Previous experiences and emotional baggage as barriers to lifestyle change - a qualitative study of Norwegian Healthy Life Centre participants

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Abstract

Background

Changing lifestyle is challenging and difficult. The Norwegian Directorate of Health recommends that all municipalities establish Healthy Life Centres targeted to people with lifestyle issues. Little is known about the background, experiences and reflections of participants. More information is needed about participants to shape effective lifestyle interventions with lasting effect. This study explores how participants in a lifestyle intervention programme describe previous life experiences in relation to changing lifestyle.

Methods

Semi-structured qualitative in-depth interviews were performed with 23 participants (16 women and 7 men) aged 18 – 70 years. The data were analysed using systematic text condensation searching for issues describing participants’ responses, and looking for the essence, aiming to share the basis of life-world experiences as valid knowledge.

Results

Participants identified two main themes: being stuck in old habits, and being burdened with emotional baggage from their previous negative experiences. Participants expressed a wish to change their lifestyles, but were unable to act in accordance with the health knowledge they possessed. Previous experiences with lifestyle change kept them from initiating attempts without professional assistance. Participants also described being burdened by an emotional baggage with problems from childhood and/or with family, work and social life issues. Respondents said that they felt that emotional baggage was an important explanation for why they were stuck in old habits and that conversely, being stuck in old habits added load to their already emotional baggage and made it heavier.

Conclusions

Behavioural change can be hard to perform as psychological distress from life baggage can influence the ability to change. The study participants’ experience of being stuck in old habits and having substantial emotional baggage raises questions as to whether or not Healthy Life Centres are able to help participants who need to make a lifestyle change.

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Most cited references 27

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Stress, Appraisal, and Coping

PhD Richard S. Lazarus, PhD Susan Folkman (1984)

The reissue of a classic work, now with a foreword by Daniel Goleman!Here is a monumental work that continues in the tradition pioneered by co-author Richard Lazarus in his classic book Psychological Stress and the Coping Process. Dr. Lazarus and his collaborator, Dr. Susan Folkman, present here a detailed theory of psychological stress, building on the concepts of cognitive appraisal and coping which have become major themes of theory and investigation. As an integrative theoretical analysis, this volume pulls together two decades of research and thought on issues in behavioral medicine, emotion, stress management, treatment, and life span development. A selective review of the most pertinent literature is included in each chapter. The total reference listing for the book extends to 60 pages. This work is necessarily multidisciplinary, reflecting the many dimensions of stress-related problems and their situation within a complex social context. While the emphasis is on psychological aspects of stress, the book is oriented towards professionals in various disciplines, as well as advanced students and educated laypersons. The intended audience ranges from psychiatrists, clinical psychologists, nurses, and social workers to sociologists, anthropologists, medical researchers, and physiologists.

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Stages and processes of self-change of smoking: toward an integrative model of change.

J Prochaska, C C DiClemente (1983)

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Association of an intensive lifestyle intervention with remission of type 2 diabetes.

Edward Gregg, Haiying Chen, Lynne Wagenknecht … (2012)

