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Being physically active — A bodily anchorage on the journey for recovery in mental ill-health
Mälardalen University, School of Health, Care and Social Welfare, Health and Welfare. Karolinska Institutet, Stockholm, Sweden.ORCID iD: 0000-0001-8218-1236
2014 (English)Doctoral thesis, comprehensive summary (Other academic)
Abstract [en]

Suffering from mental ill-health does not merely involve mental distress; it also often comprises deteriorated physical health. The physical consequences can be of a severe nature and may lead to premature death. Since physical inactivity has been identified as a critical health risk factor, there is an imperative need to support physical activity in persons with mental ill-health. The benefits of being physically active for persons with mental ill-health are many, but there are also considerable barriers. In mental healthcare and research, there has been increasing attention on a recovery perspective that focuses the personal journey on repossessing meaning in one’s own life. However, in the recovery perspective, as well as in mental healthcare research and praxis in general, there is a lack of recognition of the lived body of the person and the lived experiences of being physically active as a potential part of that journey.

The aim of this thesis is to contribute to our knowledge of aspects of being physically active for recovery in mental ill-health, and how this can be supported in mental healthcare. Overall, this research was conducted using a mixed methods research design, including both qualitative and quantitative methods. Philosophical and theoretical underpinnings consisting of a lifeworld perspective, of the notion of human capability, and of the existential dimensions of recovery have guided the process of seeking a comprehensive understanding of the phenomenon. An initial cross-sectional inventory of the self-reported health and physical activity of persons with mental ill-health was conducted (study I). This inventory showed that this population was a vulnerable group affected by both physical and mental health risk factors and low levels of physical activity. The lived experiences of being physically active in persons with mental ill-health were illuminated, and were interpreted to render opportunities to connect to one’s being-in-the-world and to experienced meaning (study II). As physical activity enabled a sense of meaning, the person’s ability to reclaim life was strengthened. Caregivers’ lived experiences of motivating persons with mental ill-health to be physically active were described as something more than an act of doing – it was a way of being together, sharing experiences through being physically active, and interacting with each other’s life-worlds (study III). In order to investigate a novel mode of physical activity, the use of interactive video games for physical activity among persons with mental ill-health was explored (study IV). Playing interactive video games was found to enable experiences of evolvement and competence, which can be understood as dimensions of personal recovery.

The main finding from this thesis is a recognition of the potential of physical activity for embodied recovery in mental ill-health. Three core aspects were found to articulate the qualitative significance of being physically active as meaning and capability, connectedness, and wholeness. Furthermore, it is assumed, that a person’s barriers to being physically active may not only represent realms of the mental illness itself, but also constitute expressions of disconnectedness from the lived body, as subjectively experienced disembodiment. In conclusion, there is a need to develop a more nuanced understanding of the potential of physical activity in mental healthcare, and by giving room for the lived body, experiences of embodied recovery in mental ill-health can be enabled.

Place, publisher, year, edition, pages
Stockholm: Karolinska Institutet , 2014. , 73 p.
Keyword [en]
caregivers, embodiment, lifeworld, lived body, mental healthcare, mental health nursing, mental ill-health, mixed methods research, personal recovery, phenomenological hermeneutics, physical activity, psychiatric disabilities, self-assessment, single case design
National Category
Health Sciences Other Medical Sciences
Research subject
Care Sciences
Identifiers
URN: urn:nbn:se:mdh:diva-26589ISBN: 978-91-7549-579-8 (print)OAI: oai:DiVA.org:mdh-26589DiVA: diva2:764485
Public defence
2014-06-13, 13:00 (Swedish)
Opponent
Supervisors
Available from: 2014-11-20 Created: 2014-11-19 Last updated: 2016-02-25Bibliographically approved
List of papers
1. Motivation does not come with an ending-it's the beginning of something new: Experiences of motivating persons with psychiatric disabilities to physical activity
Open this publication in new window or tab >>Motivation does not come with an ending-it's the beginning of something new: Experiences of motivating persons with psychiatric disabilities to physical activity
2014 (English)In: Issues in Mental Health Nursing, ISSN 0161-2840, E-ISSN 1096-4673, Vol. 35, no 9, 713-720 p.Article in journal (Refereed) Published
Abstract [en]

Despite strong evidence for the positive relationship between physical activity and mental health, physical activity is used far too little to promote health in mental health care. Fourteen caregivers working in community mental health services were interviewed about their experiences of motivating adult persons with psychiatric disabilities to be physically active, and data were analysed using a phenomenological-hermeneutical approach. Three themes emerged: (1) An approach of conscious acts, (2) Companionship as a joint creation, and (3) Understanding as a way to create meaning. The interpreted meaning of motivating to physical activity was expressed as a dynamic way of being, relating, and understanding.

