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Experiences of health among persons with psychiatric disabilityparticipating in a life style intervention
Umeå University, Faculty of Medicine, Omvårdnad.
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(English)Manuscript (preprint) (Other academic)
Abstract [en]

Background: Persons with psychiatric disabilities describe health in similar ways to others, although the prevalence of ill-health and risk factors are larger than in the general population.

Aim: To describe the experience of health and body in order to enable the creation of health interventions for this group of users.

Design: The first author interviewed five women and six men with psychiatric disabilities, aged 26 to 53, participating in a life style programme.

Method: The transcribed interviews were analysed by qualitative description.

Result: The categories Health is having a life as others have disclosed losses of important life domains and experiences of being different, and “Health is absence of psychological and physical problems” describes their symptoms and its hampering effects on quality of life and self-esteem. The category “Health is being able to influence one’s own health” reveals a sense of hope that health is manageable.

Conclusion: Not having a life or being as others causes a sense of being different and stigmatization, which might affect self esteem, quality of life and possibilities for recovery. Health is to be spared physical and psychological problems as the lack of energy which affects motivation and the ability to gain a quality of life. But health is also described in terms of a conviction that it can be affected through knowledge and self-management of symptoms.

Clinical implications: Health intervention programmes should be designed in such a way that promotes motivation and self-management as it is an important factor in recovery. Carers should also promote and support clients to find activities, relationships and sites where symptom relief can be experienced.

Keyword [en]
Psychiatric disability, health, qualitative description, health education, health
National Category
Research subject
Caring Sciences
URN: urn:nbn:se:umu:diva-25937OAI: diva2:235169
Available from: 2009-09-14 Created: 2009-09-14 Last updated: 2010-01-14Bibliographically approved
In thesis
1. Att främja förändrad livsstil bland personer med psykiskt funktionshinder: studier av metabola och psykologiska effekter, upplevd mening och hälsa
Open this publication in new window or tab >>Att främja förändrad livsstil bland personer med psykiskt funktionshinder: studier av metabola och psykologiska effekter, upplevd mening och hälsa
2009 (Swedish)Doctoral thesis, comprehensive summary (Other academic)
Alternative title[en]
To promote life style changes among persons with psychiatric disabilities : studies of metabolic and psychological effects, experienced meaning and health
Abstract [en]

The overall aim of this thesis is to investigate if the somatic comorbidity and increased mortality among persons with psychiatric disability (residents in supported housing facilities) can be influenced. The thesis comprises four papers. Paper I describes the lived experience of health and body. Papers II and III examine the effects of a lifestyle programme on physiological markers (II) and on psychological and quality of life parameters (III). Paper (IV) illustrates the meaning of participating in a life style programme. The data in Papers I and IV comprises narrative interviews with residents (n=11). The studies in Papers II and III are focused on residents and were carried out with a randomized design. The randomization was performed on a group level (supported housing facility). The 12 month intervention consisted of study circles with a theoretical and practical application of dietary information and physical activity for two hours, on a twice weekly basis under the supervision of a study circle leader. The controls were offered an aesthetic study circle and met once a week. The data in Paper II comprises physiological quantitative data from both residents (n=41) and staff (n=41) and in Paper III questionnaires on symptoms and quality of life completed only by residents (n=41). The data was analysed with Qualitative description (I), Phenomenological-hermeneutics (IV), and for papers II and III relevant statistical calculations were used. Health is described in paper I as “having a life as others have” and discloses the losses of important life domains (family, work, security) and the experiences of being deviant and stigmatized. Health is described as “absence of psychological and physical problems” and its hampering effects on quality of life and self-esteem. Health is understood as a phenomenon that could “be influenced by one self”, and there is an insight that health is manageable. Participating in a life style intervention (paper II) meant a significant improvement in risk factors for metabolic syndrome among the residents in comparison with controls. No differences were seen on weight, BMI and improved physical capacity. In paper III a significant positive increase in the Sense of Coherence compared to controls was seen. However no effect was seen on quality of life, psychosocial function or on reduction of symptoms in comparison with controls. Participating in a lifestyle intervention can be understood as the gaining of insights that health can be improved and that the daily life is partly given a changed content (paper II). The participation is also described as meaning an increased sense of closeness and equality in relation to the staff and sometimes a painful insight of their life situation. Participating is also described as entailing a hope that one’s life situation can be affected. In summary this thesis shows that there is some possibility of influencing the physical health (reduced risk of metabolic syndrome) among persons with psychiatric disability by participating in a 12 month intervention programme. The intervention does not show any effects on measures such as quality of life, psychosocial function and presence of symptoms. However, the participants describe that the participation had a meaning in a number of respects. This is a finding that is confirmed by the positive change in sense of coherence. The need to develop preventive care for persons with psychiatric disability and the importance of monitoring the treatment with neuroleptics and its side effects on physical health is an important clinical implication. Furthermore the importance of the responsibility of the care staff is emphasized as well as the importance of supporting a change in lifestyle.

Place, publisher, year, edition, pages
Umeå: Umeå Universitet, 2009. 91 p.
Umeå University medical dissertations, ISSN 0346-6612 ; 1277
community psychiatric nursing, life style intervention, lived experience, health, metabolic syndrome, psychiatric illness, randomized controlled trail, sense of coherence, Personer med psykiskt funktionshinder, omvårdnad, socialpsykiatri, hälsa, metabolt syndrom, livsstil, RCT, KASAM, livsvärld
National Category
Research subject
Caring Sciences
urn:nbn:se:umu:diva-25947 (URN)978-91-7264-822-7 (ISBN)
Institutionen för omvårdnad, 90187, Umeå
Public defence
2009-10-09, Aulan, Vårdvetarhuset, Umeå Universitet, Umeå, 09:00 (Swedish)
Available from: 2009-09-21 Created: 2009-09-14 Last updated: 2011-10-06Bibliographically approved

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