School of Health and Related Research (ScHARR), University of Sheffield, Regent Court, Sheffield, United Kingdom.
Health and Social Care Research, Sheffield Hallam University, Sheffield, United Kingdom.
Eur Psychiatry. 2020 Oct 22;63(1):e95. doi: 10.1192/j.eurpsy.2020.93.
People living with serious mental illness (SMI) experience debilitating symptoms that worsen their physical health and quality of life. Regular physical activity (PA) may bring symptomatic improvements and enhance wellbeing. When undertaken in community-based group settings, PA may yield additional benefits such as reduced isolation. Initiating PA can be difficult for people with SMI, so PA engagement is commonly low. Designing acceptable and effective PA programs requires a better understanding of the lived experiences of PA initiation among people with SMI.
This systematic review of qualitative studies used the meta-ethnography approach by Noblit and Hare (1988). Electronic databases were searched from inception to November 2017. Eligible studies used qualitative methodology; involved adults (≥18 years) with schizophrenia, bipolar affective disorder, major depressive disorder, or psychosis; reported community-based group PA; and captured the experience of PA initiation, including key features of social support. Study selection and quality assessment were performed by four reviewers.
Sixteen studies were included in the review. We identified a "journey" that depicted a long sequence of phases involved in initiating PA. The journey demonstrated the thought processes, expectations, barriers, and support needs of people with SMI. In particular, social support from a trusted source played an important role in getting people to the activity, both physically and emotionally.
The journey illustrated that initiation of PA for people with SMI is a long complex transition. This complex process needs to be understood before ongoing participation in PA can be addressed. Registration-The review was registered on the International Prospective Register of Systematic Reviews (PROSPERO) on 22/03/2017 (registration number CRD42017059948).
患有严重精神疾病（SMI）的人会经历使他们的身体健康和生活质量恶化的衰弱症状。定期进行身体活动（PA）可能会带来症状改善并提高幸福感。当在基于社区的小组环境中进行时，PA 可能会带来额外的益处，例如减少孤立感。对于患有 SMI 的人来说，开始进行 PA 可能很困难，因此他们参与 PA 的意愿通常较低。设计可接受且有效的 PA 计划需要更好地了解患有 SMI 的人开始进行 PA 的体验。
本系统评价使用 Noblit 和 Hare（1988）的元人种学方法对定性研究进行了综述。从建立到 2017 年 11 月，电子数据库被搜索。合格的研究使用定性方法；涉及成年（≥18 岁）精神分裂症、双相情感障碍、重性抑郁障碍或精神病；报告了基于社区的小组 PA；并记录了 PA 起始的经验，包括社会支持的关键特征。四名审查员进行了研究选择和质量评估。
综述包括 16 项研究。我们确定了一个“旅程”，描述了参与 PA 起始的漫长阶段序列。该旅程展示了 SMI 患者的思维过程、期望、障碍和支持需求。特别是，来自可信赖来源的社会支持在身体和情感上都对人们参与活动起着重要作用。
该旅程表明，对于患有 SMI 的人来说，开始 PA 是一个漫长而复杂的转变。在解决 PA 的持续参与问题之前，需要了解这个复杂的过程。注册-本综述于 2017 年 3 月 22 日在国际前瞻性系统评价注册库（PROSPERO）上进行了注册（注册号 CRD42017059948）。
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