Physical Health Interventions Research Articles

Exploring the role of dietitians in mental health services and the perceived barriers and enablers to service delivery: A cross-sectional study.

Mental health is a rapidly evolving area of practice for dietitians. The role of dietitians in supporting the physical health of consumers experiencing mental illness is becoming more widely recognised given the importance of lifestyle interventions for physical health. The present study aimed to explore the dietitian role in mental health services as well as identify barriers and enablers to service delivery. This was a cross-sectional survey of dietitians currently employed in any capacity in public and private mental health services. An online survey comprised of questions pertaining to four domains, including demographics, role and service provision, experience and supervision, barriers/challenges and drivers/enablers was completed and included closed and open-ended responses. In total, 48 responses were included. The mean ± SD age of respondents was 36.1 ± 10.9 years (range 23-67 years) with the majority working in inpatient settings. The top three tasks respondents reported conducting were individual consultations (n = 47; 98%), group programs (n = 23; 48%) and multidisciplinary team meetings. Barriers included a lack of awareness from others regarding a dietitian's role in mental health, and a lack of specific tools for nutrition screening. More training, resources and increased evidence base to guide practice would enable better service provision. The present study provides insights regarding the possible drivers and barriers to effective service provision for dietitians working in mental health services focusing on the local contexts of respondents. The findings highlight the importance and value of working collaboratively within a multidisciplinary team.

Using digital technology to promote physical health in mental healthcare: A sequential mixed-methods study of clinicians' views.

Recent years have seen innovation in 'mHealth' tools and health apps for the management/promotion of physical health and fitness across the general population. However, there is limited research on how this could be applied to mental healthcare. Therefore, we examined mental healthcare professionals' current uses and perceived roles of digital lifestyle interventions for promoting healthy lifestyles, physical health and fitness in youth mental healthcare. A sequential, mixed-methods design was used, consisting of a quantitative online survey, followed by qualitative in-depth interviews. A total of 127 mental healthcare professionals participated in the online survey. Participants had limited mHealth experience, and the majority agreed that further training would be beneficial. Thirteen mental healthcare professionals were interviewed. Five themes were generated (i) digital technology's ability to enhance the physical healthcare; (ii) Conditions for the acceptability of apps; (iii) Limitations on staff capability and time; (iv) Motivation as the principal barrier; and (v) Practicalities around receiving lifestyle data. Systematic integration of data produced novel insights around: (i) staff involvement and needs; (ii) ideal focus and content of digital lifestyle interventions; and (iii) barriers towards implementation (including mental healthcare professionals own limited experience using digital lifestyle interventions, which aligned with the appeal of formal training). Overall, digital lifestyle interventions were positively received by mental healthcare professionals, particularly for health behaviour-tracking and mHealth support for exercise and nutrition. Practical suggestions for facilitating their uptake/implementation to improve availability of physical health interventions in mental healthcare are presented.

Association between social media use and health promotion among individuals with depression and anxiety: Insights from the 2017–2020 Health Information National Trends Survey

IntroductionIndividuals with mental disorders have elevated risk factors for cardiovascular disease, and as a result, experience earlier mortality than the general population. Yet, evidence-based strategies and interventions to promote physical and cardiometabolic health in mental health contexts remains limited. Social media has emerged as a promising and readily affordable tool to expand the reach of mental health services, including the delivery of behavioral and physical health interventions. Despite its widespread availability, the potential for social media use to support positive lifestyle behaviors in mental health contexts remains relatively unexplored. We examined the potential for using social media tools for health promotion by people with anxiety or depression. MethodsUsing cross-sectional data from the 2017–2020 edition of the Health Information National Trends Survey (HINTS), we evaluated differences between individuals with self-reported history of diagnosed depression/anxiety and the general population concerning health-related usage of social media platforms. Multivariable logistic regression was performed to evaluate the association between social media usage and positive health behaviors. ResultsOverall, individuals with mental disorders were more likely than the general population to engage in health-related social media usage. Those with anxiety or depression who engaged in health-related social media usage were significantly more likely to; report intentions to quit smoking (OR 3.13, 95% CI 1.12 – 8.70; p = 0.029) endorse past 12-month attempts at smoking cessation (OR 3.41, 95% CI 1.32 –8.82; p = 0.012) and were more likely to meet national recommendation for weekly strength training (OR 1.49, 95% CI 1.11 – 2.00; p = 0.008). ConclusionsPeople with anxiety or depression use social media for health purposes at rates higher than the general population. Our findings suggest that these tools can reach many people with mental disorders and offer a novel window of opportunity to promote physical health and positive lifestyle behavior change in this highly vulnerable population.

