P-56

Background

Research increasingly confirms that physical health of patients with severe mental illness (SMI) needs urgent attention. Life-expectancy of these patients is approximately 15 to 25 years shorter, compared to the general population, with multiple causes. E.g. stigma by health professionals causes patients with SMI not receiving adequate care for physical illness. Moreover, the psychiatric illness affects physical health, by genetic overlap between psychiatric and physical illnesses. Side-effects of medication cause metabolic changes. Research shows that mental healthcare professionals do not address these physical problems in a systematic way.

Methods

In the LEF project, an e-healthprogram based on motivational interviewing and selfmanagement-support was developed for somatic screening and lifestyle-interventions for patients with SMI. Implementation strategies were training of nurses and advanced nurse practitioners (NP), ongoing coaching, achieving commitment and support by managers of teams, the availability of the e-healthprogram. Nurses and NP’s screened patients, aiming at patients formulating their own lifestyle-goal and coaching them in trying to achieve this goal. Research questions were: 1. Is the chosen method of implementation adequate? and 2. Do patients show changes in health-parameters (Body Mass Index, bloodpressure, lipids and cholesterol) after 6 months? Mixed methods were applied. Measurements were performed at baseline and after 6 months and participating nurses were interviewed about their experiences.

Results

84 nurses and 17 NP’s started working with patients in the e-healthprogram. At baseline, 336 patients were screened on somatic health, and 269 patients formulated a lifestyle goal. At follow-up, 68 patients were screened and 33 patients formulated a goal. No differences on health parameters could be found. Nurses interviewed about their experiences with the intervention mentioned organization-related factors, instrumental factors, factors related to nurse-functioning and patient-related factors.

Conclusion

Lessons can be learned about implementation to be able to address physical health and lifestyle of patients with SMI.