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Table 3 Topics mentioned ≥2x in open-ended questions

From: Implementation barriers and facilitators of an integrated multidisciplinary lifestyle enhancing treatment for inpatients with severe mental illness: the MULTI study IV

 

Barriers

n (%)

Facilitators

n (%)

HCPs

(N = 42)

Personal development is no specific part of MULTI, which causes a lack of time to support this and to tailor towards patients’ needsa

9 (21)

Time for own lifestyle behaviour

4 (9)

The decrease of support by allied health professionals such as activity coordinators and dietitian due to budget cuts

8 (20)

Better relationship with patients

2 (5)

It takes a lot of energy to get everyone involved appropriatelyb

7 (17)

  

The shop and restaurant at the hospital where patients can easily buy unhealthy food and beverages – the lack of affordable healthy alternatives

3 (7)

  

Difficult to communicate with patients who do not see or understand the topic of poor physical health

3 (7)

  

Lack of education and clear communication to take away ambiguity and face challengesc

3 (7)

  

Patients

(N = 33)

Lack of time within the day-to-day program to choose own activities independent from the group

8 (24)

Activities

17 (52)

Lack of sports activities

3 (9)

Interaction with peers during activities

3 (9)

Too much sports activities

3 (9)

Healthier food

3 (9)

Lack of care after moving to another ward/facility

2 (6)

Daily structure with regular circadian rhythm

2 (6)

  

Commitment and support of activity coordinators and nurses during activities

2 (6)

  1. HCPs: Healthcare Professionals
  2. ae.g. to find activities meeting patients’ abilities and interests and supporting independence, for example, to prepare them for maintaining an improved lifestyle after moving to another ward/facility. Relapse in both physical and mental health in some patients after moving to other wards or facilities such as sheltered housing
  3. be.g. due to heterogeneity in patients at wards, patients who are unresponsive to motivational interviewing or a lack of consistent action within the team
  4. ce.g. dealing with patients who are unresponsive to motivational interviewing and food issues such as binge eating