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Öksüz E, Mersin S, Uçgun T, Sarikoc G. Experiences of nurses providing care to hospitalized patients with acute mania in Türkiye: A phenomenological study. Arch Psychiatr Nurs 2024; 50:33-39. [PMID: 38789231 DOI: 10.1016/j.apnu.2024.03.005] [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: 01/02/2023] [Revised: 10/01/2023] [Accepted: 03/07/2024] [Indexed: 05/26/2024]
Abstract
The main purpose of this study was to determine the experiences of nurses who care for hospitalized patients experiencing an acute manic episode. This qualitative study was carried out with 15 nurses working in a psychiatric ward in Türkiye. Data were collected through semi-structured in-depth individual interviews and focus-group interviews in which the face-to-face interview technique was used. Two main themes emerged from the analysis of the qualitative data: (1) the difficulties experienced and (2) the most effective elements of care. Under the first main theme, the following sub-themes emerged: difficulties in setting boundaries, safety concerns, difficulties in managing the patient's demands, inability to choose the appropriate word(s), and the "emotional whirlwind" experienced. The second main theme, on the other hand, included the following sub-themes: meeting basic needs, ensuring treatment compliance, encouragement to engage in physical activity, and having a sufficient number of qualified personnel. The study revealed that the nurses had difficulties in caring for their manic patients. On the basis of these results, it is recommended that nurses be given counseling and training on setting boundaries, ensuring safety, managing the patient's demands, coping with their own emotions, and communicating better. In addition, the study identified the importance of nursing interventions to meet patients' basic needs, encourage them to engage in physical activity, and ensure treatment compliance, and the importance of there being an adequate number of qualified personnel. These results may help students and other nurses in terms of assessing and setting priorities in cases needing acute psychiatric care.
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Affiliation(s)
- Emine Öksüz
- University of Health Sciences Turkey, Gulhane Faculty of Nursing, Psychiatric and Mental Health Nursing Department, Ankara, Turkey.
| | - Sevinç Mersin
- Bilecik Şeyh Edebali University, Faculty of Health Sciences, Psychiatric and Mental Health Nursing Department, Bilecik, Turkey.
| | - Tuğçe Uçgun
- Başkent University, Faculty of Health Sciences, Department of Mental Health and Psychiatric Nursing, Ankara, Turkey.
| | - Gamze Sarikoc
- University of Health Sciences Turkey, Gulhane Faculty of Nursing, Psychiatric and Mental Health Nursing Department, Ankara, Turkey.
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2
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Martland R, Korman N, Firth J, Stubbs B. The efficacy of exercise interventions for all types of inpatients across mental health settings: A systematic review and meta-analysis of 47 studies. J Sports Sci 2023; 41:232-271. [PMID: 37132599 DOI: 10.1080/02640414.2023.2207855] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/27/2021] [Accepted: 04/18/2023] [Indexed: 05/04/2023]
Abstract
This systematic review and meta-analysis investigated the benefits, safety and adherence of exercise interventions delivered in inpatient mental health settings, quantified the number of exercise trials that provided support to maintain engagement in exercise post-discharge, and reported patient feedback towards exercise interventions. Major databases were searched from inception to 22.06.2022 for intervention studies investigating exercise in mental health inpatient settings. Study quality was assessed using Cochrane and ROBINS-1 checklists. Fifty-six papers were included from 47 trials (including 34 RCTs), bias was high. Exercise improved depression (Standardised mean difference = -0.416; 95% Confidence interval -0.787 to -0.045, N = 15) compared to non-exercise comparators amongst people with a range of mental illnesses, with further (albeit limited) evidence suggesting a role of exercise in cardiorespiratory fitness and various other physical health parameters and ameliorating psychiatric symptoms. No serious exercise-related adverse events were noted, attendance was ≥80% in most trials, and exercise was perceived as enjoyable and useful. Five trials offered patients post-discharge support to continue exercise, with varying success. In conclusion, exercise interventions may have therapeutic benefits in inpatient mental health settings. More high-quality trials are needed to determine optimal parameters, and future research should investigate systems to support patients to maintain exercise engagement once discharged.
