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患有精神分裂症的退伍军人减肥的策略、障碍和动机。

Strategies, barriers, and motivation for weight loss among veterans living with schizophrenia.

作者信息

Klingaman Elizabeth A, Viverito Kristen M, Medoff Deborah R, Hoffmann Rebecca M, Goldberg Richard W

机构信息

Veterans Affairs Capitol Health Care Network, Mental Illness Research, Education, and Clinical Center, VA Maryland Health Care System.

Center for Mental Healthcare.

出版信息

Psychiatr Rehabil J. 2014 Dec;37(4):270-6. doi: 10.1037/prj0000084. Epub 2014 Jun 2.

Abstract

OBJECTIVE

Weight loss programs for veterans living with schizophrenia have demonstrated mixed efficacy, highlighting unique obstacles faced by this population. Data from a large national sample provide an opportunity to characterize the unique factors related to weight loss for veterans with schizophrenia. The present study compared veterans living with schizophrenia (n = 5,388) to veterans with no mental health diagnoses (n = 81,422) on responses to the MOVE!23, a multidimensional assessment of factors related to weight management.

METHODS

Responses to the MOVE!23 between August, 2005 and May, 2013 by veterans with a body mass index in the overweight or obese range were used to describe clinical characteristics, current strategies, perceived barriers, stages of readiness, and importance of and confidence to change behaviors related to their weight management.

RESULTS

Both groups reported similar stages of readiness and high ratings of importance and confidence regarding weight loss behaviors. Compared with veterans with no mental health diagnoses, over 5 times as many veterans living with schizophrenia reported smoking to control weight, and a greater number endorsed 18 of the 21 barriers to modifying eating and physical activity.

CONCLUSIONS AND IMPLICATIONS FOR PRACTICE

RESULTS highlight the necessity of addressing healthy lifestyles from a holistic perspective for all veterans. Adding regular physical activity as part of daily treatment may address the accessibility, safety concerns, and lack of social support reported as physical activity barriers. Increased access to healthier food choices and addressing smoking in conjunction with weight loss are also warranted.

摘要

目的

针对患有精神分裂症的退伍军人的减肥项目已显示出不同的效果,凸显了这一人群面临的独特障碍。来自一个大型全国样本的数据提供了一个机会,以描述与患有精神分裂症的退伍军人减肥相关的独特因素。本研究将患有精神分裂症的退伍军人(n = 5388)与没有心理健康诊断的退伍军人(n = 81422)在对MOVE!23的反应上进行了比较,MOVE!23是一项对与体重管理相关因素的多维评估。

方法

2005年8月至2013年5月期间,体重指数处于超重或肥胖范围的退伍军人对MOVE!23的反应被用于描述临床特征、当前策略、感知到的障碍、准备阶段以及与体重管理相关行为改变的重要性和信心。

结果

两组报告的准备阶段相似,对减肥行为的重要性和信心评分都很高。与没有心理健康诊断的退伍军人相比,患有精神分裂症的退伍军人中报告通过吸烟来控制体重的人数是前者的5倍多,并且在21项饮食和身体活动改变障碍中有18项障碍得到了更多人的认可。

结论及对实践的启示

结果强调了从整体角度为所有退伍军人解决健康生活方式问题的必要性。将定期体育活动作为日常治疗的一部分,可能会解决被报告为体育活动障碍的可及性、安全问题和缺乏社会支持等问题。增加获得更健康食物选择的机会以及在减肥的同时解决吸烟问题也是必要的。

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