What are the key influences and challenges around weight management faced by patients in UK adult secure mental health settings? A focused ethnographic approach
Objectives Excess weight is highly prevalent in secure (forensic) mental health services and impacts negatively on patients’ physical and mental health. This study sought to identify the key influences and challenges around weight management in UK adult secure mental health settings.Design Qualitati...
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| Format: | Article |
| Language: | English |
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BMJ Publishing Group
2024-03-01
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| Series: | BMJ Open |
| Online Access: | https://bmjopen.bmj.com/content/14/3/e079406.full |
| _version_ | 1797224030591254528 |
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| author | Sheena E Ramsay Eileen F S Kaner Iain McKinnon Susanna Mills |
| author_facet | Sheena E Ramsay Eileen F S Kaner Iain McKinnon Susanna Mills |
| author_sort | Sheena E Ramsay |
| collection | DOAJ |
| description | Objectives Excess weight is highly prevalent in secure (forensic) mental health services and impacts negatively on patients’ physical and mental health. This study sought to identify the key influences and challenges around weight management in UK adult secure mental health settings.Design Qualitative focused ethnography. Analysis of written fieldnotes was undertaken through a combined inductive and deductive approach, informed by thematic analysis.Setting Low secure male mental health ward and associated patient activities and events, in a National Health Service Trust delivering mental health, intellectual disability and neurorehabilitation services in the UK.Participants 12 males (primarily white British) on the low secure ward; additional male participants from low and medium secure services, who took part in group events and activities; and multidisciplinary low and medium secure services staff. Approximately 23 hours of observation were undertaken over a 6-month period from April 2022.Results Secure mental healthcare delivered an environment predisposing patients to excessive weight gain and sedentary behaviour, which was often perceived as inevitable. Key themes highlighted the heightened salience of food in secure settings; inadequacy of catered hospital food and shortcomings of alternative food options; limited physical activity opportunities; and a ward culture that was not conducive to healthy behaviours. Perceptions and behaviour towards the ethnographer were primarily positive and accepting.Conclusions Weight management in secure services is a complex challenge. In future, whole setting-based interventions to promote healthy weight are likely to be required. These should integrate physical and mental health, incorporate underpinning determinants such as adequate staffing and a culture promoting weight management, and involve both patients and staff. |
| first_indexed | 2024-04-24T13:46:38Z |
| format | Article |
| id | doaj.art-eb803db4d22d4a4bb31baaa7ad4cd3d6 |
| institution | Directory Open Access Journal |
| issn | 2044-6055 |
| language | English |
| last_indexed | 2024-04-24T13:46:38Z |
| publishDate | 2024-03-01 |
| publisher | BMJ Publishing Group |
| record_format | Article |
| series | BMJ Open |
| spelling | doaj.art-eb803db4d22d4a4bb31baaa7ad4cd3d62024-04-04T06:25:08ZengBMJ Publishing GroupBMJ Open2044-60552024-03-0114310.1136/bmjopen-2023-079406What are the key influences and challenges around weight management faced by patients in UK adult secure mental health settings? A focused ethnographic approachSheena E Ramsay0Eileen F S Kaner1Iain McKinnon2Susanna Mills3Newcastle University Faculty of Medical Sciences, Newcastle upon Tyne, UKNIHR Policy Research Unit in Behavioural Science, Newcastle University, Newcastle upon Tyne, UK1Northumberland, Tyne and Wear NHS Trust, Newcastle upon Tyne, UKNewcastle University Faculty of Medical Sciences, Newcastle upon Tyne, UKObjectives Excess weight is highly prevalent in secure (forensic) mental health services and impacts negatively on patients’ physical and mental health. This study sought to identify the key influences and challenges around weight management in UK adult secure mental health settings.Design Qualitative focused ethnography. Analysis of written fieldnotes was undertaken through a combined inductive and deductive approach, informed by thematic analysis.Setting Low secure male mental health ward and associated patient activities and events, in a National Health Service Trust delivering mental health, intellectual disability and neurorehabilitation services in the UK.Participants 12 males (primarily white British) on the low secure ward; additional male participants from low and medium secure services, who took part in group events and activities; and multidisciplinary low and medium secure services staff. Approximately 23 hours of observation were undertaken over a 6-month period from April 2022.Results Secure mental healthcare delivered an environment predisposing patients to excessive weight gain and sedentary behaviour, which was often perceived as inevitable. Key themes highlighted the heightened salience of food in secure settings; inadequacy of catered hospital food and shortcomings of alternative food options; limited physical activity opportunities; and a ward culture that was not conducive to healthy behaviours. Perceptions and behaviour towards the ethnographer were primarily positive and accepting.Conclusions Weight management in secure services is a complex challenge. In future, whole setting-based interventions to promote healthy weight are likely to be required. These should integrate physical and mental health, incorporate underpinning determinants such as adequate staffing and a culture promoting weight management, and involve both patients and staff.https://bmjopen.bmj.com/content/14/3/e079406.full |
| spellingShingle | Sheena E Ramsay Eileen F S Kaner Iain McKinnon Susanna Mills What are the key influences and challenges around weight management faced by patients in UK adult secure mental health settings? A focused ethnographic approach BMJ Open |
| title | What are the key influences and challenges around weight management faced by patients in UK adult secure mental health settings? A focused ethnographic approach |
| title_full | What are the key influences and challenges around weight management faced by patients in UK adult secure mental health settings? A focused ethnographic approach |
| title_fullStr | What are the key influences and challenges around weight management faced by patients in UK adult secure mental health settings? A focused ethnographic approach |
| title_full_unstemmed | What are the key influences and challenges around weight management faced by patients in UK adult secure mental health settings? A focused ethnographic approach |
| title_short | What are the key influences and challenges around weight management faced by patients in UK adult secure mental health settings? A focused ethnographic approach |
| title_sort | what are the key influences and challenges around weight management faced by patients in uk adult secure mental health settings a focused ethnographic approach |
| url | https://bmjopen.bmj.com/content/14/3/e079406.full |
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