Nachhaltige Veränderung von Sport- und Bewegungsaktivität: Maßnahmen während und nach dem Klinikaufenthalt

People with mental illness have reduced physical activity and rarely meet international recommendations for sufficient sport/exercise (Vancampfort et al., 2017). Therefore, exercise therapy measures are applied in clinics to achieve health-relevant standards (Pfeifer et al., 2010). After a stay in hospital, there is a risk that these positive adaptations will regress due to a lack of movement stimuli (Geidl et al., 2012; Pearsall et al., 2014). In order to counteract this, movement therapy care that is anchored in theory as well as practicable and sustainable is required (Romain et al., 2020).

In the present project, the theoretical conception for clinical as well as post-clinical care is based on the one hand on the Rubicon model (Heckhausen et al., 1987), which divides a successful implementation of a (health-promoting) behaviour (e.g. sport/exercise) into phases and thus served to specify different thematic blocks. The self-determination theory (Deci & Ryan, 2008) was used to develop specific modules for the thematic blocks. In order for the concept to be practicable in everyday clinical practice, semi-structured interviews were conducted with staff and patients of a psychosomatic and psychiatric clinic. A total of 13 actors from different areas were interviewed on relevant aspects (e.g. resources, diagnostics, sustainability of care).

The interviews provided information on how the theoretical concept can be applied in the clinic. In particular, the available time and personnel resources concretised the support concept. In addition, sports psychological diagnostics (i.e. self-concept, goal motivation, action motivation, self-efficacy expectation) as well as modules with different thematic focuses were developed taking into account current literature and with regard to the assessments of the interviewees, which enable individual support for the patients. Clinical care includes thematic blocks (i.e. identification, intention formation, goal setting, action planning, intention formation, support factors) aimed at establishing regular physical activity. In post-hospital care, various topics (i.e. implementation, barrier management, resource management, action change) are used to ensure that the level of physical activity is maintained and continued independently. During the clinic stay (approx. 6-8 weeks), individual and group sessions with sports therapists are held in person and thus serve as learning environments for the patients. After the stay in the clinic (approx. 6 months), both telephone calls and short messages are used as digital support methods. In order to enable the sports therapists to apply this concept, they undergo training. In this training, the (theoretical) background and procedures for the diagnostics as well as the modules and support methods are taught.
After a feasibility study, the concept will be evaluated in terms of feasibility and effectiveness. On the basis of the data collected, the concept can be adapted if necessary and expanded to make the care available to a larger number of patients.