Attitude Scale to measure nurse perceived barriers to encouraging lifestyle change of consumers with SMI and frequency of nurse physical healthcare practices. Structural equation modelling was applied to investigate antecedents to physical health care, as well as relationships between antecedents. A national sample of 643 nurses reported regular engagement in health promotion (e.g. advice on diet). There was statistical support for a model depicting perceived consumer-nurse collaboration as a dual-determinant of nurse perceived barriers and self-reported health promotion to consumers with SMI. Perceived barriers to consumer lifestyle change did not predict health promotion. The effects of nurse-consumer collaboration were significant, but small. Perceived consumer-nurse collaboration in preventative care may positively influence the amount of health promotion by nurses in mental health. Perceived barriers to consumer adherence with a healthy lifestyle did not have an impact on nurse-delivered health promotion.
International Journal of Mental Health Nursing, 2015
The physical health of people with serious mental illness (SMI) has become a focal area of resear... more The physical health of people with serious mental illness (SMI) has become a focal area of research. The aim of the present study was to ascertain the attention and distribution of research from within Australia on physical illness and SMI co-occurrence, and to identify gaps. A scoping review of peer-reviewed research literature from Australia, published between January 2000 and March 2014, was undertaken through an electronic literature search and coding of papers to chart trends. Four trends are highlighted: (i) an almost threefold increase in publications per year from 2000-2006 to 2007-2013; (ii) a steady release of literature reviews, especially from 2010; (iii) health-related behaviours, smoking, integrated-care programmes, and antipsychotic side-effects as the most common topics presented; and (iv) paucity of randomized, controlled trials on integrated-care models. Despite a marked increase in research attention to poorer physical health, there remains a large gap between research and the scale of the problem previously identified. More papers were descriptive or reviews, rather than evaluations of interventions. To foster more research, 12 research gaps are outlined. Addressing these gaps will facilitate the reduction of inequalities in physical health for people with SMI. Mental health nurses are well placed to lead multidisciplinary, consumer-informed research in this area.
Issues in mental health nursing, 2015
People with serious mental illness experience premature death due to higher rates of cardiometabo... more People with serious mental illness experience premature death due to higher rates of cardiometabolic conditions (e.g. cardiovascular disease, diabetes) than the general population. Mental health services often do not provide sufficient cardiometabolic clinical care to address these risks. The cardiometabolic health nurse (CHN) role has been suggested as a strategy for ensuring integrated care is provided and sustained. The views of nurses in mental health would be essential in informing the viability and development for this initiative. This paper presents the findings of open-ended comments from a cross-sectional online survey of nurses working in mental health in Australia (n = 643) eliciting views about the possible introduction of the cardiometabolic nurse. Thematic analysis was undertaken, of 133 open comments on this topic. The findings suggest that nurses see the specialist role as suitable and valuable for mental health services. Some nurses voiced concern about specialisa...
Perspectives in Psychiatric Care, 2015
Exploration of the views and experiences of nurse academics and consumer academics and educators ... more Exploration of the views and experiences of nurse academics and consumer academics and educators regarding the scope of consumer participation in mental health nursing education. A qualitative, exploratory inquiry into the description and views of mental health nurse academics and consumer educators about these roles FINDINGS: A significant variation in roles from guest speaker to substantive academic positions was evident, with most involvement brief and specifically teaching focused. Consumer participation in education was generally valued but noted to be limited in breadth and scope. Some concern was raised about the relevance of consumer academic roles, with a clear conceptualization of the consumer academic role necessary to facilitate their contribution to the education of health professionals. Mental health consumer involvement in the education of nurses has been shown to impact positively on the attitudes of health professionals to people with mental illness. Advocacy for increased, meaningful input from consumers into nursing education is therefore necessary to improve practice.
Perspectives in psychiatric care, Jan 23, 2014
A cardiometabolic specialist nursing role could potentially improve physical health of people wit... more A cardiometabolic specialist nursing role could potentially improve physical health of people with serious mental illness. A national survey of Australian nurses working in mental health settings investigated predictors of support for the role. Predictors included belief in physical healthcare neglect, interest in training; higher perceived value of improving physical health care. The findings suggest that nurses see the cardiometabolic health nurse role as a promising initiative for closing gaps in cardiometabolic health care and skilling other nurses in mental health. However, as the majority of variance in cardiometabolic health nurse support was unexplained, more research is urgently needed on factors that explain differences in cardiometabolic health nurse endorsement.
Perspectives in psychiatric care, Jan 20, 2014
This paper examines the findings from an exit interview with a cardiometabolic health nurse (CHN)... more This paper examines the findings from an exit interview with a cardiometabolic health nurse (CHN) following a 26-week trial. The CHN participated in a semi-structured exit interview following completion of the 26-week trial. Applied thematic analysis was used to identify themes contained in the resultant transcript. Contrary to the literature, the CHN did not consider additional training necessary to undertake the role. The CHN felt additional information regarding the research implications of the trial and greater organizational support would contribute to better consumer and health service outcomes. While personally rewarding, more can be done to help the CHN role reach its potential.
