Abstract
BackgroundEffective person-centred interventions are needed to support people living with mental-physical multimorbidity to achieve better health and wellbeing outcomes. Depression is identified as the most common mental health condition co-occurring with a physical health condition and is the focus of this intervention development study. The aim of this study is to identify the key components needed for an effective intervention based on a clear theoretical foundation, consideration of how motivational interviewing can inform the intervention, clinical guidelines to date, and the insights of primary care nurses.MethodsA multimethod approach to intervention development involving review and integration of the theoretical principles of Theory of Planned Behavior and the patient-centred clinical skills of motivational interviewing, review of the expert consensus clinical guidelines for multimorbidity, and incorporation of a thematic analysis of group interviews with Australian nurses about their perspectives of what is needed in intervention to support people living with mental-physical multimorbidity.ResultsThree mechanisms emerged from the review of theory, guidelines and practitioner perspective; the intervention needs to actively ‘engage’ patients through the development of a collaborative and empathic relationship, ‘focus’ on the patient’s priorities, and ‘empower’ people to make behaviour change.ConclusionThe outcome of the present study is a fully described primary care intervention for people living with mental-physical multimorbidity, with a particular focus on people living with depression and a physical health condition. It builds on theory, expert consensus guidelines and clinician perspective, and is to be tested in a clinical trial.
Highlights
Effective person-centred interventions are needed to support people living with mental-physical multimorbidity to achieve better health and wellbeing outcomes
There is a consistent call for interventions focused on patient priorities and preferences for how to improve their own health [15, 18,19,20,21,22,23]. .Evidence about public and health care interventions that address the issues of people living with mental-physical multimorbidity is limited, and effective interventions are urgently needed [24, 25]
We identified a potential role for nurses in delivering collaborative care for people living with mental-physical multimorbidity in Australian primary care settings
Summary
Effective person-centred interventions are needed to support people living with mental-physical multimorbidity to achieve better health and wellbeing outcomes. This review concluded that interventions which can be integrated into routine care and include a focus on addressing functional difficulty may be more effective [17]. Consistent with these findings, there is a call for cross-cutting interventions that promote health generally, and impact across both mental and physical health conditions [5, 18]. .Evidence about public and health care interventions that address the issues of people living with mental-physical multimorbidity is limited, and effective interventions are urgently needed [24, 25]
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