Stakeholder Consultation- Physical Activity & Inpatient Mental Health
Research type
Research Study
Full title
Co-design of a research study to evaluate a physical activity intervention in inpatient acute mental health settings: pre-protocol study and stakeholder involvement.
IRAS ID
321626
Contact name
Michelle Glascott
Contact email
Duration of Study in the UK
0 years, 11 months, 31 days
Research summary
Research Summary
Physical activity (PA) is an effective intervention supporting recovery from many forms of mental ill health (NICE, 2022); however, it’s still not routinely offered by mental health services (Way et al, 2018). In 2021, we conducted a small study evaluating the impact of implementing a PA on a female acute mental health ward (AMHW). The patients were involved in designing the study and choice of PA. Over a 2-week period, we ran the physical activities each day for 30 minutes. We evaluated impact using individual and collective measures, and gathered qualitative feedback from staff and patients. Despite limitations in relation to sample size and study design, there were promising signs to suggest the intervention may have an impact on reducing incidents on the ward (violence/aggression/ rapid tranquilisation). The data also indicated that that the intervention may improve ward atmosphere, cohesion between staff and patients and feelings of wellbeing and self-confidence.
This proposal aims to build on this initial study, co-designing a research protocol to evaluate the impact of PA on AMHW’s across two NHS sites. To design this protocol, we will engage key stakeholders (people with recent lived experience of inpatient care and inpatient care teams) in focus groups to design the PAs that will be used in the research, and to shape the evaluation methods.
Participants will take part in one focus group of their peers, lasting no longer than 90 minutes in duration. The focus groups will be facilitated by two researchers- one lived experience, the other a mental health clinician. The data will be analysed by an academic partner and the findings will be used to design a research protocol to evaluate the impact of PA on AMHW environments.Lay summary of study results
Plain English Summary Why did we do this research?
Acute wards provide care for people experiencing a severe episode of mental illness. They are busy environments which people often describe as unpredictable and distressing. Patients are often detained under The Mental Health Act, meaning they cannot leave the ward without permission from the person in charge of their care. Patients say this is frustrating and describe acute wards as very boring places. Being stuck on an acute ward can lead to people feeling more distressed and serious incidents of self-harm, aggression and violence may happen more often. This is very upsetting for both patients and staff.
People with severe mental illness often have many physical health conditions and are much less active than the general population. This is thought to be one of the reasons why people with severe mental illness may die as much as 25 years earlier than those without severe mental illness.
Physical activity is very helpful for many mental health and has very few side effects. It can also help with the physical health problems that people with severe mental illness may have such as heart problems, high blood pressure and illnesses associated with putting on weight.
Even though we have known for a long time about how good physical activity is for patients with mental health problems, it is not always offered on acute wards, or it may be cancelled because of staff shortages and safety worries.
Previously, an acute ward in the North-East of England ran a pilot study which offered physical activities to patients and staff for two weeks. Patients and staff said this was helpful to their wellbeing and relationships with one another. They also found that the number of frightening incidents reduced.
The aim of our project was to find out if physical activities help patients and staff feel better when offered on an acute ward. We also wanted to find out what gets in the way and stops physical activities being offered, and what might help them happen more often. We also wanted to know what a good way would be to measure if the physical activity was helpful.How did we do the research?
Our project team included people who work on acute wards, people who have previously received care on an acute ward (called peer researchers), and people who understand research.
The peer researchers were important members of the team and were involved from the very start of the project. They were involved in every part of the research, including planning the study, searching previous literature, collecting the views of people who were patients, carers or staff on an acute ward. The peer researchers have also helped write up the study and present the results in journals and at conferences.
Our project was in two parts: looking for other research like ours that has been done before. This is called a literature review. And the second part was talking with patients, carers and ward staff about physical activity on acute wards.Literature Review
We looked at research that has already been done between 2012 and 2024. We looked at what types of physical activities have been used on acute wards for people aged 18-65. Our search used key words such as “acute”, “mental health”, “ward” and “physical activity”. We found 12 research studies that had looked at the effect of physical activity on acute wards.Focus Groups
The focus groups brought people with experience of acute wards together to talk about how physical activities could help them feel better and improve their time when on the ward. Six focus groups were held in two mental health trusts. Three of the focus groups were with people who had previously been patients or a carer of someone who had been on an acute ward. The other three focus groups were with staff who work on acute wards.What Did We Find
Information from the literature review suggested that physical activity is a useful way to help patients on an acute ward. However, there were many differences in the types of physical activity studied and ways they measured if it worked. This made comparing the studies difficult.
Information from the focus groups suggested that acute wards are stressful for patients and staff and there are many hurdles to offering physical activity on the ward. These included how unwell patients are and the medication they are given. Other things that stop physical activities happening was staff shortages and worries about risk. People offered ways to overcome these difficulties, and they helped us with ideas on how we can find out if this has been helpful.Recommendations
- Future research on physical activities on acute wards should be planned by both people who have experience of being a patient on an acute ward or who have worked on an acute ward. They know best what is helpful and what might stop the physical activity from happening.
The physical activity intervention should include- -Helping people understand that physical activity can be any way in which you move more.
-Asking patients what physical activities they want and when they want it.
-Helping patients and staff understand the benefits of physical activity.
-Offering some physical activities on the ward and inviting staff to join in and lead some activities.
-Leaders need to give permission to staff to take part in the physical activity.
-To measure if physical activity has been helpful, we should ask patients and staff their views. Any measures must be simple and easy to use for patients and staffREC name
East of England - Cambridge East Research Ethics Committee
REC reference
23/EE/0089
Date of REC Opinion
12 Apr 2023
REC opinion
Favourable Opinion