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Affiliation(s)
- Rebecca Martland
- King's College London, Institute of Psychiatry, Psychology and Neuroscience (IoPPN), London, UK
| | - Nicole Korman
- Metro South Addiction and Mental Health Services, Brisbane, Australia
- School of Medicine, University of Queensland, Brisbane, Australia
| | - Joseph Firth
- Western Sydney University, Westmead, NSW, NICM Health Research Institute, Australia
- Faculty of Biology, Medicine & Health, Division of Psychology and Mental Health, University of Manchester, Manchester, United Kingdom
| | - Brendon Stubbs
- King's College London, Institute of Psychiatry, Psychology and Neuroscience (IoPPN), London, UK
- South London and Maudsley NHS Foundation Trust, London, United Kingdom
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3
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Svensson M, Erhardt S, Hållmarker U, James S, Deierborg T. A physically active lifestyle is associated with lower long-term incidence of bipolar disorder in a population-based, large-scale study. Int J Bipolar Disord 2022; 10:26. [DOI: 10.1186/s40345-022-00272-6] [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] [Received: 06/29/2022] [Accepted: 09/27/2022] [Indexed: 11/05/2022] Open
Abstract
Abstract
Background
Physical activity has been proposed to be beneficial for the symptomatic control of bipolar disorder, but the duration of the effects, sex-specific mechanisms, and impact of exercise intensity are not known.
Method
With an observational study design, we followed skiers and age and sex-matched non-skiers from the general population to investigate if participation in a long-distance cross-country ski race (Vasaloppet) was associated with a lower risk of getting diagnosed with bipolar disorder. Using the Swedish population and patient registries, skiers in Vasaloppet and age and sex-matched non-skiers from the general population were analyzed for any diagnosis of bipolar disorder after participation in the race. Additionally, we used finishing time of the ski race as a proxy for intensity levels to investigate if exercise intensity impacts the risk of bipolar disorder among the physically active skiers.
Results
Previous participation in a long distance ski race (n = 197,685, median age 36 years, 38% women) was associated with a lower incidence of newly diagnosed bipolar compared to an age and sex-matched general population (n = 197,684) during the up to 21 years follow-up (adjusted hazard ratio, HR = 0.48). The finishing time of the race did not significantly impact the risk of bipolar disorder in men. Among women, high performance (measured as the finishing time to complete the race, a proxy for higher exercise dose) was associated with an increased risk of bipolar disorder compared to slower skiing women (HR = 2.07).
Conclusions
Our results confirm that a physically active lifestyle is associated with a lower risk of developing bipolar disorder. Yet, to elucidate the direction of causality in this relationship requires complementary study designs. And the influence of physical performance level on the risk of bipolar disorder warrants further examinations among women.
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Li Y, Xia X, Yu A, Xu H, Zhang C. Duration of an acute moderate-intensity exercise session affects approach bias toward high-calorie food among individuals with obesity. Appetite 2022; 172:105955. [PMID: 35122877 DOI: 10.1016/j.appet.2022.105955] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/29/2021] [Revised: 01/15/2022] [Accepted: 01/31/2022] [Indexed: 11/25/2022]
Abstract
Obesity is partly driven by unhealthy eating behaviors underpinned by an approach bias toward high-calorie food. Although exercise is a useful strategy for weight loss among individuals with obesity, whether exercise modulates this approach bias is unclear. This study assessed whether the duration of an acute moderate-intensity exercise altered the approach bias toward high-calorie food among individuals with obesity. In total, 24 individuals with obesity were included in this study with a randomized, counterbalanced, crossover design. Participants completed three sessions of 30, 45, or 60 minutes of moderate-intensity exercise (40%-59% of heart rate reserve) on an elliptical trainer or completed a control rest session for 55 minutes. Food approach bias was evaluated using a joystick-based approach-avoidance task immediately before and after each session. Two-way repeated-measures analysis of variance was used to analyze the data. We found that compared with that before exercise, the approach bias score toward high-calorie food was significantly decreased only in the 45-minute exercise session (p = .015) and that this score was also significantly lower than that after both the 60-minute exercise session (p = .002) and the control session (p = .024). These findings suggest a dose-response relationship between exercise duration and approach bias, with 45 minutes of moderate-intensity exercise being an effective strategy for decreasing the approach bias toward high-calorie food among individuals with obesity.