Australian health review : a publication of the Australian Hospital Association, Jan 10, 2015
Objectives The aim of the present study was to document Australian policies on the physical healt... more Objectives The aim of the present study was to document Australian policies on the physical health of people with mental illness and evaluate the capacity of policy to support health needs. Methods A search of state and federal policies on mental and physical illness was conducted, as well as detailed analysis of policy content and the relationships between policies, by applying the World Health Organization Mental Health Action Plan 2013-2020 as an evaluative framework. Results National policy attention to the physical health of people with mental illness has grown, but there is little interconnection at the national and state levels. State policies across the country are inconsistent, and there is little evidence of consistent policy implementation. Conclusions A coherent national health policy framework on addressing co-occurring physical and mental illnesses that includes healthcare system reforms and ensuring the interconnectedness of other relevant services should be prioritis...
Australian nursing journal (July 1993), 2012
International Journal of Mental Health Nursing, 2015
Consumers of mental health services have an important role to play in the higher education of nur... more Consumers of mental health services have an important role to play in the higher education of nursing students, by facilitating understanding of the experience of mental illness and instilling a culture of consumer participation. Yet the level of consumer participation in mental health nursing programmes in Australia is not known. The aim of the present study was to scope the level and nature of involvement of consumers in mental health nursing higher education in Australia. A cross-sectional study was undertaken involving an internet survey of nurse academics who coordinate mental health nursing programmes in universities across Australia, representing 32 universities. Seventy-eight percent of preregistration and 75% of post-registration programmes report involving consumers. Programmes most commonly had one consumer (25%) and up to five. Face-to-face teaching, curriculum development, and membership-to-programme committees were the most regular types of involvement. The content was generally codeveloped by consumers and nurse academics (67.5%). The frequency of consumer involvement in the education of nursing students in Australia is surprisingly high. However, involvement is noticeably variable across types of activity (e.g. curriculum development, assessment), and tends to be minimal and ad hoc. Future research is required into the drivers of increased consumer involvement.
Issues in Mental Health Nursing, 2014
To combat the increasingly poor physical health of people with serious mental illness, the positi... more To combat the increasingly poor physical health of people with serious mental illness, the position of a cardiometabolic health nurse has been proposed. We recently conducted a 26-week trial in a regional mental health service. This paper describes the background and rationale for the position, presents the outcomes on health behaviours and health behaviour knowledge and attitudes, and offers recommendations for the future direction of the role. We show that a cardiometabolic health nurse can improve the physical health behaviours in people with mental illness, however much needs to be done to further develop and implement the role.
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Other by Chris Platania-Phung
To ascertain the views and experiences of mental health consumers regarding the availability and quality of care and treatment received for their physical health needs.
Background:
People diagnosed with mental illness have higher occurrence of physical health problems. Responsive health care services are crucial for prevention and management of physical health problems, and for reducing disparities in health between people diagnosed with mental illness and those who are not. There is limited research giving voice to consumer perspectives on their experiences with health care providers.
Design:
Exploratory qualitative.
Methods:
Focus group interviews with mental health consumers accessed via a consumer network group in a region of Australia (n = 31). All interview audio recordings were transcribed professionally. Interviews were thematically analysed.
Results:
The main themes were: symptomising; failure to act and alertness to prejudice. The first two themes were consumer perceptions of the actions and behaviours of health professionals, and the third describes consumer responses to these behaviours and actions. Consumers described increased risks of illness and death because of undiagnosed physical illness despite their physical health advice-seeking as the reason for the health consultation.
Conclusion:
Health care providers' non-recognition of physical health problems presents a clear example of a significant and potentially life threatening health inequity. The service provider responses described by participants suggest that mental health consumers' physical health needs may not be taken seriously.
Relevance to clinical practice:
Clinicians need to take seriously the physical health needs and concerns of people with mental illness. Nurses can play a crucial role in the prevention of diagnostic overshadowing as part of a broader direction of balancing biomedical perspectives with other approaches to health care.
Papers by Chris Platania-Phung
To ascertain the views and experiences of mental health consumers regarding the availability and quality of care and treatment received for their physical health needs.
Background:
People diagnosed with mental illness have higher occurrence of physical health problems. Responsive health care services are crucial for prevention and management of physical health problems, and for reducing disparities in health between people diagnosed with mental illness and those who are not. There is limited research giving voice to consumer perspectives on their experiences with health care providers.
Design:
Exploratory qualitative.
Methods:
Focus group interviews with mental health consumers accessed via a consumer network group in a region of Australia (n = 31). All interview audio recordings were transcribed professionally. Interviews were thematically analysed.
Results:
The main themes were: symptomising; failure to act and alertness to prejudice. The first two themes were consumer perceptions of the actions and behaviours of health professionals, and the third describes consumer responses to these behaviours and actions. Consumers described increased risks of illness and death because of undiagnosed physical illness despite their physical health advice-seeking as the reason for the health consultation.
Conclusion:
Health care providers' non-recognition of physical health problems presents a clear example of a significant and potentially life threatening health inequity. The service provider responses described by participants suggest that mental health consumers' physical health needs may not be taken seriously.
Relevance to clinical practice:
Clinicians need to take seriously the physical health needs and concerns of people with mental illness. Nurses can play a crucial role in the prevention of diagnostic overshadowing as part of a broader direction of balancing biomedical perspectives with other approaches to health care.