A pilot study describing physical activity in persons with schizophrenia spectrum disorders (SSDS) after an exercise program.

Despite the well known mental and physical health benefits of exercise, persons with schizophrenia spectrum disorders remain sedentary. While the exercise barriers (i.e., lack of motivation, poor concentration, sedative effects of medication, poverty, and lack of access to exercise education/programs) of persons with SSDs are numerous, lack of motivation is considered foremost among them. Exercise interventions have been shown to improve exercise behavior, but there is a need for longitudinal documentation of physical activity after interventions conclude. This pilot study describes the physical activity level of 22 persons with SSDs 14 to 34 (mean 22) months after the conclusion of an exercise intervention provided in a randomized controlled trial (RCT). Eighteen months after the RCT, 22 participants wore pedometers daily for one week without altering their activity. Experimental participants walked more steps and covered more distance on average than control participants on six of the seven days. This pilot study is among the first to document the physical activity level of persons with SSDs after exercise intervention. While our findings confirm the low activity level of persons with SSDs reported by others, experimental participants demonstrated higher activity levels than controls on most days. Future studies should increase the sample size and recruit participants from multiple sites to enhance power and generalizability.

Effect of a motivational intervention on exercise behavior in persons with schizophrenia spectrum disorders.

Ninety seven outpatients with schizophrenia spectrum disorders (SSDs) were randomly assigned to the Walk, Address Sensations, Learn About Exercise, Cue Exercise Behavior for SSDs (WALC-S), a motivational intervention designed to increase exercise in SSDs (n = 48), or a time and attention control group (TAC, n = 49). WALC-S and TAC groups met weekly for 4 weeks before a 16 week walking program was offered to all subjects. We compared the exercise attendance, persistence and compliance of the groups during the walking program. WALC-S recipients attended more walking groups, for more weeks and walked more minutes than those receiving TAC. Percent of WALC-S or TAC groups attended was significantly correlated with overall attendance (r = 0.38, P = 0.001) and persistence (r = -.29, P = 0.01), as well as number of minutes walked. This study is among the first to examine interventions designed to enhance exercise motivation in SSDs.

Effect of a motivational group intervention upon exercise self efficacy and outcome expectations for exercise in Schizophrenia Spectrum Disorders (SSDs).

BACKGROUND: Persons with SSDs contend with multiple barriers to exercise. Interventions are needed to enhance attitudes theoretically linked to exercise behavior. OBJECTIVE: Examine effect of Walk, Address Sensations, Learn About Exercise, Cue Exercise for SSDs (WALC-S) intervention upon exercise self efficacy (SEE) and outcome expectations (OEES) in 97 outpatients with SSDs. DESIGN: Experimental, pre test posttest. Randomization to experimental (WALC-S) or time-and-attention control (TAC) after baseline SEE and OEES measures. Measures repeated after WALC-S or TAC. RESULTS: N = 97, 46% female, 43% African American, average age 46.9 years (SD = 2.0). Mean SEE scores were significantly higher in WALC-S participants after intervention (F ((1,95)) = 5.92, p = 0.0168), however, mean OEES scores were significantly higher in control participants after intervention (F ((1,95)) = 5.76, p = 0.0183. CONCLUSION: This is the first study to examine SEE and OEES in SSDs. Interventions to enhance exercise attitudes are a critical first step toward the ultimate goal of increasing exercise participation.

Effect of a motivational group intervention on exercise self-efficacy and outcome expectations for exercise in schizophrenia spectrum disorders.

BACKGROUND: Persons with schizophrenia spectrum disorders (SSDs) contend with multiple barriers to exercise. Interventions are needed to enhance attitudes theoretically linked to exercise behavior. OBJECTIVE: To examine the effect of Walk, Address Sensations, Learn About Exercise, Cue Exercise for SSDs (WALC-S) intervention on exercise self-efficacy (SEE) and outcome expectations (OEES) in 97 outpatients with SSDs. DESIGN: Experimental, pre- and posttest. Randomization to experimental (WALC-S) or time-and-attention control (TAC) after baseline SEE and OEES measures. Measures repeated after WALC-S or TAC. RESULTS: N = 97, 46% female, 43% African American, average age 46.9 years (SD = 2.0). Mean SEE scores were significantly higher in WALC-S participants after intervention, F(1, 95) = 5.92, p = .0168, however, mean OEES scores were significantly higher in control participants after intervention, F(1, 95) = 5.76, p = .0183. CONCLUSION: This is the first study to examine SEE and OEES in SSDs. Interventions to enhance exercise attitudes are a critical first step toward the ultimate goal of increasing exercise participation.

Junior nursing students' experiences of vertical violence during clinical rotations.

Horizontal violence is a form of workplace violence, a phenomenon that is prevalent in the nursing profession. Research has revealed a variety of negative peer-to-peer behaviors that lower morale and lead to turnover. However, little research has been conducted on "eating our young" (violence occurring between individuals with unequal power, such as staff nurse and student). We propose "vertical violence" as the appropriate term when abusive registered nurse (RN) behavior is directed towards students. We report a content analysis of stories written by junior nursing students about incidents of injustice perpetrated by staff RNs during their clinical experiences. Four levels of injustice were described. Nursing leadership, both in hospitals and educational institutions, must become engaged in efforts to eradicate vertical violence towards students.