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Affiliation(s)
- Yansong Li
- School of Kinesiology, Shanghai University of Sport, Shanghai, China
| | - Xue Xia
- School of Psychology, Shanghai University of Sport, Shanghai, China
| | - Anqi Yu
- Shanghai Dianfeng Institute of Fat Lose, Shanghai, China
| | - Huangmei Xu
- School of Kinesiology, Shanghai University of Sport, Shanghai, China
| | - Chunhua Zhang
- School of Kinesiology, Shanghai University of Sport, Shanghai, China.
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Keating LE, Becker S, McCabe K, Whattam J, Garrick L, Frey BN, Sassi RB, McKinnon MC. Impact of a structured, group-based running programme on clinical, cognitive and social function in youth and adults with complex mood disorders: a 12-week pilot study. BMJ Open Sport Exerc Med 2019; 5:e000521. [PMID: 31191972 PMCID: PMC6539166 DOI: 10.1136/bmjsem-2019-000521] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/23/2019] [Indexed: 01/26/2023] Open
Abstract
Background Individuals with mood disorders often report lingering health-related quality of life (HRQOL) and social and cognitive impairments even after mood symptoms have improved. Exercise programmes improve mood symptoms in patients, but whether exercise improves functional outcomes in patients with difficult-to-treat mood disorders remains unknown. Design We evaluated the impact of a 12-week structured running programme on cognitive, social and quality-of-life outcomes in participants with difficult-to-treat mood disorders. Methods In a prospective, open-label study, patients referred to the St Joseph’s Healthcare Hamilton Team Unbreakable running programme for youth and adults with mood disorders completed a comprehensive assessment battery before and after the 12-week exercise intervention. Results We collected preintervention and postintervention data from 18 participants who improved on the general health, vitality, role of emotions, social functioning and mental health (all p≤0.01) HRQOL subscales. Performance improved on cognitive tests that assessed working memory and processing speed (p≤0.04); there were no improvements in complex executive functioning tasks. Regression analyses indicated that younger age, shorter illness duration and reduced bodily pain predicted social and cognitive outcomes. Conclusion Participation in a group-based, structured running programme was associated with improved HRQOL and social and cognitive function.
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Affiliation(s)
- Laura E Keating
- Neuroscience Graduate Program, McMaster University, Burlington, Ontario, Canada
| | - Suzanna Becker
- Psychology, Neuroscience and Behaviour, McMaster University, Hamilton, Ontario, Canada
| | - Katie McCabe
- Mood Disorders Program, St Joseph's Healthcare Hamilton, Hamilton, Ontario, Canada.,Psychiatry and Behavioural Neurosciences, McMaster University, Hamilton, Ontario, Canada
| | - Jeff Whattam
- Mood Disorders Program, St Joseph's Healthcare Hamilton, Hamilton, Ontario, Canada
| | - Laura Garrick
- Research Administration, St Joseph's Healthcare Hamilton, Hamilton, Ontario, Canada
| | - Benicio N Frey
- Mood Disorders Program, St Joseph's Healthcare Hamilton, Hamilton, Ontario, Canada.,Psychiatry and Behavioural Neurosciences, McMaster University, Hamilton, Ontario, Canada
| | - Roberto B Sassi
- Psychiatry and Behavioural Neurosciences, McMaster University, Hamilton, Ontario, Canada.,Child and Adolescent Psychiatry, St Joseph's Healthcare Hamilton, Hamilton, Ontario, Canada
| | - Margaret C McKinnon
- Mood Disorders Program, St Joseph's Healthcare Hamilton, Hamilton, Ontario, Canada.,Psychiatry and Behavioural Neurosciences, McMaster University, Hamilton, Ontario, Canada
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Farris SG, Abrantes AM, Uebelacker LA, Weinstock LM, Battle CL. Exercise as a Nonpharmacological Treatment for Depression. Psychiatr Ann 2019. [DOI: 10.3928/00485713-20181204-01] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/05/2023]
