Background
Methods
Ethics, consent and permissions
Intervention
Qualitative interviews
Data analysis
Interpretive rigor
Characteristic | Interviewees (n = 13) | Total sample (n = 31) |
---|---|---|
Gender | ||
Male; n (%) | 12 (92) | 25 (81) |
Female; n (%) | 1 (8) | 6 (19) |
Age, years; mean (s.d.) | 26.5 (4.5) | 25.8 (4.6) |
Time in EIS, years; mean (s.d.) | 2.0 (1.3) | 1.9 (1.4) |
ICD-10 Diagnosis; n (%) | ||
Non organic psychosis | 6 (46) | 15 (48) |
Schizophrenia | 5 (38) | 9 (29) |
Schizoaffective disorder | 1 (8) | 3 (10) |
Bipolar disorder | 0 (0) | 1 (3) |
Other psychotic disorder | 1 (8) | 3 (10) |
Physical and Mental Health | ||
BMI, kg/m2: mean (s.d.) | 32.4 (7.2) | 30.4 (6.9) |
PANSS total; mean (s.d.) | 76.7 (12.8) | 79.0 (18.0) |
PANSS positive; mean (s.d.) | 19.8 (5.7) | 18.9 (6.2) |
PANSS negative; mean (s.d.) | 17.5 (3.0) | 19.0 (6.1) |
BDI-II total; mean (s.d.) | 25.1 (12.7) | 21.7 (10.9) |
SOFAS; mean (s.d.) | 47.5 (9.0) | 46.6 (8.0) |
Results
Theme (and subthemes) | Additional example quotes |
---|---|
(A) Exercise alleviating psychiatric symptoms | |
(A1) Reducing positive symptoms | P011: “It’s like, when I’m doing the weights or I’m running, I don’t sit there and think about the voices or what they’re saying, I just think ‘yeah let’s do it!” |
P006: “All your mental issues are going to go away because once you’re concentrating on picking up weights and doing exercise. Then your mind goes somewhere else.” | |
P008: “It makes you calmer when exercising. It gives you a fresh mind. If you have got any worries then just it’ll go away.” | |
(A2) Overcoming negative symptoms and depression | P012: “I felt the change, emotional changes, you know what I mean, that I was like flooded with chemicals if you will, like made me feel good by myself” |
P007: “I think more energetic a bit more enthusiastic kind of thing. Yeah more up for doing things which I probably normally wouldn’t do” | |
P004: “More energetic, feeling happier, makes you feel a lot happier I think. Erm you feel motivated to do things - and energetic.” | |
(A3) Supporting psychological well-being | P006: “Go and exercise you’ll feel you’ll feel your minds gone free. And you’re stress free. You’ll get all your worries to go away, cos you’re concentrating on something else” |
P005: “A lot of people don’t understand how much exercise helps. But if I didn’t do exercise I’d be in a lot worse place than what I am right now cos at times when I feel like I’m just so angry, and stuff like that, I’ve gone training, I’ve done press ups and stuff at home and it’s cleared my head, killed me anger and you feel better for it…” | |
P003: “Yeah, makes you happier really. I don’t know really, just when you’ve done it you’re buzzing aren’t you.” | |
(B) Improved self-perceptions from exercise | |
(B1) Overall confidence | P002: “Has a big err, a big big er, has a big effect on all of it. It makes me feel more happy in myself, you know, more confident, more self erm… [esteem], you know, believe in myself better, a lot more.” |
P012: “once you once you go gym and that after a while you start feeling good about yourself. You start walking round like yeah I’m getting big and do you know what I mean type thing.” | |
P011: “I love it. It’s just like, thinking yeah, I couldn’t do this 4 months ago, now look at me doing it comfortably. Let’s throw it up a gear!” | |
(B2) Benefits extending to other areas of life | P001: “I feel good knowing that I’ve lost weight. I’m really excited and proud of meself that I’ve lost weight…Erm I go out with my friends more and they are like proud of me because they know I’ve lost weight because they know about me wanting to lose it and they have been very supportive as well.” |
P005: “it’s a lot better when you start doing it and like I said you gain that confidence up and you think you just think to yourself I can do this. I’m training and, er give me another year year of doing this I think I’ll be ready to go back to work…and you’ll be nervous getting a job interview or anything, like anyone would, but you’ll go in with your confidence that you gained from going from doing your exercise. And when er like people from interviews see that, you work hard in the gym or something like that they’ll look at you and they’ll think well this guy’s got quite good confidence.” | |
P009: “My head felt a bit better after I’d done the exercise, like it was easier to do uni work and…. I dunno my head just felt a lot clearer.” | |
(B3) Sense of achievement | P002:” Yeah I feel like I’ve achieved summat I feel like you know a lot better in myself I feel like, I should do this every day” |
