Participação de pessoas com esquizofrenia em programa de exercícios físicos com duração de cinco meses: estudo CORTEX-SP
DOI:
https://doi.org/10.47197/retos.v54.102995Palavras-chave:
schizophrenia, community exercise, qualitative methos, environmental health, mental healthResumo
Os programas de exercício representam recursos não farmacológicos úteis na prevenção e tratamento de perturbações mentais graves, como a esquizofrenia (SZ), mas há razões já mencionadas (ou seja, baixas taxas de participação). O objetivo do estudo foi explorar a participação de pessoas com diagnóstico de SZ em um programa de exercícios de cinco meses. Amostragem de critério proposital foi usada para recrutar 35 participantes com diagnóstico de SZ. Os dados qualitativos foram coletados por meio de entrevistas semiestruturadas, que foram gravadas e transcritas na íntegra. Posteriormente, os dados foram analisados por meio da análise temática. A partir da análise foram identificados três temas: fatores intrapessoais (características e consequências clínicas da SZ e da farmacoterapia), fatores interpessoais (relações com as pessoas que participam, profissionais de saúde e familiares e amigos) e fatores ambientais (organização do programa de exercícios e percepção dos participantes em relação ao programa). Conclui-se que os sintomas e tratamentos farmacológicos da doença foram percebidos como as principais barreiras à prática de exercícios físicos pelos participantes. O grupo de participantes deu grande importância aos fatores interpessoais, perceberam o ambiente grupal e o ambiente do programa como eixos fundamentais do mesmo. A presença de profissionais de saúde, bem como o apoio, também foram percebidos como facilitadores do comprometimento com o programa de exercícios ao participar do programa. Palavras-chave: esquizofrenia, exercício comunitário, métodos qualitativos, saúde ambiental, saúde mental.Referências
Abi-Dargham, A. (2014). Schizophrenia: overview and dopamine dysfunction. The Journal of Clinical Psychiatry, 75(11), e31. DOI: 10.4088/JCP.13078tx2c
American Psychiatric Association. (2013). Diagnostic and statistical manual of mental disorders: DSM-5. American Psychi-atric Publishing, Inc.
Bishop, D. J., Bartlett, J., Fyfe, J. J., & Lee, M. (2019). Methodological considerations for concurrent training: Scientific basics and practical applications. Concurrent Aerobic and Strength Training.
Brand, S., Colledge, F., Beeler, N., Pühse, U., Kalak, N., Sadeghi Bahmani, D., Mikoteit, T., Holsboer-Trachsler, E., & Gerber, M. (2016). The current state of physical activity and exercise programs in German-speaking, Swiss psy-chiatric hospitals: results from a brief online survey. Neuropsychiatric Disease and Treatment, 12, 1309-1317. DOI: 10.2147/NDT.S107313
Braun, V., & Clarke, V. (2006). Using thematic analysis in psychology. Qualitative Research in Psychology, 3(2), 77-101. DOI: 10.1191/1478088706qp063oa
Bryant, R. A., Moulds, M. L., Guthrie, R. M., & Nixon, R. D. V. (2005). The Additive Benefit of Hypnosis and Cogni-tive-Behavioral Therapy in Treating Acute Stress Disorder. Journal of Consulting and Clinical Psychology, 73(2), 334-340. DOI: 10.1037/0022-006X.73.2.334
Bueno-Antequera, J., & Munguía-Izquierdo, D. (2020). Exercise and Schizophrenia. Advances in Experimental Medicine and Biology, 1228, 317-332. DOI: 10.1007/978-981-15-1792-1_21
Bull, F. C., Al-Ansari, S. S., Biddle, S., Borodulin, K., Buman, M. P., Cardon, G., Carty, C., Chaput, J., Chastin, S., Chou, R., Dempsey, P. C., DiPietro, L., Ekelund, U., Firth, J., Friedenreich, C. M., Garcia, L., Gichu, M., Jago, R., Katzmarzyk, P. T., . . . Willumsen, J. F. (2020). World Health Organization 2020 guidelines on physical activ-ity and sedentary behaviour. British Journal of Sports Medicine, 54(24), 1451-1462. DOI: 10.1136/bjsports-2020-102955
Callaghan, P. (2004). Exercise: a neglected intervention in mental health care? Journal of Psychiatric and Mental Health Nursing, 11(4), 476-483. DOI: 10.1111/j.1365-2850.2004.00751.x
Carless, D., & Sparkes, A. C. (2008). The physical activity experiences of men with serious mental illness: Three short stories. Psychology of Sport and Exercise, 9(2), 191-210. DOI: 10.1016/j.psychsport.2007.03.008
Chapman, J. J., Fraser, S. J., Brown, W. J., & Burton, N. W. (2016). Physical activity preferences, motivators, barri-ers and attitudes of adults with mental illness. Journal of Mental Health (Abingdon, England), 25(5), 448-454. DOI: 10.3109/09638237.2016.1167847
Crone, D., & Guy, H. (2008). 'I know it is only exercise, but to me it is something that keeps me going': a qualitative approach to understanding mental health service users' experiences of sports therapy. International Journal of Mental Health Nursing, 17(3), 197-207. DOI: 10.1111/j.1447-0349.2008.00529.x
Eatough, V., & Smith, J. A. (2008). Interpretative phenomenological analysis. The sage handbook of qualitative research in psychology.