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7
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Keating LE, Becker S, McCabe K, Whattam J, Garrick L, Sassi RB, Frey BN, McKinnon MC. Effects of a 12-week running programme in youth and adults with complex mood disorders. BMJ Open Sport Exerc Med 2018; 4:e000314. [PMID: 29955373 PMCID: PMC6018895 DOI: 10.1136/bmjsem-2017-000314] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/02/2018] [Revised: 04/16/2018] [Accepted: 04/16/2018] [Indexed: 12/23/2022] Open
Abstract
Objective Although numerous studies suggest a salutary effect of exercise on mood, few studies have explored the effect of exercise in patients with complex mental illness. Accordingly, we evaluated the impact of running on stress, anxiety and depression in youth and adults with complex mood disorders including comorbid diagnoses, cognitive and social impairment and high relapse rates. Methods Participants were members of a running group at St Joseph Healthcare Hamilton’s Mood Disorders Program, designed for clients with complex mood disorders. On a weekly basis, participants completed Cohen’s Perceived Stress Scale, Beck Depression Inventory (BDI) and Beck Anxiety Inventory (BAI) questionnaires, providing an opportunity to evaluate the effect of running in this population. Results Data collected for 46 participants from April 2012 to July 2015 indicated a significant decrease in depression (p<0.0001), anxiety (p<0.0001) and stress (p=0.01) scores. Whereas younger participant age, younger age at onset of illness and higher perceived levels of friendship with other running group members (ps≤0.04) were associated with lower end-of-study depression, anxiety and stress scores, higher attendance was associated with decreasing BDI and BAI (ps≤0.01) scores over time. Conclusions Aerobic exercise in a supportive group setting may improve mood symptoms in youth and adults with complex mood disorders, and perceived social support may be an important factor in programme’s success. Further research is required to identify specifically the mechanisms underlying the therapeutic benefits associated with exercise-based therapy programmes.
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Affiliation(s)
- Laura E Keating
- McMaster Integrative Neuroscience and Discovery, McMaster University, Hamilton, Canada
| | - Suzanna Becker
- McMaster Integrative Neuroscience and Discovery, McMaster University, Hamilton, Canada.,Department of Psychology, Neuroscience and Behaviour, McMaster University, Hamilton, Canada
| | - Katie McCabe
- Department of Psychiatry and Behavioural Neurosciences, McMaster University, Hamilton, Canada.,Mood Disorders Program, St Joseph's Healthcare Hamilton, Hamilton, Canada
| | - Jeff Whattam
- Mood Disorders Program, St Joseph's Healthcare Hamilton, Hamilton, Canada
| | - Laura Garrick
- Mood Disorders Program, St Joseph's Healthcare Hamilton, Hamilton, Canada
| | - Roberto B Sassi
- McMaster Integrative Neuroscience and Discovery, McMaster University, Hamilton, Canada.,Department of Psychiatry and Behavioural Neurosciences, McMaster University, Hamilton, Canada.,Mood Disorders Program, St Joseph's Healthcare Hamilton, Hamilton, Canada
| | - Benicio N Frey
- McMaster Integrative Neuroscience and Discovery, McMaster University, Hamilton, Canada.,Department of Psychiatry and Behavioural Neurosciences, McMaster University, Hamilton, Canada.,Mood Disorders Program, St Joseph's Healthcare Hamilton, Hamilton, Canada
| | - Margaret C McKinnon
- McMaster Integrative Neuroscience and Discovery, McMaster University, Hamilton, Canada.,Department of Psychiatry and Behavioural Neurosciences, McMaster University, Hamilton, Canada.,Mood Disorders Program, St Joseph's Healthcare Hamilton, Hamilton, Canada.,Homewood Research Institute, Guelph, Canada
