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☐ ☆ ✇ BMJ Open

Why do older people not adhere to a healthy lifestyle: a qualitative exploration of perceived barriers among older people living in a low-income and middle-income country setting

Por: Jayasinghe · V. · Ferdinando · R. · Abeysena · C. — Abril 8th 2026 at 11:37
Objective

To explore perceived barriers to adhering to a healthy lifestyle among older people living in a Sri Lankan setting.

Design

Qualitative thematic analysis of in-depth interviews among older people.

Setting

The study was conducted in Kalutara district, Sri Lanka.

Participants

In total, 28 older people aged between 60 years and 74 years were interviewed.

Results

Six major themes were identified following the analysis. They were named as lack of knowledge, financial difficulties, poor health status, domestic constraints, cultural norms and changing the living environment. Lack of knowledge emerged through two subthemes, namely lack of information and lack of services. Domestic constraints were derived from family commitments and domestic conflicts, while cultural norms came via beliefs and customs. Poor health status emerged through three subthemes, namely disabilities, diseases and polypharmacy, while changing the living environment emerged via adaptation and urbanisation.

Conclusion

This study provides evidence of real-life perceptions on why older people do not adhere to a healthy lifestyle. Barriers are multifaceted and complex, yet those dimensions need to be considered heavily while developing lifestyle programmes to get maximum benefit for the older people.

☐ ☆ ✇ Journal of Nursing Scholarship

Nursing Care in Hospital Settings for Victims of Mental Disorders: Systematic Review With Meta‐Aggregation

ABSTRACT

Introduction

Approximately 25% of the Brazilian population suffers from mental disorders, a prevalence exacerbated by systemic and cultural factors such as socioeconomic inequalities, underfunded mental health services, regional disparities, and persistent stigma. These conditions significantly impact hospital care. Nurses, due to their direct contact with these patients, face challenges ranging from managing physical conditions to handling verbal aggression and psychiatric crises. This study aimed to assess the scientific evidence regarding nursing care for hospitalized patients with psychiatric disorders.

Methods

A systematic review with a mixed-methods approach was conducted, registered in PROSPERO (#CRD42022359288) and guided by PRISMA standards. Databases, such as MEDLINE, LILACS, PubMed, Web of Science, Scopus, and BDEnf, were searched using keywords like “Mental disorder,” “Psychiatric health,” “Nursing care,” and “Hospital.” Methodological quality was assessed using JBI and SQUIRE tools. The integration of quantitative and qualitative components occurred through meta-aggregation of qualitative data and frequency-based coding of quantitative themes, allowing thematic convergence across study designs.

Results

Six studies were included. Meta-aggregation revealed frequent terms, such as “Nurse,” “Emergency,” “Screening,” “Patient,” and “Care.” Similarity analysis linked “Nurse” with “perception” and “experience” and “Emergency” with “Screening” and “Mental health,” highlighting the importance of experience and training. Five categories emerged: (1) professional experience (19.05%, showing skill gaps despite experience); (2) caring process (19.05%, stressing efficient screening); (3) barriers and challenges (19.05%, revealing difficulty with comorbidities); (4) training process (19.05%, identifying training deficiencies); and (5) therapeutic interventions (23.81%, discussing restraint use). These percentages refer to the proportional frequency of themes identified across the total number of studies analyzed. For thematic classification, only statistically significant chi-square values (p < 0.05) were considered in the grouping of content.

Conclusion

Nursing care for psychiatric patients in hospitals faces challenges like insufficient training and difficulty managing psychiatric comorbidities. Recommendations include incorporating structured mental health content into nursing curricula and hospital-based continuing education programs. These strategies may guide future healthcare policies in Brazil by improving patient safety, reducing hospital readmissions, and promoting more humane, evidence-based therapeutic interventions.

Clinical Relevance

The findings emphasize the urgent need for targeted education and training to improve nursing care for psychiatric patients in hospital settings.

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