Human Reactions to Public Health Interventions—Implications for Evaluation and Well-being

This JAMA Forum discusses the public health community’s reaction to a recent Cochrane Collaboration review on whether face masks and other physical public health interventions reduced the spread of the COVID-19 and provides counterarguments to the review’s findings that these interventions did not help.

Designing Practical Motivational Interviewing Training for Mental Health Practitioners Implementing Behavioral Lifestyle Interventions: Protocol for 3 Pilot Intervention Studies

Motivational interviewing (MI) is an evidence-based, patient-centered communication method shown to be effective in helping persons with serious mental illness (SMI) to improve health behaviors. In clinical trials where study staff conducted lifestyle interventions incorporating an MI approach, cardiovascular disease (CVD) risk profiles of participants with SMI showed improvement. Given the disproportionate burden of CVD in this population, practitioners who provide somatic and mental health care to persons with SMI are ideally positioned to deliver patient-centered CVD risk reduction interventions. However, the time for MI training (traditionally 16-24 hours), follow-up feedback, and the coaching required to develop and maintain patient-centered skills are significant barriers to incorporating MI when scaling up these evidence-based practices. We describe the design and development of the following 2 scalable MI training approaches for community mental health practitioners: real-time brief workshops and follow-up asynchronous avatar training. These approaches are being used in 3 different pilot implementation research projects that address weight loss, smoking cessation, and CVD risk reduction in people with SMI who are a part of ALACRITY Center, a research-to-practice translation center funded by the National Institute of Mental Health. Clinicians and staff in community mental health clinics across Maryland were trained to deliver 3 distinct evidence-based physical health lifestyle interventions using an MI approach to persons with SMI. The real-time brief MI workshop training for ACHIEVE-D weight loss coaches was 4 hours; IMPACT smoking cessation counselors received 2-hour workshops and prescribers received 1-hour workshops; and RHYTHM CVD risk reduction program staff received 4 hours of MI. All workshop trainings occurred over videoconference. The asynchronous avatar training includes 1 common didactic instructional module for the 3 projects and 1 conversation simulation unique to each study's target behavior. Avatar training is accessible on a commercial website. We plan to assess practitioners' attitudes and beliefs about MI and evaluate the impact of the 2 MI training approaches on their MI skills 3, 6, and 12 months after training using the MI Treatment Integrity 4.2.1 coding tool and the data generated by the avatar-automated scoring system. The ALACRITY Center was funded in August 2018. We have implemented the MI training for 126 practitioners who are currently delivering the 3 implementation projects. We expect the studies to be complete in May 2023. This study will contribute to knowledge about the effect of brief real-time training augmented with avatar skills practice on clinician MI skills. If MI Treatment Integrity scoring shows it to be effective, brief videoconference trainings supplemented with avatar skills practice could be used to train busy community mental health practitioners to use an MI approach when implementing physical health interventions. DERR1-10.2196/44830.

Secular trends in physical fitness of rural Chinese children and adolescents aged 7–18 years from 1985 to 2019

The main purpose of the study was to evaluate the secular trends in physical fitness of Chinese rural children and adolescents aged 7–18 from 1985 to 2019. The speed, muscular strength, explosive power fitness, cardiorespiratory fitness, and flexibility were investigated by National Survey on Students’ Constitution and Health in 1985, 2000, 2010 and 2019. During the period 1985–2000, the physical fitness of Chinese rural children and adolescents improved except for flexibility, and almost all of them reached the maximum increase rate. During the period 2000–2010, in addition to the improvement of flexibility, other fitness showed downward trends, and the decline ranges were large. During the period 2010–2019, the speed of boys rebounded, flexibility, explosive power and muscular strength continued to decrease. Meanwhile, speed, flexibility and muscular strength in girls rebounded, and the explosive power continued to decline. From 2000 to 2019, the body mass index increase accelerated. This study shows that some components of physical fitness of Chinese rural children and adolescents have shown positive trends in recent years, especially for girls and adolescents aged 13–15 years. However, it may also imply inequality between sexes and ages, which provides a reference for the focus of the country's physical fitness and health monitoring and intervention measures.

