Ask an answerable question (PICO)：
The prevalence of obesity in patients with chronic mental illness is higher than that in the general population. Obesity is one of the risk factors for many chronic diseases, it also makes patients’ physical and mental health worse, lowers self-esteem, lacks confidence and withdraws from interpersonal interaction. In recent years, many reports have pointed out that changes in lifestyle, such as dietary control, exercise and behavioral modification, can significantly reduce weight. According to the client has highly motivation for losing weight , we apply the evidence based intervention to propose a clinical problem. The PICO was (P) is “psychiatric patients or mental illness”, (I) are “lifestyle intervention”, (C) are “routine care” and outcome evaluation (O) is “weight” as keywords to explore whether lifestyle intervention can reduce weight in patients with mental illness?
The Method and Analysis of Literature Review：
Following the evidence-based nursing 5A steps, search PubMed, Embase, Cochrane Library and Chinese electronic journals (CEPS) and other databases that meet the PICO problem. Search for literature from 2017 to 2022. The search strategy uses keywords, related words and MeSH Term with Boolean logic for searching. A total of six systematic literature reviews that meet PICO were searched.
Using the latest version of CASP for SR appraisal tool in 2018, appraise six systematic literature reviews, the evidence level of those articles were evidence level 1 and the recommendation strength was grade A according to The Oxford 2011 Levels of Evidence rating criteria.
Clinical Application of Evidence：
Follow the 7A steps of evidence-based translation for clinical application. The author formulated lifestyle intervention measures for diet, exercise and behavioral modification. The subjects were five patients with BMI≧27 kg/m2 and weight loss motivation in the day ward of a medical center in Taichung. The intervention measures were six months of diet control and aerobic exercise training five times a week for 30 minutes each time. Weight was measured every month and individual counseling was conducted every day.
Evaluation of Effectiveness：
Evidence-based translation was applied to clinical cases. After six months of intervention, the average weight of the five patients decreased by 3.98 kg, with the highest decrease being 10.6 kg, and the average BMI decreased by 1.4 kg/m2, with the highest decrease being 4.0 kg/m2. In terms of additional benefits, it improved patients' confidence and made them pay more attention to personal appearance. It also made one of the female patients with obesity-induced secondary amenorrhea menstruate regularly again.
Conclusions and Recommendations：
After six months of lifestyle intervention, weight loss was achieved in patients with mental illness. The results confirmed that motivation and willingness are key factors affecting successful weight loss, and it is recommended to continue to follow up and develop good habits to achieve effective weight loss and long-term weight control.