Australian Journal of Nursing Research

(ISSN 2652-9386)

Brief Communication

Qualitative Nursing Research for Older Adults Diagnosed with Schizophrenia

Veronica Walker*

Clinical Assistant Professor Luci Baines Johnson Fellow, The University of Texas at Austin Nursing School, Austin, USA

*Corresponding author: Veronica Walker, Clinical Assistant Professor Luci Baines Johnson Fellow, The University of Texas at Austin Nursing School, 1710 Red River St Austin Texas 78701, USA, Tel: 512-471-7913; Email: rwalker@mail.nur.utexas.edu

Citation: Walker V (2021) Qualitative Nursing Research for Older Adults Diagnosed with Schizophrenia. Aus J Nursing Res. AJNR-100031. DOI:10.53634/2652-9386.100031

Received date: 20 July, 2021; Accepted date: 09 August, 2021; Published date: 13 August, 2021

 

Brief Communication

Schizophrenia is a mental illness that affects cognition, language, behavior, speech, and perception [1-4]. Experienced by approximately 21 million individuals worldwide [5], schizophrenia is a leading cause of mental-health disability [6]. Data have reported that people with schizophrenia have mean life expectancies of 20 years less than the general population’s which may be associated with traumatic life course experiences [7-9], accelerated aging [6, 10-13] and co-morbidities which can include cardiovascular disease, diabetes, substance use, and depression [14-20]. Older adults diagnosed with schizophrenia may enter the health care system and receive treatment for their mental illness, but may also have serious physiological illnesses that are not as thoroughly addressed due to a process known as fragmentation. Fragmentation occurs when mental healthcare systems specialize in psychological care, but may ignore physiological needs of patients, or when the medical healthcare systems specialize in physiological care, but may ignore psychological needs of patients. Healthcare providers in these systems have stated feeling unprepared to work with the physical compounded with the mental complexities of older adults diagnosed with schizophrenia [21-23]. The combination of both physical and mental illnesses in fragmented and unprepared environments has been reported as associated with increased morbidities and mortalities in older adults diagnosed with schizophrenia [16,24]. Added to the process of fragmentation, being a minority has been reported as a risk factor for developing a psychotic disorder as well as being offered psychological and pharmacological evidenced based therapies less when compared to those who are not minorities and are diagnosed with schizophrenia [9,25,26]. Compounded stigmatism for this population may include factors such as: 1) aging; 2) having a mental illness, and 3) being a minority. Self-perceived stigma has been linked to higher relapse and admission rates in individuals diagnosed with schizophrenia [27].Qualitative nursing research with this population is an important step which may uncover identifiable focus points for public health interventions. Nursing research has the potential to influence the morbidity and mortality in older adults diagnosed with schizophrenia, a population whose care is becoming more prevalent as well as complex in long-term care settings [28-31]. Nursing research will be essential as a starting point to improve a system that is often referred to as fragmented due to the singular focus on either medical or mental health needs, but unpreparedness to work with the also important accompanying psychological and physiological needs of older adults diagnosed with schizophrenia.


