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Warrender D, Connell C, Jones E, Monteux S, Colwell L, Laker C, Cromar-Hayes M. Mental health deserves better: Resisting the dilution of specialist pre-registration mental health nurse education in the United Kingdom. Int J Ment Health Nurs 2024; 33:202-212. [PMID: 37788130 DOI: 10.1111/inm.13236] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/05/2023] [Revised: 08/29/2023] [Accepted: 09/19/2023] [Indexed: 10/05/2023]
Abstract
This article aims to draw attention to increasing genericism in nurse education in the United Kingdom, which sees less specialist mental health education for mental health nursing students and offers opposition to such direction. In 2018, the Nursing and Midwifery Council produced the 'Future Nurse' standards which directed changes to pre-registration nurse education. This led to dissatisfaction from many mental health nurses, specifically regarding reduced mental health content for students studying mental health nursing. Concerns have been raised through public forum and evolved into a grassroots national movement 'Mental Health Deserves Better' (#MHDeservesBetter). This is a position paper which presents the perspective of many mental health nurse academics working at universities within the United Kingdom. Mental health nurse academics collaborated to develop ideas and articulate arguments and perspectives which present a strong position on the requirement for specialist pre-registration mental health nurse education. The key themes explored are; a conflict of ideologies in nursing, no parity of esteem, physical health care needs to be contextualized, the unique nature of mental health nursing, ethical tensions and values conflict, implications for practice, necessary improvements overlooked and the dangers of honesty and academic 'freedom'. The paper concludes by asserting a strong position on the need for a change of direction away from genericism and calls on mental health nurses to rise from the ashes to advocate for a quality education necessary to ensure quality care delivery. The quality of mental health care provided by mental health nurses has many influences, yet the foundation offered through pre-registration education is one of the most valuable. If the education of mental health nurses does not attend to the distinct and unique role of the mental health nurse, standards of mental health care may diminish without assertive action from mental health nurses and allies.
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Affiliation(s)
- Dan Warrender
- Mental Health Nursing, Robert Gordon University, Aberdeen, Scotland, UK
| | - Chris Connell
- Mental Health Nursing, University of Central Lancashire, Preston, UK
| | - Emma Jones
- Mental Health Nursing, University of Central Lancashire, Preston, UK
| | | | - Lucy Colwell
- Mental Health Nursing, University of Brighton, Brighton, UK
| | - Caroline Laker
- Mental Health Nursing, City University of London, London, UK
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Peisser AM, Cornet S, Moerkl S, Müller-Stierlin A. ["But without Therapeutic Support, I wouldn't Succeed" - Exploration of Subjective Experiences of People with Mental Illness Regarding Support with Diet-Related Problems]. PSYCHIATRISCHE PRAXIS 2024; 51:16-23. [PMID: 37429315 DOI: 10.1055/a-2106-7234] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 07/12/2023]
Abstract
OBJECTIVE In this study we explored the subjective experiences and needs of people with severe mental illness regarding dietary and weight-related support within routine care. METHODS For this purpose, a total of 16 interviews with adults living with mental illness were conducted in Ulm (Germany) and Graz (Austria) using a semi-structured topic guide and were analysed in a qualitative approach. RESULTS Several participants criticized the limited support by professionals regarding diet- and weight-related problems and wished for greater awareness of these issues in mental health care. CONCLUSION The implementation of health-promoting services in mental health care is important to ensure needs-oriented care from the patients' point of view. Interdisciplinary care concepts could be used to share responsibilities among several professional groups.
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Affiliation(s)
- Anna Maria Peisser
- Universitätsklinik für Psychiatrie, Psychosomatik und Psychotherapie, Klinische Abteilung für Psychiatrie und Psychotherapeutische Medizin, Medizinische Universität Graz, Österreich
| | - Sebastian Cornet
- Klinik für Psychiatrie und Psychotherapie II, Ulm University Medical Faculty, Günzburg, Deutschland
| | - Sabrina Moerkl
- Klinische Abteilung für medizinische Psychologie, Psychosomatik und Psychotherapie, Medizinische Universität Graz, Österreich
| | - Annabel Müller-Stierlin
- Klinik für Psychiatrie und Psychotherapie II, Ulm University Medical Faculty, Günzburg, Deutschland
- Institut für Allgemeinmedizin, Universitätsklinikum Ulm, Deutschland
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Roberts SH, Bailey J. Exergaming (physically active video gaming) for mental health service users in a community mental health care setting: an ethnographic observational feasibility study. BMC Psychiatry 2023; 23:752. [PMID: 37845683 PMCID: PMC10577994 DOI: 10.1186/s12888-023-05233-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/07/2023] [Accepted: 09/29/2023] [Indexed: 10/18/2023] Open
Abstract
BACKGROUND People with severe and enduring mental illness experience health inequalities with premature mortality; lifestyle behaviours are known to be contributing factors with low levels of physical activity reported. Facilitating physical activity to help maintain or improve health for those who are disadvantaged is essential. Exergaming (gaming involving physical movement) is increasingly used to improve physical activity across the lifespan and for those with a range clinical conditions; this might offer a way to increase physical activity for those with severe mental illness. The aim of this study was to explore engagement of mental health service users with exergaming to increase physical activity in a community mental health care setting. METHODS An ethnographic observational feasibility study was undertaken through participant observation and semi-structured interviews. A gaming console was made available for 2 days per week for 12 months in a community mental health setting. A reflexive thematic analysis was performed on the data. RESULTS Twenty one mental health service users engaged with the intervention, with two thirds exergaming more than once. One participant completed the semi-structured interview. Key themes identified from the observational field notes were: support (peer and staff support); opportunity and accessibility; self-monitoring; and perceived benefits. Related themes that emerged from interview data were: benefits; motivators; barriers; and delivery of the intervention. Integrating these findings, we highlight social support; fun, enjoyment and confidence building; motivation and self-monitoring; and, accessibility and delivery in community mental health care context are key domains of interest for mental health care providers. CONCLUSIONS We provide evidence that exergaming engages people with SMI with physical activity. The value, acceptability and feasibility of open access exergaming in a community mental health service context is supported. Facilitating exergaming has the potential to increase physical activity for mental health service users leading to possible additional health benefits.
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Affiliation(s)
- Seren Haf Roberts
- School of Healthcare Sciences, College of Biomedical and Life Sciences, Cardiff University, Heath Park, Cardiff, CF144XN, UK.
| | - Jois Bailey
- Betsi Cadwaladr University Health Board, Wrexham, UK
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Tous-Espelosin M, Fernandez-Lasa U, Romaratezabala E. "Out-of-Hospital and with Qualified Exercise Professionals": Keys to the CORTEX-SP Physical Exercise Program According to the Experience of the Participants. Eur J Investig Health Psychol Educ 2023; 13:1728-1737. [PMID: 37754464 PMCID: PMC10529622 DOI: 10.3390/ejihpe13090125] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/28/2023] [Revised: 08/22/2023] [Accepted: 09/03/2023] [Indexed: 09/28/2023] Open
Abstract
Physical exercise programs are useful and necessary for the treatment of schizophrenia. The aim of this study was to assess the experiences of participants with schizophrenia in an out-of-hospital exercise program designed and supervised by qualified exercise professionals. Thirty-five individuals with schizophrenia from the intervention group of the CORTEX-SP study were interviewed. The interviews were transcribed verbatim and content analysis was performed using inductive coding. Two main categories emerged: the importance of the program being conducted out-of-hospital, and the individuals responsible for the program being qualified exercise professionals. The participants highlighted the importance of conducting the program outside the psychiatric center since it gave them greater satisfaction. They perceived greater seriousness and a greater number of resources and felt encouraged to repeat the program or prolong it. The success of the program, in addition to the space, was due to the personnel in charge of the program, i.e., the qualified exercise professionals, and the fact that the activities were designed and supervised. Participants emphasized the qualifications of the exercise professionals, key for this type of program, their social skills and the level of involvement with participants and their follow-up.
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Affiliation(s)
- Mikel Tous-Espelosin
- GIzartea, Kirola eta Ariketa Fisikoa Ikerkuntza Taldea (GIKAFIT), Society, Sports, and Physical Exercise Research Group, Department of Physical Education and Sport, Faculty of Education and Sport-Physical Activity and Sport Sciences Section, University of the Basque Country (UPV/EHU), 01007 Vitoria-Gasteiz, Spain; (U.F.-L.); (E.R.)
- Physical Activity, Exercise, and Health Group, Bioaraba Health Research Institute, 01007 Vitoria-Gasteiz, Spain
| | - Uxue Fernandez-Lasa
- GIzartea, Kirola eta Ariketa Fisikoa Ikerkuntza Taldea (GIKAFIT), Society, Sports, and Physical Exercise Research Group, Department of Physical Education and Sport, Faculty of Education and Sport-Physical Activity and Sport Sciences Section, University of the Basque Country (UPV/EHU), 01007 Vitoria-Gasteiz, Spain; (U.F.-L.); (E.R.)
| | - Estibaliz Romaratezabala
- GIzartea, Kirola eta Ariketa Fisikoa Ikerkuntza Taldea (GIKAFIT), Society, Sports, and Physical Exercise Research Group, Department of Physical Education and Sport, Faculty of Education and Sport-Physical Activity and Sport Sciences Section, University of the Basque Country (UPV/EHU), 01007 Vitoria-Gasteiz, Spain; (U.F.-L.); (E.R.)