P005: And you think yeah I feel good, and erm especially if you got somebody with you you know you’ll have it all out that were a good session that and then you’ll go you’ll sit down or you go home you’ll turn your xbox on or you do your house cleaning or something like that and then when you’re going to bed you think I had a good day today | |
P012: “For me…it’s not so much as like putting weight on or losing weight or it was just that feel good factor that I enjoyed…I used to look forward to going to the gym for that particular reason you know to make me feel good and that.” | |
(C) Factors determining participation | |
(C1) Acceptability of individualised routines | P003: “It was good that we got to choose something out of like a list. We could have done all different things… I thought the options were quite good. But I would have like to have done boxercise as well.” |
P007: yeah let them try all the different er materials out there in the gym um different weights machines, definitely they will fit into something that they like yeah | |
P004: “I think it’s er finding what they enjoy what they love to do… And if you can maybe, er, assess what type of exercise would be desirable um then, er, I’m sure they they’re more likely to exercise” | |
(C2) Importance of a training partner | P006: “It wasn’t just him [the trainer] standing and shouting at you. He was like persuading us on like ‘come on you can do it, you can do it!’ when he says things like that it makes me more activate.” |
P005: “[You’ve] got someone there also who’s basically saying, ‘it’s alright I’m here. I’ll show you what you need to learn’ and once like the 6 months is over they’ve got that extra bit of confidence to say I’ll give it a go on me own.” | |
P010: “Yeah definitely I think group work group exercising gets you more motivated than…Whereas if you’re going on your own you don’t really motivate yourself especially this time of year as well.” | |
(C3) Overcoming anxiety and motivational barriers | P001: “…if you go on your own you like don’t know somebody and you feel dead shy and timid and stuff like that, whereas if you go with somebody you’re chatting as you’re swimming or on bikes or at gym or something the time passes and stuff.” |
P002: “They push you to do more than you would and if you’re on your own you might just say oh well I’m not really bothered, but if someone’s with you they’ll they’ll push you to do more they’ll push you to go.” | |
P004: “What really gave me the confidence to go, because the err, we had to work in sort of a group, so we worked in a group and did some sets and stuff, so that was really good. It made me feel a lot secure.” |
P005: “Well with psychosis, which is partly what I suffer from, I hear the voices and stuff like that. But when I’m training, the voices are suppressed, cos I’m so concentrated on lifting that weight up, doing the next exercise, that everything else clears out of your head.”
P006: “it makes me more active, before I was lazy and couldn’t be bothered doing things. But now it’s like I’m more active and I just want to go out there and start going to the gym… Got my get up and go back!”
P002: “I always get them bad days but when I go the gym, like I said, physical exercise, it lets endorphins off in your brain doesn’t it. So even if you are a bit depressed it can erm make you not depressed, [laughs] or make you slightly more happy.”
P009: “…I’d notice, after I’d done the gym sessions, I felt really fresh. Like afterwards like my mind felt kind of washed, if you like.”
P003: “I think people can benefit from it - to get fitter and healthier - Get more confidence and self-esteem.”
P007: “if you can learn and do things in the gym, then you can do it anywhere outside and, you know, you can get other people involved as well. And er it definitely helps your lifestyle you know - it improves your lifestyle.”
P010: “Just lifts your spirits I think when you’ve done it and just makes you feel like you’ve achieved a goal in a day when you go to the gym and if you go swimming or…Definitely lifts it yeah, bit of exercise does.”
P004: “…it’s very important in drawing the individual towards making their own choice, because it is about choice. They can make a choice in what they want to do, and what they love to do, it motivates them to sort of do what they feel happy to do.”
P001: “It’s just summat’ I want to do and it’s just a bit of support and more encouragement to do it. And I got the encouragement and the support, so I did it.
P012: “It’s just good to have a partner you know mentally it’s good having a partner. You know what I mean; when you go out there on your own you just feel like, you know, like you really need somebody to come with you I suppose.”