Associations between physical activity and motivation, competence, functioning, and apathy in inhabitants with mental illness from a rural municipality: a cross-sectional study

Anders Farholm,Marit Sørensen,Hallgeir Halvari,Torfinn Hynnekleiv

doi:10.1186/s12888-017-1528-3

Abstract

BackgroundThere is increasing evidence for physical activity (PA) having a positive impact on physical and mental health as well as illness symptoms in individuals with severe mental illness (SMI). However, individuals with SMI experience several barriers that makes it difficult to take advantage of the benefits associated with PA. One barrier consistently reported to impede PA is motivational issues. Thus, the main aim of the present study was to examine associations between PA and motivation for PA, perceived competence for PA, functioning, apathy, and demographic variables among individuals with SMI. This was conducted within a larger study aiming at including all inhabitants with SMI in one particular small, rural municipality.MethodA total of 106 participants were recruited to the study. Questionnaire-based interviews conducted by two mental health nurses assessed self-reported PA, motivation and competence for PA, functioning, and apathy. Additionally, 71 participants accepted to wear an accelerometer-equipped wristwatch yielding an objective assessment of PA.ResultsThe participants engaged in little PA. However, they did not lack motivation, as over 90% stated that they would like to be more active, and participants across PA level displayed high scores of a motivation reflecting that they valued the benefits of PA. Results showed that higher self-reported PA level was associated with higher levels of integrated regulated motivation and perceived competence for PA while it was unrelated to functioning and apathy. In the subpopulation with objectively measured PA, integrated regulated motivation for PA remained significantly associated with PA level, whereas poor scores on functioning lowered the odds ratio for higher PA level.ConclusionThe results show that PA specific motivation is associated with PA even when controlling for functioning and apathy. This highlight the importance of facilitating context specific motivation (i.e., motivation for PA) and that health care practitioners should emphasise helping people with SMI develop more intrinsic forms of motivation.

Highlights

There is increasing evidence for physical activity (PA) having a positive impact on physical and mental health as well as illness symptoms in individuals with severe mental illness (SMI)
Results showed that higher self-reported PA level was associated with higher levels of integrated regulated motivation and perceived competence for PA while it was unrelated to functioning and apathy
The results show that PA specific motivation is associated with PA even when controlling for functioning and apathy

Summary

Introduction

There is increasing evidence for physical activity (PA) having a positive impact on physical and mental health as well as illness symptoms in individuals with severe mental illness (SMI). It is well established that people with severe mental illness (SMI) have increased mortality and morbidity compared with the general population. Their life expectancy is reduced by around 15–20 years, and they display disproportionally high prevalence of somatic diseases [1, 2]. Illness symptoms, and physical health comorbidities are consistently reported as major barriers for participating in PA [20,21,22]. Another debilitating factor could be related to motivation. A theoretical framework that have been applied to understand the role of motivation in general [29] and in PA in particular [28] is the Self-Determination Theory (SDT; 30)

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Discussion

Conclusion