“Out-of-hospital and with qualified exercise professionals”keys to the CORTEX-SP physical exercise program according to the experience of the participants

  1. Mikel Tous-Espelosin 1
  2. Uxue Fernandez-Lasa 1
  3. Estibaliz Romaratezabala 1
  1. 1 Universidad del País Vasco/Euskal Herriko Unibertsitatea
    info

    Universidad del País Vasco/Euskal Herriko Unibertsitatea

    Lejona, España

    ROR https://ror.org/000xsnr85

Revista:
EJIHPE: European Journal of Investigation in Health, Psychology and Education

ISSN: 2174-8144 2254-9625

Año de publicación: 2023

Volumen: 13

Número: 9

Páginas: 1728-1737

Tipo: Artículo

DOI: 10.3390/EJIHPE13090125 DIALNET GOOGLE SCHOLAR lock_openDialnet editor

Otras publicaciones en: EJIHPE: European Journal of Investigation in Health, Psychology and Education

Resumen

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.

Información de financiación

Financiadores

  • Spanish Ministry of Economy and Competitiveness “Fondo de Investigación Sanitaria del Instituto de Salud Carlos III”
    • PI16/01022
  • Department of Education and Science of the Basque Government
    • IT946-16
  • University of the Basque Country
    • UPV/EHU
    • PIF19/40