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Aouira N, Khan S, Heussler H, Haywood A, Karaksha A, Bor W. Understanding the Perspective of Youths on Undergoing Metabolic Monitoring While on Second-Generation Antipsychotics: Challenges, Insight, and Implications. J Child Adolesc Psychopharmacol 2023; 33:279-286. [PMID: 37504897 DOI: 10.1089/cap.2023.0016] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 07/29/2023]
Abstract
Introduction: Prescription of second-generation antipsychotics (SGAs) in youths is rapidly increasing globally, despite the potential for significant adverse effects and long-term health consequences. A known adverse reaction resulting from SGAs is metabolic syndrome (MS). Youths exposed to antipsychotics are at higher risk than adults for adverse drug reactions, including adverse events such as MS (with weight gain as the most significant adverse outcome) and other long-term endocrinological abnormalities. This study aimed to explore the experiences of young patients on factors impacting barriers to metabolic monitoring of SGAs and the strategies to address those barriers thereby providing further guidance on policy and service delivery. Methods: Semi-structured interviews were conducted with patients (youths who were prescribed SGAs) who attended Child and Youth Mental Health Services. The interviews focused on barriers to monitoring and strategies to enhance rates of monitoring that could be customized across study sites. Results: Young patients revealed that none of them had any concerns or objections to receiving anthropometric metabolic measurements. However, they seemed concerned to undergo blood tests as part of the metabolic monitoring process. Specifically, youths cited their fear of the needles as barrier to undergo the required blood tests. Youths have also reported that their dislike to healthy foods and exercise being the most common challenge they face while trying to engage in a healthy lifestyle to manage the SGAs resulted weight gain. Conclusion: Prescribers are recommended to actively engage young patients about the expected SGAs-induced adverse effects, the importance of conducting metabolic monitoring, and how to prevent and minimize the expected adverse effects from the start of initiating SGAs. This could be a vital step toward a successful treatment as the insight of youths into the details of the chosen treatment can play a significant role into treatment adherence and recovery.
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Affiliation(s)
- Nisreen Aouira
- School of Pharmacy and Medical Sciences, Menzies Health Institute Queensland, Griffith University, Gold Coast, Australia
| | - Sohil Khan
- School of Pharmacy and Medical Sciences, Menzies Health Institute Queensland, Griffith University, Gold Coast, Australia
- Mater Research Institute-The University of Queensland, Brisbane, Australia
- Prasanna Institute of Public Health and Manipal College of Pharmaceutical Sciences, Manipal Academy of Higher Education, Manipal, India
| | - Helen Heussler
- Mater Research Institute-The University of Queensland, Brisbane, Australia
- Children's Health Queensland Hospital and Health Services, South Brisbane, Australia
| | - Alison Haywood
- School of Pharmacy and Medical Sciences, Menzies Health Institute Queensland, Griffith University, Gold Coast, Australia
- Mater Research Institute-The University of Queensland, Brisbane, Australia
| | - Abdullah Karaksha
- School of Pharmacy and Medical Sciences, Menzies Health Institute Queensland, Griffith University, Gold Coast, Australia
| | - William Bor
- Mater Research Institute-The University of Queensland, Brisbane, Australia
- Children's Health Queensland Hospital and Health Services, South Brisbane, Australia
- Child and Youth Mental Health Service, Centre for Children's Health Research, Queensland Health, Brisbane, Australia
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Will the Construction of Sports Facilities Nudge People to Participate in Physical Exercises in China? The Moderating Role of Mental Health. Healthcare (Basel) 2023; 11:healthcare11020219. [PMID: 36673586 PMCID: PMC9858653 DOI: 10.3390/healthcare11020219] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/17/2022] [Revised: 01/05/2023] [Accepted: 01/09/2023] [Indexed: 01/13/2023] Open
Abstract
This study aims to examine the nudging effect of the sports facility construction on physical exercise (PE) participation with consideration of the moderating role of mental health in China. Multiple linear regression models are used in this study. The subjects are 4634 from the 2014 China Family Panel Studies (CFPS) data, which is a nationally representative longitudinal survey of Chinese individuals. We find that the construction of sports facilities nudges people to participate in PE, and gender, age, and education significantly influence people's participation in PE. Young, female, and better-educated people compose the "neo-vulnerable" population, who participate less in PE in China and need more interventions. Mental health status has no significant effect on people's PE participation, while it negatively moderates the nudging effect of the construction of sports facilities on PE. The results of this study suggest that only building sporting facilities is insufficient to encourage PE participation. Policies and interventions should be given to mentally disturbed individuals to guarantee and magnify the nudging effect of sports facilities on PE.
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Carswell C, Coventry PA, Brown JVE, Alderson SL, Double K, Gilbody S, Holt RIG, Jacobs R, Lister JE, Osborn DPJ, Shiers D, Najma S, Taylor J, Kellar I. A theory and evidence-based co-design approach to develop a supported self-management intervention for people with severe mental illness and type 2 diabetes (Preprint). J Med Internet Res 2022; 25:e43597. [PMID: 37171868 DOI: 10.2196/43597] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/17/2022] [Revised: 02/20/2023] [Accepted: 03/14/2023] [Indexed: 03/15/2023] Open
Abstract
BACKGROUND Type 2 diabetes is 2 to 3 times more common among people with severe mental illness (SMI). Self-management is crucial, with additional challenges faced by people with SMI. Therefore, it is essential that any diabetes self-management program for people with SMI addresses the unique needs of people living with both conditions and the inequalities they experience within health care services. OBJECTIVE We combined theory, empirical evidence, and co-design approaches to develop a type 2 diabetes self-management intervention for people with SMI. METHODS The development process encompassed 4 steps: step 1 involved prioritizing the mechanisms of action (MoAs) and behavior change techniques (BCTs) for the intervention. Using findings from primary qualitative research and systematic reviews, we selected candidate MoAs to target in the intervention and candidate BCTs to use. Expert stakeholders then ranked these MoAs and BCTs using a 2-phase survey. The average scores were used to generate a prioritized list of MoAs and BCTs. During step 2, we presented the survey results to an expert consensus workshop to seek expert agreement with the definitive list of MoAs and BCTs for the intervention and identify potential modes of delivery. Step 3 involved the development of trigger films using the evidence from steps 1 and 2. We used animations to present the experiences of people with SMI managing diabetes. These films were used in step 4, where we used a stakeholder co-design approach. This involved a series of structured workshops, where the co-design activities were informed by theory and evidence. RESULTS Upon the completion of the 4-step process, we developed the DIAMONDS (diabetes and mental illness, improving outcomes and self-management) intervention. It is a tailored self-management intervention based on the synthesis of the outputs from the co-design process. The intervention incorporates a digital app, a paper-based workbook, and one-to-one coaching designed to meet the needs of people with SMI and coexisting type 2 diabetes. CONCLUSIONS The intervention development work was underpinned by the MoA theoretical framework and incorporated systematic reviews, primary qualitative research, expert stakeholder surveys, and evidence generated during co-design workshops. The intervention will now be tested for feasibility before undergoing a definitive evaluation in a pragmatic randomized controlled trial.
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Tabvuma TS, Stanton R, Browne G, Happell B. Mental health consumers' perspectives of physical health interventions: An integrative review. Int J Ment Health Nurs 2022; 31:1046-1089. [PMID: 35388954 PMCID: PMC9542531 DOI: 10.1111/inm.13000] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/14/2021] [Revised: 03/09/2022] [Accepted: 03/18/2022] [Indexed: 12/12/2022]
Abstract
Consumers of mental health services experience poor physical health compared to the general population, leading to long-term physical illness and premature death. Current research and policy activity prioritizes the physical health of consumers yet few of these recommendations have translated to practice. This implementation gap may be influenced by the paucity of literature exploring consumer perceptions and experiences with physical healthcare and treatment. As a result, little is understood about the views and attitudes of consumers towards interventions designed to improve their physical health. This integrative review aims to explore the literature regarding consumer perspectives of physical healthcare and, interventions to improve their physical health. A systematic search was undertaken using (i) CINAHL, (ii) MEDLINE, (iii) PsycINFO, (iv) Scopus, and (v) Google Scholar between September and December 2021. Sixty-one papers comprising 3828 consumer participants met the inclusion criteria. This review found that consumers provide invaluable insights into the barriers and enablers of physical healthcare and interventions. When consumers are authentically involved in physical healthcare evaluation, constructive and relevant recommendations to improve physical healthcare services, policy, and future research directions are produced. Consumer evaluation is the cornerstone required to successfully implement tailored physical health services.
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Affiliation(s)
- Tracy Samkele Tabvuma
- School of Nursing and Midwifery, College of Health, Medicine and Wellbeing, University of Newcastle, Callaghan, New South Wales, Australia
| | - Robert Stanton
- School of Health, Medical and Applied Sciences, Central Queensland University, Rockhampton, Queensland, Australia
| | - Graeme Browne
- School of Nursing and Midwifery, College of Health, Medicine and Wellbeing, University of Newcastle, Callaghan, New South Wales, Australia
| | - Brenda Happell
- School of Nursing and Midwifery, College of Health, Medicine and Wellbeing, University of Newcastle, Callaghan, New South Wales, Australia
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Talking about Health: A Topic Analysis of Narratives from Individuals with Schizophrenia and Other Serious Mental Illnesses. Behav Sci (Basel) 2022; 12:bs12080286. [PMID: 36004857 PMCID: PMC9405157 DOI: 10.3390/bs12080286] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/14/2022] [Revised: 07/31/2022] [Accepted: 08/08/2022] [Indexed: 11/23/2022] Open
Abstract
Individuals with schizophrenia have higher mortality and shorter lifespans. There are a multitude of factors which create these conditions, but one aspect is worse physical health, particularly cardiovascular and metabolic health. Many interventions to improve the health of individuals with schizophrenia have been created, but on the whole, there has been limited effectiveness in improving quality of life or lifespan. One potential new avenue for inquiry involves a more patient-centric perspective; understanding aspects of physical health most important, and potentially most amenable to change, for individuals based on their life narratives. This study used topic modeling, a type of Natural Language Processing (NLP) on unstructured speech samples from individuals (n = 366) with serious mental illness, primarily schizophrenia, in order to extract topics. Speech samples were drawn from three studies collected over a decade in two geographically distinct regions of the United States. Several health-related topics emerged, primarily centered around food, living situation, and lifestyle (e.g., routine, hobbies). The implications of these findings for how individuals with serious mental illness and schizophrenia think about their health, and what may be most effective for future health promotion policies and interventions, are discussed.
