Abstract
BackgroundInformal carers play an important role in the care of patients with mental illness. Little is known of the relationship experience of the patient and their informal carer (caring dyad) as the context for the intersection between physical and mental health.AimThis study aimed to explore the impact of comorbid cardiometabolic risk (CMR), metabolic syndrome (MetS) and related diseases and severe mental illness (SMI) on the caring dyad.DesignBetween October 2018 and March 2020, we conducted 11 in‐depth semi‐structured interviews across 6 adult caring dyads, interviewing each individual separately.SettingDyads were recruited within the United Kingdom; informal carers were nominated by the patient as a person who provided a significant amount of support.Variable Being StudiedParticipants were asked about the impacts of illness and caring on daily life.Data AnalysisData were analysed at the dyad level using thematic analysis, comparing and contrasting responses from each individual.ResultsThemes were identified: enhanced closeness, dissonance and balance within the caring dyad.Discussion and ConclusionsThis study uses a particular population of patients with comorbid CMR factors, MetS and related diseases and SMI and their informal carers to explore the relevance and utility of caring dyads as an analytical framework to inform practice and policy. Future interventions should consider factors impacting on dyadic relationships to formulate effective and sustainable dyadic care and treatment to improve health outcomes for both patients with SMI and their informal carers.Patient/Public InvolvementIn this study, patients and informal carers were participants. Topic guides were piloted with a patient and informal carer.
Highlights
Informal carers play a vital role in supporting patients with severe mental illness (SMI)[1] and are an important social contact for patients who experience high levels of social exclusion, isolation, loneliness and stigma
The majority of deaths in patients with SMI are due to preventable physical diseases, in particular, cardiovascular disease (CVD); they have a 2–3 times higher risk of dying from CVD compared to the general population.[14]
This study focused on a sample of patients with comorbid SMI and cardiometabolic risk (CMR), metabolic syndrome (MetS) and related disease and the nature and consequences on their lives and illness of the involvement of their informal carers
Summary
Informal carers play a vital role in supporting patients with severe mental illness (SMI)[1] and are an important social contact for patients who experience high levels of social exclusion, isolation, loneliness and stigma. Our analysis draws on the interdependence theory[19,20,21] to understand CMR, MetS and related diseases and SMI and their link with closeness, dissonance and balance within the caring dyad This theory considers the ways in which bilateral influence within the dyad affects the outcomes (behaviour or experience) of individuals. The dyad provides a critical unit for the analysis of health behaviours[22] where the characteristics (beliefs, identity and actions) of the interacting partners affect the outcomes of one or both individuals.[20] We argue that the experience of CMR, MetS and related diseases and SMI is a dyadic phenomenon. |3 dyadic health and functionality within the context of illness; the presence of CMR, MetS or related diseases and SMI can generate both enhanced closeness and dissonance within dyads as well as challenging role identities and balance within the relationship, which in turn affects health outcomes. Our analysis focuses on how CMR, MetS and related diseases and SMI interact with, and impact on, the relationship within the caring dyad and correspondingly on illness management
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