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Inhibited autonomy for promoting physical health: qualitative analysis of narratives from persons living with severe mental illness

  • Miharu Nakanishi (a1), Shintaro Tanaka (a2), George Kurokawa (a3), Shuntaro Ando (a4), Syudo Yamasaki (a5), Masato Fukuda (a6), Kiyohisa Takahashi (a7), Takuya Kojima (a8) and Atsushi Nishida (a9)...

Abstract

Background

Autonomy is a key factor in the reduction of inequitable physical healthcare among people with severe mental illness compared with the general population.

Aims

To clarify the critical mechanism underlying autonomy in physical health promotion based on the perspectives of people with severe mental illness.

Method

We employed a conventional content analysis of narrative data from the Healthy Active Lives in Japan (HeAL Japan) workshop meetings.

Results

‘Inhibited autonomy’ was extracted as a central component and shaped by the users’ experiences, both in a healthcare setting and in real life. This component emerged based on the lack of an empowerment mechanism in psychiatric services.

Conclusions

A barrier to the encouragement of autonomy in physical health promotion was found in current psychiatric services. An effective strategy should be explored to foster an empowerment mechanism in psychiatric and mental health services.

Declaration of interest

None.

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Copyright

This is an Open Access article, distributed under the terms of the Creative Commons Attribution-NonCommercial-NoDerivatives licence (http://creativecommons.org/licenses/by-nc-nd/4.0/), which permits non-commercial re-use, distribution, and reproduction in any medium, provided the original work is unaltered and is properly cited. The written permission of Cambridge University Press must be obtained for commercial re-use or in order to create a derivative work.

Corresponding author

Correspondence: Miharu Nakanishi, Mental Health Promotion Project, Tokyo Metropolitan Institute of Medical Science, 2-1-6 Kamikitazawa, Setagaya-ku, Tokyo 156-8506, Japan. Email: mnakanishi-tky@umin.ac.jp