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Carswell C, Brown JVE, Lister J, Ajjan RA, Alderson SL, Balogun-Katung A, Bellass S, Double K, Gilbody S, Hewitt CE, Holt RIG, Jacobs R, Kellar I, Peckham E, Shiers D, Taylor J, Siddiqi N, Coventry P. The lived experience of severe mental illness and long-term conditions: a qualitative exploration of service user, carer, and healthcare professional perspectives on self-managing co-existing mental and physical conditions. BMC Psychiatry 2022; 22:479. [PMID: 35850709 PMCID: PMC9295434 DOI: 10.1186/s12888-022-04117-5] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/20/2022] [Accepted: 06/30/2022] [Indexed: 12/04/2022] Open
Abstract
BACKGROUND People with severe mental illness (SMI), such as schizophrenia, have higher rates of physical long-term conditions (LTCs), poorer health outcomes, and shorter life expectancy compared with the general population. Previous research exploring SMI and diabetes highlights that people with SMI experience barriers to self-management, a key component of care in long-term conditions; however, this has not been investigated in the context of other LTCs. The aim of this study was to explore the lived experience of co-existing SMI and LTCs for service users, carers, and healthcare professionals. METHODS A qualitative study with people with SMI and LTCs, their carers, and healthcare professionals, using semi-structured interviews, focused observations, and focus groups across the UK. Forty-one interviews and five focus groups were conducted between December 2018 and April 2019. Transcripts were coded by two authors and analysed thematically. RESULTS Three themes were identified, 1) the precarious nature of living with SMI, 2) the circularity of life with SMI and LTCs, and 3) the constellation of support for self-management. People with co-existing SMI and LTCs often experience substantial difficulties with self-management of their health due to the competing demands of their psychiatric symptoms and treatment, social circumstances, and access to support. Multiple long-term conditions add to the burden of self-management. Social support, alongside person-centred professional care, is a key facilitator for managing health. An integrated approach to both mental and physical healthcare was suggested to meet service user and carer needs. CONCLUSION The demands of living with SMI present a substantial barrier to self-management for multiple co-existing LTCs. It is important that people with SMI can access person-centred, tailored support for their LTCs that takes into consideration individual circumstances and priorities.
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Affiliation(s)
- C. Carswell
- grid.5685.e0000 0004 1936 9668Department of Health Sciences, University of York, York, UK
| | - J. V. E. Brown
- grid.5685.e0000 0004 1936 9668Department of Health Sciences, University of York, York, UK
| | - J. Lister
- grid.5685.e0000 0004 1936 9668Department of Health Sciences, University of York, York, UK
| | - R. A. Ajjan
- grid.9909.90000 0004 1936 8403Clinical and Population Sciences Department, Leeds institute for Cardiovascular and Metabolic Medicine, University of Leeds, Leeds, LS2 9JT UK
| | - S. L. Alderson
- grid.9909.90000 0004 1936 8403Leeds Institute of Health, University of Leeds, Leeds, UK
| | - A. Balogun-Katung
- grid.1006.70000 0001 0462 7212Population Health Sciences Institute, Newcastle University, Newcastle, UK
| | - S. Bellass
- grid.25627.340000 0001 0790 5329Department of Sport and Exercise Sciences, Manchester Metropolitan University, Manchester, UK
| | - K. Double
- grid.498142.2Bradford District Care NHS Foundation Trust, Bradford, UK
| | - S. Gilbody
- grid.5685.e0000 0004 1936 9668Department of Health Sciences, University of York, York, UK ,grid.413631.20000 0000 9468 0801Hull York Medical School, York, UK
| | - C. E. Hewitt
- grid.5685.e0000 0004 1936 9668Department of Health Sciences, University of York, York, UK ,grid.5685.e0000 0004 1936 9668York Trials Unit, Department of Health Sciences, University of York, York, UK
| | - R. I. G. Holt
- grid.5491.90000 0004 1936 9297Human Development and Health, Faculty of Medicine, University of Southampton, Southampton, UK ,grid.430506.40000 0004 0465 4079National Institute for Health Research Biomedical Research Centre, University Hospital Southampton NHS Foundation Trust, Southampton, UK
| | - R. Jacobs
- grid.5685.e0000 0004 1936 9668Centre for Health Economics, University of York, York, UK
| | - I. Kellar
- grid.9909.90000 0004 1936 8403School of Psychology, University of Leeds, Leeds, UK
| | - E. Peckham
- grid.5685.e0000 0004 1936 9668Department of Health Sciences, University of York, York, UK
| | - D. Shiers
- Psychosis Research Unit, Greater Manchester Mental Health NHS Trust, Manchester, UK ,grid.5379.80000000121662407Division of Psychology and Mental Health, University of Manchester, Manchester, UK ,grid.9757.c0000 0004 0415 6205School of Medicine, Keele University, Staffordshire, UK
| | - J. Taylor
- grid.5685.e0000 0004 1936 9668Department of Health Sciences, University of York, York, UK
| | - N. Siddiqi
- grid.5685.e0000 0004 1936 9668Department of Health Sciences, University of York, York, UK ,grid.498142.2Bradford District Care NHS Foundation Trust, Bradford, UK ,grid.413631.20000 0000 9468 0801Hull York Medical School, York, UK
| | - P. Coventry
- grid.5685.e0000 0004 1936 9668Department of Health Sciences, University of York, York, UK ,grid.5685.e0000 0004 1936 9668York Environmental Sustainability Institute, University of York, York, UK
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Mueller-Stierlin AS, Cornet S, Peisser A, Jaeckle S, Lehle J, Moerkl S, Teasdale SB. Implications of Dietary Intake and Eating Behaviors for People with Serious Mental Illness: A Qualitative Study. Nutrients 2022; 14:nu14132616. [PMID: 35807799 PMCID: PMC9268504 DOI: 10.3390/nu14132616] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/30/2022] [Revised: 06/20/2022] [Accepted: 06/22/2022] [Indexed: 11/16/2022] Open
Abstract
The impact of poor diet quality and nutritional inadequacies on mental health and mental illness has recently gained considerable attention in science. As the opinions and experiences of people living with serious mental illness on dietary issues are unknown, we aimed to understand the role of nutrition in a biopsychosocial approach. In total, 28 semi-structured interviews were conducted with people living with serious mental illness (SMI) in Australia, Germany and Austria, and a generic thematic analysis approach was applied. Four positive (positive effects on the body and mind, therapeutic effects in treating somatic illnesses, pleasure and opportunity for self-efficacy) and three negative (impairment related to mental illness and its treatment, perceived stigma and negative effects on the body and mind) implications of diet were identified. A key issue for most of the participants was the mental burden arising from their body weight. This might indicate that negative implications, such as guilt and stigma, were of primary importance for people with SMI when talking about their dietary behavior. In conclusion, diet-related support is urgently needed for people with SMI. However, especially participants from Germany and Austria reported that this is not yet widely available in mental health settings, leading to hopelessness and resignation.
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Affiliation(s)
- Annabel S. Mueller-Stierlin
- Department of Psychiatry and Psychotherapy II, Ulm University, 89070 Ulm, Germany; (A.S.M.-S.); (S.C.); (S.J.); (J.L.)
| | - Sebastian Cornet
- Department of Psychiatry and Psychotherapy II, Ulm University, 89070 Ulm, Germany; (A.S.M.-S.); (S.C.); (S.J.); (J.L.)
| | - Anna Peisser
- Department of Psychiatry and Psychotherapeutic Medicine, Medical University of Graz, 8036 Graz, Austria;
| | - Selina Jaeckle
- Department of Psychiatry and Psychotherapy II, Ulm University, 89070 Ulm, Germany; (A.S.M.-S.); (S.C.); (S.J.); (J.L.)
| | - Jutta Lehle
- Department of Psychiatry and Psychotherapy II, Ulm University, 89070 Ulm, Germany; (A.S.M.-S.); (S.C.); (S.J.); (J.L.)
| | - Sabrina Moerkl
- Department of Psychiatry and Psychotherapeutic Medicine, Medical University of Graz, 8036 Graz, Austria;
- Correspondence:
| | - Scott B. Teasdale
- Discipline of Psychiatry and Mental Health, University of New South Wales (UNSW) Sydney, Sydney, NSW 2052, Australia;
- Mindgardens Neuroscience Network, Sydney, NSW 2052, Australia
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Matthews EW, Cowman M, Brannigan M, Rosenbaum S, Sloan D, Ward PB, Denieffe S. Implementing experience-based co-design to develop a physical activity programme in recovery-focused outpatient mental health services. INTERNATIONAL JOURNAL OF THERAPY AND REHABILITATION 2022. [DOI: 10.12968/ijtr.2021.0101] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
Background/Aims As mental health services focus on recovery orientated service delivery, there is a need to adopt recovery orientated approaches in interventions that promote physical activity. This article presents a process of using and modifying an experience-based co-design approach to develop an intervention that can be used to promote physical activity in mental health services: the ‘Move with Recovery’ programme. Methods A facilitated experience-based co-design approach was undertaken over four sessions. This approach included the use of a trigger film of touchpoints and sample physical activity experiences of service users, in addition to the use of a storyboard for emotional mapping and prioritising exercises. The final two co-design sessions involved programme prototyping and development using the TIDieR framework. Results The outcome of this process, the Move with Recovery programme, was a peer-developed and peer-led, community-focused programme structured around nine action points. It is made up of a combination of motivation, education and support sessions, together with light intensity aerobic activity sessions that is structured using the TIDieR framework, and intended for implementation in the recovery college. In this regard, the developed programme is inherently recovery orientated in its design and its aim. Conclusions The developed programme can be embedded into existing mental health services that lack integrated exercise resources. This articles details the experience-based co-design process undertaken here and offers future learning for using experience-based co-design to promote physical activity in mental health.
