Deenik Jeroen, Kruisdijk Frank, Tenback Diederik, Braakman-Jansen Annemarie, Taal Erik, Hopman-Rock Marijke, Beekman Aartjan, Tak Erwin, Hendriksen Ingrid, van Harten Peter
GGz Centraal, Utrechtseweg 266, 3818 EW, Amersfoort, The Netherlands.
Faculty of Behavioural, Management and Social sciences, University of Twente, Drienerlolaan 5, 7522 NB, Enschede, The Netherlands.
BMC Psychiatry. 2017 Aug 18;17(1):298. doi: 10.1186/s12888-017-1466-0.
Increasing physical activity in patients with severe mental illness is believed to have positive effects on physical health, psychiatric symptoms and as well quality of life. Till now, little is known about the relationship between physical activity and quality of life in long-term hospitalized patients with severe mental illness and knowledge of the determinants of behavioural change is lacking. The purpose of this study was to elucidate the relationship between objectively measured physical activity and quality of life, and explore modifiable psychological determinants of change in physical activity in long-term hospitalized patients with severe mental illness.
In 184 inpatients, physical activity was measured using an accelerometer (ActiGraph GTX+). Quality of life was assessed by EuroQol-5D and WHOQol-Bref. Attitude and perceived self-efficacy towards physical activity were collected using the Physical Activity Enjoyment Scale and the Multidimensional Self Efficacy Questionnaire, respectively. Patient and disease characteristics were derived retrospectively from electronic patient records. Associations and potential predictors were analysed using hierarchical regression.
Physical activity was positively related with and a predictor of all quality of life outcomes except on the environmental domain, independent of patient and disease characteristics. However, non-linear relationships showed that most improvement in quality of life lies in the change from sedentary to light activity. Attitude and self-efficacy were not related to physical activity.
Physical activity is positively associated with quality of life, especially for patients in the lower spectrum of physical activity. An association between attitude and self-efficacy and physical activity was absent. Therefore, results suggest the need of alternative, more integrated and (peer-)supported interventions to structurally improve physical activity in this inpatient population. Slight changes from sedentary behaviour to physical activity may be enough to improve quality of life.
人们认为，增加重症精神疾病患者的身体活动对其身体健康、精神症状以及生活质量都有积极影响。到目前为止，对于长期住院的重症精神疾病患者的身体活动与生活质量之间的关系了解甚少，且缺乏对行为改变决定因素的认识。本研究的目的是阐明客观测量的身体活动与生活质量之间的关系，并探索长期住院的重症精神疾病患者身体活动变化的可改变心理决定因素。
对184名住院患者，使用加速度计（ActiGraph GTX+）测量身体活动。采用欧洲五维健康量表（EuroQol-5D）和世界卫生组织生活质量简表（WHOQol-Bref）评估生活质量。分别使用身体活动愉悦感量表和多维自我效能量表收集对身体活动的态度和感知自我效能。患者和疾病特征通过回顾电子病历获得。使用分层回归分析关联和潜在预测因素。
身体活动与除环境领域外的所有生活质量结果呈正相关且是其预测因素，独立于患者和疾病特征。然而，非线性关系表明，生活质量的最大改善在于从久坐不动到轻度活动的转变。态度和自我效能与身体活动无关。
身体活动与生活质量呈正相关，尤其是对于身体活动水平较低的患者。态度和自我效能与身体活动之间不存在关联。因此，结果表明需要替代性的、更综合且（同伴）支持的干预措施，以结构性地改善该住院人群的身体活动。从久坐行为到身体活动的轻微改变可能足以改善生活质量。
