European Journal of Adapted Physical Activity 16, 13 (2023) | DOI: 10.5507/euj.2023.006

Perceptions of patients with psychosis on living an active lifestyle

Marte Bentzen1, Ida Jarstadmarken2, Gro Rugseth2
1 The Norwegian School of Sport Sciences, Department of Teacher Education and Outdoor Studies, Oslo, Norway
2 The Norwegian School of Sport Sciences, Department of Sports Medicine, Oslo, Norway

The aim of the study was to gain insights into how people living with psychosis at a psychiatric hospital describe what living an active lifestyle means for them. Interpretative phenomenological analysis was used to guide the methodology. The study involved three participants diagnosed with psychotic disorder living at an institution offering long-term in-patient treatment. Semi-structured interviews were conducted, including inviting participants to ‘walking-by-talking’ and to bring photos representing their notions of an active lifestyle to enhance the richness of the data and increase participants’ agency. All participants talked about a range of different activities they associated with an active lifestyle. One important dimension of these activities was the quality of relationships with others. However, as long-term inpatients, the participants experienced individual and structural barriers to living an active lifestyle. Individuals living with psychosis revealed a broader and deepened understanding of how an active lifestyle is and is profoundly bound to living a socially active life, beyond ‘physical activity and exercise’. The participants described how long-term hospitalization made them feel that their real life was on hold. These seem to be important challenges to address, in order to offer meaningful activity integrated with treatment. The study highlights the importance of individual, relational and contextual meaning dimensions.

Keywords: severe mental illness; physical activity; positive mental health; health promotion; interpretative phenomenological

Received: April 2, 2022; Revised: June 26, 2023; Accepted: June 28, 2023; Published online: December 20, 2023  Show citation

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Bentzen, M., Jarstadmarken, I., & Rugseth, G. (2023). Perceptions of patients with psychosis on living an active lifestyle. European Journal of Adapted Physical Activity16, Article 13. https://doi.org/10.5507/euj.2023.006
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References