Referencias bibliográficas

  • American Psychiatric Association. Diagnostic and Statistical Manual of Mental Disorders: DSM-5; American Psychiatric Publishing Inc.: Arlington, VA, USA, 2013; Volume xliv, p. 947.
  • Andersen, E.; Bang-Kittilsen, G.; Bigseth, T.T.; Egeland, J.; Holmen, T.L.; Martinsen, E.W.; Stensrud, T.; Engh, J.A. Effect of high-intensity interval training on cardiorespiratory fitness, physical activity and body composition in people with schizophrenia: A randomized controlled trial. BMC Psychiatry 2020, 20, 425.
  • Bang-Kittilsen, G.; Engh, J.A.; Holst, R.; Holmen, T.L.; Bigseth, T.T.; Andersen, E.; Mordal, J.; Egeland, J. High-intensity interval training may reduce depressive symptoms in individuals with schizophrenia, putatively through improved VO2max: A randomized controlled trial. Front. Psychiatry 2022, 13, 921689.
  • Brand, S.; Colledge, F.; Beeler, N.; Pühse, U.; Kalak, N.; Sadeghi Bahmani, D.; Mikoteit, T.; Holsboer-Trachsler, E.; Gerber, M. The current state of physical activity and exercise programs in German-speaking, Swiss psychiatric hospitals: Results from a brief online survey. Neuropsychiatr. Dis. Treat. 2016, 12, 1309–1317.
  • Braun, V.; Clarke, V. Using thematic analysis in psychology. Qual. Res. Psychol. 2006, 3, 77–101.
  • Bueno-Antequera, J.; Munguía-Izquierdo, D. Exercise and Schizophrenia. Adv. Exp. Med. Biol. 2020, 1228, 317–332.
  • Callaghan, P. Exercise: A neglected intervention in mental health care? J. Psychiatr. Ment. Health Nurs. 2004, 11, 476–483.
  • Chalfoun, C.; Karelis, A.; Stip, E.; Abdel-Baki, A. Running for your life: A review of physical activity and cardiovascular disease risk reduction in individuals with schizophrenia. J. Sports Sci. 2015, 34, 1119875.
  • Chapman, J.J.; Fraser, S.J.; Brown, W.J.; Burton, N.W. Physical activity preferences, motivators, barriers and attitudes of adults with mental illness. J. Ment. Health 2016, 25, 448–454.
  • Ciudad, A.; Bobes García, J.; Álvarez, E.; San Molina, L.; Novick, D.; Gilaberte Asín, I. Resultados Clínicos Relevantes en Esquizofrenia: Remisión y Recuperación. Rev. De Psiquiatr. Y Salud Ment. 2011, 4, 53–65. Available online: https://dialnet. unirioja.es/servlet/articulo?codigo=7477459 (accessed on 25 July 2023).
  • Crawford, P.; Go, K.V. Schizophrenia. Am. Fam. Physician 2022, 106, 388–396.
  • Crone, D.; Guy, H. ‘I know it is only exercise, but to me it is something that keeps me going’: A qualitative approach to understanding mental health service users’ experiences of sports therapy. Int. J. Ment. Health Nurs. 2008, 17, 197–207.
  • Eatough, V.; Smith, J.A. Interpretative Phenomenological Analysis; The sage handbook of qualitative research in psychology: London, UK, 2008; pp. 179–194.
  • Fogarty, M.; Happell, B. Exploring the benefits of an exercise program for people with schizophrenia: A qualitative study. Issues Ment. Health Nurs. 2005, 26, 341–351.
  • Gomes, E.; Bastos, T.; Probst, M.; Ribeiro, J.C.; Silva, G.; Corredeira, R. Effects of a group physical activity program on physical fitness and quality of life in individuals with schizophrenia. Ment. Health Phys. Act. 2014, 7, 155–162.
  • Gorczynski, P.; Faulkner, G.; Cohn, T. Dissecting the Obesogenic Environment of a Psychiatric Setting: Client Perspectives. Can. J. Community Ment. Health 2013, 32, 51–68.
  • Guerrero, L.M. La Entrevista en el Método Cualitativo; Facultad de Ciencias Sociales, Universidad de Chile: Santiago, Chile, 2001.
  • Happell, B.; Dares, G.; Russell, A.; Cokell, S.; Platania-Phung, C.; Gaskin, C.J. The relationships between attitudes toward seclusion and levels of burnout, staff satisfaction, and therapeutic optimism in a district health service. Issues Ment. Health Nurs. 2012, 33, 329–336.
  • Ho, P.A.; Dahle, D.N.; Noordsy, D.L. Why Do People With Schizophrenia Exercise? A Mixed Methods Analysis Among Community Dwelling Regular Exercisers. Front. Psychiatry 2018, 9, 596.
  • International Advisory Group for the Revision of ICD-10 Mental and Behavioural Disorders. A conceptual Framework for the Revision of the ICD-10 Classification of Mental and Behavioural Disorders. World Psychiatry 2011, 10, 86–92. Available online: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3104876/ (accessed on 26 July 2023).
  • Johnstone, R.; Nicol, K.; Donaghy, M.; Lawrie, S. Barriers to uptake of physical activity in community-based patients with schizophrenia. J. Ment. Health 2009, 18, 523–532.
  • Karlsson, V.; Danielsson, L. Motivators for patients with schizophrenia spectrum disorders to start and maintain exercising: A qualitative interview study. Eur. J. Physiother. 2020, 24, 30–38.
  • Karow, A.; Moritz, S.; Lambert, M.; Schöttle, D.; Naber, D. Remitted but still impaired? Symptomatic versus functional remission in patients with schizophrenia. Eur. Psychiatry 2012, 27, 401–405.
  • Laliberte-Rudman, D.; Yu, B.; Scott, E.; Pajouhandeh, P. Exploration of the perspectives of persons with schizophrenia regarding quality of life. Am. J. Occup. Ther. 2000, 54, 137–147.
  • Lieberman, J.A.; First, M.B. Psychotic Disorders. N. Engl. J. Med. 2018, 379, 270–280.
  • Lloyd, J.; Lloyd, H.; Fitzpatrick, R.; Peters, M. Treatment outcomes in schizophrenia: Qualitative study of the views of family carers. BMC Psychiatry 2017, 17, 266.
