How can we facilitate mutual support for mental wellbeing between people living with chronic physical conditions and their supporters?

Talk Code: 
EP2C.02
Presenter: 
Gemma-Claire Ali
Co-authors: 
Dr Morag Farquhar, Prof Jonathan Mant
Author institutions: 
University of Cambridge, University of East Anglia

Problem

Chronic physical conditions can negatively affect the mental wellbeing of both service users and their supporters, which in turn can worsen physical health outcomes for both parties. Studies of unmet needs in these populations have identified a thirst for strategies that help people living with chronic physical conditions and their supporters to cope with their own and each other’s emotional reactions, but research into interventions facilitating mutual support is scarce. Furthermore, the little existing research has focused on developing and evaluating dyadic mental wellbeing interventions in narrowly defined populations, limiting their potential scope and cost-effectiveness. Mixed methods research is required to develop a relevant, acceptable and evidence-based intervention facilitating mutual support for mental wellbeing between service users and supporters living with a diverse range of chronic physical conditions.

Approach

An evidence-based intervention framework will be developed through synthesis of a triad of expert sources: i) a three-pronged literature review of individual and dyadic mental wellbeing interventions for people living with chronic physical conditions and their supporters, ii) individual and dyadic in-depth qualitative interviews with service users and supporters, and iii) focus groups with service users and supporters separately and together. Literature review findings are summarised through narrative synthesis. Interview transcripts will be analysed using a combination of interpretative phenomenological analysis and the framework method.

Findings

Findings from phase one (the literature review) highlight strong similarities in the types of interventions tested and found to be effective among individuals and dyads living with different chronic physical conditions, as well as large discrepancies in the degree of research interest afforded to different chronic physical conditions. Several studies report that intervention effectiveness depends on baseline characteristics, for example greater effectiveness among service users experiencing greater distress at baseline. Qualitative interviews are due to begin in May 2017, so preliminary results will be available for presentation at the SAPC ASM. These will include working theories about the interaction between chronic physical conditions, mental wellbeing and relationships, and interviewees’ ideas and preferences for an intervention facilitating mutual support for mental wellbeing.

Consequences

Phase one literature review findings provide evidence in support of moving away from designing and testing resource-intensive, disease-specific mental wellbeing interventions, and instead developing interventions that help dyads living with any and/or multiple chronic physical conditions to draw on their own skills and strengths to improve their mental wellbeing. Phases two and three will now build on this work to develop a relevant, acceptable and evidence-based intervention framework facilitating mutual support for mental wellbeing, and in doing so promote the more efficient, more cost-effective, and thus more widely available delivery of mental wellbeing support to dyads living with diverse chronic physical conditions.

Submitted by: 
Gemma-Claire Ali
Funding acknowledgement: 
This abstract presents independent research funded by the National Institute for Health Research School for Primary Care Research (NIHR SPCR). The views expressed are those of the author(s) and not necessarily those of the NIHR, the NHS or the Department of Health.