Mental health bias in physical care: an integrative review of the literature
A Hallyburton, L Allison‐Jones - Journal of Psychiatric and …, 2023 - Wiley Online Library
A Hallyburton, L Allison‐Jones
Journal of Psychiatric and Mental Health Nursing, 2023•Wiley Online LibraryAccessible Summary What is known on the subject? Individuals experiencing mental illness
make up a significant portion of the world's population. Individuals with mental illness
experience higher rates of morbidity and die on average at least a decade earlier than
individuals without mental health disorders. What this paper adds to existing knowledge?
Issues of stigma, diagnostic overshadowing, premature closure, inadequate workup, fear
and lack of training negatively impact the care of individuals with mental illness. Issues …
make up a significant portion of the world's population. Individuals with mental illness
experience higher rates of morbidity and die on average at least a decade earlier than
individuals without mental health disorders. What this paper adds to existing knowledge?
Issues of stigma, diagnostic overshadowing, premature closure, inadequate workup, fear
and lack of training negatively impact the care of individuals with mental illness. Issues …
Accessible Summary
What is known on the subject
- Individuals experiencing mental illness make up a significant portion of the world's population.
- Individuals with mental illness experience higher rates of morbidity and die on average at least a decade earlier than individuals without mental health disorders.
What this paper adds to existing knowledge
- Issues of stigma, diagnostic overshadowing, premature closure, inadequate workup, fear and lack of training negatively impact the care of individuals with mental illness.
- Issues impacting the care of individuals experiencing mental illness cross geographic and care setting boundaries.
What are the implications for practice
- Partnerships between physical and mental health practitioners are needed to thoroughly assess and accurately diagnose symptoms experienced by individuals with mental illness.
- Educational interventions can help prepare practitioners to care for individuals with mental illness.
- Nurses can better advocate for effective patient care by learning about the phenomenon of diagnostic overshadowing and calling attention to its occurrence.
Abstract
Introduction
Individuals with mental illness experience significantly higher overall rates of morbidity and mortality than counterparts without mental illness. Misdiagnosis of symptoms emanating from physical illnesses as psychiatric in nature presents one important cause.
Aim
This integrative review explores research on healthcare professionals' misattribution of physical health symptoms to patients' comorbid psychiatric issues and seeks to identify unifying themes, shared causes, and possible strategies for addressing the issue.
Method
This review uses Whittemore and Knafl's 2005 integrative review methodology coupled with vetted quality appraisal tools.
Results
Following a systematic search of allied health, medical, psychological, sociological and general literature, 24 publications employing qualitative, quantitative, mixed and synthesis research methodologies were selected. Each study was appraised according to design, and relevant data were extracted.
Discussion
Themes of stigmatization, diagnostic overshadowing, incomplete medical examination, insufficient training, and fears experienced by providers and patients emerged.
Implications for Practice
Increased partnering between physical and mental health practitioners, continuing education, and improving patient–provider communication are key to providing equitable care. Nurses play primary roles in empathizing with patients, advocating for appropriate care and educating others on the dangers of misattributing physical symptoms to psychiatric cause.
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