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Meanings of participating in a lifestyle programme for persons with psychiatric disabilities.
Umeå University, Faculty of Medicine, Department of Nursing.
Umeå University, Faculty of Medicine, Department of Nursing.
Umeå University, Faculty of Medicine, Department of Nursing.
Umeå University, Faculty of Medicine, Department of Clinical Sciences, Psychiatry.
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2011 (English)In: Scandinavian Journal of Caring Sciences, ISSN 0283-9318, E-ISSN 1471-6712, Vol. 25, no 2, 357-364 p.Article in journal (Refereed) Published
Abstract [en]

Lifestyle changes that affect physical and psychological health are described in research literature; however, the meaning of participating in a lifestyle intervention programme together with the staff has not been described. This study illuminates meanings of participating in a lifestyle programme as experienced by persons with psychiatric disabilities. The first author interviewed five women and six men with schizophrenia and depressive syndrome, aged 26-53, participating in a lifestyle programme. The transcribed interviews were analysed using a phenomenological hermeneutic approach inspired by the philosophy of Ricoeur. Meanings of participating in a lifestyle programme include my health can be improved as both the physical effects and the obstacles are considered and the daily life is partially given a changed content in new experiences and by participating in something to take pride in. The meanings of participating together with the staff mean an increased sense of closeness and equality with the staff expressed in changes in relationships and the difference between the two groups being revealed and also in becoming aware of the life situation, an insight into the loss of a healthy life but also hope for the future is expressed. The conclusions that could be drawn from this study are that a lifestyle intervention affects health and other important life areas such as the content of daily life and the relationship with the carers, which appears to affect the sense of hope and the ability to see new possibilities. Carers should find situations and activities where the residents and carers participate under equal conditions giving the residents the opportunity to leave the sick roll, experience equality and develop good relationships.

Place, publisher, year, edition, pages
Wiley , 2011. Vol. 25, no 2, 357-364 p.
Keyword [en]
Persons with psychiatric disabilities, community psychiatric nursing, phenomenological hermeneutics, nurse–patient relationship, health education, lived experience
National Category
Psychiatry Nursing
URN: urn:nbn:se:umu:diva-41039DOI: 10.1111/j.1471-6712.2010.00834.xISI: 000290589300020PubMedID: 21029143OAI: diva2:404331
Available from: 2011-03-16 Created: 2011-03-16 Last updated: 2015-06-22Bibliographically 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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Forsberg, Karl-AntonLindqvist, OlavBjörkman, Tommy NilsSandlund, MikaelSandman, Per Olof
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