Exercise is well-known to have beneficial effects on many aspects of health, including the heart, lungs, muscles, and bones. Exercise is also good for those with mental illnesses. Nurses are on the front lines of treating patients with mental illness in hospitals and other treatment facilities.
While nurses generally believe that exercise is important for their patients, they often run into barriers that prevent them from implementing exercise routines on a regular basis.
A Study To Examine Exercise’s Impact On Mental Health
A recent study, Barriers to exercise prescription and participation in people with mental illness: The perspectives of nurses working in mental health, was carried out to examine mental health nurses’ level of agreement with identified barriers to the prescription of exercise for patients in mental health facilities and in the participation of patients in exercise routines.
As part of the study, the researchers set out to determine the frequency with which nurses prescribed exercise at in-patient facilities.
The intended study participants were 38 mental health nurses in two in-patient facilities in Australia. Of these 38 nurses, 34 completed the survey. The average age was 42.8 years, with a range from 21 to 70 years. The median years of experience was 6, with a range from less than 1 to 43 years.
Data Collection Method
The researchers did not develop their own questionnaire for this study but administered a survey for which validity and reliability had already been established: the Exercise in Mental Illness Questionnaire – Health Professions Version. The paper survey is anonymous and takes about 15 minutes to complete and uses a Likert scale to rate the level of agreement with the given statements (1 = strongly disagree; 5 = strongly agree).
It covers the topics of exercise knowledge, beliefs, personal habits, and prescription behaviors. It also asks about barriers to exercise through 11 statements about barriers to prescribing exercise to patients with mental illness and 12 statements about barriers to participating in exercise programs. One item also asks for the frequency of exercise prescription for patients.
Data Analysis and Results
The researchers first looked at the frequency with which nurses reported they prescribed exercise for in-patients. Over half (53%) said they prescribe exercise always or most of the time. The rest said they prescribe exercise occasionally or never.
For analysis purposes, the responses to each Likert-scale statement were collapsed into three categories: agree, neutral, and disagree. Chi-square tests were used to determine if there were differences in the proportion of nurses’ responses to each statement.
It was found that there were significant differences for 8 of the 11 statements about barriers to prescribing exercise, with the “disagree” category being selected significantly more often than “neutral” or “agree” for these statements. (Sample statement: “I don’t believe exercise will help people with a mental illness.”)
For the statements on barriers to participation, Chi-square tests showed significant differences for only 2 of the 12 statements, with nurses disagreeing more often with the statements “I am too unwell to exercise” and “It takes too much time.” For the other 10 statements, nurses’ responses were spread out more evenly among disagree, neutral, and agree.
In addition, the researchers used one-way analysis of variance to examine the relationship between how often nurses prescribed exercise and their responses to the statements on barriers to exercise prescription and participation. No significant correlations were found between frequency of prescribing exercise and their responses to the statements.
In this study, over 85% of the respondents disagreed with statements that exercise would not benefit patients with mental illness, and 80% disagreed with statements that the physical health of people with mental illness was a barrier to prescribing exercise for these patients.
In addition, 90% of the nurses in this study disagreed that prescribing exercise to patients with mental illness was not part of their job.
The authors recognize that their study had important limitations, including that the survey instrument, while valid and reliable, may not include all barriers to exercise prescription and participation. They also recognize that their findings have limited generalizability because of the small sample size coming from one geographic location and the fact that only a small amount of demographic data were collected.
To help confirm or contradict their findings, the researchers call for further research on nurses’ perceptions of the barriers to prescribing and participating in exercise programs for patients with mental illness. They also recommend that other health professionals be included in the studies to get a broader picture of health-care workers’ beliefs.
Stanton, R., Reaburn, P., & Happell, B. (2015). Barriers to exercise prescription and participation in people with mental illness: The perspectives of nurses working in mental health. Journal of Psychiatric and Mental Health Nursing, 22, 440-448.