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theses

Objectives: The objective of this review was to examine the barriers and facilitators surrounding the adoption and maintenance of healthy diet and physical activity among the seriously mentally ill (SMI) population.
Introduction: Lack of physical activity and unhealthy eating are known factors that contribute to poor clinical outcomes in adults suffering from serious mental illness. However, there is a need to examine the barriers and facilitators to adopting healthy lifestyles and healthy eating in SMI and the responses to different approaches that have been employed in addressing these challenges.
Inclusion criteria: This systematic review considered any qualitative studies that describe adults18 years of age or older and suffering from serious mental illness (SMI).
Phenomena of interest: This review examined the facilitators and barriers to healthy diets and physical activity among the SMI.
Context: This review considered SMI individuals that reside in the community and are being treated with either first or second-generation antipsychotic medications.
Methods: This review followed the Joanna Briggs Institute (JBI) approach for qualitative systematic reviews. This review considered any qualitative studies published in full text, English language, and between 2006 when facilitators and barriers to adopting and maintaining healthy diets and physical activities among SMI living in the community were first examined and August 2018 when the search was completed. The databases searched for published and unpublished studies included: CINAHL, PubMed, Scopus, Psych Info, Web of Sciences for published articles, and Virginia Henderson Nursing Library, ProQuest Dissertation and Theses Global, Robert Wood Johnson Foundation Research and Publications, Nutritional Psychiatry and Greynet.
Results: Eighteen articles, representing studies conducted across eight countries and a total of 440 participants (378 individuals suffering from SMI and 62 providers), met the criteria for inclusion. A total of 169 findings were extracted and combined to form 12 categories based on similarities and meanings and then aggregated into 4 synthesized findings (meta-syntheses). 1) Social barriers, stigma and access are significant barriers to healthy eating and physical activity; 2) The disabling physical and psychological symptoms of mental illness, medication side effects and accompanying co-morbid conditions are significant barriers to healthy eating and physical activity; 3) Structured wellness/health promotion programs that include provider and family support and the opportunity to establish connections with others facilitate accomplishment of healthy eating and physical activity; and 4) Physical activity enhances enjoyment in life and well-being and can positively impact mental health symptoms.
Conclusions: The major conclusion of this review is that promoting structured physical activity and healthy eating, reducing social barriers and creating knowledge, a general awareness that physical activity and healthy eating prevent disease and SMI are an at-risk group with notable disparities in health outcomes and greater efforts must be taken to improve knowledge not only of those with SMI but their professional and family caregivers.

ETD_10040

DNP

Includes bibliographical references

doi:10.7282/t3-n0fn-jq06

ETD doctoral

The author owns the copyright to this work.