References

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1Lawrence, D, Hancock, K, Kiseky, S. The gap in life expectancy from preventable physical illness in psychiatric patients in Western Australia: retrospective analysis of population based registers. BMJ 2013; 346: f2539.
2Kondo, S, Kumakura, Y, Kanehara, A, Nagato, D, Ueda, T, Matsuoka, T, et al. Premature deaths among individuals with severe mental illness after discharge from long-term hospitalisation in Japan: a naturalistic observation during a 24-year period. BJPsych Open 2017; 3: 193–5.
3Correll, CU, Solmi, M, Veronese, N, Bortolato, B, Rosson, S, Santonastaso, P, et al. Prevalence, incidence and mortality from cardiovascular disease in patients with pooled and specific severe mental illness: a large-scale meta-analysis of 3 211 768 patients and 113 383 368 controls. World Psychiatry 2017; 16: 163–80.
4Correll, CU, Detraux, J, De Lepeleire, J, De Heart, M. Effects of antipsychotics, antidepressants and mood stabilizers on risk for physical diseases in people with schizophrenia, depression and bipolar disorder. World Psychiatry 2015; 14: 119–36.
5Meyer, JM, Davis, VG, Goff, DC, McEvoy, JP, Nasrallah, HA, Davis, SM, et al. Change in metabolic syndrome parameters with antipsychotic treatment in the CATIE Schizophrenia Trial: prospective data from phase 1. Schizophr Res 2008; 101: 273–86.
6Hert, MD, Correll, CU, Bobes, J, Cetkovich-Bakmas, M, Cohen, D, Asai, I, et al. Physical illness in patients with severe mental disorders. I. Prevalence, impact of medications and disparities in health care. World Psychiatry 2011; 10: 5277.
7Moreno, C, Nuevo, R, Chatterji, S, Verdes, E, Arango, C, Ayuso-Mateos, JL. Psychotic symptoms are associated with physical health problems independently of a mental disorder diagnosis: results from the WHO World Health Survey. World Psychiatry 2013; 12: 251–7.
8Moore, S, Shiers, D, Daly, B, Mitchell, AJ, Gaughran, F. Promoting physical health for people with schizophrenia by reducing disparities in medical and dental care. Acta Psychiatr Scand 2015; 132: 109–21.
9Scott, D, Happel, B. The high prevalence of poor physical health and unhealthy lifestyle behaviours in individuals with severe mental illness. Issues Ment Health Nurs 2011; 32: 589–97.
10De Hert, M, Cohen, D, Bobes, J, Cetkovich-Bakmas, M, Leucht, S, Ndetei, DM, et al. Physical illness in patients with severe mental disorders. II. Barriers to care, monitoring and treatment guidelines plus recommendations at the system and individual level. World Psychiatry 2011; 10: 138–51.
11Bartels, SJ, Pratt, SI, Aschbrenner, KA, Barre, LK, Jue, K, Wolfe, RS, et al. Clinically significant improved fitness and weight loss among overweight persons with serious mental illness. Psychiatr Serv 2013; 64: 729–36.
12Wu, RR, Zhao, JP, Jin, H, Shao, P, Fang, MS, Guo, XF, et al. Lifestyle intervention and metformin for treatment of antipsychotic-induced weight gain. JAMA 2008; 29: 185–93.
13Daumit, GL, Dickerson, FB, Wang, NY, Dalcin, A, Jerome, GJ, Anderson, CAM, et al. A behavioral weight-loss intervention in persons with serious mental illness. N Engl J Med 2013; 368: 1594–602.
14Firth, J, Cotter, J, Elliott, R, French, P, Yung, AR. A systematic review and meta-analysis of exercise interventions in schizophrenia patients. Psychol Med 2015; 45: 1343–61.
15Rosenbaum, S, Tiedemann, A, Sherrington, C, Curtis, J, Ward, PB. Physical activity interventions for people with mental illness: a systematic review and meta-analysis. J Clin Psychiatry 2014; 75: 964–74.
16Vancampfort, D, Rosenbaum, S, Schuch, FB, Ward, PB, Probst, M, Stubbs, B. Prevalence and predictors of treatment dropout from physical activity interventions in schizophrenia: a meta-analysis. Gen Hosp Psychiatry 2016; 39: 1523.
17Vancampfort, D, De Hert, M, Vansteenkiste, M, De Herdt, A, Scheewe, TW, Soundy, A, et al. The importance of self-determined motivation towards physical activity in patients with schizophrenia. Psychiatry Res 2013; 210: 812–8.
18Carney, R, Cotter, J, Bradshaw, T, Yung, AR. Examining the physical health and lifestyle of young people at ultra-high risk for psychosis: a qualitative study involving service users, parents and clinicians. Psychiatry Res 2017; 255: 8793.
19Vancampfort, D, Vansteenkiste, M, De Hert, M, De Hert, A, Soundy, A, Stubbs, B, et al. Self-determination and stage of readiness to change physical activity behaviour in schizophrenia. Ment Health Phys Act 2014; 7: 171–6.
20Organisation for Economic Co-operation and Development (OECD). OECD Reviews of Health Care Quality: Japan 2015: Raising Standards. OECD Publishing, 2015.
21Hsieh, H-F, Shannon, SE. Three approaches to qualitative content analysis. Qual Health Res 2005; 15: 1277–88.
22National Center of Neurology and Psychiatry. The survey of Mental Health (630 survey). Department of Mental Health Policy and Evaluation, National Institute of Mental Health, National Center of Neurology and Psychiatry, 2017 (http://www.ncnp.go.jp/nimh).
23Hatano, M, Kamei, H, Kato, A, Takeuchi, I, Hanya, M, Uno, J, et al. Assessment of the latent adverse events of antipsychotic treatment using a subjective questionnaire in Japanese patients with schizophrenia. Clin Psychopharmacol Neurosci 2017; 15: 132–7.
24Sullivan, G, Mittal, D, Reaves, CM, Haynes, TF, Han, X, Mukherjee, S, et al. Influence of schizophrenia diagnosis on providers’ practice decisions. J Clin Psychiatry 2015; 76: 1068–74.
25Laugharne, J, Waterreus, AJ, Castle, DJ, Dragovic, M. Screening for the metabolic syndrome in Australia: a national survey of psychiatrists’ attitudes and reported practice in patients prescribed antipsychotic drugs. Australas Psychiatry 2015; 24: 62–6.

Keywords

Inhibited autonomy for promoting physical health: qualitative analysis of narratives from persons living with severe mental illness

  • Miharu Nakanishi (a1), Shintaro Tanaka (a2), George Kurokawa (a3), Shuntaro Ando (a4), Syudo Yamasaki (a5), Masato Fukuda (a6), Kiyohisa Takahashi (a7), Takuya Kojima (a8) and Atsushi Nishida (a9)...

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Inhibited autonomy for promoting physical health: qualitative analysis of narratives from persons living with severe mental illness

  • Miharu Nakanishi (a1), Shintaro Tanaka (a2), George Kurokawa (a3), Shuntaro Ando (a4), Syudo Yamasaki (a5), Masato Fukuda (a6), Kiyohisa Takahashi (a7), Takuya Kojima (a8) and Atsushi Nishida (a9)...
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