Erlandson, D. A., Harris, E. L., Skipper, B. L., & Allen, S. D. (1993). Doing naturalistic inquiry: A guide to methods. Sage Publications, Inc.
Firth, J., Rosenbaum, S., Stubbs, B., Gorczynski, P., Yung, A. R., & Vancampfort, D. (2016). Motivating factors and barriers towards exercise in severe mental illness: a systematic review and meta-analysis. Psychological Medicine, 46(14), 2869-2881. DOI: 10.1017/S0033291716001732
Firth, J., Solmi, M., Wootton, R. E., Vancampfort, D., Schuch, F. B., Hoare, E., Gilbody, S., Torous, J., Teasdale, S. B., Jackson, S. E., Smith, L., Eaton, M., Jacka, F. N., Veronese, N., Marx, W., Ashdown-Franks, G., Siskind, D., Sarris, J., Rosenbaum, S., . . . Stubbs, B. (2020). A meta-review of "lifestyle psychiatry": the role of exercise, smoking, diet and sleep in the prevention and treatment of mental disorders. World Psychiatry: Official Journal of the World Psychiatric Association (WPA), 19(3), 360-380. DOI: 10.1002/wps.20773
Gandhi, S., Gurusamy, J., Damodharan, D., Ganesan, V., & palaniappan, M. (2019). Facilitators of healthy life style behaviors in persons with schizophrenia—A qualitative feasibility pilot study. Asian Journal of Psychiatry, 40, 3-8. DOI: 10.1016/j.ajp.2019.01.003
Geretsegger, M., Mössler, K. A., Bieleninik, Ł, Chen, X., Heldal, T. O., & Gold, C. (2017). Music therapy for people with schizophrenia and schizophrenia-like disorders. The Cochrane Database of Systematic Reviews, 5(5), CD004025. DOI: 10.1002/14651858.CD004025.pub4
Gibbs, G. (2013). El análisis de datos cualitativos en investigación cualitativa (Vol. 6). Ediciones Morata.
