Understanding the physical activity behavior among patients with psychosis

Abstract

BACKGROUND: Regular physical activity in reducing the risk of certain kinds of cancer, decreasing the chance of suffering chronic diseases, improving the cognitive and executive functioning and diminishing the severity of the mental illness are well developed [1–3]. However, the physical activity level among patients with mental illness was insufficient mainly due to the symptoms of the illness and the side-effect of the medication [4]. In order to successfully promoting regular physical activity in this population, examining the potential factors in predicting the change of physical activity behavior is needed to bring about change in physical activity habit. METHODS: A cross sectional survey questionnaires, which include stages of change, decisional balance, self-efficacy and processes of change, were used in measuring the physical activity behavior of the out-patients who are diagnosed with psychosis with an age between 18 and 64 at the out-patient clinic. RESULTS: Among 181 outpatients, the majority of the subjects were in contemplation stage (51.4%), followed by preparation stage (25.4%), pre-contemplation stage (17.1%) and action and maintenance stages (6.1%). Data in action and maintenance stages were excluded due to the small sample size. Over 64.2% of subjects were diagnosed as schizophrenia spectrum disorder. The mean age of the subjects was 29.2 years old and 55.3% were female. Except the cons of decisional balance and dramatic relief, significant findings were found on all factors. Significant differences were found on self-efficacy F(2,167)=22.74, p<0.001 and the pros of decisional balance F(2,167)=12.21, p<0.001. In the processes of change, consciousness raising F(2,167)=13.90, p<0.001, environmental reevaluation F(2,167)=3.60, p=0.03, self-reevaluation F(2,167)=23.42, p<0.001, social liberation F(2,167)=6.99, p=0.001, counterconditioning F(2,167)=22.61, p<0.001, helping relationships F(2,167)=7.69, p=0.001, reinforcement management F(2,167)=16.92, p<0.001, self-liberation F(2,167)=42.07, p<0.001 and stimulus control F(2,167)=23.69, p<0.001 were also statistically significant. DISCUSSION: Examining the physical activity behavior among patients with psychosis in Hong Kong found significant difference across different stages of change, hence, the strategies in promoting physical activity could be based on these factors. The use of motivational interviewing, which focus on person-centered counselling, will also facilitate the change of physical activity behavior. However, further study is needed to test the utility of these factors in this population as action and maintenance stages were excluded in this study.