The frequency of remission of type 2 diabetes achievable with lifestyle intervention is unclear. To examine the association of a long-term intensive weight-loss intervention with the frequency of remission from type 2 diabetes to prediabetes or normoglycemia. Ancillary observational analysis of a 4-year randomized controlled trial (baseline visit, August 2001-April 2004; last follow-up, April 2008) comparing an intensive lifestyle intervention (ILI) with a diabetes support and education control condition (DSE) among 4503 US adults with body mass index of 25 or higher and type 2 diabetes. Participants were randomly assigned to receive the ILI, which included weekly group and individual counseling in the first 6 months followed by 3 sessions per month for the second 6 months and twice-monthly contact and regular refresher group series and campaigns in years 2 to 4 (n=2241) or the DSE, which was an offer of 3 group sessions per year on diet, physical activity, and social support (n=2262). Partial or complete remission of diabetes, defined as transition from meeting diabetes criteria to a prediabetes or nondiabetic level of glycemia (fasting plasma glucose <126 mg/dL and hemoglobin A1c <6.5% with no antihyperglycemic medication). RESULTS Intensive lifestyle intervention participants lost significantly more weight than DSE participants at year 1 (net difference, -7.9%; 95% CI, -8.3% to -7.6%) and at year 4 (-3.9%; 95% CI, -4.4% to -3.5%) and had greater fitness increases at year 1 (net difference, 15.4%; 95% CI, 13.7%-17.0%) and at year 4 (6.4%; 95% CI, 4.7%-8.1%) (P < .001 for each). The ILI group was significantly more likely to experience any remission (partial or complete), with prevalences of 11.5% (95% CI, 10.1%-12.8%) during the first year and 7.3% (95% CI, 6.2%-8.4%) at year 4, compared with 2.0% for the DSE group at both time points (95% CIs, 1.4%-2.6% at year 1 and 1.5%-2.7% at year 4) (P < .001 for each). Among ILI participants, 9.2% (95% CI, 7.9%-10.4%), 6.4% (95% CI, 5.3%-7.4%), and 3.5% (95% CI, 2.7%-4.3%) had continuous, sustained remission for at least 2, at least 3, and 4 years, respectively, compared with less than 2% of DSE participants (1.7% [95% CI, 1.2%-2.3%] for at least 2 years; 1.3% [95% CI, 0.8%-1.7%] for at least 3 years; and 0.5% [95% CI, 0.2%-0.8%] for 4 years). In these exploratory analyses of overweight adults, an intensive lifestyle intervention was associated with a greater likelihood of partial remission of type 2 diabetes compared with diabetes support and education. However, the absolute remission rates were modest. TRIAL REGISTRATION clinicaltrials.gov Identifier: NCT00017953.

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Author and article information

Contributors

Ingrid S Følling: +47 74 02 25 97 , ingfoll@gmail.com

Marit Solbjør: +47 73 59 02 20 , marit.solbjor@svt.ntnu.no

Anne-S Helvik: +47 73 59 75 65 , anne-sofie.helvik@ntnu.no

Journal

Journal ID (nlm-ta): BMC Fam Pract

Journal ID (iso-abbrev): BMC Fam Pract

Title: BMC Family Practice

Publisher: BioMed Central (London )

ISSN (Electronic): 1471-2296

Publication date (Electronic): 23 June 2015

Publication date PMC-release: 23 June 2015

Publication date Collection: 2015

Volume: 16

Electronic Location Identifier: 73

Affiliations

[ ]Department of Health Sciences, North-Trøndelag University College, Røstad, 7600 Levanger, Norway

[ ]Department of Public Health and General Practice, Faculty of Medicine, Norwegian University of Science and Technology, Post box 8905, 7491 Trondheim, Norway

[ ]Department of Social Work and Health Science, Faculty of Social Sciences and Technology Management, Norwegian University of Science and Technology, Dragvoll, Edvard Bulls veg 1, Bygg, 7491 Trondheim, Norway

[ ]St. Olavs University Hospital, Trondheim, Norway

[ ]Norwegian National Advisory Unit on Ageing and Health, Vestfold Hospital Trust, Tønsberg, Norway

Article

Publisher ID: 292

DOI: 10.1186/s12875-015-0292-z

PMC ID: 4476174

PubMed ID: 26100276

SO-VID: 5131ac36-e11f-4be4-9c2d-15509ce2f6cb

License:

This is an Open Access article distributed under the terms of the Creative Commons Attribution License ( http://creativecommons.org/licenses/by/4.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly credited. The Creative Commons Public Domain Dedication waiver ( http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated.

History

Date received : 8 January 2015

Date accepted : 8 June 2015

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ScienceOpen disciplines: Medicine

Keywords: primary healthcare,health behaviour,lifestyle change,multi-comorbidity,overweight,qualitative research

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ScienceOpen disciplines: Medicine

Keywords: primary healthcare, health behaviour, lifestyle change, multi-comorbidity, overweight, qualitative research

Previous experiences and emotional baggage as barriers to lifestyle change - a qualitative study of Norwegian Healthy Life Centre participants

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Most cited references 27

Stress, Appraisal, and Coping

Stages and processes of self-change of smoking: toward an integrative model of change.

Association of an intensive lifestyle intervention with remission of type 2 diabetes.

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