  • Ma, H.; Cheng, N.; Zhang, C. Schizophrenia and Alarmins. Medicina 2022, 58, 694.
  • Martland, R.; Stubbs, B. High-intensity interval training: An adjunctive treatment for schizophrenia spectrum disorders? Acta Psychiatr. Scand. 2019, 140, 495–497.
  • Mestdagh, A.; Hansen, B. Stigma in patients with schizophrenia receiving community mental health care: A review of qualitative studies. Soc. Psychiatry Psychiatr. Epidemiol. 2014, 49, 79–87.
  • Miyamoto, S.; Miyake, N.; Jarskog, L.F.; Fleischhacker, W.W.; Lieberman, J.A. Pharmacological treatment of schizophrenia: A critical review of the pharmacology and clinical effects of current and future therapeutic agents. Mol. Psychiatry 2012, 17, 1206–1227.
  • O’Connor, C.; Joffe, H. Intercoder Reliability in Qualitative Research: Debates and Practical Guidelines. Int. J. Qual. Methods 2020, 19, 160940691989922.
  • Orzelska-Górka, J.; Mikulska, J.; Wiszniewska, A.; Biała, G. New Atypical Antipsychotics in the Treatment of Schizophrenia and Depression. Int. J. Mol. Sci. 2022, 23, 10624.
  • Rapley, T. Los Análisis de la Conversación, del Discurso y de Documentos en Investigación Cualitativa; Ediciones Morata: Madrid, Spain, 2014.
  • Rastad, C.; Martin, C.; Asenlöf, P. Barriers, benefits, and strategies for physical activity in patients with schizophrenia. Phys. Ther. 2014, 94, 1467–1479.
  • Roberts, S.H.; Bailey, J.E. An ethnographic study of the incentives and barriers to lifestyle interventions for people with severe mental illness. J. Adv. Nurs. 2013, 69, 2514–2524.
  • Ruiz Olabuénaga, J.I. Metodología de la Investigación Cualitativa; Servicio de Publicaciones = Argitalpen Zerbitzua: Bilbao, Spain, 2012.
  • Schmidt, C. The Analysis of Semi-Structured Interviews. In A Companion to Qualitative Research; Flick, U., von Kardoff, E., Steinke, I., Eds.; SAGE Publications: London, UK, 2004; pp. 253–259.
  • Soundy, A.; Stubbs, B.; Probst, M.; Hemmings, L.; Vancampfort, D. Barriers to and Facilitators of Physical Activity among Persons with Schizophrenia: A Survey of Physical Therapists. Psychiatr. Serv. 2014, 65, 693–696. Available online: https: //ps.psychiatryonline.org/doi/10.1176/appi.ps.201300276 (accessed on 22 June 2023).
  • Stubbs, B.; Firth, J.; Berry, A.; Schuch, F.B.; Rosenbaum, S.; Gaughran, F.; Veronesse, N.; Williams, J.; Craig, T.; Yung, A.R.; et al. How much physical activity do people with schizophrenia engage in? A systematic review, comparative meta-analysis and meta-regression. Schizophr. Res. 2016, 176, 431–440.
  • Stubbs, B.; Soundy, A.; Probst, M.; De Hert, M.; De Herdt, A.; Vancampfort, D. Understanding the role of physiotherapists in schizophrenia: An international perspective from members of the International Organisation of Physical Therapists in Mental Health (IOPTMH). J. Ment. Health. 2014, 23, 125–129.
  • Stubbs, B.; Vancampfort, D.; Hallgren, M.; Firth, J.; Veronese, N.; Solmi, M.; Brand, S.; Cordes, J.; Malchow, B.; Gerber, M.; et al. EPA guidance on physical activity as a treatment for severe mental illness: A meta-review of the evidence and Position Statement from the European Psychiatric Association (EPA), supported by the International Organization of Physical Therapists in Mental Health (IOPTMH). Eur. Psychiatry 2018, 54, 124–144.
  • Thomas, J.; Harden, A. Methods for the thematic synthesis of qualitative research in systematic reviews. BMC Med. Res. Methodol. 2008, 8, 45.
  • Tous-Espelosin, M.; de Azua, S.R.; Iriarte-Yoller, N.; MartinezAguirre-Betolaza, A.; Sanchez, P.M.; Corres, P.; Arratibel-Imaz, I.; Sampedro, A.; Pena, J.; Maldonado-Martin, S. Clinical, physical, physiological, and cardiovascular risk patterns of adults with schizophrenia: CORTEX-SP study: Characterization of adults with schizophrenia. Psychiatry Res. 2021, 295, 113580.
  • Tous-Espelosin, M.; Crone, D.; Ruiz de Azua, S.; Iriarte-Yoller, N.; Sampedro, A.; Maldonado-Martín, S. ‘It Helped Me to Disconnect My Mind from the Problems’: The Subjective Experiences of People with Schizophrenia Taking Part in a Concurrent Exercise Program. Issues Ment. Health Nurs. 2023, 44, 717–725.
  • Vancampfort, D.; Probst, M.; Scheewe, T.; De Herdt, A.; Sweers, K.; Knapen, J.; van Winkel, R.; De Hert, M. Relationships between physical fitness, physical activity, smoking and metabolic and mental health parameters in people with schizophrenia. Psychiatry Res. 2013, 207, 25–32.
  • Vancampfort, D.; Rosenbaum, S.; Probst, M.; Connaughton, J.; du Plessis, C.; Yamamoto, T.; Stubbs, B. What are the top 10 physical activity research questions in schizophrenia? Disabil. Rehabil. 2016, 38, 2235–2243.
  • Vancampfort, D.; Sánchez, C.P.R.; Hallgren, M.; Schuch, F.; Firth, J.; Rosenbaum, S.; Van Damme, T.; Stubbs, B. Dropout from exercise randomized controlled trials among people with anxiety and stress-related disorders: A meta-analysis and meta-regression. J. Affect. Disord. 2021, 282, 996–1004.
  • Warner, R. Recovery from schizophrenia and the recovery model. Curr. Opin. Psychiatry 2009, 22, 374–380.
  • Wu, M.H.; Lee, C.P.; Hsu, S.C.; Chang, C.M.; Chen, C.Y. Effectiveness of high-intensity interval training on the mental and physical health of people with chronic schizophrenia. Neuropsychiatr Dis. Treat. 2015, 11, 1255–1263.