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Affiliation(s)
- Evan W Matthews
- School of Health Sciences, Waterford Institute of Technology, Waterford, Ireland
- Nursing and Midwifery Planning and Development Unit, South-East, The Health Service Executive, Ireland
| | - Mary Cowman
- School of Health Sciences, Waterford Institute of Technology, Waterford, Ireland
| | - Michele Brannigan
- The Health Service Executive, Mental Health Services, South-East, Ireland
| | - Simon Rosenbaum
- School of Psychiatry, University of New South Wales, Sydney, Australia
| | - Darina Sloan
- The Health Service Executive, Mental Health Services, South-East, Ireland
| | - Philip B Ward
- School of Psychiatry, University of New South Wales, Sydney, Australia
| | - Suzanne Denieffe
- School of Humanities, Waterford Institute of Technology, Waterford, Ireland
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13
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Brown JV, Ajjan R, Alderson S, Böhnke JR, Carswell C, Doherty P, Double K, Gilbody S, Hadjiconstantinou M, Hewitt C, Holt RI, Jacobs R, Johnson V, Kellar I, Osborn D, Parrott S, Shiers D, Taylor J, Troughton J, Watson J, Siddiqi N, Coventry PA. The DIAMONDS intervention to support self-management of type 2 diabetes in people with severe mental illness: Study protocol for a single-group feasibility study. SSM - MENTAL HEALTH 2022. [DOI: 10.1016/j.ssmmh.2022.100086] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022] Open
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14
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Arnautovska U, Kesby JP, Korman N, Rebar AL, Chapman J, Warren N, Rossell SL, Dark FL, Siskind D. Biopsychology of Physical Activity in People with Schizophrenia: An Integrative Perspective on Barriers and Intervention Strategies. Neuropsychiatr Dis Treat 2022; 18:2917-2926. [PMID: 36544549 PMCID: PMC9763049 DOI: 10.2147/ndt.s393775] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/18/2022] [Accepted: 12/02/2022] [Indexed: 12/23/2022] Open
Abstract
People with severe mental illness such as schizophrenia experience high physical comorbidity, leading to a 15-20-year mortality gap compared with the general population. Lifestyle behaviours such as physical activity (PA) play important roles in the quest to bridge this gap. Interventions to increase PA engagement in this population have potential to be efficacious; however, their effectiveness can be hindered by low participant engagement, including low adherence and high drop-out, and by implementation of interventions that are not designed to compensate for the cognitive and motivational impairments characteristic for this group. Moreover, and importantly, the negative symptoms of schizophrenia are associated with neurobiological changes in the brain, which-based on principles of biopsychology-can contribute to poor motivation and impaired decision-making processes and behavioural maintenance. To increase PA levels in people with schizophrenia, better understanding of these neurological changes that impact PA engagement is needed. This has the potential to inform the design of interventions that, through enhancement of motivation, could effectively increase PA levels in this specific population. Incorporating strategies that address the dopamine dysregulation associated with schizophrenia, such as boosting the role of reward and self-determined motivation, may improve long-term PA maintenance, leading to habitual PA. Consideration of motivation and behavioural maintenance is also needed to impart health benefits such as prevention of chronic disease, which is associated with currently low PA levels in this high metabolic risk population. Taking a biopsychological perspective, we outline the neural pathways involved in motivation that are impacted by schizophrenia and propose strategies for promoting motivation for and PA engagement from adoption to habit formation.
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Affiliation(s)
- Urska Arnautovska
- Faculty of Medicine, The University of Queensland, Woolloongabba, QLD, Australia.,Metro South Addictions and Mental Health Service, Woolloongabba, QLD, Australia
| | - James P Kesby
- Centre for Mental Health, Griffith University, Nathan, QLD, Australia.,Queensland Centre for Mental Health Research, Wacol, QLD, 4076, Australia
| | - Nicole Korman
- Faculty of Medicine, The University of Queensland, Woolloongabba, QLD, Australia.,Metro South Addictions and Mental Health Service, Woolloongabba, QLD, Australia
| | - Amanda L Rebar
- Motivation of Health Behaviours Lab, Appleton Institute, School of Health, Medical, and Applied Sciences; Central Queensland University, Rockhampton, QLD, Australia
| | - Justin Chapman
- Metro South Addictions and Mental Health Service, Woolloongabba, QLD, Australia.,Centre for Mental Health, Griffith University, Nathan, QLD, Australia
| | - Nicola Warren
- Faculty of Medicine, The University of Queensland, Woolloongabba, QLD, Australia.,Metro South Addictions and Mental Health Service, Woolloongabba, QLD, Australia
| | - Susan L Rossell
- Centre for Mental Health, School of Health Sciences, Swinburne University of Technology, Hawthorn, VIC, Australia.,Psychiatry, St Vincent's Hospital Melbourne, Fitzroy, VIC, Australia
| | - Frances L Dark
- Faculty of Medicine, The University of Queensland, Woolloongabba, QLD, Australia.,Metro South Addictions and Mental Health Service, Woolloongabba, QLD, Australia
| | - Dan Siskind
- Faculty of Medicine, The University of Queensland, Woolloongabba, QLD, Australia.,Metro South Addictions and Mental Health Service, Woolloongabba, QLD, Australia.,Queensland Centre for Mental Health Research, Wacol, QLD, 4076, Australia
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15
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Matthews E, Cowman M, Denieffe S. Exploring the Experiences of Physical Activity among Key Stakeholders in Rehabilitation and Recovery Mental Health Services. Issues Ment Health Nurs 2021; 42:128-137. [PMID: 32749911 DOI: 10.1080/01612840.2020.1789782] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
Physical activity has therapeutic benefits for mental health service users. To date, there is limited evidence that has brought together the experiences of physical activity for service users and key multi-disciplinary service providers that support activity in outpatient settings, particularly in contexts where activity is not well integrated into policy and care structures. Previous research has relied on homogenous samples of either service users or service providers of a specific discipline, and key stakeholders like peer-support workers are under-represented. This research explored and thematically analysed multi-stakeholder (service users, n = 6; and service providers, n = 8) experiences of physical activity in outpatient mental health service in Ireland using phenomenologically influenced qualitative interviews. Two salient themes were identified; 'The challenges of being physically active in recovery' and 'Physical activity is a tool for recovery'. This research presents an account of the experiences of some of these poorly represented stakeholders such as carers, peer-support workers, doctors and nurse management, in addition to other well represented stakeholders.
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Affiliation(s)
- Evan Matthews
- Department of Nursing and Health Care, Waterford Institute of Technology, Waterford, Ireland.,Nursing and Midwifery Planning and Development Unit, South East, The Health Service Executive, Ireland
| | - Mary Cowman
- Department of Sport and Exercise Science, Waterford Institute of Technology, Waterford, Ireland
| | - Suzanne Denieffe
- School of Humanities, Waterford Institute of Technology, Waterford, Ireland
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16
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Svensson K, Hagström J, Blomqvist M, Jormfeldt H. "Waiting in the Wings"-Next-of-Kin's Experiences of Lifestyle Interventions for People with Schizophrenia. Issues Ment Health Nurs 2020; 41:832-839. [PMID: 32421461 DOI: 10.1080/01612840.2020.1731026] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
Abstract
People with schizophrenia have an increased risk of experiencing physical ill health and thus risk premature death. It is important to gain knowledge about the next-of-kin's experiences of lifestyle interventions in order to increase the understanding of the development of health promotion. This study aimed to describe the experiences of next-of-kin of lifestyle interventions for people with schizophrenia. Ten next-of-kin to people diagnosed with schizophrenia were interviewed and content analysis was used to analyze the data. Three categories emerged in the analysis: Low prioritization of physical health, Patients' needs for motivational support and Next-of-kin's' limited and distant participation. Mental health nurses need a holistic view of human beings and to include the patients' physical health and the role of the family in their responsibilities. Further studies are needed that focus on the views of the next-of-kin and the staff from the mental health services about the care and support needs for promoting physical health in this patient group.
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Affiliation(s)
- Kristina Svensson
- Department of Psychiatry, Psychiatric Clinic in Varberg, Region Halland, Sweden
| | - Johanna Hagström
- Department of Psychiatry, Psychiatric Clinic in Varberg, Region Halland, Sweden
| | - Marjut Blomqvist
- School of Health and Welfare, Halmstad University, Halmstad, Sweden
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17
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Watkins A, Denney-Wilson E, Curtis J, Teasdale S, Rosenbaum S, Ward PB, Stein-Parbury J. Keeping the body in mind: A qualitative analysis of the experiences of people experiencing first-episode psychosis participating in a lifestyle intervention programme. Int J Ment Health Nurs 2020; 29:278-289. [PMID: 31840386 DOI: 10.1111/inm.12683] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 11/18/2019] [Indexed: 12/14/2022]
Abstract
The life expectancy gap experienced by people living with severe mental illness is primarily a result of cardiometabolic disease that is often exacerbated by side effects of antipsychotic medication. Commencement of atypical antipsychotic medication is commonly associated with weight gain. The Keeping the Body in Mind programme has demonstrated that early intervention with lifestyle activities can attenuate this weight gain and potentially improve long-term health outcomes. The aim of this study was to explore the experiences of young people who participated in the Keeping the Body in Mind programme, a targeted lifestyle intervention programme. A qualitative approach was used employing a semi-structured interview format. The interview schedule included questions related to four topics: aspects of the programmes that were useful, attributes of staff members that influenced the programme, changes in attitudes towards their own physical health, and suggestions for programme improvements. Interviews were recorded with duration ranging from 40 to 65 min. Thematic analysis was used to detect and assemble codes. These were then synthesized and classified into themes. Eleven participants were interviewed (seven males), aged between 18 and 25 years. Thematic analysis revealed four main themes: the role of physical health in mental health recovery; the importance of staff interactions; the value of peer interaction; and graduation to a sustainable healthy lifestyle. Study participants reported that they valued the programme for both their physical health and mental health recovery.
