Research Article| Volume 41, P51-61, December 2022

The Transtheoretical Model based psychoeducation's effect on healthy lifestyle behaviours in schizophrenia: A randomized controlled trial


      What is known about the subject?
      • Unhealthy lifestyle behaviors play an important role in the formation of physical health problems in individuals with chronic mental disorders such as schizophrenia. The transtheoretic model is an appropriate model used in the development of healthy lifestyle behaviours.
      What is the contribution of this article to what is known?
      • Although the effect of the transtheoretic model in developing healthy lifestyle behaviors is known, the evidence for its effectiveness in individuals with schizophrenia is limited. The study will provide evidence about the effectiveness of the transtheoretic model in individuals with schizophrenia.
      What is its contribution in practice?
      • The study data will contribute to mental health and psychiatry nurses in terms of approaches and models that can be used to identify the physical health problems of individuals with schizophrenia and to develop healthy life behaviors. By using this model, they will be able to make a more systematic and holistic approach to individuals diagnosed with schizophrenia.



      The study was conducted with the pretest-posttest randomized controlled trial design to detect the psychoeducation's effect, based on the Transtheoretical Model, on the healthy lifestyle behaviours of individuals with schizophrenia.


      The data were collected from 82 participants, as 41 intervention and 41 control. The data were collected via personal information form, behavioural change stage diagnosis form and healthy lifestyle scale II. 6-week psychoeducation, consisting of 6 modules, based on the Transtheoretical Model, was applied to the intervention group. No interventions were applied to the control group. Pretests and posttests were applied to both groups.


      When the healthy lifestyle scale II of intervention and control groups and final test results arranged according to ANCOVA analysis are compared, average final test results were meaningfully positive for the intervention group with taking control of the pretest and other covariants. When the pretest-posttest results in terms of behavioural change of the intervention group are evaluated; a meaningful difference among nutrition, physical exercises, spiritual self-improvement and stress management, which all are the stages of behavioural change, was detected.


      It was determined that psychoeducation on a healthy lifestyle, based on the Transtheoretical Model in an individual with schizophrenia affected physical exercises, spiritual self-improvement and interpersonal relationships sub-dimension in medium level, and had a drastic influence on health responsibility, nutrition, stress management sub-dimensions and all healthy lifestyle behaviours. Progress in behavioural change stages was detected.

      Clinical trials ID



      To read this article in full you will need to make a payment

      Purchase one-time access:

      Academic & Personal: 24 hour online accessCorporate R&D Professionals: 24 hour online access
      One-time access price info
      • For academic or personal research use, select 'Academic and Personal'
      • For corporate R&D use, select 'Corporate R&D Professionals'


      Subscribe to Archives of Psychiatric Nursing
      Already a print subscriber? Claim online access
      Already an online subscriber? Sign in
      Institutional Access: Sign in to ScienceDirect


