The Effects of an Integrated Health Care Program on the Physical, Psychosocial, and Spiritual Health of People with Mental Disorder in Community

Article information

Res Community Public Health Nurs. 2015;26(2):69-78
Publication date (electronic) : 2015 June 30
doi : https://doi.org/10.12799/jkachn.2015.26.2.69
1Somangnamu Community Mental Rehabilitation Center, Seoul, Korea.
2Department of Nursing, Chungwoon University, Hongseong, Korea.
Corresponding author: Chin, Young Ran. Department of Nursing, Chungwoon University, 25 Daehak-gil, Hongseong-eup, Hongseong 350-701, Korea. Tel: +82-41-630-3408, Fax: +82-41-630-3303, chinyoungran@hanmail.net
Received 2015 January 09; Revised 2015 March 21; Accepted 2015 May 13.

Abstract

Purpose

This study was conducted in order to investigate changes in the physical, psychosocial and spiritual health of people with mental disorder in community participating in the Integrated Health Care Program (IHCP).

Methods

This study applied the non-equivalent control group pretest-posttest quasi-experimental design. The participants were 37 chronic psychiatric patients who had been clinically diagnosed with mental disorder and visiting a mental rehabilitation center located in S City (17 in the experimental group, and 20 in the control group). The experimental group participated in the IHCP consisting of 24 sessions for eight weeks.

Results

After the intervention, only the participants in the experimental group reported significant improvement in physical (body mass, triglyceride), psychosocial (mental symptoms, depression, self-esteem, ability of problem solving), and spiritual wellbeing when compared with those in the control group.

Conclusion

These results indicate that IHCP is effective in improving the physical, psychosocial, and spiritual wellbeing of people with mental disorder. Therefore, IHCP developed in this study is considered a useful nursing intervention for raising the comprehensive health level of people with mental disorder in community.

References

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Article information Continued

Figure 1

The design of this study.

Figure 2

Conceptual framework.

Table 1

Contents of Integrated Health Promotion Program

Week Sessions Physical (60 mins) Psychosocial (60 mins) Spiritual (60 mins)
Topics/contents Topics Contents and activity Topics Contents and activity
1 1 Physical exercise/stretching

Aerobic exercising

Anaerobic exercising
Social relation Understanding of program Meaning and purpose of life Couple prayer/
2 Laughter Seeking empirical values
3 Art Intercessory prayer/
Meaning of Life
Changing stance of life
2 4 Social relation Training on ice-breaking Purpose of life
5 Laughter Humor quiz Seeking values of future
6 Art Painting for self introduction Hugging/rebuilding meaning and goals of life
3 7 Social relation Saying confirmation question Strengthening love and relations Couple prayer/ Who am I?
8 Laughter Smile, Greeting, Conversation Praise My merits and demerits
9 Art Painting on first impression Understanding another persons
4 10 Social relation Training on social situational understanding (1) Rating value of life
11 Laughter Laughter training Outcast experience and confidence games
12 Art Painting with left hand Love basket
5 13 Social relation Training on social situational understanding (2) Sharing forgiveness Couple prayer/
14 Laughter Laughter of Snow White Recognizing and expressing rage and
15 Art Clay arts Intercessory prayer/
Forgiveness
Placing myself in other's place
6 16 Social relation Seeking problems Beyond halter of sentiment
17 Laughter Laughter make-up Beyond halter of rage
18 Art Finger painting From healing to spiritual
maturation
7 19 Social relation Solving problems (1) Seeking hope Couple prayer/
20 Laughter Applause mingled with Positive thinking
21 laughter Intercessory prayer/
Art Orchid with Chinese ink Hope image
Writing diary of success
8 22 Social relation Solving problems (2) Postcard of hope
23 Laughter Self change Enhancing hope
24 Art Painting harmony tree Intercessory prayer/
Hugging and accepting myself