Effectiveness of physical and mental health interventions for young people with heart conditions: protocol for a systematic review and meta-analysis

IntroductionCardiovascular disease is among the most common of non-communicable diseases, affecting 13.9 million children and young people (CYP) globally. Survival rates for CYP with heart conditions are rising, however, support...

Improving physical health monitoring and interventions in a learning disabilities forensic psychiatric secure service.

Patients in psychiatric inpatient settings are at increased risk of developing physical health complications due to the structure of inpatient wards, the metabolic side-effects of antipsychotic medications and socioeconomic factors. Robust physical health monitoring and interventions are paramount in reducing this health inequality. To improve the quality of physical health interventions in the ward environment and empower patients to follow healthy lifestyle guidance to reduce their risk of metabolic syndrome. Patient weight and waist circumference data were collected at baseline and weekly throughout the 8-week intervention period. A questionnaire was recorded from baseline to week-5 to assess patient understanding. Two Plan-Do-Study-Act (PDSA) cycles were completed: (1) Series of weekly psychoeducation sessions and group exercise and (2) Implementation of healthy living diaries. Our data did not demonstrate any definitive impact upon the waist circumference and weight of participants. However, analysis of the questionnaires showed a consistent trend in knowledge improvement. Whilst our aim of reducing patient weight and waist circumference was not realised, there was a significant impact on participant's knowledge, demonstrating a subjective benefit of our interventions. Our project also highlighted inconsistencies in physical health measurements and data collection, providing vital information for further quality improvement measures.

Addressing privacy concerns for mobile and wearable devices sensors: Small-group interviews with healthy adults and cancer survivors.

Mobile and wearable sensor technology is increasingly common and accessible. The aim of this study was to explore individuals' perceptions and acceptability of mobile and wearable sensors, as well as concerns. Purposive sampling was used to recruit non-patient adults (n = 22) and cancer survivors (n = 17) for face-to-face and virtual small-group interviews. Reflexive thematic analysis of the data focused on privacy concerns. Participants reported that privacy was generally not a concern for sensor adoptions for physical activity health interventions except for health insurer access. The patient perspectives as reported in the findings illustrate the need for transparency between potential adopters and users of mobile and wearable devices and health care practitioners, as well as secure privacy policies for health insurers. Older adults often are perceived as unwilling to adopt mHealth technologies for many reasons, including privacy concerns. This study examined an important patient population, cancer survivors, who are often overlooked yet may benefit from targeted health interventions using mHealth technologies, and compared their responses with a non-patient population for prevention purposes. Our findings suggest that one's lived health experiences (cancer survivorship) are more influential than one's age in adopting mHealth technologies.

Mental health nursing identity: a critical analysis of the UK’s Nursing and Midwifery Council’s pre-registration syllabus change and subsequent move towards genericism

Purpose This paper aims to explain how and why the philosophical changes to the pre-registration nursing standards by the UK’s Nursing and Midwifery Council (NMC) have resulted in a paradigm shift for mental health nursing. Design/methodology/approach This paper critically examines the changes to nursing education standards and offers an analysis of the problems associated with the shift towards a generic nursing syllabus. Findings The said shift prioritises physical health intervention, skills, procedures and tasks over the uniqueness of mental health nursing. Practical implications This paper argues that mental health nursing skills and qualities such as connection, genuine advocacy and therapeutic-use-of-self have been undervalued and under-represented by the new education standards. Originality/value This paper calls on the profession and service users to join the discourse and inform future mental health nursing identity. Ultimately, this paper calls on the NMC to reconsider the underpinning principles of the education standards and allot due consideration to the specific needs of the mental health nursing profession.

Cardiorespiratory fitness and self-reported physical activity levels of referring mental healthcare professionals, and their attitudes and referral practices related to exercise and physical health

