Seymour Jessica, Pratt Greg, Patterson Sue, Korman Nicole, Rebar Amanda, Tillston Stephen, Chapman Justin
Queensland Police-Citizens Youth Welfare Association, Brisbane, Queensland, Australia.
QIMR Berghofer Medical Research Institute, Brisbane, Queensland, Australia.
Health Soc Care Community. 2022 Sep;30(5):e1611-e1624. doi: 10.1111/hsc.13588. Epub 2021 Oct 6.
Exercise has diverse benefits for physical and mental health in people with mental illness; however, it is unclear how to effectively promote exercise motivation in this group. The aim of this study is to evaluate the effectiveness of interventions utilising exercise instruction or behavioural counselling with people with mental illness to improve self-determined motivation for exercise, and physical and mental health. Participants were adults (aged 18+ years) receiving mental health services. Participants could choose from two 8-week programs comprising weekly group-based sessions delivered by an exercise physiologist: (a) exercise instruction in a gym (GYM) or (b) behavioural counselling (MOT). Self-determined motivation was measured using the Behaviour Regulations for Exercise Questionnaire (BREQ3). Physical health indicators included waist circumference, blood pressure, leg strength (sit-to-stand test), physical capacity (six-minute walk test) and self-reported exercise. Mental health was assessed using the Kessler-6 scale of psychological distress. Most of the 95 participants chose exercise instruction (GYM = 60; MOT = 35). At baseline, participants who chose MOT had higher external motivation, body mass index, waist circumference and psychological distress, and a higher proportion had multiple physical comorbidities than those who chose GYM. More self-determined motivation was associated with meeting physical activity guidelines. Post-intervention, GYM participants had significant improvements in self-determined motivation, psychological distress and sit-to-stand test; MOT participants had significant improvements in integrated regulation, self-reported exercise and physical functioning. In conclusion, exercise instruction can improve self-determined motivation; however, more intensive behavioural counselling support may be needed to improve self-determined motivation. Counselling programs can increase exercise behaviour and may appeal more to people with poorer health and more external motivation. Findings have high ecological validity and applicability to real-world implementation of exercise interventions. To accommodate people with diverse conditions and motivations, motivational counselling should be combined with practical exercise support, and participants afforded the autonomy to decide their level of involvement.
运动对患有精神疾病的人的身心健康有多种益处；然而，目前尚不清楚如何有效提高该群体的运动动机。本研究的目的是评估利用运动指导或行为咨询对患有精神疾病的人进行干预，以提高其自主运动动机以及身心健康的有效性。参与者为接受心理健康服务的成年人（年龄在18岁及以上）。参与者可以从两个为期8周的项目中选择，这两个项目均包括由运动生理学家每周进行的小组课程：（a）健身房运动指导（GYM）或（b）行为咨询（MOT）。使用运动行为调节问卷（BREQ3）来测量自主运动动机。身体健康指标包括腰围、血压、腿部力量（从坐到站测试）、身体能力（六分钟步行测试）以及自我报告的运动量。使用凯斯勒心理困扰6项量表评估心理健康状况。95名参与者中的大多数选择了运动指导（GYM组=60人；MOT组=35人）。在基线时，选择MOT组的参与者比选择GYM组的参与者具有更高的外部动机、体重指数、腰围和心理困扰，并且有更多身体合并症的比例更高。更多的自主运动动机与达到身体活动指南相关。干预后，GYM组参与者在自主运动动机、心理困扰和从坐到站测试方面有显著改善；MOT组参与者在综合调节、自我报告的运动量和身体功能方面有显著改善。总之，运动指导可以提高自主运动动机；然而，可能需要更强化的行为咨询支持来提高自主运动动机。咨询项目可以增加运动行为，并且可能对健康状况较差和外部动机更强的人更有吸引力。研究结果具有较高的生态效度，适用于运动干预在现实世界中的实施。为了适应不同状况和动机的人群，动机咨询应与实际的运动支持相结合，并给予参与者自主决定参与程度的权利。
