The impact of exercise training complementary to early intervention in patients with first-episode psychosis: a qualitative sub-study from a randomized controlled feasibility trial.
Early intervention
Exercise training
First-episode psychosis
Recovery
Schizophrenia
Thematic analysis
Young adults
Journal
BMC psychiatry
ISSN: 1471-244X
Titre abrégé: BMC Psychiatry
Pays: England
ID NLM: 100968559
Informations de publication
Date de publication:
21 06 2019
21 06 2019
Historique:
received:
20
03
2019
accepted:
12
06
2019
entrez:
23
6
2019
pubmed:
23
6
2019
medline:
31
3
2020
Statut:
epublish
Résumé
Burgeoning evidence suggests that exercise improves physical and mental health in people with schizophrenia. However, little is known about the feasibility and acceptability of high-intensity training in patients with first-episode psychosis. This qualitative study explored motivation, social interaction and experiences of participants and instructors in relation to an eight-week moderate to high intensity exercise training programme in a clinical trial including patients with first-episode psychosis. The study used a combination of method, source and investigator triangulation. Data were collected by means of semi-structured individual interviews with participants at baseline (n = 16) and at follow-up (n = 9), as well as by means of participant observations during the programme (8 sessions × 1.5 h, 12 h in total) and focus group discussions with participants (n = 3) and instructors (n = 4), respectively, after the programme. Data were analysed using thematic analysis as described by Braun and Clarke. Three main themes and ten subthemes emerged during the analysis: 1) motivation and expectations for enrolment (subthemes: routines and structure, social obligation, goal setting and self-worth); 2) new demands and opportunities (subthemes: practicalities of the training, an understanding exercise setting, and alone and together); and 3) looking ahead - reflections on impact (subthemes: restored sleep and circadian rhythm, energy and sense of achievement, changed everyday life, and hope of finding a new path). Findings suggest that the programme was appealing to, and appreciated by, the participants because of its potential to create an equally challenging and caring non-clinical environment. This study indicates that supervised, group-based, moderate to high intensity exercise training complementary to early intervention in psychosis is acceptable. Specifically, the intervention appeared to provide patients an opportunity to integrate the notion of being a young individual along with being a patient with a psychiatric diagnosis, thus supporting and promoting recovery. ClinicalTrials.gov identifier: NCT03409393. Registered January 24, 2018.
Sections du résumé
BACKGROUND
Burgeoning evidence suggests that exercise improves physical and mental health in people with schizophrenia. However, little is known about the feasibility and acceptability of high-intensity training in patients with first-episode psychosis. This qualitative study explored motivation, social interaction and experiences of participants and instructors in relation to an eight-week moderate to high intensity exercise training programme in a clinical trial including patients with first-episode psychosis.
METHODS
The study used a combination of method, source and investigator triangulation. Data were collected by means of semi-structured individual interviews with participants at baseline (n = 16) and at follow-up (n = 9), as well as by means of participant observations during the programme (8 sessions × 1.5 h, 12 h in total) and focus group discussions with participants (n = 3) and instructors (n = 4), respectively, after the programme. Data were analysed using thematic analysis as described by Braun and Clarke.
RESULTS
Three main themes and ten subthemes emerged during the analysis: 1) motivation and expectations for enrolment (subthemes: routines and structure, social obligation, goal setting and self-worth); 2) new demands and opportunities (subthemes: practicalities of the training, an understanding exercise setting, and alone and together); and 3) looking ahead - reflections on impact (subthemes: restored sleep and circadian rhythm, energy and sense of achievement, changed everyday life, and hope of finding a new path). Findings suggest that the programme was appealing to, and appreciated by, the participants because of its potential to create an equally challenging and caring non-clinical environment.
CONCLUSIONS
This study indicates that supervised, group-based, moderate to high intensity exercise training complementary to early intervention in psychosis is acceptable. Specifically, the intervention appeared to provide patients an opportunity to integrate the notion of being a young individual along with being a patient with a psychiatric diagnosis, thus supporting and promoting recovery.
TRIAL REGISTRATION
ClinicalTrials.gov identifier: NCT03409393. Registered January 24, 2018.
Identifiants
pubmed: 31226959
doi: 10.1186/s12888-019-2179-3
pii: 10.1186/s12888-019-2179-3
pmc: PMC6588866
doi:
Banques de données
ClinicalTrials.gov
['NCT03409393']
Types de publication
Journal Article
Randomized Controlled Trial
Research Support, Non-U.S. Gov't
Langues
eng
Sous-ensembles de citation
IM
Pagination
192Références
BMC Psychiatry. 2016 Feb 20;16:36
pubmed: 26896958
Can Fam Physician. 2002 Jan;48:65-71
pubmed: 11852614
J Clin Psychiatry. 2015 Apr;76(4):e477-86
pubmed: 25919840
Psychiatry Res. 2014 Dec 15;220(1-2):11-9
pubmed: 25149128
BMJ. 2017 Jan 12;356:i6681
pubmed: 28082379
Early Interv Psychiatry. 2015 Apr;9(2):156-62
pubmed: 24304658
Schizophr Bull. 2018 Oct 17;44(6):1195-1203
pubmed: 29762765
BMJ Open Sport Exerc Med. 2018 Nov 2;4(1):e000435
pubmed: 30498574
J Psychiatr Res. 2018 Jul;102:245-253
pubmed: 29723811
Early Interv Psychiatry. 2019 Jun;13(3):358-368
pubmed: 30039635
J Nerv Ment Dis. 2015 May;203(5):310-8
pubmed: 25919380
Br J Psychiatry Suppl. 2005 Aug;48:s85-90
pubmed: 16055815
Schizophr Bull. 2015 May;41(3):617-26
pubmed: 25381449
BMJ. 2013 May 21;346:f2539
pubmed: 23694688
Schizophr Res. 2013 Sep;149(1-3):112-5
pubmed: 23871398
J Psychiatr Res. 2016 Jun;77:42-51
pubmed: 26978184
Sports Med Open. 2018 Feb 26;4(1):11
pubmed: 29484512
BMJ. 2009 Sep 10;339:b3496
pubmed: 19744976
J Am Heart Assoc. 2015 Jun 26;4(7):
pubmed: 26116691
Eur Neuropsychopharmacol. 2005 Aug;15(4):399-409
pubmed: 15925493
Early Interv Psychiatry. 2018 Jun;12(3):307-315
pubmed: 26987871
PLoS One. 2013 Jun 24;8(6):e67133
pubmed: 23826212
Schizophr Bull. 2017 May 1;43(3):546-556
pubmed: 27521348
New Dir Youth Dev. 2006 Fall;(111):13-28, 7
pubmed: 17225644
Lancet Psychiatry. 2018 Sep;5(9):739-746
pubmed: 30099000
J Ment Health. 2012 Jun;21(3):274-84
pubmed: 22533784
Am Psychol. 2000 Jan;55(1):68-78
pubmed: 11392867
Br J Psychiatry. 2011 Dec;199(6):445-52
pubmed: 22130746
Lancet. 2009 Aug 22;374(9690):635-45
pubmed: 19700006
Trials. 2011 Mar 10;12:72
pubmed: 21392377
Early Interv Psychiatry. 2016 Jun;10(3):267-76
pubmed: 25721464