BackgroundPhysical activity (PA) interventions can improve mental and physical health of people with mental illness, especially when delivered by qualified exercise professionals. Also, the behaviour, engagement and support of referring mental healthcare professionals (HCP) seem essential, but research is scarce. We aimed to study HCP physical fitness and PA, and associations with their attitudes and referral practices related to physical health and PA interventions. MethodsHCP at the Dutch Association for Psychiatry congress (2019) were invited to an online questionnaire (demographic/work characteristics, stress, PA levels, knowledge/attitudes regarding PA, referral practices) and cycle ergometer test. Strongest associations were analysed using linear and logistic regression. ResultsOf the 115 HCP who completed the questionnaire (40 also completed the ergometer test), 43% (n = 50) met PA guidelines (i.e., ≥150min moderate-to-vigorous PA and ≥2x bone/muscle-strengthening exercises/week). Women, HCP interns/residents and HCP experiencing more stress were less active and less likely to meet PA guidelines. Conversely, there were positive associations with personal experience with an exercise professional. Knowledge/attitudes on physical health and PA were positive. HCP were more likely to refer patients to PA interventions if they met PA guidelines (OR = 2.56, 95%BI = 0.85–7.13) or had higher beliefs that exercise professionals can increase adherence to PA interventions (OR = 3.72, 95%BI = 1.52–9.14). LimitationsMainly psychiatrists, affecting generalizability. ConclusionsHCP report the importance and relevance of PA in mental healthcare. Despite strong evidence and guidance for PA interventions in prevention and treatment, referral to such interventions partly depends on the PA behaviour and attitude of patient's physician/clinician.

Older forensic mental healthcare patients in England: demographics, physical health, mental wellbeing, cognitive ability and quality of life [version 2; peer review: 2 approved

Older individuals (e.g., 55 years and over) constitute a growing proportion of the forensic mental health patient population. As a group, they are vulnerable to health outcomes similar to other individuals with serious mental disorders of the same age; however, these concerns can be compounded by complex forensic-related care backgrounds and clinical presentations, lengthy periods of time spent in prison or psychiatric hospitals, substance use histories, and crime perpetration or victimisation. The healthcare needs and strengths of this group are not well understood.The aim of this study was to identify and describe the demographic, physical health, mental wellbeing, cognitive ability, and quality of life profiles of older forensic patients in community, low, medium, and high security settings in England. A cross-sectional quantitative study design was used. N=37 forensic patients aged 55 years and over completed six questionnaires. Data were also collected from patient records. Most patients were male and were diagnosed with psychosis. The most frequently committed index offence types were violent offences. Patients were prescribed 7.6 medications on average and had average anticholinergic effect on cognition scores of 2.4. Nearly half the sample had diabetes, with an average BMI score of 31.7 (indicating obesity). Possible cognitive impairment was identified in 65% of the sample. Patients' assessments of their recovery-related quality of life and mental wellbeing were comparable to published UK general population values. Assessments of quality of life were positively correlated with the ability to undertake everyday activities and cognitive performance. We suggest that forensic services are well-placed to provide holistic mental and physical care to this group but that they should co-develop with patients a greater range of age-appropriate meaningful activities that are mindful of mobility issues and consider implementing more cognition-based and physical health interventions.

Consensus statements on optimal adult post-autism diagnosis support and services: Delphi process following a UK survey of autistic adults, relatives and clinicians.

Research has identified types of support helpful to autistic people, for example, physical and mental health interventions, psycho-education, peer support, developing positive identities and affiliation with social groups. However, accessing suitable post-autism diagnosis support and services is extremely difficult. We asked autistic adults, relatives and clinicians about their experiences of receiving and delivering post-autism diagnosis support/services. In Stage 1, 343 autistic adults and 45 relatives completed a survey. They answered questions about their experiences of UK autism post-diagnosis support/services for adults within 12 months after receiving a diagnosis. Thirty-five clinicians completed a similar survey. Just over half of adults and relatives said there was a follow-up appointment or discussion about support after diagnosis. Fewer than 40% received any support/services in 12 months after diagnosis. We used information from the surveys to create 11 statements describing characteristics of appropriate adult post-autism diagnosis support/services. In Stage 2, we asked clinicians for their views on the statements - they agreed with all of them. For example, those adults are offered an additional follow-up meeting after diagnosis and have access to mental and physical health services. We shared results with autistic adults, relatives and clinicians at two events. Some autistic adults, relatives and clinicians were positive about post-autism diagnosis support/services. However, they described many areas for improvement. The study findings can be used to define, develop and improve the types of adult post-diagnosis support services.

Improving Physiological, Physical, and Psychological Health Outcomes: A Narrative Review in US Veterans with COPD.