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8
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Ahmed AM, Qureshi WT, Sakr S, Blaha MJ, Brawner CA, Ehrman JK, Keteyian SJ, Al-Mallah MH. Prognostic value of exercise capacity among patients with treated depression: The Henry Ford Exercise Testing (FIT) Project. Clin Cardiol 2018; 41:532-538. [PMID: 29665017 DOI: 10.1002/clc.22923] [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: 11/29/2017] [Revised: 01/28/2018] [Accepted: 02/04/2018] [Indexed: 12/12/2022] Open
Abstract
BACKGROUND Exercise capacity is associated with survival in the general population. Whether this applies to patients with treated depression is not clear. HYPOTHESIS High exercise capacity remains associated with lower risk of all-cause mortality (ACM) and nonfatal myocardial infraction (MI) among patients with treated depression. METHODS We included 5128 patients on antidepressant medications who completed a clinically indicated exercise stress test between 1991 and 2009. Patients were followed for a median duration of 9.4 years for ACM and 4.5 years for MI. Exercise capacity was estimated in metabolic equivalents of tasks (METs). Cox proportional hazards regression models were used. RESULTS Patients with treated depression who achieved ≥12 METs (vs those achieving <6 METs) were younger (age 46 ± 9 vs 61 ± 12 years), more often male (60% vs 23%), less often black (10% vs 27%), and less likely to be hypertensive (51% vs 86%), have DM (9% vs 38%), or be obese (11% vs 36%) or dyslipidemic (45% vs 54%). In the fully adjusted Cox proportional hazard regression model, exercise capacity was associated with a lower ACM (HR per 1-MET increase in exercise capacity: 0.82, 95% CI: 0.79-0.85, P < 0.001) and nonfatal MI (HR: 0.92, 95% CI: 0.87-0.97, P = 0.004). CONCLUSIONS Exercise capacity had an inverse association with both ACM and nonfatal MI in patients with treated depression, independent of cardiovascular risk factors. These results highlight the potential impact of assessing exercise capacity to identify risk, as well as promoting an active lifestyle among treated depression patients.
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Affiliation(s)
- Amjad M Ahmed
- King Abdulaziz Cardiac Center, King Abdulaziz Medical City, Ministry of National Guard-Health Affairs, Riyadh, Saudi Arabia
| | - Waqas T Qureshi
- Department of Internal Medicine, Wake Forest School of Medicine, Medical Center Boulevard, Winston-Salem, North Carolina
| | - Sherif Sakr
- Department of Public Health, King Saud bin Abdulaziz University for Health Sciences, Riyadh, Saudi Arabia
| | - Michael J Blaha
- Johns Hopkins Ciccarone Center for the Prevention of Heart Disease, Baltimore, Maryland
| | - Clinton A Brawner
- Heart and Vascular Institute, Henry Ford Hospital, Detroit, Michigan
| | - Jonathan K Ehrman
- Johns Hopkins Ciccarone Center for the Prevention of Heart Disease, Baltimore, Maryland
| | - Steven J Keteyian
- Heart and Vascular Institute, Henry Ford Hospital, Detroit, Michigan
| | - Mouaz H Al-Mallah
- King Abdulaziz Cardiac Center, King Abdulaziz Medical City, Ministry of National Guard-Health Affairs, Riyadh, Saudi Arabia.,Heart and Vascular Institute, Henry Ford Hospital, Detroit, Michigan.,King Abdullah International Medical Research Center, Riyadh, Saudi Arabia.,Department of medicine, King Saud bin Abdulaziz for Health Sciences, Riyadh, Saudi Arabia
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9
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Kaufman KR, Campeas M, Coluccio M, Babalola R, Tobia A. Bipolar disorders and comorbid conditions – Ethical considerations in sports. ACTA ACUST UNITED AC 2018. [DOI: 10.1016/j.apunts.2017.10.001] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/19/2022]
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