Medical Comorbidities of Patients Admitted to an Acute Care Psychiatric Hospital
Cynthia L. Dakin, PhD, RN, Nursing, Northeastern University School of Nursing, 102 Robinson Hall, Boston, MA 02115-5000
Purpose: The purpose of this study was to identify the medical comorbidities of patients admitted to an acute care psychiatric hospital. Recent studies have indicated the need for additional research to identify comorbidities of patients with a psychiatric diagnosis as well as preventative and maintenance health care and teaching for this population. Theoretical Framework: The framework used in this study was Peplau's Interpersonal Relations in Nursing: Psychodynamic Nursing. Methods (Design, Sample, Setting, Measures, Analysis): This was a descriptive study. A retrospective chart review was conducted using random sampling (n=1097)of patients admitted to an acute care psychiatric hospital over 10 months to identify medical comorbidities. The setting was an acute care suburban teaching psychiatric hospital in Massachusetts. A chart review form was used to collect admission date; unit; admitting diagnoses; gender; age; tobacco use, type, frequency/amount; and medical comorbidities. Descriptive statistics were calculated. Results: Sample characteristics show a range of age 18 to 93 years; gender 41% male and 59% female; and 43% used tobacco. The most frequent admitting DSM IV diagnoses were major depressive disorder 30%, bipolar disorder 21%, substance intoxication, dependence or abuse 15%, schizophrenia 13%, psychotic disorder 4%, dementia 3%. The most frequently occurring medical comorbidities were hypertension 22.2%, gastroesophageal reflux disease (GERD) 13.7%, asthma 10.5%, chronic pain 10.4%, hypothyroidism 8.4%, chronic headaches/migraines 8.2%, and diabetes mellitus II (NIDDM) 6.9%. Greater than 70% of the sample reported one or more medical comorbidities. Conclusions and Implications: Most research regarding medical comorbidities of psychiatric patients has been directed at identifying comorbidities of selected psychiatric disorders. This is one of the few nurse conducted studies that reviewed all psychiatric diagnoses of a group of patients admitted to an acute care psychiatric hospital. The medical comorbidities identified in this study have been supported by findings of previous research. This pilot data will be used to develop teaching strategies that encourage health promotion activities in psychiatric patients.