Figures



  1. American Psychiatric Association. (2013). Diagnostic and statistical manual of mental disorders (5th ed.). Washington, DC: Author.
  2. Angers K, Suhr J A, & Buelow MT (2021) Cognitive-perceptual and disorganized schizotypal traits are nonlinearly related to atypical semantic content on tasks of semantic fluency. Journal of Psychiatric Research, 136: 7-13.
  3. Medvedev ON, Berk M, Dean OM, Brown E, Sandham, et al. (2020) A novel way to quantify schizophrenia symptoms in clinical trials. European Journal of Clinical Investigation 51: e13398.
  4. Verma G, Brahmbhatt M, Vankar GK, & Parikh MN (2021) Auditory hallucinations: A phenomenological study. Asian Journal of Medical Sciences, 12: 75-82.
  5. World Health Organization (2018). Schizophrenia.
  6. National Institute of Mental Health (2018). Schizophrenia.
  7. Liu J, Mahendran R, Chong SA, & Subramaniam M (2021) Elucidating the Impact of childhood, adulthood, and cumulative lifetime trauma exposure on psychiatric symptoms in early schizophrenia spectrum disorders. Journal of Traumatic Stress 34: 137-148.
  8. Longden E, Branitsky A, Moskowitz A, Berry K, Bucci S & Varese F (2020) The relationship between dissociation and symptoms of psychosis: A meta-analysis.Schizophrenia Bulletin 46: 1104-1113.
  9. Vassos E, Sham P, Kempton M, Trotta A, Stilo SA, et al. (2019) The Maudsley environmental risk score for psychosis.Psychological Medicine 50: 2213-2220.
  10. Lee EE, Eyler LT, Wolkowitz OM, Martin AS, Reuter C, et al. (2016) Elevated plasma F2-isoprostane levels in schizophrenia. Schizophrenia Research 176: 320-326.
  11. Moradi H, Harvey PD, Helldin L (2018) Correlates of risk factors for reduced life expectancy in schizophrenia: Is it possible to develop a predictor profile? Schizophrenia Research 201: 388-392.
  12. Muntané G, Farré X, Bosch E, Martorell L, Navarro A & Vilella E (2021) The shared genetic architecture of schizophrenia, bipolar disorder and lifespan. Human Genetics 140: 441-455.
  13. Seeman MV (2019) Schizophrenia mortality: Barriers to progress. Psychiatric Quarterly 90: 553-563.
  14. Brooks JM, Blake J, Sánchez J, Mpofu E, Wu JR, et al. (2019) Self-reported pain intensity and depressive symptoms among community dwelling older adults with schizophrenia spectrum disorders. Community Mental Health Journal 55: 1298-1304.
  15. Crespo-Facorro B, Such P, Nylander AG, Madera J, Resemann H, et al. (2020)The burden of disease in early schizophrenia – A systematic literature review. Current Medical Research and Opinion 37: 109-121.
  16. Gur S, Weizman S, Stubbs B, Matalon A, Meyerovitch J, et al. (2018) Mortality, morbidity and medical resources utilization of patients with schizophrenia: A case-control community-based study. Psychiatry Research 260: 177-181.
  17. Nath S, Kalita KN, Baruah A, Saraf AS, Mukherjee D & Singh PK (2021) Suicidal ideation in schizophrenia: A cross sectional study in a tertiary mental hospital in North-East India. Indian Journal of Psychiatry 63: 179-183.
  18. Siddi S, Nuñez C, Senior C, Preti A, Cuevas-Esteban J, et al. (2019) Depression, auditory-verbal hallucinations, and delusions in patients with schizophrenia: Different patterns of association with prefrontal and white matter volume. Psychiatry Research: Neuroimaging 283: 55-63.
  19. Sofia AD, Ionescu TC & Dragoi AM (2020) Comorbidity of schizophrenia and alcohol use disorder: implications for clinical practice. Journal of Educational Sciences and Psychology 10: 93-100.
  20. Toender A, Vestergaard M, Munk-Olsen T, Larsen JT, Kristensen JK & Laursen TM (2020) Risk of diabetic complications and subsequent mortality among individuals with schizophrenia and diabetes - a population-based register study.Schizophrenia Research 218: 99-106.
  21. Kusmaul N (2016) The content of education for direct caregivers. Educational Gerontology 42: 19-24.
  22. Molinari V, Hobday JV, Roker R, Kunik ME, Kane R & Kaas MJ (2016) Impact of serious mental illness online training for certified nursing assistants in long term care. Gerontology and Geriatrics Education 38:  359-374.
  23. Walker VG & Walker EK (2021) Older adults diagnosed with schizophrenia in long-term care facilities: Life course theory for holistic nursing research and practice. Journal of Holistic Nursing. 1-12.
  24. Filipcic I, Filipcic IS, Ivezic E, Matic K, Vukadinovic NT, et al. (2017) Chronic physical illnesses in patients with schizophrenia spectrum disorders are independently associated with higher rates of psychiatric rehospitalization; A cross-sectional study in Croatia. European Psychiatry 43: 73-80.
  25. Das-Munshi J, Bhugra D & Crawford MJ (2018) Ethnic minority inequalities in access to treatments for schizophrenia and schizoaffective disorders: findings from a nationally representative cross-sectional study. BMC Medicine 16: 1-10.
  26. McCutcheon R, Bloomfield MAP, Dahoun T, Quinlan M, Terbeck S, et al. (2018) Amygdala reactivity in ethnic minorities and its relationship to the social environment: an fMRI study. Psychological Medicine 48: 1985-1992.
  27. Tesfaw G, Kibru B & Ayano G (2020) Prevalence and factors associated with higher levels of perceived stigma among people with schizophrenia Addis Ababa, Ethiopia. International Journal of Mental Health Systems 14: 1-8.
  28. Brink A & Anderson K (2020) Subjective health-related quality of life in community-dwelling middle-aged and older adults with early-onset schizophrenia. Nordic Journal of Psychiatry 74: 585-593.
  29. Cohen CI, Vengassery A & Garcia EF (2017) A longitudinal analysis of quality of life and associated factors in older adults with schizophrenia spectrum disorder. The American Journal of Geriatric Psychiatry 25: 755-765.
  30. Muralidharan A, Mills WL, Evans DR, Fujii D & Molinari V (2019) Preparing long-term care staff to meet the needs of aging persons with serious mental illness. Journal of the American Medical Directors Association 20: 683-688.
  31. Shoyinka S (2016) Understanding behavioral issues in long term patients [PowerPoint presentation].Kansas Healthcare Association Annual Conference 2016.

Citation: Walker V (2021) Qualitative Nursing Research for Older Adults Diagnosed with Schizophrenia. Aus J Nursing Res. AJNR-100031. DOI:10.53634/2652-9386.100031