National Category
Health Sciences
Identifiers
urn:nbn:se:mdh:diva-25910 (URN)10.3109/01612840.2014.901448 (DOI)000353245900010 ()2-s2.0-84906709209 (Scopus ID)
Available from: 2014-09-12 Created: 2014-09-12 Last updated: 2016-04-20Bibliographically approved
2. Moving toward Reclaiming Life: Lived Experiences of Being Physically Active Among Persons with Psychiatric Disabilities
Open this publication in new window or tab >>Moving toward Reclaiming Life: Lived Experiences of Being Physically Active Among Persons with Psychiatric Disabilities
Show others...
2013 (English)In: Issues in Mental Health Nursing, ISSN 0161-2840, E-ISSN 1096-4673, Vol. 34, no 10, 739-746 p.Article in journal (Refereed) Published
Abstract [en]

There is abundant documentation in research about the significant relationship between physical activity and mental health, but there is still more to be learned about what can enhance motivation to become more physically active. Fourteen persons with psychiatric disabilities were interviewed about their experiences of being physically active, and data was analyzed using a phenomenologicalhermeneutic method. Five themes emerged: Capability for Living, Liberation from a Heavy Mind, Companionship in Being in Motion, Longing for Living One’s Life, and Struggling with Limitations. The interpreted meaning of being physically active was to be moving toward reclaiming one’s life.

Keyword
body, hermeneutic phenomenology, physical activity, psychiatric care
National Category
Medical and Health Sciences
Research subject
Care Sciences
Identifiers
urn:nbn:se:mdh:diva-21753 (URN)10.3109/01612840.2013.813097 (DOI)000209366800004 ()2-s2.0-84884806993 (Scopus ID)
Available from: 2013-10-02 Created: 2013-10-02 Last updated: 2016-02-25Bibliographically approved
3. Exploring the significance of interactive video games for physical activity among persons with psychiatric disabilities using experimental single case design
Open this publication in new window or tab >>Exploring the significance of interactive video games for physical activity among persons with psychiatric disabilities using experimental single case design
(English)Manuscript (preprint) (Other academic)
Abstract [en]

Problem: Persons with psychiatric disabilities exhibit low levels of physical activity, which is a known general health risk factor. Nonetheless, physical activity is used far too little as health promotion in mental health care. Interactive video games are an emerging technology that can be used to increase physical activity levels. This study primarily aimed at exploring the significance of these games as a way to promote physical activity and health among persons with psychiatric disabilities.

Method: Two participants played the interactive video game during an intervention for a period of 15 weeks. The study was conducted as a pilot study with a single case design and with an applied mixed methods approach.

Results: Both participants increased their playing time during the intervention, and playing the game was experienced as fun, stimulating, and evolving. Through the challenge that the game provided, the participants’ motivation to continue playing seemed to be reinforced. Playing the game was found to strengthen the participants’ sense of capability and provided an experience of companionship with oneself.

Conclusions: Being physically active in this manner enabled experiences of evolvement and competence, which could be considered an essential driving force of recovery and reconnection with one’s own life. The technique can therefore be regarded as an enabling tool for physical activity — however, the value of the support from another human being cannot be overlooked.

Keyword
mental illness; physical activity; intervention; interactive video game; single case design; mixed methods
National Category
Medical and Health Sciences
Research subject
Care Sciences
Identifiers
urn:nbn:se:mdh:diva-26588 (URN)
Projects
Being physically active — A bodily anchorage on the journey for recovery in mental ill-health
Available from: 2014-11-19 Created: 2014-11-19 Last updated: 2016-02-25Bibliographically approved
4. Self-reported health and physical activity among community mental healthcare users
Open this publication in new window or tab >>Self-reported health and physical activity among community mental healthcare users
Show others...
2013 (English)In: Journal of Psychiatric and Mental Health Nursing, ISSN 1351-0126, E-ISSN 1365-2850, Vol. 20, no 1, 82-90 p.Article in journal (Refereed) Published
Abstract [en]

The aim of the study was to survey the self-reported health and physical activity in a sample of community mental healthcare users in a city of Sweden. The study was conducted through a cross-sectional design with participants requested to fill out a self-report questionnaire. Participants (n =103) were persons with psychiatric disabilities living in residential psychiatric settings and/or participating in daily activities provided by community mental healthcare services. The results showed that the group is affected with serious risk factors, such as high body mass index, low rated extent and frequency of physical activity and low self-estimated general state of health. Even though some difficulties associated with the answering process of this questionnaire emerged, these self-reported results clearly confirm the fact that persons with psychiatric disabilities constitute a vulnerable group in need for health-promoting caring activities and interventions.

Keyword
community mental health care, cross-sectional design, health, physical activity, psychiatric disabilities, self-reported
National Category
Medical and Health Sciences
Research subject
Care Sciences
Identifiers
urn:nbn:se:mdh:diva-15111 (URN)10.1111/j.1365-2850.2012.01951.x (DOI)000312992300010 ()22852556 (PubMedID)2-s2.0-84871812628 (Scopus ID)
Available from: 2012-08-10 Created: 2012-08-10 Last updated: 2016-02-25Bibliographically approved

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