  1. Abed, H. (2010). What factors affect the lifestyle choices of people with schizophrenia? The Mental Health Review, 15(2), 21-27. https://doi.org/10.5042/mhrj.2010.0368 Go to original source...
  2. Anderson, J. (2004). Talking whilst walking: a geographical archaeology of knowledge. Area, 36(3), 254-261. https://doi.org/10.1111/j.0004-0894.2004.00222.x Go to original source...
  3. Aschbrenner, K., Carpenter-Song, E., Mueser, K., Kinney, A., Pratt, S., & Bartels, S. (2013). A qualitative study of social facilitators and barriers to health behavior change among persons with serious mental illness. Community Mental Health Journal, 49(2), 207-212. https://doi.org/10.1007/s10597-012-9552-8 Go to original source... Go to PubMed...
  4. Berry, C., & Greenwood, K. (2015). Hope-inspiring therapeutic relationships, professional expectations and social inclusion for young people with psychosis. Schizophrenia Research, 168(1-2), 153-160. https://doi.org/10.1016/j.schres.2015.07.032 Go to original source... Go to PubMed...
  5. Boydell, K. M., Stasiulis, E., Volpe, T., & Gladstone, B. (2010). A descriptive review of qualitative studies in first episode psychosis. Early Intervention in Psychiatry, 4(1), 7-24. https://doi.org/10.1111/j.1751-7893.2009.00154.x Go to original source... Go to PubMed...
  6. Brokmeier, L. L., Firth, J., Vancampfort, D., Smith, L., Deenik, J., Rosenbaum, S., Stubbs, B., & Schuch, F. B. (2020). Does physical activity reduce the risk of psychosis? A systematic review and meta-analysis of prospective studies. Psychiatry Research, 284, 112675. https://doi.org/10.1016/j.psychres.2019.112675 Go to original source... Go to PubMed...
  7. Bueno-Antequera, J., Oviedo-Caro, M. Á., & Munguía-Izquierdo, D. (2018). Sedentary behaviour, physical activity, cardiorespiratory fitness and cardiometabolic risk in psychosis: the PsychiActive project. Schizophrenia Research, 195, 142-148. https://doi.org/10.1016/j.schres.2017.10.012 Go to original source... Go to PubMed...
  8. Dauwan, M., Begemann, M. J., Heringa, S. M., & Sommer, I. E. (2016). Exercise improves clinical symptoms, quality of life, global functioning, and depression in schizophrenia: a systematic review and meta-analysis. Schizophrenia Bulletin, 42(3), 588-599. https://doi.org/10.1093/schbul/sbv164 Go to original source... Go to PubMed...
  9. Drake, R., Green, A., Mueser, K., & Goldman, H. (2003). The history of community mental health treatment and rehabilitation for persons with severe mental illness. Community Mental Health Journal, 39(5), 427-440. https://doi.org/10.1023/A:1025860919277 Go to original source... Go to PubMed...
  10. Erdner, A. & Magnusson, A. (2012). Physical activities and their importance to the health of people with severe mental illness in Sweden. Issues in Mental Health Nursing, 33(10), 676-679. https://doi.org/10.3109/01612840.2012.697253 Go to original source... Go to PubMed...
  11. Evans, J., & Jones, P. (2011). The walking interview: Methodology, mobility and place. Applied Geography 31(2), 849-858. https://doi.org/10.1016/j.apgeog.2010.09.005 Go to original source...
  12. Farholm, A., Sørensen, M., & Halvari, H. (2017). Motivational factors associated with physical activity and quality of life in people with severe mental illness. Scandinavian Journal of Caring Sciences, 31(4), 914-921. https://doi.org/10.1111/scs.12413 Go to original source... Go to PubMed...
  13. Firth, J., Cotter, J., Elliott, R., French, P., & Yung, A. R. (2015). A systematic review and meta-analysis of exercise interventions in schizophrenia patients. Psychological Medicine, 45(7), 1343-1361. https://doi.org/10.1017/S0033291714003110 Go to original source... Go to PubMed...
  14. Fraser, S. J., Chapman, J. J., Brown, W. J., Whiteford, H. A., & Burton, N. W. (2015). Physical activity attitudes and preferences among inpatient adults with mental illness. International Journal of Mental Health Nursing, 24(5), 413-420. https://doi.org/10.1111/inm.12158 Go to original source... Go to PubMed...
  15. Franken, K., Lamers, S. M. A., Ten Klooster, P. M., Bohlmeijer, E. T., & Westerhof, G. J. (2018). Validation of the mental health continuum-short form and the dual continua model of well-being and psychopathology in an adult mental health setting. Journal of Clinical Psychology, 74(12), 2187-2202. https://doi.org/10.1002/jclp.22659 Go to original source... Go to PubMed...
  16. Glover, C. M., Ferron, J. C., Whitley, R., Cook, J. A., & Mueser, K. T. (2013). Barriers to exercise among people with severe mental illnesses. Psychiatric Rehabilitation Journal, 36(1), 45-47. https://doi.org/10.1037/h0094747 Go to original source... Go to PubMed...
  17. Glowacki, K., Weatherson, K., & Faulkner, G. (2019). Barriers and facilitators to health care providers' promotion of physical activity for individuals with mental illness: A scoping review. Mental Health and Physical Activity, 16, 152-168. https://doi.org/10.1016/j.mhpa.2018.10.006 Go to original source...
  18. Gomes, E., Bastos, T., Probst, M., Ribeiro, J. C., Silva, G., & Corredeira, R. (2014). A contribution to designing effective and enjoyable physical activity programs for individuals with schizophrenia. European Journal of Adapted Physical Activity, 7(2). https://doi.org/10.5507/euj.2014.008 Go to original source...