Gomes, E., Bastos, T., Probst, M., Ribeiro, J. C., Silva, G., & Corredeira, R. (2014). Effects of a group physical activi-ty program on physical fitness and quality of life in individuals with schizophrenia. Mental Health and Physical Activi-ty, 7(3), 155-162. DOI: 10.1016/j.mhpa.2014.07.002
Gross, J., Vancampfort, D., Stubbs, B., Gorczynski, P., & Soundy, A. (2016). A narrative synthesis investigating the use and value of social support to promote physical activity among individuals with schizophrenia. Disability and Rehabilitation, 38(2), 123-150. DOI: 10.3109/09638288.2015.1024343
Happell, B., Dares, G., Russell, A., Cokell, S., Platania-Phung, C., & Gaskin, C. J. (2012). The relationships between attitudes toward seclusion and levels of burnout, staff satisfaction, and therapeutic optimism in a district health ser-vice. Issues in Mental Health Nursing, 33(5), 329-336. DOI: 10.3109/01612840.2011.644028
Ho, S. S., Dhaliwal, S. S., Hills, A. P., & Pal, S. (2012). The effect of 12 weeks of aerobic, resistance or combination exercise training on cardiovascular risk factors in the overweight and obese in a randomized trial. BMC Public Health, 12, 704. DOI: 10.1186/1471-2458-12-704
Johnstone, R., Nicol, K., Donaghy, M., & Lawrie, S. (2009). Barriers to uptake of physical activity in community-based patients with schizophrenia. Journal of Mental Health, 18(6), 523-532. DOI: 10.3109/09638230903111114
Karlsson, V., & Danielsson, L. (2020). Motivators for patients with schizophrenia spectrum disorders to start and maintain exercising: a qualitative interview study. European Journal of Physiotherapy, 24(1), 30-38. DOI: 10.1080/21679169.2020.1776386
Lieberman, J. A., & First, M. B. (2018). Psychotic Disorders. The New England Journal of Medicine, 379(3), 270-280. DOI: 10.1056/NEJMra1801490
Maayan, L., Vakhrusheva, J., & Correll, C. U. (2010). Effectiveness of medications used to attenuate antipsychotic-related weight gain and metabolic abnormalities: a systematic review and meta-analysis. Neuropsychopharmacology: Official Publication of the American College of Neuropsychopharmacology, 35(7), 1520-1530. DOI: 10.1038/npp.2010.21
Mason, O. J., & Holt, R. (2012). Mental health and physical activity interventions: a review of the qualitative litera-ture. Journal of Mental Health (Abingdon, England), 21(3), 274-284. DOI: 10.3109/09638237.2011.648344
Miyamoto, S., Miyake, N., Jarskog, L. F., Fleischhacker, W. W., & Lieberman, J. A. (2012). Pharmacological treat-ment of schizophrenia: a critical review of the pharmacology and clinical effects of current and future therapeutic agents. Molecular Psychiatry, 17(12), 1206-1227. DOI: 10.1038/mp.2012.47
Olfson, M., Gerhard, T., Huang, C., Crystal, S., & Stroup, T. S. (2015). Premature Mortality Among Adults With Schizophrenia in the United States. JAMA Psychiatry, 72(12), 1172-1181. DOI: 10.1001/jamapsychiatry.2015.1737
Pescatello, L. S., MacDonald, H. V., Ash, G. I., Lamberti, L. M., Farquhar, W. B., Arena, R., & Johnson, B. T. (2015). Assessing the Existing Professional Exercise Recommendations for Hypertension: A Review and Recom-mendations for Future Research Priorities. Mayo Clinic Proceedings, 90(6), 801-812. DOI: 10.1016/j.mayocp.2015.04.008
Pettigrew, T. F. (1998). Intergroup contact theory. Annual Review of Psychology, 49(1), 65-85. DOI: 10.1146/annurev.psych.49.1.65
Pitschel-Walz, G., Leucht, S., Bauml, J., Kissling, W., & Engel, R. R. (2001). The effect of family interventions on relapse and rehospitalization in schizophrenia--a meta-analysis. Schizophrenia Bulletin, 27(1), 73-92. DOI: 10.1093/oxfordjournals.schbul.a006861
Rastad, C., Martin, C., & Asenlöf, P. (2014). Barriers, benefits, and strategies for physical activity in patients with schizophrenia. Physical Therapy, 94(10), 1467-1479. DOI: 10.2522/ptj.20120443
Roberts, S. H., & Bailey, J. E. (2013). An ethnographic study of the incentives and barriers to lifestyle interventions for people with severe mental illness. Journal of Advanced Nursing, 69(11), 2514-2524. DOI: 10.1111/jan.12136
Riddoch, C. J., Puig-Ribera, A., & Cooper, A. R. (1998). Effectiveness of physical activity promotion schemes in pri-mary care: A review. Hea
Rosenbaum, S., Hobson-Powell, A., Davison, K., Stanton, R., Craft, L. L., Duncan, M., Elliot, C., & Ward, P. B. (2018). The Role of Sport, Exercise, and Physical Activity in Closing the Life Expectancy Gap for People with Mental Illness: An International Consensus Statement by Exercise and Sports Science Australia, American College of Sports Medicine, British Association of Sport and Exercise Science, and Sport and Exercise Science New Zealand. Translational Journal of the American College of Sports Medicine, 3(10), 72–73. DOI: 10.1249/TJX.0000000000000061
Sáez Olmos, J., & Caravaca Llamas, C. (2021). Resultados del programa de actividades físicas asistidas con animales como forma de motivación deportiva en personas con enfermedad mental (Results of the program of assisted phy-sical activities with animals as a form of sports motivation in people with. Retos: nuevas tendencias en educación física, deporte y recreación, 39, 675–680. DOI: 10.47197/retos.v0i39.82158
Sallis, J. F., & Owen, N. (1999). Physical activity and behavioural medicine. Sage Publications.
