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. 2017 Aug 18;17(1):298.
doi: 10.1186/s12888-017-1466-0.

Physical activity and quality of life in long-term hospitalized patients with severe mental illness: a cross-sectional study

Jeroen Deenik  1   2   3 , Frank Kruisdijk  4   5 , Diederik Tenback  4   6 , Annemarie Braakman-Jansen  7 , Erik Taal  7 , Marijke Hopman-Rock  5   8   9 , Aartjan Beekman  10 , Erwin Tak  5   8 , Ingrid Hendriksen  5   8 , Peter van Harten  4   11
Affiliations

Physical activity and quality of life in long-term hospitalized patients with severe mental illness: a cross-sectional study

Jeroen Deenik et al. BMC Psychiatry. .

Abstract

Background: 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.

Methods: 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.

Results: 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.

Conclusions: 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.

Keywords: Accelerometry; Attitude; self-efficacy; Inpatients; Physical activity; Quality of life; Schizophrenia.

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Conflict of interest statement

Ethics approval and consent to participate

After extensive verbal explanation per ward, taking understandable comments due to the mental illness into account (e.g. fear, suspicion and psychotic thoughts), written informed consent was obtained from all subjects who understood the intent of the study and were willing to participate. All participants were able to decide this by themselves, as reviewed by their attending psychiatrist. The study protocol was approved by the Central Committee on Research Involving Human Subjects (CCMO) before measurements were started.

Consent for publication

Not applicable.

Competing interests

The authors declare that they have no competing interests.

Publisher’s Note

Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Figures

Fig. 1
Fig. 1
Non-linear distributions between physical activity (TAC/h) and Quality of Life (QoL) variables. Explored using scatterplots and LOESS Curves (Kernel: Epanechnikov, = 0.5) on standardized axis. TAC/h ×1000. TAC/h = average Total Activity Counts per hour; QoL = Quality of Life; LOESS = Locally Estimated Scatterplot Smoothing; EQ5D = EuroQol-5D; WHO = World Health Organisation
Fig. 2
Fig. 2
Summary of the relationships found, controlled for patient and disease characteristics*.(a) between physical activity and quality of life. (b) between attitude/self-efficacy and physical activity. TAC/h = average Total Activity Counts per hour; QoL = Quality of Life; EQ5D = EuroQol-5D; WHO = World Health Organisation. *corrected for any added value to the prediction by gender, age, diagnosis, years of hospitalization, illness severity and use of antipsychotics and antidepressants †For at least one of the quartiles of TAC/h.
See this image and copyright information in PMC

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