  19. Gumber, S., & Stein, C. H. (2013). Consumer perspectives and mental health reform movements in the United States: 30 years of first-person accounts. Psychiatric Rehabilitation Journal, 36(3), 187. https://doi.org/10.1037/prj0000003 Go to original source... Go to PubMed...
  20. Hargreaves, J., Lucock, M., & Rodriguez, A. (2017). From inactivity to becoming physically active: The experiences of behaviour change in people with serious mental illness. Mental Health and Physical Activity, 13, 83-93. https://doi.org/10.1016/j.mhpa.2017.09.006 Go to original source...
  21. Harper, K. (2019). Essentials of Photovoice in participatory visual research. Qualitative essentials. Taylor & Francis Group.
  22. Hawkley, L. C., Cacioppo, J. T. & Hawkley, L. C. (2010). Loneliness matters: a theoretical and empirical review of consequences and mechanisms. Annals of Behavioral Medicine: a publication of the Society of Behavioral Medicine, 40(2), 218-227. https://doi.org/10.1007/s12160-010-9210-8 Go to original source... Go to PubMed...
  23. Helsedirektoratet. (2013). Nasjonal faglig retningslinje for utredning, behandling og oppfølging av personer med psykoselidelser. [National professional guideline for the investigation, treatment and follow-up of people with psychotic disorders]. The Norwegian Directorate of Health.
  24. Keyes, C. L. M. (2002). The mental health continuum: From languishing to flourishing in life. Journal of Health and Social Research, 43, 207-222. https://doi.org/10.2307/3090197 Go to original source...
  25. Keyes, C. L. (2005). Mental illness and/or mental health? Investigating axioms of the complete state model of health. Journal of Consulting and Clinical Psychology, 73(3), 539. https://doi.org/10.1037/0022-006X.73.3.539 Go to original source... Go to PubMed...
  26. Keyes, C. L. M. (2007). Promoting and protecting mental health as flourishing. American Psychologist, 62(2), 95-108. https://doi.org/10.1037/0003-066X.62.2.95 Go to original source... Go to PubMed...
  27. Keyes, C. L. & Lopez, S. J. (2002). Toward a science of mental health. In Snyder, R. & Lopez, S. (Eds), Handbook of Positive Psychology (pp. 45-59. Oxford University Press. Go to original source...
  28. Koenders, J. F., de Mooij, L. D., Dekker, J. M., & Kikkert, M. (2017). Social inclusion and relationship satisfaction of patients with a severe mental illness. International Journal of Social Psychiatry, 63(8), 773-781. https://doi.org/10.1177/0020764017737572 Go to original source... Go to PubMed...
  29. Kobau, R., Seligman, M. E., Peterson, C., Diener, E., Zack, M. M., Chapman, D., & Thompson, W. (2011). Mental health promotion in public health: Perspectives and strategies from positive psychology. American Journal of Public Health, 101(8), e1-e9. https://doi.org/10.2105/AJPH.2010.300083 Go to original source... Go to PubMed...
  30. La, S., Ungar, M., Malla, A., Frankish, J., & Suto, M. (2014). Meanings of well-being from the perspectives of youth recently diagnosed with psychosis. Journal of Mental Health, 23(1), 25-30. https://doi.org/10.3109/09638237.2013.841866 Go to original source... Go to PubMed...
  31. Lauveng, A. (2005). Tomorrow I was Always a lion. Cappelen Damm.
  32. McCulloch, G. F., & Boxer, J. (1997). Mental health promotion: policy, practice and partnerships. Baillière Tindall.
  33. Linz, S. J., & Sturm, B. A. (2013). The phenomenon of social isolation in the severely mentally ill. Perspectives in Psychiatric Care, 49(4), 243-254. https://doi.org/10.1111/ppc.12010 Go to original source... Go to PubMed...
  34. Morres, I. D., Hatzigeorgiadis, A., Stathi, A., Comoutos, N., Arpin-Cribbie, C., Krommidas, C., & Theodorakis, Y. (2019). Aerobic exercise for adult patients with major depressive disorder in mental health services: A systematic review and meta-analysis. Depression and Anxiety, 36(1), 39-53. https://doi.org/10.1002/da.22842 Go to original source... Go to PubMed...
  35. Mjøsund, N.H., Eriksson, M., Espnes, G.A., Haaland-Øverby, M., Jensen, S.L., Norheim, I., Kjus, S.H.H., Portaasen, I.-L., & Vinje, H.F. (2017). Service user involvement enhanced the research quality in a study using interpretative phenomenological analysis-the power of multiple perspectives. Journal of Advanced Nursing, 73(1), 265-278. https://doi.org/10.1111/jan.13093 Go to original source... Go to PubMed...
  36. Mjøsund, N. H., Eriksson, M., Norheim, I., Keyes, C. L., Espnes, G. A., & Vinje, H. F. (2015). Mental health as perceived by persons with mental disorders-an interpretative phenomenological analysis study. International Journal of Mental Health Promotion, 17(4), 215-233. https://doi.org/10.1080/14623730.2015.1039329 Go to original source...
  37. National Committee for Research Ethics in the Social Sciences and the Humanities. (2010). Guidelines for research ethics in the social sciences, law and the humanities. National Committees for Research Ethics in Norway.
  38. Newberry, R. E., Dean, D. J., Sayyah, M. D., & Mittal, V. A. (2018). What prevents youth at clinical high risk for psychosis from engaging in physical activity? An examination of the barriers to physical activity. Schizophrenia Research, 201, 400-405. https://doi.org/10.1016/j.schres.2018.06.011 Go to original source... Go to PubMed...