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Affiliation(s)
- Andrew Watkins
- Keeping the Body in Mind Program, The Bondi Centre, South Eastern Sydney Local Health District, Bondi Junction, New South Wales, Australia.,Faculty of Health, University of Technology, Sydney, Sydney, New South Wales, Australia
| | - Elizabeth Denney-Wilson
- Faculty of Medicine and Health, University of Sydney, Sydney, Sydney, New South Wales, Australia
| | - Jackie Curtis
- Keeping the Body in Mind Program, The Bondi Centre, South Eastern Sydney Local Health District, Bondi Junction, New South Wales, Australia.,School of Psychiatry, University of New South Wales, Sydney, Sydney, New South Wales, Australia
| | - Scott Teasdale
- Keeping the Body in Mind Program, The Bondi Centre, South Eastern Sydney Local Health District, Bondi Junction, New South Wales, Australia.,School of Psychiatry, University of New South Wales, Sydney, Sydney, New South Wales, Australia
| | - Simon Rosenbaum
- School of Psychiatry, University of New South Wales, Sydney, Sydney, New South Wales, Australia
| | - Philip B Ward
- School of Psychiatry, University of New South Wales, Sydney, Sydney, New South Wales, Australia.,Schizophrenia Research Unit, Ingham Institute for Applied Medical Research, Liverpool Hospital, South Western Sydney Local Health District, Bondi Junction, New South Wales, Australia
| | - Jane Stein-Parbury
- Faculty of Health, University of Technology, Sydney, Sydney, New South Wales, Australia
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18
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Pals RAS, Drejer S, Laursen RH, Oest L, Levisen VDH, Krogh NR, Hempler NF. Implementing a collaborative model in health education practice: a process evaluation of a health education programme targeting users with mental health problems. BMC Health Serv Res 2020; 20:38. [PMID: 31937316 PMCID: PMC6961358 DOI: 10.1186/s12913-019-4819-1] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/07/2018] [Accepted: 12/09/2019] [Indexed: 01/19/2023] Open
Abstract
Background Users with mental health problems (users) have a substantially higher risk of developing type 2 diabetes than the general population. Recent studies show that traditional lifestyle interventions focusing solely on exercise and diet among users have limited effect. Studies suggest collaborative models as a starting point for health behaviour change are more beneficial, but implementation in practice is a challenge. Using the Medical Research Council’s guidance for process evaluation, we explored implementation of a collaborative model in health education activities targeting users. The collaborative model focused on involving users in agenda setting and reflection about readiness to change health behaviour and was supported by dialogue tools (e.g., quotes and games). Educators received 3 days of training in applying the model. Methods Collected data included questionnaires for users (n = 154) and professionals (n = 158), interviews with users (n = 14), and observations of health education activities (n = 37) and the professional development programme (n = 9). Data were analysed using descriptive statistics and systematic text condensation. Results Ninetysix percent (152) of professionals tested the model in practice and tried at least one tool. Users reported that the model supported them in expressing their thoughts about their health and focused on their needs rather than the agenda of the professional. Ninetythree percent (143) of users strongly agreed that professionals were open-minded and responsive. However, observations showed that some professionals overlooked cues from users about motivation for health behaviour change. Furthermore, professionals identified lack of involvement from their managers as a barrier to implementation. Conclusions Implementation of a collaborative model was feasible in practice. Training of professionals in active listening and involvement of managers prior to implementation is crucial.
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Affiliation(s)
| | - Sabina Drejer
- Steno Diabetes Center Copenhagen, Niels Steensens Vej 6, 2820, Gentofte, Denmark
| | | | - Lone Oest
- University College South Denmark, Lembckesvej 3, 6100, Haderslev, Denmark
| | | | | | - Nana Folmann Hempler
- Steno Diabetes Center Copenhagen, Niels Steensens Vej 6, 2820, Gentofte, Denmark
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19
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Tailoring Diabetes Education to Meet the Needs of Adults With Type 2 Diabetes and Mental Illness: Client and Health-Care Provider Perspectives From an Exploratory Pilot Study. Can J Diabetes 2019; 43:421-428.e3. [DOI: 10.1016/j.jcjd.2018.09.008] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/13/2018] [Revised: 07/14/2018] [Accepted: 09/18/2018] [Indexed: 12/17/2022]
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20
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Forsythe AM, Venter C. Behavioral Economics, Motivating Psycho-Education Improvements: A Mobile Technology Initiative in South Africa. Front Psychol 2019; 10:1560. [PMID: 31354576 PMCID: PMC6635590 DOI: 10.3389/fpsyg.2019.01560] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/10/2019] [Accepted: 06/20/2019] [Indexed: 11/13/2022] Open
Abstract
Here we report on a health behavioral support project, using incentivized behavior on a mobile platform through M4JAM. This was a proof of concept study to support further developments, more specifically targeted at the management of tuberculosis and human immunodeficiency virus. The study reported here examines the impact of financial rewards and app toward improving mental health outcomes in South Africa. A total of 136 participants were recruited from a database and dichotomized into self-determined and heteronomous groups based on self-report scores. Overall the findings reported here highlight that personal financial incentives have a role in motivating behavior. The findings are discussed in light of the usefulness of an incentivized mobile platform in real-world practice to encourage mental health improvements in low- to middle-income countries.
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Affiliation(s)
- Alexandra Mary Forsythe
- Centre for Psychological Research, University of Wolverhampton, Wolverhampton, United Kingdom
| | - Catherine Venter
- School of Psychology, University of Liverpool, Liverpool, United Kingdom
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21
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Nieminen I, Kaunonen M. Mental health service users' experiences of an education intervention based on a European Union project: A comparison between nine European countries. Int J Ment Health Nurs 2019; 28:128-139. [PMID: 29920908 DOI: 10.1111/inm.12501] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 05/15/2018] [Indexed: 11/30/2022]
Abstract
Mental health service users (MHSUs) often face difficulties in achieving successful participation in education; however, the tools that could help them succeed are rarely investigated. This study aimed to illuminate the experiences of MHSUs in an education intervention based on a European Union (EU) project. Their experiences are compared across nine EU countries. The data were collected through individual interviews with MHSUs (n = 47) at day activity centres that provide mental health services. An inductive content analysis was used as the method of analysis. Three main categories, which include seven subcategories, are revealed by the analysis. The main categories are as follows: (i) the factors related to MHSUs' educational preparedness, (ii) the dimensions of the learning environment, and (iii) the effects of training intervention. The MHSUs' experiences with the education intervention were similar across all countries. The findings showed that this education intervention is a multidimensional process. It contains social, mental, and physical dimensions linked to a learner and learning environment. These dimensions influence the MHSUs' ability to participate in the education process. At its best, the education intervention supports the personal growth of MHSUs and prepares them for social integration. An education intervention can be a usable tool in the rehabilitation of MHSUs if the multidimensional nature of education is taken into consideration. Therefore, designing and executing education interventions requires the attendance of the MHSUs in cooperation with mental health and education professionals. Our findings suggest a tentative framework that can be used in designing and executing education for MHSUs.
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Affiliation(s)
- Irja Nieminen
- Nursing Science, Faculty of Social Sciences, University of Tampere, Tampere, Finland
| | - Marja Kaunonen
- Nursing Science, Faculty of Social Sciences, General Administration Pirkanmaa Hospital District, University of Tampere, Tampere, Finland
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22
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Lund K, Hultqvist J, Bejerholm U, Argentzell E, Eklund M. Group leader and participant perceptions of Balancing Everyday Life, a group-based lifestyle intervention for mental health service users. Scand J Occup Ther 2019; 27:462-473. [DOI: 10.1080/11038128.2018.1551419] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/09/2023]
Affiliation(s)
- Kristine Lund
- Department of Health Sciences/Mental Health, Activity and Participation, Lund University, Lund, Sweden
| | - Jenny Hultqvist
- Department of Health Sciences/Mental Health, Activity and Participation, Lund University, Lund, Sweden
| | - Ulrika Bejerholm
- Department of Health Sciences/Mental Health, Activity and Participation, Lund University, Lund, Sweden
| | - Elisabeth Argentzell
- Department of Health Sciences/Mental Health, Activity and Participation, Lund University, Lund, Sweden
| | - Mona Eklund
- Department of Health Sciences/Mental Health, Activity and Participation, Lund University, Lund, Sweden
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23
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More Harm than Good? A Pilot of a Motivational Interviewing Based Intervention for Increasing Readiness to Improve Nutrition in Young People Experiencing a First Episode of Psychosis. HEALTH PSYCHOLOGY BULLETIN 2019. [DOI: 10.5334/hpb.10] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
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24
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Sharma-Kumar R, Meurk C, Ford P, Beere D, Gartner C. Are Australian smokers with mental illness receiving adequate smoking cessation and harm reduction information? Int J Ment Health Nurs 2018; 27:1673-1688. [PMID: 29718549 DOI: 10.1111/inm.12465] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 03/21/2018] [Indexed: 02/05/2023]
Abstract
Provision of smoking cessation support in the form of advice and information is central to increasing quit rates, including among people with mental illness (MI), who have 3-5 times higher odds of smoking than those without MI. This study investigated the extent and perceived utility of quit smoking advice and information available to Australian smokers with MI through face-to-face, semi-structured, in-depth interviews with 29 current smokers with MI. Qualitative analysis identified four major sources of quit smoking advice and information: (i) mental health practitioners; (ii) Quitline; (iii) social networks; and (iv) Internet and media. All identified sources, including formal sources (mental health practitioners and Quitline), were perceived as providing inadequate information about quitting smoking, particularly regarding optimal usage of nicotine replacement therapy (NRT). Social networks emerged as a substantial source of quit smoking advice and information, especially for nontraditional methods such as vaping. Participants showed high interest in receiving support from peer-led smoking cessation groups. A minority of participants reported that they had received quit smoking information from Internet and media; this was largely restricted to negative reports about e-cigarettes and short advertisements for nicotine replacement therapy. Our findings suggest that more can be done to provide smokers with MI with practical smoking cessation advice and support. Comprehensive information resources tailored for smokers with MI should be developed and disseminated via multiple pathways. We also recommend a number of policy and practice reforms to promote smoking cessation among those with MI.
