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Górna K, Szpalik R, Rybakowski JK, Jaracz K. Health behaviours of patients with affective disorders: a cross-sectional study. BMC Psychiatry 2023; 23:561. [PMID: 37542249 PMCID: PMC10401855 DOI: 10.1186/s12888-023-05056-5] [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: 05/31/2023] [Accepted: 07/27/2023] [Indexed: 08/06/2023] Open
Abstract
BACKGROUND Severe mental disorders, including affective disorders (AD), are associated with high rates of physical illnesses that lead to premature patient death. Excess somatic comorbidity may be partially explained by lifestyle factors. This study aimed to investigate the health behaviours (HBs) of patients with AD in comparison to the HBs of patients with type 2 diabetes (T2D) and healthy controls (HCs) and to examine associations among HBs and sociodemographic and clinical factors, subjective quality of life and health status, and health locus of control. METHODS The sample consisted of 108 patients with AD, including 60 with bipolar disorder (BP) and 48 with unipolar disorder (UAD). Analyses included comparisons with a subgroup of AD individuals, patients with T2D and HCs matched in age and sex. The Health Behaviour Inventory was used to evaluate the overall levels of HBs and 4 HB categories. To identify independent determinants of health behaviours, a multivariate linear regression analysis was performed with factors identified as significant in bivariate analyses. RESULTS Most AD patients had a low level of HBs (40%), followed by moderate (35%) and high levels (25%), and there were no significant differences in HBs between the BP and UAD groups. Compared with the T2D and HC groups, the AD group had a significantly lower level of overall HBs and lower levels of HBs in one of the categories. Independent predictors of overall HBs were quality of life (β = 0.28, p < 0.001), age (β = 0.27, p = 0.002), and depressive symptoms (β = 0.23, p = 0.008). A total of 30% of the variance in HBs was explained. CONCLUSIONS These findings emphasise the need for a systematic assessment of single and multiple health behaviours to provide better care for patients with AD and reduce the potential adverse effects of an unhealthy lifestyle.
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Affiliation(s)
- Krystyna Górna
- Department of Psychiatric Nursing, Poznan University of Medical Sciences, Rokietnicka 2A, Poznań, 60-806, Poland.
| | - Renata Szpalik
- Department of Psychiatric Nursing, Poznan University of Medical Sciences, Rokietnicka 2A, Poznań, 60-806, Poland
| | - Janusz K Rybakowski
- Department of Adult Psychiatry, Poznan University of Medical Sciences, Szpitalna 27/33, Poznań, 60-572, Poland
| | - Krystyna Jaracz
- Department of Neurological Nursing, Poznan University of Medical Sciences, Rokietnicka 2A, Poznań, 60-806, Poland
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Wazni L, Gifford W, Perron A, Vandyk A. Understanding the Physical Health Problems of People with Psychotic Disorders Using Digital Storytelling. Issues Ment Health Nurs 2023; 44:690-701. [PMID: 37549316 DOI: 10.1080/01612840.2023.2229435] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 08/09/2023]
Abstract
People with psychotic disorders struggle to be heard and express concerns beyond their mental health, especially concerns related to the side effects of treatment. Using digital storytelling, this study aimed to uncover and expose the underlying systems that oppress people with psychotic disorders from meeting their physical health needs. The stories revealed two themes: body as a contested site and biological entity with society, and (in)visible patient and paternalism. Spivak's theory of subalternity provided the theoretical basis for a critical analysis and discussion of the experiences. More research is required to highlight the power relations and structures that lead to health disparity in psychiatry.
