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Supporting healthy lifestyle habits in persons with mental disorders: The development of a nurse-led lifestyle intervention
Mid Sweden University, Faculty of Human Sciences, Department of Nursing Sciences.
2018 (English)Doctoral thesis, comprehensive summary (Other academic)
Abstract [en]

Persons with mental disorders have an increased risk of developing health problems. One reason for this is poor lifestyle habit support. The aim of this thesis was to develop and evaluate a nurse-led lifestyle intervention for persons with mental disorders. Two versions of the intervention were conducted in the municipality (versions I, II) and one in a primary healthcare setting (version III). The educational elements of the intervention were led by nurses and practically executed by nursing staff (study II and III). In study IV education was both led and executed in practice by nurses. Data were collected through focus groups, individual interviews, and measurements. Study I, a qualitative development study, showed that, when motivating for lifestyle changes, it was important to structure daily life and provide emotional support. Loneliness, lack of knowledge and support, and general resources were identified as barriers to lifestyle changes. Version I contained health education for nursing staff and individual lifestyle habit support to persons with mental disorders, which included physical exercises and cognitive support. Study II was a qualitative acceptability study of the intervention (version I) and its assessment tools. The intervention with its relational, educational, and supportive dimensions and the assessment tools was promising. In Study III (version II), a quantitative pilot study, persons with mental disorders received health education together with the nursing staff. The intervention provided improvements to various degrees in health-related variables of quality of life, cognitive performance, walking capacity, and waist circumference. Study IV (version III), a qualitative study, included health education and individual lifestyle habit support for young adults with mental illness. The young adults experienced challenges including psychiatric symptoms, loneliness, and a lack of social understanding. The thesis results showed that the core components of the intervention with interpersonal relationships, where nursing staff played an important role, and further components such as health education and health discussions, in addition to cognitive support, worked well together to support lifestyle habit changes. Those components already exist and may therefore be easy to implement into daily nursing practice in different housing conditions and with individuals of different ages and needs for mental health care support. Group education was a way not only to develop new health strategies but also to establish social relationships. The intervention may also be modified to work with other groups of persons who need more explicit lifestyle habit support. However, to better determine the efficacy and sustainability of the intervention, larger studies over a longer time should be conducted.

 

 

Place, publisher, year, edition, pages
Sundsvall: Mid Sweden Univsersity , 2018. , p. 117
Series
Mid Sweden University doctoral thesis, ISSN 1652-893X ; 279
Keyword [en]
interpersonal relationships, lifestyle intervention, mental disorders, mental illness, nurse-led
National Category
Medical and Health Sciences
Identifiers
URN: urn:nbn:se:miun:diva-33358ISBN: 978-91-88527-46-2 (print)OAI: oai:DiVA.org:miun-33358DiVA, id: diva2:1193610
Public defence
2018-05-18, M108, Sundsvall, 10:30 (Swedish)
Opponent
Supervisors
Available from: 2018-03-27 Created: 2018-03-27 Last updated: 2018-04-05Bibliographically approved
List of papers
1. LIFEHOPE.EU – Lifestyle & Healthy Outcome in Physical Education: Development of a lifestyle intervention program for people with severe mental illness: Physical activity, dietary changes, and cognitive adaptation training
Open this publication in new window or tab >>LIFEHOPE.EU – Lifestyle & Healthy Outcome in Physical Education: Development of a lifestyle intervention program for people with severe mental illness: Physical activity, dietary changes, and cognitive adaptation training
2014 (English)In: Journal of Psychiatric and Mental Health Nursing, ISSN 1351-0126, E-ISSN 1365-2850, Vol. 21, no 10, p. 924-930Article in journal (Refereed) Published
Abstract [en]

People with severe mental illness (SMIs) are more prone to physicalillnesses, increased mortality and cognitive impairments, all of whichnegatively influence their daily lives. Physical activity (PHYS)programmes have helped alleviate SMI. LIFEHOPE is an ongoing researchproject with the purpose of developing a sustainable lifestyleintervention for physical and mental health. PHYS/cognitive adaptationtraining (CAT) is a newly created lifestyle intervention that providesgroup education and is based on CAT. It provides individualized supportfor PHYS and dietary change in a natural nursing environment. The aim ofthis study was to obtain further knowledge for developing a sustainablelifestyle programme by exploring psychiatric clients' experiences withPHYS and lifestyle habits, which we did by interviewing a localreference group, community mental healthcare users and community mentalhealthcare workers. Then, we developed a lifestyle programme for peoplewith SMI using information obtained from these focus group interviews.Our results suggest that there is a need for support and education, aswell as active interventions, in carrying out PHYS and dietary changesamong people with SMIs, and the PHYS/CAT may be a useful strategy.