The Veterans Health Administration (VHA) is the largest integrated healthcare system in the United States (US) providing healthcare to an increasing number of middle-aged and older adults who remain at greater risk for chronic obstructive pulmonary disease (COPD) compared to their civilian counterparts. The VHA has obligated research funds, drafted clinical guidelines, and built programmatic infrastructure to support the diagnosis, treatment, and care management of Veterans with COPD. Despite these efforts, COPD remains a leading cause of morbidity and mortality in Veterans. This paper provides a narrative review of research conducted with US Veteran samples targeting improvement in COPD outcomes. We review key physiological, physical, and psychological health outcomes and intervention research that included US Veteran samples. We conclude with a discussion of directions for future research to continue advancing the treatment of COPD in Veterans and inform advancements in COPD research within and outside the VHA.

Trauma, Mental Health Distress, and Infectious Disease Prevention Among Women Recently Released From Incarceration.

BackgroundU.S. women recently released from incarceration experience significantly higher rates of trauma and exacerbation of mental health conditions, and the period following release has been identified as a window of heightened risk for mental health distress and human immunodeficiency virus (HIV), sexually transmitted infections (STI) and hepatitis C (HCV) transmissions. Despite these vulnerabilities, and an urgent need for supports, optimal engagement strategies remain unclear. WORTH Transitions is a program made up of two evidence-based interventions focused on improving the health of women returning to the community from incarceration with substance use disorders. Combining the two was designed to reduce HIV/STIs/HCV risks and increase overall health treatment engagement using a community health worker led intervention.MethodsWe examined associations between trauma, mental health symptomology, and HIV/STI/HCV outcomes among women who engaged in the WORTH Transitions intervention (N = 206) Specifically, bivariate and longitudinal multivariate models were created to examine associations between trauma and mental health distress (defined as depressive and PTSD symptoms), on (1) types of engagement in HIV/STIs/HCV prevention and behavioral health services; and (2) HIV/STIs/HCV risk outcomes. The women who engaged in the intervention were 18 years and older and some were White, Black and other racial or ethnic minority.ResultsPTSD symptomology and being a Black or indigenous woman of color was significantly (p = 0.014) associated with individual or group session engagement. Neither trauma nor PTSD symptoms were associated with higher HIV/STIs/HCV risks. Instead, relative to those who did not engage in HIV/STI/HCV risky behaviors, PTSD symptomology (p = 0.040) was associated with more than 3-fold increase in the probability of being lost to follow up (relative risk ratio = 3.722).ConclusionGiven the impact of PTSD-related symptoms on driving both engagement in HIV/STIs/HCV prevention services and intervention attrition among women leaving incarceration, physical and behavioral health interventions must be both overtly trauma- and mental health-informed. As was the case with WORTH Transitions, physical and behavioral health services for this population must include intentional and active support of the forms of treatment participants endorse to ensure maximal engagement.

Design of a Rheumatology Transition Clinic for a Resource-Constrained Setting.

To describe the design process of a medical care program for adolescents with pediatric onset rheumatic diseases (PRD) during the transition from pediatric to adult care in a resource-constrained hospital. The model of attention was developed in three steps: 1) the selection of a multidisciplinary team, 2) the evaluation of the state of readiness of patients and caregivers for the transition, and 3) the design of a strategy of attention according to local needs. The results of the first two steps were used in order to develop the strategy of attention. The transition process was structured in three stages: pretransition (at pediatric rheumatology clinic), Transition Clinic for Adolescents with Rheumatic Diseases (TCARD, the main intervention), and post-transition (at adult rheumatology clinic). Each stage was divided, in turn, into a variable number of phases (8 in total), which included activities and goals that patients and caregivers were to accomplish during the process. A multidisciplinary approach was planned by pediatric and adult rheumatologists, nutritionists, physiatrists, psychiatrist, psychologist, nurse, and social worker. During TCARD, counseling, education, nutritional, physical, and mental health interventions were considered. The proposed transition model for patients with rheumatic diseases can be a useful tool in developing countries.

Mental health consumers' perspectives of physical health interventions: An integrative review.

Consumers of mental health services experience poor physical health compared to the general population, leading to long‐term physical illness and premature death. Current research and policy activity prioritizes the physical health of consumers yet few of these recommendations have translated to practice. This implementation gap may be influenced by the paucity of literature exploring consumer perceptions and experiences with physical healthcare and treatment. As a result, little is understood about the views and attitudes of consumers towards interventions designed to improve their physical health. This integrative review aims to explore the literature regarding consumer perspectives of physical healthcare and, interventions to improve their physical health. A systematic search was undertaken using (i) CINAHL, (ii) MEDLINE, (iii) PsycINFO, (iv) Scopus, and (v) Google Scholar between September and December 2021. Sixty‐one papers comprising 3828 consumer participants met the inclusion criteria. This review found that consumers provide invaluable insights into the barriers and enablers of physical healthcare and interventions. When consumers are authentically involved in physical healthcare evaluation, constructive and relevant recommendations to improve physical healthcare services, policy, and future research directions are produced. Consumer evaluation is the cornerstone required to successfully implement tailored physical health services.