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Affiliation(s)
- Ratika Sharma-Kumar
- School of Public Health, Faculty of Medicine, The University of Queensland, Brisbane, QLD, Australia
| | - Carla Meurk
- School of Public Health, Faculty of Medicine, The University of Queensland, Brisbane, QLD, Australia.,Policy and Epidemiology Group, Queensland Centre for Mental Health Research, Brisbane, QLD, Australia
| | - Pauline Ford
- School of Dentistry, The University of Queensland, Brisbane, Queensland, Australia
| | - Diana Beere
- School of Public Health, Faculty of Medicine, The University of Queensland, Brisbane, QLD, Australia.,Policy and Epidemiology Group, Queensland Centre for Mental Health Research, Brisbane, QLD, Australia
| | - Coral Gartner
- School of Public Health, Faculty of Medicine, The University of Queensland, Brisbane, QLD, Australia
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25
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Innes K, Jackson D, Plummer V, Elliott D. A profile of the waiting room nurse in emergency departments: An online survey of Australian nurses exploring implementation and perceptions. Int Emerg Nurs 2018; 43:67-73. [PMID: 30381142 DOI: 10.1016/j.ienj.2018.10.003] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/17/2018] [Revised: 08/27/2018] [Accepted: 10/12/2018] [Indexed: 11/26/2022]
Abstract
BACKGROUND In response to increasing waiting times, adverse patient outcomes and patient dissatisfaction, some emergency departments introduced a Waiting Room Nurse role. Despite implementation into routine practice, there remains limited formal evaluation of the role. AIM To explore the implementation of a Waiting Room Nurse role in Australian emergency departments and emergency nurses' perceptions. METHODS Survey design. A 40-item survey was developed, piloted and then distributed to members of a professional College for online completion. Responses for closed-ended and open-ended items were reported using frequencies or proportions, and quantitative content analysis, respectively. RESULTS Respondents (n = 197) reported that 51 emergency departments allocated a Waiting Room Nurse, with varying hours of operation. Five key areas of responsibility were: patient care, patient safety, escalation of care, triage and communication. Role variations were identified in experience, preparation and supporting policies. Challenges, including workload and personal safety issues, were reported. CONCLUSIONS The role was perceived as vital, especially at times of high demand, in ensuring that patients were safe to wait, detecting deterioration and escalating care as needed. Communication and therapeutic relationships were key to effective performance. Challenges identified had clear implications for the welfare of nurses performing the role.
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Affiliation(s)
- Kelli Innes
- Faculty of Health University of Technology Sydney, 15 Broadway, Ultimo, N.S.W 2007, Australia; Nursing and Midwifery, Monash University, 47-49 Moorooduc Highway, Frankston, Victoria 3199, Australia.
| | - Debra Jackson
- Faculty of Health University of Technology Sydney, 15 Broadway, Ultimo, N.S.W 2007, Australia.
| | - Virginia Plummer
- Nursing and Midwifery, Monash University, 47-49 Moorooduc Highway, Frankston, Victoria 3199, Australia; Peninsula Health, 2 Hastings Road, Frankston, Victoria 3199, Australia.
| | - Doug Elliott
- Faculty of Health University of Technology Sydney, 15 Broadway, Ultimo, N.S.W 2007, Australia.
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26
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Hempler NF, Pals RAS, Pedersbæk L, DeCosta P. Barriers and facilitators of effective health education targeting people with mental illness: a theory-based ethnographic study. BMC Psychiatry 2018; 18:353. [PMID: 30376824 PMCID: PMC6208025 DOI: 10.1186/s12888-018-1924-3] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/02/2018] [Accepted: 10/08/2018] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Health education is particularly important for people with mental illness because they are at higher risk of becoming overweight or obese and developing type 2 diabetes than are members of the general population. However, little is known about how to provide health education activities that promote engagement and motivation among people with mental illness. METHODS This study used ethnographic methods to examine barriers and facilitators of effective health education targeting people with mental illness by applying the concept of flow as a theoretical framework. Flow refers to immersion in an activity and is related to motivation. Data were collected through participant observation during eight health-educating activities and were thematically analysed using the concept of flow. Fieldwork was carried out between May and July 2015 in Denmark. RESULTS Barriers to flow included: 1) information overload, particularly of biomedical rationales for behaviour change; 2) a one-size-fits-all approach that failed to address the needs and preferences of the target group; and 3) one-way communication allowing little time for reflection. Educators promoted a state of flow when they spoke less and acted outside of a traditional expert role, thus engaging participants in the activity. Flow was facilitated when educators were attentive and responsive to people with mental illness, and when they stimulated reflection about health and health behaviour through open-ended questions, communication tools and in small group exercises. CONCLUSIONS This study suggests that more focus should be paid to training of educators in terms of skills to involve and engage people with mental illness in health education activities.
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Affiliation(s)
- N. F. Hempler
- Diabetes Management Research, Steno Diabetes Center Copenhagen, Niels Steensens Vej 6, 2820 Gentofte, Denmark
| | - R. A. S. Pals
- Diabetes Management Research, Steno Diabetes Center Copenhagen, Niels Steensens Vej 6, 2820 Gentofte, Denmark
| | - L. Pedersbæk
- Diabetes Management Research, Steno Diabetes Center Copenhagen, Niels Steensens Vej 6, 2820 Gentofte, Denmark
| | - P. DeCosta
- Diabetes Management Research, Steno Diabetes Center Copenhagen, Niels Steensens Vej 6, 2820 Gentofte, Denmark
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27
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Juel A, Hjorth P, Munk-Jørgensen P, Buus N. Health Beliefs and Experiences of a Health Promotion Intervention Among Psychiatric Patients With Substance Use: An Interview Study. Arch Psychiatr Nurs 2018; 32:462-468. [PMID: 29784231 DOI: 10.1016/j.apnu.2018.01.004] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/08/2017] [Revised: 12/19/2017] [Accepted: 01/01/2018] [Indexed: 11/27/2022]
Abstract
We aimed to explore beliefs about physical health from the perspective of patients with concurrent mental illness and substance use and to explore how a health promotion intervention influenced their personal agency for changing health-related behaviour. Our findings were that patients' beliefs were focused on their present day state of health and that patients had strategies to normalize their health and health-related behaviour. Health promotion to this group of patients should be tailored to fit their particular beliefs. Health measurements were experienced as providing tangible insight into their health and appeared to prevent patients from minimizing physical health problems.
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Affiliation(s)
- Anette Juel
- Department of Affective Disorders Q, Aarhus University Hospital, Risskov, Denmark.
| | - Peter Hjorth
- Department of Regional Health Research, University of Southern Denmark, Denmark
| | | | - Niels Buus
- Faculty of Nursing and Midwifery, University of Sidney, Australia; St. Vincent's Hospital Sydney, Australia; St. Vincent's Private Hospital Sydney, Australia
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Rönngren Y, Björk A, Haage D, Audulv Å, Kristiansen L. Perspectives of a tailored lifestyle program for people with severe mental illness receiving housing support. Perspect Psychiatr Care 2018; 54:309-316. [PMID: 28901554 DOI: 10.1111/ppc.12239] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/23/2017] [Accepted: 08/06/2017] [Indexed: 11/30/2022] Open
Abstract
PURPOSE The purpose of the present study was to describe the acceptability of the lifestyle program PHYS/CAT and to get information about the tools used for assessment of functional exercise capacity, cognitive performance, and self-health-related quality of life. DESIGN AND METHODS The findings are based on focus groups and the researchers' experiences of conducting the program as well as using the assessment tools. FINDINGS The acceptability of the program and the assessment tools was mainly satisfactory. PRACTICE IMPLICATIONS The program with relational, educational, and supportive dimensions may be a promising tool to be integrated into daily nursing care.
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Affiliation(s)
- Ylva Rönngren
- Department of Nursing Sciences, Mid Sweden University, Sundsvall, Sweden
| | - Annette Björk
- Department of Health Sciences, Mid Sweden University, Sundsvall, Sweden
| | - David Haage
- Department of Nursing Sciences, Mid Sweden University, Sundsvall, Sweden
| | - Åsa Audulv
- Department of Nursing Sciences, Mid Sweden University, Sundsvall, Sweden
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Pals RAS, Hempler NF. How to achieve a collaborative approach in health promotion: preferences and ideas of users of mental health services. Scand J Caring Sci 2018; 32:1188-1196. [DOI: 10.1111/scs.12564] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/22/2017] [Accepted: 01/10/2018] [Indexed: 01/15/2023]
Affiliation(s)
| | - Nana Folmann Hempler
- Diabetes Management Research; Steno Diabetes Center Copenhagen; Gentofte Denmark
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Burns A, Webb M, Stynes G, O'Brien T, Rohde D, Strawbridge J, Clancy L, Doyle F. Implementation of a Quit Smoking Programme in Community Adult Mental Health Services-A Qualitative Study. Front Psychiatry 2018; 9:670. [PMID: 30622485 PMCID: PMC6308392 DOI: 10.3389/fpsyt.2018.00670] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/25/2018] [Accepted: 11/20/2018] [Indexed: 01/01/2023] Open
Abstract
Little is known about the experiences of people with severe mental health difficulties in smoking cessation interventions. This study aimed to review the implementation of a smoking cessation programme across 16 community mental health day services. The aim was to establish the experience from both service user and facilitator perspectives and refine implementation for future groups. In-depth interviews were conducted with 20 service users and four focus groups held with 17 facilitators. Thematic analysis was used to analyse the data for emergent themes in relation to key enablers and barriers to implementation. Data from service users and facilitators revealed that implementation was enabled by an open and engaged recruitment approach; the resourcefulness of facilitators; programme materials and group-based format; combining the cessation programme with other and broader health initiatives; and participants' motivations, including health and money. Barriers included the structure of the service; the lack of a joined-up approach across the health services; literacy issues and the serial/logical process assumed by the programme. Barriers perceived as more specific to those with mental health difficulties included the use of smoking as a coping mechanism, lack of alternative activities/structure and lack of consistent determination. The tobacco free policy, implemented shortly before the programme, interestingly emerged as both a barrier and an enabler. In conclusion, although this group-based cessation programme in community mental health settings was well-received overall, a number of key barriers persist. A joined-up approach which addresses the culture of smoking in mental health settings, inconsistencies in smoking policies, and provides consistent cessation support, is needed. Care needs to be taken with the timing as overall it may not be helpful to introduce a new smoking cessation programme at the same time as a tobacco free policy.