  39. Pedersen, P. B., & Kolstad, A. (2009). De-institutionalisation and trans-institutionalisation - changing trends of inpatient care in Norwegian mental health institutions 1950-2007. International Journal of Mental Health Systems, 3(1), 28. https://doi.org/10.1186/1752-4458-3-28 Go to original source... Go to PubMed...
  40. Pietkiewicz, I., & Smith, J. A. (2014). A practical guide to using interpretative phenomenological analysis in qualitative research psychology. Psychological Journal, 20(1), 7-14. https://doi.org/10.14691/CPPJ.20.1.7 Go to original source...
  41. Rebar, A. L., & Taylor, A. (2017). Physical activity and mental health; it is more than just a prescription. Mental Health and Physical Activity, 13, 77-82. https://doi.org/10.1016/j.mhpa.2017.10.004 Go to original source...
  42. Richardson, C. R., Faulkner, G., McDevitt, J., Skrinar, G. S., Hutchinson, D. S., & Piette, J. D. (2005). Integrating physical activity into mental health services for persons with serious mental illness. Psychiatric Services, 56(3), 324-331. https://doi.org/10.1176/appi.ps.56.3.324 Go to original source... Go to PubMed...
  43. Rosenbaum, S., Tiedemann, A., Sherrington, C., Curtis, J., & Ward, P. B. (2014). Physical activity interventions for people with mental illness: a systematic review and meta-analysis. The Journal of Clinical Psychiatry, 75(9), 964-974. https://doi.org/10.4088/JCP.13r08765 Go to original source... Go to PubMed...
  44. Seow, L. S. E., Vaingankar, J. A., Abdin, E., Sambasivam, R., Jeyagurunathan, A., Pang, S., Chong, S. A., & Subramaniam, M. (2016). Positive mental health in outpatients with affective disorders: Associations with life satisfaction and general functioning. Journal of Affective Disorders, 190, 499-507. https://doi.org/10.1016/j.jad.2015.10.021 Go to original source... Go to PubMed...
  45. Sibeoni, J., Costa-Drolon, E., Poulmarc'h, L., Colin, S., Valentin, M., Pradère, J., & Revah-Levy, A. (2017). Photo-elicitation with adolescents in qualitative research: an example of its use in exploring family interactions in adolescent psychiatry. Child and Adolescent Psychiatry and Mental Health, 11, 49. https://doi.org/10.1186/s13034-017-0186-z Go to original source... Go to PubMed...
  46. Smith, J. A., Flowers, P., & Larkin, M. (2009). Interpretative phenomenological analysis: Theory, method and research. Sage.
  47. Smith, B., & Sparkes, A.C. (Eds.) (2016). Routledge Handbook of Qualitative Research in Sport and Exercise. Routledge. Go to original source...
  48. Stensrud, B., Høyer, G., Granerud, A., & Landheim, A. S. (2015). "Life on hold": a qualitative study of patient experiences with outpatient commitment in two Norwegian counties. Issues in Mental Health Nursing, 36(3), 209-216. https://doi.org/10.3109/01612840.2014.955933 Go to original source... Go to PubMed...
  49. Stubbs, B., Vancampfort, D., Hallgren, M., Firth, J., Veronese, N., Solmi, M., Brand, S., Cordes, J., Malchow, B., Gerber, M., Schmitt, A., Correll, C. U., De Hert, M., Gaughran, F., Schneider, F., Kinnafick, F., Falkai, P., Möller, H-J., & Schmitt, A. (2018). 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). European Psychiatry, 54, 124-144. https://doi.org/10.1016/j.eurpsy.2018.07.004 Go to original source... Go to PubMed...
  50. Sørensen, M., Bentzen, M., & Farholm, A. (2020). Lessons learned from a physical activity intervention in psychiatric treatment: Patient, staff, and leader perspectives. Frontiers in Psychiatry, 11, 87. https://doi.org/10.3389/fpsyt.2020.00087 Go to original source... Go to PubMed...
  51. Sørensen, M., Bentzen, M., & Farholm, A. (2021). Motivational physical activity intervention for psychiatric inpatients: A two phased single-cases experimental study. European Journal of Adapted Physical Activity, 14(2). https://doi.org/10.5507/euj.2021.008 Go to original source...
  52. Tandon, R., Keshavan, M. S., & Nasrallah, H. A. (2008). Schizophrenia, "just the facts" what we know in 2008. 2. Epidemiology and etiology. Schizophrenia Research, 102(1), 1-18. https://doi.org/10.1016/j.schres.2008.04.011 Go to original source... Go to PubMed...
  53. Vancampfort, D., Rosenbaum, S., Schuch, F., Ward, P. B., Richards, J., Mugisha, J., Probst, M., & Stubbs, B. (2017). Cardiorespiratory fitness in severe mental illness: a systematic review and meta-analysis. Sports Medicine, 47(2), 343-352. https://doi.org/10.1007/s40279-016-0574-1 Go to original source... Go to PubMed...
  54. Westerhof, G. J., & Keyes, C. L. M. (2009). Mental illness and mental health: The two continua model across the lifespan. Journal of Adult Development, 17(2), 110-119. https://doi.org/10.1007/s10804-009-9082-y Go to original source... Go to PubMed...
  55. World Health Organization. (1992). The ICD-10 classification of mental and behavioural disorders: clinical descriptions and diagnostic guidelines (Vol. 1). World Health Organization.
  56. World Medical Association. (2013). World medical association declaration of Helsinki: Ethical principles for medical research involving human subjects. Jama, 310(20), 2191-2194. https://doi.org/10.1001/jama.2013.281053 Go to original source... Go to PubMed...

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