Table 2

Homogeneity of General Characteristics and Dependent Variables

Variables Characteristics Categories Exp. (n=17) Cont. (n=20) x2 or t p
n (%)/M±SD n (%)/M±SD
General characteristics Gender Male 5 (29.4) 7 (35.0) 0.13 .717
Female 12 (70.6) 13 (65.0)
Age (year) ≤29 6 (35.3) 7 (35.0) 0.05 .997
30~49 7 (41.2) 8 (40.0)
≥50 4 (23.5) 5 (25.0)
Marriage Unmarried 13 (76.5) 13 (65.0) 3.28 .512
Divorced 3 (17.6) 6 (30.0)
Married 1 (5.9) 1 (5.0)
Education ≤Middle school 3 (17.7) 3 (15.0) 2.96 .398
High school 10 (58.8) 12 (60.0)
College or University 4 (23.5) 5 (13.5)
Length of care (year) 1~5 8 (48.1) 6 (30.0) 2.11 .673
6~10 0 (0.0) 2 (10.0)
≥10 9 (52.9) 12 (60.0)
Medical diagnosis Obsessive compulsive disorder 0 (0.0) 1 (5.0) 1.13 .738
Schizophrenia 15 (88.2) 17 (85.0)
Affective disorder 2 (11.8) 2 (10.0)
Onset age of mental disease ≤19 5 (29.4) 4 (20.0) 3.25 .354
20~29 8 (47.1) 10 (50.0)
30~39 4 (23.5) 3 (15.0)
≥40 0 (0.0) 3 (15.0)
Religion None 4 (23.5) 4 (20.0) 7.94 .147
Christian 8 (47.1) 12 (60.0)
Catholic 5 (29.4) 3 (15.0)
etc. 0 (0.00) 1 (5.0)
Physical health Body mass 26.3±4.68 25.3±4.50 0.69 .495
Triglyceride 148.4±79.24 126.6±69.18 0.89 .377
HDL-cholestrol 36.6±0.24 41.2±2.73 -1.20 .239
BMI (body mass index) 33.3±8.33 32.5±9.04 0.26 .799
Abdominal fat ratio 0.9±0.03 0.9±0.05 -0.68 .502
Psycho-social health Mental symptoms 53.4±6.62 52.1±8.83 0.52 .608
Depression 15.7±6.98 15.4±6.01 0.14 .890
Self-esteem 27.8±4.92 27.2±4.80 0.42 .677
Ability of problem solving 102.0±10.05 103.4±9.93 -0.41 .684
Spiritual health Spiritual well-being 51.2±7.95 50.2±9.49 0.37 .712

Exp.=experimental group; Cont.=control group; BMI=body mass index.

Table 3

Differences in Dependent Variables between Experimental and Control Groups

Variables Categories Group Exp. (n=17) Cont. (n=20) Difference paired-t p Source F p
M±SD M±SD M±SD
Physical health Body mass Exp. 26.3±4.68 25.9±4.74 0.4±0.44 2.18 .036 Group 0.13 .718
Cont. 25.3±4.50 25.1±4.49 0.1±0.47 Time 6.28 .017
G×T 1.81 .188
Triglyceride Exp. 148.4±79.24 134.8±69.45 13.6±46.24 2.46 .019 Group 0.01 .928
Cont. 126.6±69.18 152.9±81.05 -26.3±51.51 Time 0.90 .349
G×T 8.87 .005
HDL-cholesterol Exp. 36.6±10.24 35.6±10.64 1.0±6.75 -0.74 .462 Group 1.58 .217
Cont. 41.2±12.73 38.9±9.33 2.3±4.19 Time 9.53 .004
G×T 1.51 .227
BMI Exp. 33.3±8.33 33.7±7.37 -0.4±1.75 -0.70 .487 Group 0.36 .555
Cont. 32.5±9.04 32.7±8.79 -0.1±0.86 Time 6.33 .017
G×T 2.77 .105
Abdominal fat ratio Exp. 0.9±0.03 0.9±0.04 0.0±0.02 -0.70 .487 Group 0.16 .289
Cont. 0.9±0.05 0.9±0.05 0.0±0.01 Time 3.73 .062
G×T 3.73 .062
Psycho-social health Mental symptoms Exp. 53.4±6.62 49.7±5.38 3.7±3.10 2.45 .020 Group 0.22 .642
Cont. 52.1±8.83 50.1±9.04 2.0±1.32 Time 6.37 .016
G×T 3.07 .089
Depression Exp. 15.7±6.98 14.1±7.16 1.5±1.23 5.41 <.001 Group 0.23 .637
Cont. 15.4±6.01 16.5±7.01 -1.2±1.73 Time 0.16 .691
G×T 8.00 .008
Self esteem Exp. 27.8±4.92 28.3±4.59 -0.5±0.77 -2.12 .041 Group 0.44 .510
Cont. 27.2±4.80 27.0±4.87 0.2±1.10 Time 0.09 .773
G×T 0.52 .475
Ability of problem solving Exp. 102.0±10.05 104.9±9.46 -2.9±2.11 -3.38 .002 Group 0.00 .959
Cont. 103.4±9.93 103.9±9.37 -0.5±2.14 Time 3.59 .069
G×T 1.75 .194
Spiritual health Spiritual wellbeing Exp. 51.2±7.95 55.6±8.44 -4.4±3.77 -3.41 .002 Group 1.49 .230
Cont. 50.2±9.49 50.0±10.84 0.2±4.20 Time 2.10 .149
G×T 2.50 .123

Exp.=experimental group; Cont.=control group; BMI=body mass index; ANCOVA with pretest value as covariate; Multivariate tests.