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Affiliation(s)
- Liquaa Wazni
- Faculty of Health Sciences, School of Nursing, University of Ottawa, Ottawa, Ontario, Canada
| | - Wendy Gifford
- Faculty of Health Sciences, School of Nursing, University of Ottawa, Ottawa, Ontario, Canada
| | - Amélie Perron
- Faculty of Health Sciences, School of Nursing, University of Ottawa, Ottawa, Ontario, Canada
| | - Amanda Vandyk
- Faculty of Health Sciences, School of Nursing, University of Ottawa, Ottawa, Ontario, Canada
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Ameel M, Kontio R, Välimäki M. Interventions delivered by nurses in adult outpatient psychiatric care: An integrative review. J Psychiatr Ment Health Nurs 2019; 26:301-322. [PMID: 31251445 DOI: 10.1111/jpm.12543] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/18/2019] [Revised: 06/25/2019] [Accepted: 06/26/2019] [Indexed: 12/18/2022]
Abstract
WHAT IS KNOWN ON THE SUBJECT?: In many countries, the majority of psychiatric care is being delivered in an outpatient setting and the proportion of outpatients is increasing on a global level. Nurses are the largest workforce in psychiatric care, but their role has been said to be difficult to define. According to our knowledge, there are no previous reviews focusing on nurse-delivered interventions in the adult psychiatric outpatient setting. WHAT THIS PAPER ADDS TO EXISTING KNOWLEDGE?: This review summarizes nurse-delivered interventions identified in the research literature and describes these systematically. Analysing all the identified interventions using the Nursing Interventions Classification, we conclude that the emphasis of nurse-delivered interventions in psychiatric outpatient care is on interventions aiming at improving the functioning of both patients and their family members by building on their own strengths. These findings differ from those presented in a review on inpatient psychiatric nursing. There are several clinical trials describing nurse-delivered evidence-based treatments, such as psychoeducation for patients and their family members in the case of patients diagnosed with schizophrenia and bipolar disorder. The quality of randomized controlled trials was higher than in earlier reviews describing psychiatric nursing interventions in general or in connection with a specific patient group. Further clinical trials are needed to describe the role of nurses in the care of patients diagnosed with depression and in the use of web-based interventions. Additionally, it would be important to study what supports, and on the other hand hinders, the role of nurses in delivering evidence-based treatments at the clinical level. WHAT ARE THE IMPLICATIONS FOR PRACTICE?: Nurses can play a central role in responding to the growing demand for evidence-based practices in adult outpatient psychiatry, by delivering treatments for patients and family members. It is important that both nursing education and clinical practices recognize and support this role. Abstract Introduction According to our knowledge, there are no previous reviews on nurse-delivered interventions in the adult psychiatric outpatient setting. Aim To identify and systematically describe and analyse nurse-delivered interventions based on research literature. Method An integrative review. Results This review included 60 studies, of which 46 were intervention studies, including 40 clinical trials. The most common patient groups were patients diagnosed with schizophrenia and bipolar disorder. The nursing interventions described in the studies resembled a total of 68 interventions from the Nursing Interventions Classification. The treatment delivery methods varied and treatments often lacked a clear theoretical background. Implications for practice The core of nurse-delivered interventions identified in research literature in psychiatric outpatient care is on interventions aiming at improving the functioning of both patients and their family members by building on their own strengths. These findings differ from the interventions identified in a review describing nursing in the inpatient setting. There are high-quality clinical trials describing nurse-delivered treatments for patients diagnosed with schizophrenia and bipolar disorder. These include evidence-based treatments such as psychoeducation. Understanding of how these treatments are transferred in clinical practice is missing. Clinical trials describing nurse-delivered web-based interventions and interventions for patients diagnosed with depression are needed.
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Affiliation(s)
- Maria Ameel
- Department of Nursing Science, University of Turku, Turku, Finland.,Helsinki University Hospital and Helsinki University, Helsinki, Finland
| | - Raija Kontio
- Department of Nursing Science, University of Turku, Turku, Finland.,Helsinki University Hospital and Helsinki University, Helsinki, Finland
| | - Maritta Välimäki
- Department of Nursing Science, University of Turku, Turku, Finland.,School of Nursing, The Hong Kong Polytechnic University, Hong Kong, China
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Blomqvist M, Ivarsson A, Carlsson IM, Sandgren A, Jormfeldt H. Health Effects of an Individualized Lifestyle Intervention for People with Psychotic Disorders in Psychiatric Outpatient Services: A Two Year Follow-up. Issues Ment Health Nurs 2019; 40:839-850. [PMID: 31393742 DOI: 10.1080/01612840.2019.1642425] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
People with psychotic disorders experience to a great extent avoidable physical illnesses and early mortality. The aim of the study was to investigate the potential effects for this group of participating in a lifestyle intervention. A multi-component nurse-led lifestyle intervention using quasi-experimental design was performed. Changes in biomedical and clinical measurements, self-reported health, symptoms of illness and health behavior were investigated. Multilevel modeling was used to statistically test differences in changes over time. Statistically significant changes were found in physical activity, HbA1c and waist circumference. A lifestyle intervention for people with severe mental illness can be beneficial for increasing physical activity.
