Mental Illness and Physical Health Disorders
Rogerson M, Murphy, M, Bird, S, Morris, T.“I don’t have the heart”: a qualitative study of barriers to and facilitators of physical activity for people with coronary heart disease and depressive symptoms. International Journal of Nutrition and Physical Activity, 2012, 9(140).
- Rogerson et al (2012) used the case study design in their exploration of physical activity and cardiovascular disease.
- Interviews were employed in data collection where fifteen participants with coronary heart disease and depressive symptoms were subjected to in-depth semi-structured interviews.
- A systematic review by Lavie & Milani (2011) indicates an improved health-related quality of life in cardiac patients on formal cardiac rehabilitation and exercise training programs. They recommend that cardiac patients, especially after experiencing two cardiac events should be referred to such programs. Patients should also be vigorously encouraged to attend the programs.
- An appropriate open-ended question to be used in the interviews would be: What is your view on sporting?
- Using the descriptors provided in table 2, the following statements would be categorized as follows:
- “The tennis club I used to belong to has amalgamated with another club about 5 km away, and it’s too hard to get to now.” – perceived external obstacles
- “I just don’t seem to have the energy for going swimming anymore.” – physical restrictions
- “I’d hate to miss out on things like taking my grandkids to the local park.” – having a reason for exercising
- “I’m terrified I might have another heart attack if I go jogging.” – fear of exercise
- “I don’t know if it’s the exercise or the fresh air, but I come back in a better mood than I went out!” – lack of knowledge about exercise
- I’m just not the sporty type-it’s not something I enjoy.” – lack of knowledge regarding exercise
- I can’t be bothered; I have enough of a struggle dragging myself through the day.” – low motivation
- A tentative hypothesis emerging from the study findings that could be ‘tested’ in a follow-up quantitative study is that there is need for physical activity intervention for cardiac patients experiencing depression.
- The study by Rogerson et al (2012) has two limitations. First, the research was limited to a diminutive cardiac population involving only Australians or Europeans. Second, it’s not clear whether depressive symptoms were present during the time of interview since CDS was administered two weeks before the interview.
- As the National Heart Foundation Project Officer, I would use the ‘new finding’ to prepare the transition of patients to home exercise upon completion of the supervised program (Duncan & Pozehl (2002). I would also invoke behavioral change intervention through tailored personal consultation as proposed by Alsaleh et al (2012).
Scott, D, Blurke, K, Williams, S, Happel, B, Canoy, D, & Ronan, K. Increased prevalence of chronic physical health disorders in Australians with diagnosed mental illness. Australian and New Zealand Journal of Public Health, 2012, 36(5): 483-486.
- The aim of the study by Scott et al (2012) is to compare the prevalence of chronic physical health disorders amongst adults with and without mental illness. This study differs from that of Rogerson et al (2012) by the fact that it covers a wider scope and uses comparison. The study design used was the cross-sectional study design (John et al 2010). The method of data collection involved fixed-effects panel.
- Measurement scales were used as follows:
- Physical activity – Interval measurement
- Daily serves of fruits and vegetables – Ratio measurement
- Physical conditions such as stroke, cancer and diabetes – Ordinal measurement
- Mental illness – Ordinal measurement
- The independent variable in this study is mental illness.
- Scott et al (2012) did not use the chi-square in examination of difference of age because a chi-square does not work with continuous data (John et al 2010).
- The ‘No mental illness diagnosis’ has a higher rate of employment compared to the ‘Mental illness diagnosis’. This is statistically significant because employment status is dependent on mental illness.
- The likelihood of a person with mental illness to report having a food allergy or intolerance compared to a person without a mental illness ranges from 50% to about 300%. The difference is statistically significant because it shows that food allergy or intolerance is dependent on mental illness.
- Scott et al (2012) were not able to prove definitely that mental illnesses cause chronic physical health disorders due to the fact that their study lacked reliability. Studies based on fixed-effects panel are subject to tests for causal claims since randomization is not possible and the causal interpretation can be confounded. In addition, all the individuals in the control and treatment groups are not equivalent when the experiment starts. There is no sufficient literature to their arguments. The cohort studies-prospective design would be the best alternative for this case. This is because exposure will be measured before the onset of disease and this ensures unbiased research (John et al 2010) unlike in Scot et al (2012) where exposure was not considered prior to the experiment.
- Current research still holds that people with mental illness are more likely to experience poor physical health than those without a mental illness. Such people are at a particular risk of not adhering to physical activity (Stanton, 2013). Qualitative and quantitative research should now focus on designing the best intervention programs that can help to reduce incidences of mental illness.
Alsaleh, E, Blake, H, & Windle, R 2012, “Behavioural intervention to increase physical activity among patients with coronary heart disease: protocol for a randomized controlled trial,” International Journal of Nursing Studies, 49(12): 1489-93.
Duncan, K, A, & Pozehl, B 2002, “Staying on Course: The effects of an adherence facilitation intervention on home exercise participation,” Progressive in Cardiovascular Nursing, 17(2).
John, A, Samuel, B, Jacquart, P, Lalive, R 2010, “On making causal claims: a review and recommendations,” The Leadership Quarterly, 21:1086-1120.
Lavie, C, J, Milani, R, V 2011, “Cardiac Rehabilitation and Exercise Training in Secondary Coronary Heart Disease Prevention,” Progress in Cardiovascular Diseases, 53(6):397-403.
Rogerson, M, Murphy, M, Bird, S, & Morris, T 2012, ““I don’t have the heart”: a qualitative study of barriers to and facilitators of physical activity for people with coronary heart disease and depressive symptoms,” International Journal of Nutrition and Physical Activity, 9(140).
Scott, D, Blurke, K, Williams, S, Happel, B, Canoy, D, & Ronan, K 2012, “Increased prevalence of chronic physical health disorders in Australians with diagnosed mental illness,” Australian and New Zealand Journal of Public Health, 36(5): 483-486.
Stanton, R 2013, “Accredited Exercise Psychologists and the Treatment of People with Mental Illnesses,” Clinical Practice, 2(2):5-9.
Abstract of Article Review by Lavie et al (2011)
Substantial evidence indicates that increased levels of physical activity, exercise training, and overall cardiorespiratory fitness provide protection in primary and secondary coronary heart disease (CHD) prevention. Clearly, cardiac rehabilitation and exercise training (CRET) programs have been greatly underused in patients with CHD. We review the benefits of formal CRET programs on CHD risk factors including exercise capacity, obesity indices, plasma lipids, inflammation, and psychosocial stress as well as overall morbidity and mortality. These data support the fact that patients with CHD, especially after major CHD events, need routine referral to CRET programs; and patients should be vigorously encouraged to attend these valuable programs.