The effectiveness of exercise program based on “self-determination theory” in improving metal health and metabolic control functions for patients with mental illness: a randomized clinical controlled trial The serious health issues of metabolic status in patients with mental disorders were emphasized recently in literature and mental health nursing clinical practice. Patients with psychiatric disorders suffer from health problems not only mentally, but also physically. The major mental disorders are associated with an increased risk for obesity-related cardiovascular mortality, including use of atypical antipsychotic agents with high metabolic risk. Exercise/ regular physical activity has been shown to be an effective intervention to improve physical and psychological functions. However, limitations were found including high prevalence of inactivity for Taiwanese people and few exercise programs designed for patients with mental disorders. Previous study designed an exercise program for patients with anxiety disorders in a 2-year research based on PAPA model tested in population of higher levels of state and trait anxiety. The positive outcomes were found but lacking motivations toward adopting and maintaining a regular exercise lifestyle becomes a serious problem for improving patients’mental and physical health. The Self-Determination Theory has been used as a framework for promoting regular exercise/ physical activity in many research suggested by health and exercise professionals. Evidence showed that motivations were associated with greater frequency of weekly exercise participation. Consequently, this study designs a new 12-week exercise program (SPEP) for patients with diversity of mental disorders based on Self-Determination Theory from the original one. The purpose of this study is to evaluate the effectiveness of SPEP exercise intervention for improving metal health and metabolic control functions for patients with mental disorders. The randomized clinical controlled trial will be used to evaluate short- and long-term effectiveness of exercise program. Study participants with diagnosis of psychiatric disorders will be recruited from 5 clinics in middle area of Taiwan. Subjects in experimental group receive both exercise intervention and traditional nursing care. Seven self-report scales and physiologic assessment will evaluate the outcomes variables of general mental health and metabolic control functions at the baseline and 3, 6, 12 and 18 months after baseline. Data will be analyzed major by Mix model analysis. The results of this study will provide significant knowledge in mental health nurses to be a core health manager in exercise programs for improving patients’mental and physical health. Meanwhile, metabolic status problems of patients with psychiatric disorders may be deal with suitable and effective nursing interventions.