Sallis, J. F., Cervero, R. B., Ascher, W., Henderson, K. A., Kraft, M. K., & Kerr, J. (2006). An ecological approach to creating active living communities. Annual Review of Public Health, 27, 297–322. DOI: 10.1146/annurev.publhealth.27.021405.102100
Saunders, B., Sim, J., Kingstone, T., Baker, S., Waterfield, J., Bartlam, B., Burroughs, H., & Jinks, C. (2018). Satura-tion in qualitative research: exploring its conceptualization and operationalization. Quality and Quantity, 52(4), 1893-1907. DOI: 10.1007/s11135-017-0574-8
Silva, B. A. E., Cassilhas, R. C., Attux, C., Cordeiro, Q., Gadelha, A. L., Telles, B. A., Bressan, R. A., Ferreira, F. N., Rodstein, P. H., Daltio, C. S., Tufik, S., & de Mello, M. T. (2015). A 20-week program of resistance or concurrent exercise improves symptoms of schizophrenia: results of a blind, randomized controlled trial. Brazilian Journal of Psychiatry, 37(4), 271-279. DOI: 10.1590/1516-4446-2014-1595
Soares, W., Grava, M., Cassan, S., Navarro, D., Roque, T., Soares, G.,& Lopes, E. (2021). Reasons for high school students dropping out of physical education classes. Retos: nuevas tendencias en educación física, deporte y recreación, (39), 705-712
Soundy, A., Faulkner, G., & Taylor, A. (2007). Exploring variability and perceptions of lifestyle physical activity among individuals with severe and enduring mental health problems: A qualitative study. Journal of Mental Health, 16(4), 493-503. DOI: 10.1080/09638230701482345
Soundy, A., Stubbs, B., Probst, M., Hemmings, L., & Vancampfort, D. (2014). Barriers to and Facilitators of Physical Activity Among Persons With Schizophrenia: A Survey of Physical Therapists. Psychiatric Services, 65(5), 693-696. DOI: 10.1176/appi.ps.201300276
Strassnig, M. T., Raykov, T., O'Gorman, C., Bowie, C. R., Sabbag, S., Durand, D., Patterson, T. L., Pinkham, A., Penn, D. L., & Harvey, P. D. (2015). Determinants of different aspects of everyday outcome in schizophrenia: The roles of negative symptoms, cognition, and functional capacity. Schizophrenia Research, 165(1), 76-82. DOI: 10.1016/j.schres.2015.03.033
Stubbs, B., Firth, J., Berry, A., Schuch, F. B., Rosenbaum, S., Gaughran, F., Veronesse, N., Williams, J., Craig, T., Yung, A. R., & Vancampfort, D. (2016). How much physical activity do people with schizophrenia engage in? A systematic review, comparative meta-analysis and meta-regression. Schizophrenia Research, 176(2-3), 431-440. DOI: S0920-9964(16)30241-9
Stubbs, B., Vancampfort, D., Hallgren, M., Firth, J., Veronese, N., Solmi, M., Brand, S., Cordes, J., Malchow, B., Gerber, M., Schmitt, A., Correll, C. U., De Hert, M., Gaughran, F., Schneider, F., Kinnafick, F., Falkai, P., Möl-ler, H., & Kahl, K. G. (2018). EPA guidance on physical activity as a treatment for severe mental illness: a meta-review of the evidence and Position Statement from the European Psychiatric Association (EPA), supported by the International Organization of Physical Therapists in Mental Health (IOPTMH). European Psychiatry: The Journal of the Association of European Psychiatrists, 54, 124-144. DOI: 10.1016/j.eurpsy.2018.07.004
Terry, P. C., Karageorghis, C. I., Curran, M. L., Martin, O. V., & Parsons-Smith, R. L. (2020). Effects of music in exercise and sport: A meta-analytic review. Psychological Bulletin, 146(2), 91-117. DOI: 10.1037/bul0000216
Tous-Espelosin, M., de Azua, S. R., Iriarte-Yoller, N., MartinezAguirre-Betolaza, A., Sanchez, P. M., Corres, P., Arratibel-Imaz, I., Sampedro, A., Pena, J., & Maldonado-Martin, S. (2021). Clinical, physical, physiological, and cardiovascular risk patterns of adults with schizophrenia: CORTEX-SP study: Characterization of adults with schizophrenia. Psychiatry Research, 295, 113580. DOI: S0165-1781(20)33241-8
Tous-Espelosin, M., Crone, D., Ruiz de Azua, S., Iriarte-Yoller, N., Sampedro, A., & Maldonado-Martín, S. (2023a). 'It Helped Me to Disconnect My Mind from the Problems': The Subjective Experiences of People with Schizophre-nia Taking Part in a Concurrent Exercise Program. Issues in Mental Health Nursing, 1-9. DOI: 10.1080/01612840.2023.2212781
Tous-Espelosin M, Fernandez-Lasa U, Romaratezabala E. (2023b). "Out-of-Hospital and with Qualified Exercise Professionals": Keys to the CORTEX-SP Physical Exercise Program According to the Experience of the Partici-pants. Eur J Investig Health Psychol Educ, 13(9), 1728-1737. DOI: 10.3390/ejihpe13090125.
