What’s the problem?

人们越来越意识到面对精神健康危机或存在持续的心理健康问题意味着什么。但是，鲜为人知的是，具有长期心理健康状况的人的身体疾病率是社会中任何群体中最高的人。根据World Health Organizationfigures, the lifespan of a person with severe mental health problems is as much as 20 years shorter than that of someone without. This morbidity can mostly be accounted for by physical health conditions such as heart disease, cancer, and diabetes.

我们知道这些疾病受吸烟，滥用药物和肥胖等可修改的生活方式因素的影响，并且其中一些因素在患有心理健康状况的人中更为普遍。例如，精神分裂症患者的吸烟者比不受此类疾病影响的人高3到4倍。不平等的不平等，例如较短的生活和经常健康的健康，没有有效的生活方式干预措施就不太可能发生变化，但是这些干预措施很少在精神保健环境中被视为个人治疗的一部分。

那么，心理健康护士对此做了什么？

Mental health nurses often have a trusted role, developed from building long-term therapeutic relationships with their patients. They can make significant contributions to reductions in physical ill-health burdens for those with severe mental health problems by addressing several common lifestyle risk factors. However, nurses working in the specialty have traditionally focused only on mental health issues, and may have lacked the knowledge and skills necessary to make an impact on physical health.

我们做了什么？

我们想知道全球心理健康护士是否准备好提高其身体医疗技能的挑战。我们conducted a systematic search发表研究discussing mental health nurses’ attitudes and knowledge of routine physical healthcare interventions that can contribute significantly to improving the health of people suffering from mental health conditions. We wanted to determine what nurses know about these issues and their attitude towards them. Specifically, we investigated whether nurses saw physical healthcare as a key part of their role. We also aimed to determine if they felt they had the knowledge and skills to provide routine physical healthcare, and to identify which methods of training show the greatest improvement in the provision of physical healthcare. We rated the quality of each study to ensure the strongest research was given the most consideration.

展望未来，我们需要确定培训心理健康护士提供身体医疗保健的最有效方法。

What did we find?

这是一个快速增长的研究感兴趣的领域：我们发现，过去25年中已经进行了40多项研究，自2010年以来，其中有31项发表。我们审查的研究包括7,500多名国际精神卫生护士。据我们所知，这代表了有关精神卫生护士在有史以来发表的任何单一主题的经历的最大研究。

我们发现，精神卫生护士通常对他们需要参与满足与他们合作的服务用户的身体健康需求的需求保持积极。他们认为这是他们角色的核心部分，但有些人缺乏信心和具体技能。也许毫不奇怪，那些具有更积极态度的人倾向于提供更多的身体保健。但是，研究培训心理健康护士提供有效身体医疗干预措施的有效性的研究缺乏严格，并且需要更多的工作。

Interestingly, of all the studies we investigated, UK-based nurses were most positive in their attitudes – more so than those in Australia and some Asian countries.This may be considered surprising as mental health nurse training in the UK is considered more specialized than in many other countries, with more time spent focusing on mental health than physical health.

这是什么意思？

These findings are good news insofar as nurses in this specialist field recognize and value the role they can and should play in improving health outcomes for this marginalized population group. However, there is still work to be done to improve their knowledge, confidence and skills. There is much less research about how we can do this successfully. Going forward, we need to determine the most effective ways of training mental health nurses to deliver physical healthcare. Further, specialist pre-registration in mental health, like that observed in the UK, does not seem to disadvantage nurses in terms of their self-rated physical healthcare skills.

What would be the benefit for patients?

Mental health nurses require more skills in the delivery of interventions to address lifestyle issues. If they felt better prepared to deliver smoking cessation, alcohol-related advice, weight management, and sexual healthcare, then, over time, we confidently predict improvement in the current statistics of poor physical health of people with mental health problems. Ultimately, along with other advances in care, we would expect to see people with long-term mental health problems living progressively longer and healthier lives.