Mid Sweden University

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.

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.

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.

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.