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Affiliation(s)
- Annette Burns
- Department of Psychology, Royal College of Surgeons in Ireland, Dublin, Ireland
| | | | - Greg Stynes
- EVE, Health Service Executive, Dublin, Ireland
| | - Tom O'Brien
- EVE, Health Service Executive, Dublin, Ireland
| | - Daniela Rohde
- Department of Psychology, Royal College of Surgeons in Ireland, Dublin, Ireland
| | | | - Luke Clancy
- TobaccoFree Research Institute, Dublin Institute of Technology, Dublin, Ireland
| | - Frank Doyle
- Department of Psychology, Royal College of Surgeons in Ireland, Dublin, Ireland
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31
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Lundström S, Ahlström BH, Jormfeldt H, Eriksson H, Skärsäter I. The Meaning of the Lived Experience of Lifestyle Changes for People with Severe Mental Illness. Issues Ment Health Nurs 2017; 38:717-725. [PMID: 28613126 DOI: 10.1080/01612840.2017.1330909] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Abstract
The aim of this study was to elucidate the meaning of the lived experience of lifestyle changes as perceived by people with severe mental illness (SMI). People with SMI who have experience in managing lifestyle changes were interviewed (n = 10). The interviews were analyzed with a phenomenological hermeneutic approach. The findings reveal three themes: (1) struggling with inner and outer limitations, (2) on one's own but together with others and (3) longing for living a life in harmony. The meaning of lifestyle changes can be understood as a person's internal and external endeavors to make well-considered decisions about lifestyle changes. Support should focus on strengthening the person's self-efficacy and should be based on the person's experiences.
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Affiliation(s)
- Sofie Lundström
- a School of Health and Welfare , Halmstad University , Halmstad , Sweden
| | | | - Henrika Jormfeldt
- a School of Health and Welfare , Halmstad University , Halmstad , Sweden
| | - Helena Eriksson
- a School of Health and Welfare , Halmstad University , Halmstad , Sweden
| | - Ingela Skärsäter
- a School of Health and Welfare , Halmstad University , Halmstad , Sweden
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Nieminen I, Kaunonen M. Professionals' views on mental health service users' education: challenges and support. J Psychiatr Ment Health Nurs 2017; 24:57-68. [PMID: 28090750 DOI: 10.1111/jpm.12355] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 10/06/2016] [Indexed: 11/29/2022]
Abstract
UNLABELLED WHAT IS KNOWN ON THE SUBJECT?: Mental health service users (MHSUs) may experience disruptions in their education. However, education has been shown to have a positive influence on their recovery, potentially offering them broader employment opportunities. The literature suggests that providing support for MHSUs in their educational efforts may be beneficial and is wished for by the service users themselves. However, there is a lack of mental health professionals' views on the topic in the setting of a community mental health centre. WHAT DOES THIS PAPER ADD TO THE EXISTING KNOWLEDGE?: In the perception of mental health professionals, the predominance of disease in the life of MHSUs and their marginalization may form barriers to their success in education. Professionals can support MHSUs in their educational efforts by strengthening the MHSUs' internal resources and creating a supportive environment with professional expertise available. A service user-centred education might further help MHSUs to achieve their educational goals. Our findings confirm previous knowledge of a recovery-oriented approach to supporting MHSUs' education. This study explored the topic from the professionals' perspective in the context of community mental health centres, which is a fresh view in the research literature. WHAT ARE THE IMPLICATIONS FOR PRACTICE?: The findings suggest which types of support professionals perceive to be required for MHSUs to advance their studies. Knowledge of adequate forms of support can be applied in the mental health nursing practice to develop support measures for service users to advance in their studies. All levels of the community mental health centres should be aware of and adopt a recovery-oriented approach. MHSUs and professionals need to have a shared opinion on the definition of recovery orientation. This requires mutual discussion and the more active involvement of MHSUs in the design of their own rehabilitation process. ABSTRACT Introduction Studies show the importance of providing support for mental health service users' (MHSUs') education. However, none of these studies explored this support in the community mental health centre setting. The range of MHSUs' educational activities identified in this study varied from participation in courses at the mental health centres to independent studies at different levels of education outside the centres. Aim (1) How do mental health professionals perceive the challenges that may limit service users' potential when they apply for, and complete, their education? (2) How do the professionals describe the methods of rehabilitation aimed at supporting the service users in achieving their educational goals? Method The data were collected from 14 mental health professionals using focus group interviews. Inductive content analysis was then performed. Results Professionals perceive that the predominance of disease and marginalization may be barriers to MHSUs' success in education. Strengthening the MHSUs' internal resources, creating a supportive environment with professional expertise available and service user-centred education appeared to support the MHSUs' educational achievements. Our findings confirm previous knowledge of a recovery-oriented approach to support MHSUs' education. However, professionals' views on this topic in the context of community mental health centres have not been investigated previously. Discussion Professionals perceive that a recovery-oriented approach to rehabilitation may support MHSUs in their educational efforts. Implications for practice A recovery-oriented approach should be adopted by all levels of the community mental health centres. MHSUs and professionals need to have a shared opinion on the definition of recovery orientation. This requires mutual discussion and a more active involvement of MHSUs in the design of their own rehabilitation process.
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Affiliation(s)
- I Nieminen
- Doctoral student, Nursing Science, School of Health Sciences, University of Tampere, Finland
| | - M Kaunonen
- Professor, Nursing Science, School of Health Sciences, University of Tampere, General Administration Pirkanmaa Hospital District, Finland
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Trainor K, Leavey G. Barriers and Facilitators to Smoking Cessation Among People With Severe Mental Illness: A Critical Appraisal of Qualitative Studies. Nicotine Tob Res 2016; 19:14-23. [PMID: 27613905 DOI: 10.1093/ntr/ntw183] [Citation(s) in RCA: 37] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/02/2016] [Accepted: 07/12/2016] [Indexed: 11/13/2022]
Abstract
BACKGROUND People with severe mental illness (PWSMI) die 15-20 years earlier than people in the general population and this is often due to preventable smoking-related health conditions. Studies that identify barriers and facilitators to smoking cessation are crucial for policy makers and health care professionals. AIMS This appraisal aims to identify and critically appraise qualitative studies which explore smoking experiences and barriers to smoking cessation among PWSMI. METHOD Articles were retrieved from electronic health related databases including Web of Science, Scopus, PubMed, Sage, Biomed, Medline, Embase, and electronic hand searches of bibliographies from key articles. RESULTS Eleven papers were identified. Although the overall quality of studies were sufficient, most had limited information relating to trustworthiness and sociodemographic details. Cost savings and health benefits were frequently cited as facilitators to quitting, however may be of limited impact as smoking for existential purposes, social inclusion, and mental health management appear to be considered highly important among PWSMI. CONCLUSIONS Findings were restricted to predominantly individual barriers to smoking cessation which may be more resistant to change as service users rely on smoking to manage their mental health and smoking is embedded in the culture of mental health settings. IMPLICATIONS This critical appraisal identifies qualitative evidence regarding which factors facilitate or prevent individuals with severe mental illness from engaging with smoking cessation. Healthcare professionals and policy makers should address external barriers to quitting smoking as this may increase participation in intervention studies, inform policy and assist in the development of a feasible and acceptable smoking cessation intervention among PWSMI. Methodological considerations highlight that future research should include sociodemographic and contextual factors to improve utility and applicability of findings.
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Affiliation(s)
- Katie Trainor
- Department of Health and Life Sciences, University of Ulster, Faculty of Life and Health Sciences, Coleraine, UK; .,The Bamford Centre for Mental Health and Wellbeing, University of Ulster Faculty of Life and Health Sciences, Coleraine, UK
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Chapman JJ, Fraser SJ, Brown WJ, Burton NW. Physical activity preferences, motivators, barriers and attitudes of adults with mental illness. J Ment Health 2016; 25:448-454. [DOI: 10.3109/09638237.2016.1167847] [Citation(s) in RCA: 29] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Affiliation(s)
- Justin J. Chapman
- School of Human Movement and Nutrition Sciences, The University of Queensland, Brisbane, Australia
| | - Sarah J. Fraser
- School of Human Movement and Nutrition Sciences, The University of Queensland, Brisbane, Australia
| | - Wendy J. Brown
- School of Human Movement and Nutrition Sciences, The University of Queensland, Brisbane, Australia
| | - Nicola W. Burton
- School of Human Movement and Nutrition Sciences, The University of Queensland, Brisbane, Australia
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Nicol G, Worsham E, Haire-Joshu D, Duncan A, Schweiger J, Yingling M, Lenze E. Getting to More Effective Weight Management in Antipsychotic-Treated Youth: A Survey of Barriers and Preferences. Child Obes 2016; 12:70-6. [PMID: 26788619 PMCID: PMC4753621 DOI: 10.1089/chi.2015.0076] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
BACKGROUND Mentally ill youth are at risk for developing obesity, especially when they require antipsychotic treatment; moreover, they may face unique challenges in adhering to behavioral weight loss interventions. The aims of this project were to characterize the challenges families of youth with psychiatric disorders face when engaging in weight loss treatment and to gather information on attitudes and preferences for weight management interventions in this population. METHODS We devised a telephone survey to evaluate caregiver-perceived barriers/challenges to and preferences for behavioral weight loss treatment in overweight or obese mentally ill youth ages 6-18 treated with an antipsychotic agent in an outpatient setting. RESULTS A total of 26 parents or primary caregivers completed the survey. The most commonly cited barriers to participation in physical activity (PA) and maintaining a healthy diet were child's dislike of PA and child's preference for energy-dense foods, respectively, which were impacted by psychiatric symptoms. Preferences for weight loss treatment included individualized, prescribed meal plans and shopping lists, and exercise support/demonstration, with a preference for Internet or cell phone applications to help with monitoring food intake and exercise. CONCLUSIONS These results suggest that targets for obesity treatment in this population include individualized, specific support that takes into account the child's motivation, which is effected by psychiatric symptoms. Tools for providing support may include the use of telehealth visits and mobile device applications for self-monitoring.