Tous-Espelosin, M., Ruiz de Azua, S., Iriarte-Yoller, N., Sanchez, P. M., Elizagarate, E., & Maldonado-Martín, S. (2023c). As we were and as we should be, combined exercise training in adults with schizophrenia: CORTEX-SP study part I. Medicine and Science in Sports and Exercise, 56(1), 73-81. DOI: 10.1249/MSS.0000000000003284
Urcia, I. A. (2021). Comparisons of Adaptations in Grounded Theory and Phenomenology: Selecting the Specific Qualitative Research Methodology. International Journal of Qualitative Methods, 20. DOI: 10.1177/16094069211045474
Vancampfort, D., Rosenbaum, S., Probst, M., Connaughton, J., du Plessis, C., Yamamoto, T., & Stubbs, B. (2016). What are the top 10 physical activity research questions in schizophrenia? Disability and Rehabilitation, 38(22), 2235-2243. DOI: 10.3109/09638288.2015.1116622
Vancampfort, D., Sánchez, C. P. R., Hallgren, M., Schuch, F., Firth, J., Rosenbaum, S., Van Damme, T., & Stubbs, B. (2021). Dropout from exercise randomized controlled trials among people with anxiety and stress-related dis-orders: A meta-analysis and meta-regression. Journal of Affective Disorders, 282, 996-1004. DOI: 10.1016/j.jad.2021.01.003
Yung, A. R., & Firth, J. (2017). How should physical exercise be used in schizophrenia treatment? Expert Review of Neurotherapeutics, 17(3), 213-214. DOI: 10.1080/14737175.2017.1275571
Downloads
Publicado
Como Citar
Edição
Secção
Licença
Direitos de Autor (c) 2024 Retos
Este trabalho encontra-se publicado com a Licença Internacional Creative Commons Atribuição-NãoComercial-SemDerivações 4.0.
Autores que publicam nesta revista concordam com os seguintes termos:
- Autores mantém os direitos autorais e assegurar a revista o direito de ser a primeira publicação da obra como licenciado sob a Licença Creative Commons Attribution que permite que outros para compartilhar o trabalho com o crédito de autoria do trabalho e publicação inicial nesta revista.
- Os autores podem estabelecer acordos adicionais separados para a distribuição não-exclusiva da versão do trabalho publicado na revista (por exemplo, a um repositório institucional, ou publicá-lo em um livro), com reconhecimento de autoria e publicação inicial nesta revista.
- É permitido e os autores são incentivados a divulgar o seu trabalho por via electrónica (por exemplo, em repositórios institucionais ou no seu próprio site), antes e durante o processo de envio, pois pode gerar alterações produtivas, bem como a uma intimação mais Cedo e mais do trabalho publicado (Veja O Efeito do Acesso Livre) (em Inglês).
Esta revista é a "política de acesso aberto" de Boai (1), apoiando os direitos dos usuários de "ler, baixar, copiar, distribuir, imprimir, pesquisar, ou link para os textos completos dos artigos". (1) http://legacy.earlham.edu/~peters/fos/boaifaq.htm#openaccess