title: Screening physical health? Yes! But...: nurses' views on physical health screening in mental health care.
abstract: OBJECTIVE
  To explore nurses' views on the role of nurses in screening and monitoring for physical care of consumers with serious mental illness, at a regional mental health care service.
  
  
  BACKGROUND
  People with serious mental illness experience heightened incidence of preventable and treatable physical illnesses such as cardiovascular disease and diabetes. Screening and monitoring are considered universal clinical safeguards. Nurses can potentially facilitate systematic screening, but their views on physical health care practices are rarely investigated.
  
  
  METHODS
  Qualitative exploratory study.
  
  
  METHODS
  Focus group interviews with 38 nurses of a regional mental health care service district of Australia. To facilitate discussion, participants were presented with a screening system, called the Health Improvement Profile (HIP), as an exemplar of screening of physical health risks by nurses. Inductive data analysis and theme development were guided by a thematic analysis framework.
  
  
  RESULTS
  Nurses argued that treatable and preventable physical health problems were common. Four main themes were identified: screening - essential for good practice; the policy-practice gap; 'screening then what?' and, is HIP the answer? Screening and monitoring were considered crucial to proper diagnosis and treatment, however, were not performed systematically or consistently. Nurse readiness for an enhanced role in screening was shaped by: role and responsibility issues, legal liability concerns, funding and staff shortages. Participants were concerned that lack of follow up would limit effectiveness of these interventions.
  
  
  CONCLUSIONS
  Screening was considered an important clinical step in effective diagnosis and treatment; however, identified barriers need to be addressed to ensure screening is part of a systemic approach to improve physical health of consumers with serious mental illness.
  
  
  CONCLUSIONS
  Nurses have potential to influence improvement in physical health outcomes for consumers of mental health services. Such potential can only be realised if a systematic approach to physical health care is taken.
authors.affiliation: Institute for Health and Social Science Research, School of Nursing and Midwifery, Central Queensland University, Rockhampton, QLD, Australia. b.happell@cqu.edu.au
authors.forename: Brenda
authors.initials: B
authors.lastname: Happell
authors.forename: David
authors.initials: D
authors.lastname: Scott
authors.forename: Janette
authors.initials: J
authors.lastname: Nankivell
authors.forename: Chris
authors.initials: C
authors.lastname: Platania-Phung
mesh_terms: D001291:Attitude of Health Personnel; D017144:Focus Groups; D006801:Humans; D001523:Mental Disorders / Q000150:complications*; D008605:Mental Health Services / Q000458:organization & administration*; D009740:Nursing Staff / Q000523:psychology*; D010808:Physical Examination; D011793:Queensland
keywords: monitoring; nurses; physical health; risk management; screening; side effects