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Affiliation(s)
- Ginger Nicol
- Department of Psychiatry, Washington University School of Medicine in St. Louis, St. Louis, MO
| | - Elizabeth Worsham
- Department of Psychiatry, Forensic Institute, University of Florida, Gainesville, FL
| | - Debra Haire-Joshu
- Joyce Wood Professor and Associate Dean for Research & Faculty, George Warren Brown School of Social Work Director, Center for Diabetes Translation Research and the Center for Obesity Prevention and Policy Research, Washington University, St. Louis, MO
| | - Alexis Duncan
- Assistant Professor of Public Health, George Warren Brown School of Social Work, Washington University, St. Louis, MO and Department of Psychiatry, Washington University School of Medicine, St. Louis, MO
| | - Julia Schweiger
- Clinical Lab Manager, Department of Psychiatry, Washington University School of Medicine, St. Louis, MO
| | - Michael Yingling
- Senior Data Analyst, Department of Psychiatry, Washington University School of Medicine, St. Louis, MO
| | - Eric Lenze
- Professor of Psychiatry, Department of Psychiatry, Washington University School of Medicine, St. Louis, MO
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Soundy A, Freeman P, Stubbs B, Probst M, Vancampfort D. The value of social support to encourage people with schizophrenia to engage in physical activity: an international insight from specialist mental health physiotherapists. J Ment Health 2015; 23:256-60. [PMID: 25222369 DOI: 10.3109/09638237.2014.951481] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
BACKGROUND Research is needed to understand how mental health physiotherapists use social support when promoting physical activity. AIMS The aim of this study was to establish which dimensions of social support are used within physiotherapy sessions for individuals with schizophrenia. METHOD A cross sectional international survey design of specialist mental health physiotherapists was undertaken. RESULTS Forty mental health physiotherapists provided in depth accounts of the four functional dimensions of social support (informational, tangible, esteem and emotional) and the one structural dimension (importance of group exercise). The results illustrate how these different dimensions of social support are used by physiotherapists to engage patients and identify the value of group work as a specific form of support. Specifically the importance of all types of support was reported and this helped to provide a detailed consideration to the skills that mental health physiotherapist have. CONCLUSION Providing social support is a significant part of the rehabilitation professionals' role. The current results advance the current understanding of how social support is provided to individuals with schizophrenia in rehabilitation settings.
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Affiliation(s)
- Andrew Soundy
- School of Sport, Exercise and Rehabilitation Sciences, University of Birmingham , Birmingham , UK
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Fraser SJ, Chapman JJ, Brown WJ, Whiteford HA, Burton NW. Physical activity attitudes and preferences among inpatient adults with mental illness. Int J Ment Health Nurs 2015; 24:413-20. [PMID: 26332079 DOI: 10.1111/inm.12158] [Citation(s) in RCA: 29] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
The life expectancy of adults with mental illness is worse than that of the general population and is largely due to poor physical health status. Physical activity has been consistently recommended for the prevention and management of many chronic physical health conditions and can also have benefits for mental health. This cross sectional study assessed the attitudes towards and preferences for physical activity among inpatient adults with mental illness, and differences by distress and gender. Self-report questionnaires were completed by 101 patients. Findings indicated that inpatient adults with mental illness are interested in doing physical activity while in hospital, primarily to maintain good physical health and improve emotional wellbeing. Fewer than half of participants agreed that physical activity has benefits for serious mental illness. Participants indicated a preference for walking and physical activity that can be done alone, at a fixed time and with a set routine and format. Major barriers were fatigue and lack of motivation. Females were more likely than males to prefer activities done with others of the same gender (P = 0.001) and at the same level of ability (P < 0.001). There were no significant differences by level of distress. These findings can inform physical activity intervention programming in hospital settings, which may contribute to decreasing the chronic disease burden and improve the psychological wellbeing in adults with mental illness.
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Affiliation(s)
- Sarah J Fraser
- The School of Human Movement and Nutrition Sciences, The University of Queensland, St Lucia, Queensland, Australia
| | - Justin J Chapman
- The School of Human Movement and Nutrition Sciences, The University of Queensland, St Lucia, Queensland, Australia
| | - Wendy J Brown
- The School of Human Movement and Nutrition Sciences, The University of Queensland, St Lucia, Queensland, Australia
| | - Harvey A Whiteford
- The School of Public Health, The University of Queensland, Herston, Queensland, Australia
| | - Nicola W Burton
- The School of Human Movement and Nutrition Sciences, The University of Queensland, St Lucia, Queensland, Australia
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Gross J, Vancampfort D, Stubbs B, Gorczynski P, Soundy A. A narrative synthesis investigating the use and value of social support to promote physical activity among individuals with schizophrenia. Disabil Rehabil 2015; 38:123-50. [PMID: 25786476 DOI: 10.3109/09638288.2015.1024343] [Citation(s) in RCA: 28] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
PURPOSE To review and synthesise the literature detailing the use of social support to facilitate physical activity participation in individuals with schizophrenia. METHOD A systematic review of major electronic databases was conducted to identify literature regarding the use of social support to promote physical activity among people with schizophrenia. A narrative synthesis was undertaken in four stages, including development of a theory, developing a preliminary synthesis, exploring relationships and assessing the robustness of the synthesis. RESULTS From a total of 110 studies, 23 met the inclusion criteria including 883 individuals with schizophrenia. Informational support was the most documented form of social support, followed by emotional, esteem and tangible. Providers included research personnel, healthcare professionals, family members and peers. Details of the content of the different dimensions of functional support are given. Social support appears to have an important role to help individuals with schizophrenia initiate, comply and adhere with exercise interventions. Social support may have an indirect benefit on weight maintenance. However, due to the limitations of the selected literature, it was difficult ascertain what the (in)direct benefit of social support are on health outcomes. CONCLUSIONS Social support appears to play a pivotal role in initiating physical activity as well as ensuring compliance and adherence to physical activity. Future research is required to investigate the optimal type and mode of delivery of social support on health outcomes. IMPLICATIONS FOR REHABILITATION Limited evidence is available that considers the role, value and use of social support within physical activity interventions for individuals with schizophrenia. Social support appears most likely to aid an individual's initiation, adherence and compliance to physical activity interventions. There may be an indirect benefit of social support on maintaining or enhancing health outcomes.
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Affiliation(s)
- Julia Gross
- a Department of Physiotherapy , School of Sport, Exercise and Rehabilitation Sciences, University of Birmingham , Birmingham , UK
| | - Davy Vancampfort
- b Department of Neurosciences , University Psychiatric Centre, KU Leuven , Kortenberg , Belgium .,c Department of Rehabilitation Sciences , KU Leuven , Leuven , Belgium
| | - Brendon Stubbs
- d School of Health and Social Care, University of Greenwich , London , UK , and
| | - Paul Gorczynski
- e Department of Sport and Exercise Science , University of Portsmouth , Portsmouth , Hampshire , UK
| | - Andrew Soundy
- a Department of Physiotherapy , School of Sport, Exercise and Rehabilitation Sciences, University of Birmingham , Birmingham , UK
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Soundy A, Freeman P, Stubbs B, Probst M, Coffee P, Vancampfort D. The transcending benefits of physical activity for individuals with schizophrenia: a systematic review and meta-ethnography. Psychiatry Res 2014; 220:11-9. [PMID: 25149128 DOI: 10.1016/j.psychres.2014.07.083] [Citation(s) in RCA: 53] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/14/2014] [Revised: 07/28/2014] [Accepted: 07/31/2014] [Indexed: 10/24/2022]
Abstract
A systematic review and meta-ethnographic synthesis exploring the experiences of people with schizophrenia and healthcare professionals (HCPs) towards physical activity was undertaken. Major electronic databases were searched from inception until January 2014. Studies were eligible if they considered the experiences and perceptions of people with schizophrenia or the perceptions of HCPs towards physical activity. All included studies were synthesised within a meta-ethnographic approach, including completing a methodological quality assessment. The search strategy identified 106 articles, 11 of which were included in the final analysis. Eight articles considered patients׳ experiences and perceptions, and three articles considered the experiences and perceptions of HCPs. A total of 108 patients and 65 HCPs were included. Three main themes were identified: (1) the influence of identity, culture and the environment on physical activity engagement, (2) access and barriers to participation in physical activity, and (3) the benefits of engaging in physical activity. Aspects within the built, social and political environment as well as aspects of social cognition and perceptual biases influence participation in physical activity for individuals with schizophrenia. Specific recommendations for HCPs are given to help promote physical activity in this population group.
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Affiliation(s)
- Andy Soundy
- Department of Physiotherapy, School of Sport, Exercise and Rehabilitation Sciences, University of Birmingham, Birmingham B15 2 TT UK.
| | - Paul Freeman
- Department of Sport and Health Sciences, University of Exeter, Exeter, Devon, UK
| | - Brendon Stubbs
- School of Health and Social Care, University of Greenwich, Southwood Site Avery Hill Road Eltham, London SE9 2UG, UK
| | - Michel Probst
- University Psychiatric Centre, KU Leuven, Kortenberg, Department of Neurosciences, KU Leuven, Leuvensesteenweg 517, B-3070 Kortenberg, Belgium; Department of Rehabilitation Sciences, KU Leuven, Tervuursevest 101, B-3001 Leuven, Belgium
| | - Pete Coffee
- School of Sport, University of Stirling, Stirling, Scotland, UK
| | - Davy Vancampfort
- University Psychiatric Centre, KU Leuven, Kortenberg, Department of Neurosciences, KU Leuven, Leuvensesteenweg 517, B-3070 Kortenberg, Belgium; Department of Rehabilitation Sciences, KU Leuven, Tervuursevest 101, B-3001 Leuven, Belgium
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Syrén S, Hultsjö S. A striving towards 'normality': illness-related beliefs among individuals living with a psychotic disorder. Issues Ment Health Nurs 2014; 35:842-50. [PMID: 25353297 DOI: 10.3109/01612840.2014.924043] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
Beliefs related to illness constrain or facilitate health and wellbeing, and are of importance in how people understand and manage their illness. The aim of this study was to identify illness beliefs among individuals living with illness from a psychotic disorder. Data collected through two qualitative interview studies was secondary analysed by means of a method for directed content analysis. Beliefs of being different and odd, and of what constitutes 'normality', are prominent and constrain, in several respects, wellbeing among the individuals with psychotic illness. Beliefs about possible wellbeing are preferably related to existential, human desires of caretaking and responsibility for self and others. An awareness among mental healthcare staff that one does not hold the unequivocal truth about what is normal and healthy, is of importance. They need to ask questions about illness beliefs and not ignore or judge the answers received, but instead discuss them. Relationship-centred care, where a mutual dialogue occurs between the individual, the family and mental healthcare staff, is highlighted.
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Affiliation(s)
- Susanne Syrén
- Faculty of Health and Life Sciences, Department of Health and Caring Sciences, Linnaeus University, 351 95 Växjö, Växjö, Sweden
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