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Affiliation(s)
- Marjut Blomqvist
- School of Health and Welfare, Halmstad University , Halmstad , Sweden
| | - Andreas Ivarsson
- School of Health and Welfare, Halmstad University , Halmstad , Sweden
| | | | - Anna Sandgren
- Center for Collaborative Palliative Care, Department of Health and Caring Sciences, Linnaeus University , Växjö , Sweden
| | - Henrika Jormfeldt
- School of Health and Welfare, Halmstad University , Halmstad , Sweden
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Stiekema APM, Looijmans A, van der Meer L, Bruggeman R, Schoevers RA, Corpeleijn E, Jörg F. Effects of a lifestyle intervention on psychosocial well-being of severe mentally ill residential patients: ELIPS, a cluster randomized controlled pragmatic trial. Schizophr Res 2018; 199:407-413. [PMID: 29503230 DOI: 10.1016/j.schres.2018.02.053] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/20/2017] [Revised: 12/22/2017] [Accepted: 02/25/2018] [Indexed: 12/22/2022]
Abstract
Large studies investigating the psychosocial effects of lifestyle interventions in patients with a severe mental illness (SMI) are scarce, especially in residential patients. This large, randomized controlled, multicentre pragmatic trial assessed the psychosocial effects of a combined diet-and-exercise lifestyle intervention targeting the obesogenic environment of SMI residential patients. Twenty-nine sheltered and clinical care teams were randomized into intervention (n=15) or control (n=14) arm. Team tailored diet-and-exercise lifestyle plans were set up to change the obesogenic environment into a healthier setting, and team members were trained in supporting patients to make healthier choices. The control group received care-as-usual. The Calgary Depression Scale for Schizophrenia (CDSS), Positive and Negative Syndrome Scale (PANSS), Health of the Nation Outcome Scales (HoNOS) and the Manchester Short Assessment of Quality of Life (MANSA) were assessed at baseline and after three and twelve months. Data were available for 384 intervention and 386 control patients (48.6±12.5years old, 62.7% males, 73.7% psychotic disorder). Linear mixed model analysis showed no psychosocial improvements in the intervention group compared to care-as-usual; the intervention group showed a slightly reduced quality of life (overall) and a small increase in depressive symptoms (clinical care facilities) and psychotic symptoms (sheltered facilities). This may be due to difficulties with implementation, the intervention not being specifically designed for improvements in mental well-being, or the small change approach, which may take longer to reach an effect. Further research might elucidate what type of lifestyle intervention under what circumstances positively affects psychosocial outcomes in this population.
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Affiliation(s)
- Annemarie P M Stiekema
- Department of Rehabilitation, Lentis Psychiatric Institute, Zuidlaren, The Netherlands; School for Mental Health and Neuroscience, Faculty of Health, Medicine and Life Sciences, Department of Psychiatry and Neuropsychology, Maastricht University Medical Center, Maastricht, The Netherlands
| | - Anne Looijmans
- Department of Epidemiology, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands; University of Groningen, University Medical Center Groningen, Rob Giel Research Center, Groningen, The Netherlands.
| | - Lisette van der Meer
- Department of Rehabilitation, Lentis Psychiatric Institute, Zuidlaren, The Netherlands; University of Groningen, University Medical Center Groningen, Rob Giel Research Center, Groningen, The Netherlands; University of Groningen, University Medical Center Groningen, Department of Neuroscience, Groningen, The Netherlands
| | - Richard Bruggeman
- University of Groningen, University Medical Center Groningen, Rob Giel Research Center, Groningen, The Netherlands; University of Groningen, University Medical Center Groningen, University Center of Psychiatry, Groningen, The Netherlands
| | - Robert A Schoevers
- University of Groningen, University Medical Center Groningen, University Center of Psychiatry, Groningen, The Netherlands
| | - Eva Corpeleijn
- Department of Epidemiology, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands
| | - Frederike Jörg
- University of Groningen, University Medical Center Groningen, Rob Giel Research Center, Groningen, The Netherlands; Research Department, Friesland Mental Health Services, Leeuwarden, The Netherlands
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Rönngren Y, Björk A, Audulv Å, Enmarker I, Kristiansen L, Haage D. Educational nurse-led lifestyle intervention for persons with mental illness. Int J Ment Health Nurs 2018; 27:1022-1031. [PMID: 29171905 DOI: 10.1111/inm.12410] [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: 10/09/2017] [Indexed: 12/17/2022]
Abstract
Although persons with severe mental illness face an increased risk of mortality and of developing negative health outcomes, research has shown that lifestyle interventions can sufficiently support their health. In response, this study examined a nurse-led lifestyle intervention developed in cooperation with members of municipal and county councils to gauge its impact on the quality of life, cognitive performance, walking capacity, and body composition of persons with severe mental illness. Lasting 26 weeks and involving 38 persons with severe mental illness, the intervention prioritised two components: the interpersonal relationships of persons with severe mental illness, staff, and group leaders and group education about physical and mental health. Pre-post intervention measurements of quality of life collected with the Manchester Short Assessment of Quality of Life, cognitive performance with the Frontal Systems Behaviour Scale, walking capacity with a 6-min walk test, and body composition in terms of waist circumference and body mass index were analysed using a nonparametric test Wilcoxon signed-rank test. Results suggest that the intervention afforded significant improvements in the health-related variables of quality of life, cognitive performance, walking capacity, and waist circumference for persons with severe mental illness. However, long-term studies with control groups and that examine parameters related to cardiovascular risk factors are essential to ensure the sustained impact of the intervention.