Keyword
cognitive adaptive training, cognitive disabilities, lifestyle intervention programme, nursing care, physical activity, severe mental illness
National Category
Medical and Health Sciences
Identifiers
urn:nbn:se:miun:diva-21181 (URN)10.1111/jpm.12175 (DOI)000345321900010 ()2-s2.0-84911195330 (Scopus ID)
Available from: 2014-01-29 Created: 2014-01-29 Last updated: 2018-04-16Bibliographically approved
2. Perspectives of a tailored lifestyle program for people with severe mental illness receiving housing support
Open this publication in new window or tab >>Perspectives of a tailored lifestyle program for people with severe mental illness receiving housing support
Show others...
2017 (English)In: Perspectives in psychiatric care, ISSN 0031-5990, E-ISSN 1744-6163, Vol. 54, no 2, p. 309-316Article in journal (Refereed) Published
Abstract [en]

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.

Keyword
cognitive support, interpersonal relationship, nurse-led lifestyle intervention, physical activity, severe mental illness
National Category
Health Sciences
Identifiers
urn:nbn:se:miun:diva-32016 (URN)10.1111/ppc.12239 (DOI)
Available from: 2017-11-07 Created: 2017-11-07 Last updated: 2018-04-16Bibliographically approved
3. Educational nurse-led lifestyle intervention for persons with mental illness.
Open this publication in new window or tab >>Educational nurse-led lifestyle intervention for persons with mental illness.
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2017 (English)In: International Journal of Mental Health Nursing, ISSN 1445-8330, E-ISSN 1447-0349Article in journal (Refereed) Epub ahead of print
Abstract [en]

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.

Keyword
clinical practice, educational intervention, healthy lifestyle support, interpersonal relationship, severe mental illness
National Category
Clinical Medicine
Identifiers
urn:nbn:se:miun:diva-32479 (URN)10.1111/inm.12410 (DOI)29171905 (PubMedID)2-s2.0-85035026741 (Scopus ID)
Available from: 2017-12-05 Created: 2017-12-18 Last updated: 2018-03-27Bibliographically approved
4. Meeting the needs? Perceived support of a nurse-led lifestyle programme for young adults with mental illness in a primary health-care setting
Open this publication in new window or tab >>Meeting the needs? Perceived support of a nurse-led lifestyle programme for young adults with mental illness in a primary health-care setting
Show others...
2018 (English)In: International Journal of Mental Health Nursing, ISSN 1445-8330, E-ISSN 1447-0349, Vol. 27, no 1, p. 390-399Article in journal (Refereed) Published
Abstract [en]

Being a young adult with mental illness challenges all aspects of health, including an increased risk for developing lifestyle-related diseases. There is a lack of lifestyle programmes in primary health care that target physical, mental, and social needs for young adults with mental illness. The aim of the present study was to describe the experiences of young adults with mental illness receiving support from a nurse-led lifestyle programme, and how this support was related to their life context, including challenges and coping strategies. Two focus groups and six individual interviews were performed with 13 young adults (16–25 years), and analysed using a qualitative content analysis. The findings showed that the young adults experienced challenges in their daily lives, including psychiatric symptoms, lack of social understanding, and loneliness. The study indicated that the programme could support lifestyle habits with its components of supportive interpersonal relationships, awareness of coping strategies, understanding of health and illness, and cognitive support (e.g. schedules and reminders). However, the programme could not meet everyone's needs for new social relationships or more comprehensive support. Even so, this nurse-led programme provides health information-management strategies that could easily be integrated in a primary health-care setting.

Keyword
health information management, mental illness, primary health care, young adult
National Category
Medical and Health Sciences
Identifiers
urn:nbn:se:miun:diva-30608 (URN)10.1111/inm.12333 (DOI)000419717100039 ()28374967 (PubMedID)2-s2.0-85017454831 (Scopus ID)
Available from: 2017-04-19 Created: 2017-04-19 Last updated: 2018-04-16Bibliographically approved

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Rönngren, Ylva

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