Moving from "let's fix them" to "actually listen": the development of a primary care intervention for mental-physical multimorbidity
AuthorMcKenzie, KJ; Fletcher, SL; Pierce, D; Gunn, JM
Source TitleBMC Health Services Research
University of Melbourne Author/sFletcher, Susan; Pierce, David; Gunn, Jane; McKenzie, Kylie; McKenzie, Kylie
Rural Clinical School
Document TypeJournal Article
CitationsMcKenzie, K. J., Fletcher, S. L., Pierce, D. & Gunn, J. M. (2021). Moving from "let's fix them" to "actually listen": the development of a primary care intervention for mental-physical multimorbidity. BMC HEALTH SERVICES RESEARCH, 21 (1), https://doi.org/10.1186/s12913-021-06307-5.
Access StatusOpen Access
NHMRC Grant codeNHMRC/1059863
BACKGROUND: Effective 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. METHODS: A 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. RESULTS: Three 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. CONCLUSION: The 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.
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