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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
| | - Åsa Audulv
- Department of Nursing Sciences, Mid Sweden University, Sundsvall, Sweden
| | - Ingela Enmarker
- Department of Nursing Sciences, Mid Sweden University, Sundsvall, Sweden.,Faculty of Health and Occupational Studies, University of Gävle, Gävle, Sweden.,Center for Care Research, Mid-Norway, Steinkjer, Norway
| | | | - David Haage
- Department of Nursing Sciences, Mid Sweden University, Sundsvall, Sweden
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Sancassiani F, Machado S, Preti A. Physical Activity, Exercise and Sport Programs as Effective Therapeutic Tools in Psychosocial Rehabilitation. Clin Pract Epidemiol Ment Health 2018. [PMID: 29515643 PMCID: PMC5827297 DOI: 10.2174/1745017901814010006] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
People with severe psychosocial disabilities have a 20-years shorter lifespan due to chronic somatic comorbidities and the long-term consequences of the side-effects of antipsychotic drugs. They often are sedentary and show lower levels of physical activity, factors which can contribute to their shorter lifespan, because of the greater cardiovascular risk. An increasing amount of evidence, including clinical trials, pointed out that sport, physical activity and structured exercise programs improve physical and psychological wellbeing of people with psychosocial disabilities, playing also an important role against their social isolation and self-stigma. The NICE and APA guidelines include exercise and physical activity for the management of depressive symptoms. Safe and effective programs require multidisciplinary teams that should always include mental health professionals, able to recognize the psychosocial needs, the impact of symptomatology, the role of secondary effects of psychotropic medication, the effect of previous exercise history, the lack of motivation, the inexperience with effort intensity and the frustration of people with psychosocial disabilities.
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Affiliation(s)
- Federica Sancassiani
- Department of Medical Sciences and Public Health, University of Cagliari, Cagliari, Italy
| | - Sergio Machado
- Laboratory of Panic and Respiration, Institute of Psychiatry of Federal University of Rio de Janeiro (IPUB/UFRJ), Rio de Janeiro, RJ, Brazil.,Physical Activity Neuroscience, Physical Activity Sciences Postgraduate Program - Salgado de Oliveira University, Niterói, Brazil
| | - Antonio Preti
- Department of Medical Sciences and Public Health, University of Cagliari, Cagliari, Italy.,Center for Consultation-Liaison Psychiatry and Psychosomatics, University Hospital, University of Cagliari, Cagliari, Italy
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Happell B, Ewart SB, Bocking J, Platania-Phung C, Stanton R. ‘That red flag on your file’: misinterpreting physical symptoms as mental illness. J Clin Nurs 2016; 25:2933-42. [DOI: 10.1111/jocn.13355] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/25/2016] [Indexed: 12/18/2022]
Affiliation(s)
- Brenda Happell
- Synergy, Nursing and Midwifery Research Centre; University of Canberra, Faculty of Health and ACT Health; Woden ACT Australia
- UC Health Research Institute; University of Canberra; Woden ACT Australia
| | - Stephanie B Ewart
- Synergy, Nursing and Midwifery Research Centre; University of Canberra and ACT Health; Woden ACT Australia
- Independent Consumer Academic; Life Expectancy Advocate (Mental Health); Sydney Australia
| | - Julia Bocking
- Synergy, Nursing and Midwifery Research Centre; University of Canberra, Faculty of Health and ACT Health; Woden ACT Australia
| | - Chris Platania-Phung
- Synergy, Nursing and Midwifery Research Centre; University of Canberra, Faculty of Health and ACT Health; Woden ACT Australia
- Canberra Hospital; Woden ACT Australia
| | - Robert Stanton
- Synergy, Nursing and Midwifery Research Centre; University of Canberra, Faculty of Health and ACT Health; Woden ACT Australia
- Canberra Hospital; Woden ACT Australia
- School of Medical and Applied Sciences; Central Queensland University; Rockhampton Qld Australia
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