Department of Psychiatry II, University of Ulm, Lindenallee 2, 89312, Günzburg, Germany.
Institute of Epidemiology and Medical Biometry, University of Ulm, Schwabstraße 13, 89075, Ulm, Germany.
BMC Psychiatry. 2022 Jan 4;22(1):6. doi: 10.1186/s12888-021-03640-1.
Unhealthy lifestyle constitutes a cause of increased morbidity and mortality in people with severe mental illness. The aim of this mixed-method pilot study was to investigate the feasibility and preliminary effectiveness of an intervention to promote a health-conscious lifestyle in comparison to care as usual among people with severe mental illness receiving accommodational support in community settings.
This was a prospective, quasi-experimental, controlled study over four six-month assessment points (t0, + 6 months, + 12 months, + 18 months) with 70 persons with severe mental illness receiving community based accommodational support. Mental health staff members of the housing facilities were trained in Motivational Interviewing and conducted a six-week health course with the intervention group participants in addition to care as usual. Next to the primary outcome - self-rated physical well-being (FEW 16) - anthropometric parameters and unhealthy behaviours (diet, physical activity, alcohol and tobacco consumption, and oral hygiene) were examined. Effectiveness analysis was conducted using mixed-effects regression models with propensity score adjustment to control for selection bias. One year after the end of the intervention, semi-standardized expert interviews were conducted with 12 of these employees and evaluated by content analysis.
The qualitative interviews with mental health staff underline the intervention's feasibility in people with severe mental illness in sheltered housing, and the acceptability of and satisfaction with the intervention among mental health workers. But in this pilot study no superiority of the HELPS intervention compared to routine care could be demonstrated in terms of the investigated outcomes.
The findings of this pilot study underscore the feasibility and acceptability of health promotion programmes based on Motivational Interviewing and highlight the need to further develop multi-modal programs according to the needs of the target group. Long-term and sustainable support for healthy lifestyles of people with severe mental illness receiving community mental health care requires multi-modal concepts and organisational change.
DRKS00011659 , date of registration was 2017/02/15; retrospectively registered as date of first enrolment was 2017/01/24.
不健康的生活方式是导致严重精神疾病患者发病率和死亡率上升的一个原因。本混合方法的初步研究旨在调查与常规护理相比，在社区环境中接受住宿支持的严重精神疾病患者中，促进健康生活方式的干预措施的可行性和初步效果。
这是一项前瞻性、准实验、对照研究，在四个 6 个月的评估点（t0、+6 个月、+12 个月、+18 个月）进行，共有 70 名接受社区基础住宿支持的严重精神疾病患者。住房设施的精神卫生工作人员接受了动机访谈培训，并在常规护理之外，为干预组参与者开设了为期 6 周的健康课程。除了主要结果——自我评估的身体幸福感（FEW 16）——还检查了人体测量参数和不健康行为（饮食、身体活动、酒精和烟草消费以及口腔卫生）。使用混合效应回归模型进行有效性分析，并进行倾向评分调整以控制选择偏差。干预结束一年后，对其中 12 名员工进行了半标准化专家访谈，并进行了内容分析。
与精神卫生工作者的定性访谈强调了基于动机访谈的干预措施在庇护性住房中严重精神疾病患者中的可行性，以及心理健康工作者对干预措施的接受度和满意度。但在这项初步研究中，与常规护理相比，HELPS 干预在研究结果方面没有显示出优越性。
这项初步研究的结果强调了基于动机访谈的健康促进计划的可行性和可接受性，并突出了根据目标群体的需求进一步开发多模式计划的必要性。为接受社区精神卫生保健的严重精神疾病患者提供长期和可持续的支持，需要多模式的概念和组织变革。
DRKS00011659，注册日期为 2017 年 2 月 15 日；首次注册日期为 2017 年 1 月 24 日，为回顾性注册。
