Ramón y Cajal Hospital, Madrid, Spain.
FIDMAG Hermanas Hospitalarias Research Foundation, Barcelona, Spain.
Int J Ment Health Nurs. 2019 Dec;28(6):1328-1337. doi: 10.1111/inm.12644. Epub 2019 Aug 14.
The development of metabolic syndrome negatively affects the quality of life of people with serious mental illness. Experts agree on the need to evaluate the physical health of patients and intervene in modifiable risk factors, with emphasis on the promotion of healthy lifestyles. Interventions should include nutritional counselling and physical activity. This 24-week randomized trial evaluated the effects of a community-based nurse-led lifestyle-modification intervention in people with serious mental illness meeting metabolic syndrome criteria, and its impact on health-related quality of life and physical activity. Sixty-one participants from two community mental health centres were randomly assigned to the intervention or control group. The intervention consisted of weekly group sessions, with 20 min of theoretical content and 60 min of nurse-led physical activity. Postintervention results between groups showed no differences in weight, waist circumference, fasting glucose, and systolic blood pressure. Differences in body mass index, triglyceride concentrations, and diastolic blood pressure were found to be significant (P = 0.010, P = 0.038, and P = 0.017). Participants who performed the intervention reported an increase in physical activity, which did not occur in the control group (P = 0.035), and also reported better health status (P < 0.001). Our intervention showed positive effects reducing participants' cardiovascular and metabolic risks and improving their physical activity and quality of life. To our knowledge, this is the first clinical trial led and carried out by mental health nurses in community mental health centres which takes into account the effects of a lifestyle intervention on every metabolic syndrome criterion, health-related quality of life, and physical activity.
代谢综合征的发展会降低严重精神疾病患者的生活质量。专家一致认为需要评估患者的身体健康状况并干预可改变的危险因素，重点是促进健康的生活方式。干预措施应包括营养咨询和身体活动。这项为期 24 周的随机试验评估了社区为基础的护士主导的生活方式改变干预对符合代谢综合征标准的严重精神疾病患者的影响，以及对健康相关生活质量和身体活动的影响。来自两个社区心理健康中心的 61 名参与者被随机分配到干预组或对照组。干预措施包括每周一次的小组会议，每次会议有 20 分钟的理论内容和 60 分钟的护士主导的身体活动。干预后两组间的体重、腰围、空腹血糖和收缩压没有差异。而体质指数、甘油三酯浓度和舒张压的差异有统计学意义（P=0.010、P=0.038 和 P=0.017）。进行干预的参与者报告身体活动增加，而对照组没有（P=0.035），并且健康状况也得到改善（P<0.001）。我们的干预措施显示出降低参与者心血管和代谢风险、提高身体活动和生活质量的积极效果。据我们所知，这是第一次由社区心理健康中心的精神科护士领导和开展的临床试验，考虑了生活方式干预对每个代谢综合征标准、健康相关生活质量和身体活动的影响。