A Systematic Review on Effectiveness of Online Well-Being Programs for The Physical and Mental Well-Being of University Health-Allied Students

Aim: The study reviewed available literature on the effectiveness of online well-being programs concerning university health-allied students' physical and mental well-being. Methods: Following the Preferred Reporting Items for Systematic Reviews and MetaAnalyses guidelines, this study involved searching for intervention articles for health-allied university students in the electronic databases of ProQuest, Herdin, Research Gate, ScienceDirect, Wiley Online Library, ERIC, DOAJ, CORE, PubMed, EBSCOHost, Google Scholar, Taylor & Francis, and Emerald Insights. The Cochrane Intervention Review guidelines became the basis for the results of the studies that met the quality criteria. For the other study designs, specific appraisal tools were used. Participants' characteristics, intervention parameters, and outcomes were extracted and synthesized for analysis. Results: Ten studies were included and reported in the study. All studies focusing on physical well-being (n = 2) reported significant improvements in physical activity with concurrent positive effects on mental well-being. Overall, studies focusing on mental well-being (n = 8) had mixed results on interventions providing statistically significant results. However, most studies either have practical significance ranging from mild to large effects, having a positive directional change for outcomes, or deemed helpful with a high participation rate. Conclusion and Implications: This review found evidence suggesting the effectiveness of online physical and mental health interventions for health allied university students. Interventions that encompass both physical and mental health are deemed the most effective.

High-risk sexual behaviours in young people experiencing a first episode of psychosis.

The sexual health of adults with schizophrenia is poorer than the general population; however, less is known about young people experiencing a first episode of psychosis (FEP). The aim of this study was to explore the high-risk sexual behaviours and sexual well-being indicators of a cohort of young people with FEP. Data collected from young people (15-24 years) with FEP attending the EPPIC service in Melbourne and participating in a physical health intervention were analysed. Baseline trial data collected on sexual health and high-risk behaviours, psychiatric symptomology, functioning, and substance use are presented by gender. Associations between symptomology and functioning with sexual behaviour are explored. A total of 69 young people were included in this study; mean age was 19.6 years (SD±2.8), 53.6% were male, 59.6% identified as heterosexual, and 21.7% were currently in a relationship. Within the cohort, 78.3% had ever been sexually active. Of these, 44.2% consistently used a condom at last sex act and 35.7% used barrier contraception consistently, 22.5% had previously been pregnant, and 18.6% had tested positive for an STI. Finally, young people were more likely to have been sexually active if they were currently using substances. These findings suggest that high rates of high-risk sexual behaviour remain an issue for young people experiencing a first episode of psychosis. Promoting sexual well-being and communication skills between sexual partners should be targeted to ensure that high-risk sexual health outcomes are mitigated as early as possible.

10Vida: A Mental and Physical Health Intervention for Chronically Ill Adolescents and Their Caregivers in the Hospital Setting: An Open Study.

Suffering from a chronic disease (CD) in adolescence can significantly impact the emotional health of adolescents and their families. MHealth can be a useful tool for these groups. However, few intervention programmes include the family system. The aim is to design an intervention programme (10Vida) for a paediatric population with a CD, and their families, to improve their adaptation to the disease. The study is a quasi-experimental repeated measures design in a open study, where the patients themselves, and their families, are their own control group. Participants will receive an intervention of seven individual sessions: five sessions with each patient, and two sessions with their caregivers. In the case of the patients, the aim is to improve their emotional state, their self-esteem, and their emotional competencies, reducing their perceived threat of illness. Furthermore, in the case of the caregivers, the aim is to improve their emotional state and reduce their burden. Indirectly, working with caregivers and those being cared for will improve family ties. The pilot study will involve 25 to 30 chronically ill adolescents aged between 12 and 16 years and their primary caregivers. Following the results, the necessary modifications will be included, and the programme will be offered to adolescents and their families who are willing to participate.