        • Acıl A.A.
        • Dogan S.
        • Dogan O.
        The effects of physical exercises to mental state and quality of life in patients with schizophrenia.
        Journal of Psychiatric and Mental Health Nursing. 2008; 15: 808-815
        • Alkar Ö.Y.
        • Karanci N.A.
        What are the differences in decisional balance and self-efficacy between Turkish smokers in different stages of change?.
        Addictive Behaviors. 2007; 32: 836-849
        • Aveyard P.
        • Lawrence T.
        • Cheng K.K.
        • Griffin C.
        • et al.
        A randomized controlled trial of smoking cessation for pregnant women to test the effect of a transtheoretical model-based intervention on movement in stage and interaction with baseline stage.
        British Journal of Health Psychology. 2006; 11: 263-278
        • Aveyard P.
        • Massey L.
        • Parson A.
        • Manaseki S.
        • Griffin C.
        The effect of transtheoretical model based interventions on smoking cessation.
        Social Science & Medicine. 2009; 68: 397-403
        • Ay S.
        • Temel A.B.
        The transtheoretical model of behavioral change to exercise in applying to adult Turkish people.
        Gait & Posture. 2008; 28: 118
        • Bahar Z.
        • Beşer A.
        • Gördes N.
        • Ersin F.
        • Kıssal A.
        Sağlıklı Yaşam Biçimi Davranışları Ölçeği II’nin Geçerlik ve Güvenirlik Çalışması.
        Cumhuriyet Üniversitesi Hemşirelik Yüksekokulu Dergisi. 2008; 12: 1-13
        • Baller J.B.
        • Ginty E.E.
        • Azrin S.T.
        • Juliano-Bult D.
        • Daumit G.L.
        Screening for cardiovascular risk factors in adults with serious mental illness: A review of the evidence.
        BMC Psychiatry. 2015; 15: 1-13
        • Baysal Y.H.
        Fazla Kilolu Kadınlara Transteoretik Model Temelli Verilen Eğitim ve Gözlemin Egzersiz Davranışı Kazandırmaya Etkisi. Atatürk Üniversitesi Sağlık Bilimleri Enstitüsü, Halk Sağlığı Hemşireliği Anabilim Dalı, Doktora Tezi, Erzurum.
        • Bonfioli E.
        • Berti L.
        • Goss C.
        • Muraro F.
        • Burti L.
        Health promotion lifestyle interventions for weight management in psychosis: a systematic review and meta-analysis of randomised controlled trials.
        BMC Psychiatry. 2012; : 12-78
        • Burghardt K.J.
        • Ellingrod V.L.
        Detection of the metabolic syndrome in schizophrenia and implications for antipsychotic therapy: Is there a role for folate?.
        Molecular Diagnosis & Therapy. 2013; 17: 21-30
        • Büyüköztürk Ş.
        Sosyal bilimler İçin veri analizi El Kitabı.
        Pegem Akademi, Ankara2011
        • Çavuşoğlu F.
        Kronik Obstrüktif Akciğer Hastalığı Olan Hastalarda Transteoretik Modele Göre Evde Uygulanan Hemşirelik Girişimlerinin Sigara Bırakmaya Etkisi. Dokuz Eylül Üniversitesi Sağlık Bilimleri Enstitüsü Halk Sağlığı Hemşireliği Anabilim Dalı Doktora Tezi. İzmir.
        • Çelik İnce S.
        • Partlak Günüşen N.
        Effect of a nurse-led intervention program on the physical health and quality of life of individuals with severe mental illness.
        Perspectives in Psychiatric Care. 2021; 57: 1751-1764
        • Chen S.M.
        • Creedy D.
        • Lin H.S.
        • Wollin J.
        Effect of motivational interviewing intervention on self-management, psychological and glycemic outcomes in type 2 diabetes: A randomized controlled trial.
        International of Nursing Studies. 2012; 49: 637-644
        • Choong E.
        • Bondolfi G.
        • Etter M.
        • Jermann F.
        • Aubry J.-M.
        • Bartolomei J.
        • Eap C.B.
        Psychotropic drug-induced weight gain and other metabolic complications in a Swiss psychiatric population.
        Journal of Psychiatric Research. 2012; 46: 540-548
        • Cihangiroğlu Z.
        • Deveci S.E.
        Fırat üniversitesi elazığ sağlık yüksekokulu öğrencilerinin sağlıklı yaşam biçimi davranışları ve etkileyen faktörler.
        Fırat Tıp Dergisi. 2011; 16: 78-83
        • Cohen J.
        A power primer.
        Psychological Bulletin. 1992; 112: 155-159
        • Collins E.
        • Tranter S.
        • Irvine F.
        The physical health of the seriously mentally ill: An overview of the literatüre.
        Journal of Psychiatric and Mental Health Nursing. 2011; 19: 638-646
        • Correll C.U.
        • Joffe B.I.
        • Rosen L.M.
        • Sullivan T.B.
        • Joffe R.T.
        Cardiovascular and cerebrovascular risk factors and events associated with second-generation antipsychotic compared to antidepressant use in a nonelderly adult sample: Results from a claimsbased inception cohort study.
        World Psychiatry. 2015; 14: 56-63
        • Costa R.
        • Bastos T.
        • Probst M.
        • Seabra A.
        • Abreu S.
        • Vilhena E.
        • Rosenbaum S.
        • Ward P.B.
        • Corredeira R.
        Association of lifestyle-related factors and psychological factors on quality of life in people with schizophrenia.
        Psychiatry Research. 2018; 267: 382-393
        • Crump C.
        • Winkleby M.A.
        • Sundquist K.
        • Sundquist J.
        Comorbidities and mortality in persons with schizophrenia: A swedish national cohort study.
        American Journal of Psychiatry. 2013; 170: 324-333
        • Daumit G.L.
        • Dickerson F.B.
        • Wang N.Y.
        • et al.
        A behavioral weight-loss intervention in persons with serious mental illness.
        The New England Journal of Medicine. 2013; 368: 1594-1602
        • Davis R.
        • Campbell R.
        • Hildon Z.
        • Hobbs L.
        • Michie S.
        Theories of behaviour and behaviour change across the social and behavioural sciences: A scoping review.
        Health Psychology Review. 2015; 9: 323-344
        • De Hert M.
        • Cohen D.
        • Bobes J.
        • Cetkovich-Bakmas M.
        • Leucht S.
        • Ndetei D.M.
        • et al.
        Physical illness in patients with severe mental disorders. II. Barriers to care, monitoring and treatment guidelines, plus recommendations at the system and individual level.
        World Psychiatry. 2011; 10: 138-151
        • De Hert M.
        • Correll C.U.
        • Bobes J.
        • Cetkovich-Bakmas M.
        • Cohen D.
        • Asai I.
        • amp
        • et al.
        Physical illness in patients with severe mental disorders. I. Prevalence, impact of medications and disparities in health care.
        World Psychiatry. 2011; 10: 52-77
        • De Hert M.
        • Correll C.U.
        • Bobes J.
        • Cetkovich-Bakmas M.
        • Cohen D.A.N.
        • Asai I.
        • Leucht S.
        Physical illness in patients with severe mental disorders. I. Prevalence, impact of medications and disparities in health care.
        World Psychiatry. 2011; 10: 52-77
        • Demirel Döngel B.
        • Demirkol M.E.
        • Tamam L.
        Şizofreni hastalarında fiziksel hastalık eş tanılarının değerlendirilmesi.
        Cukurova Medical Journal. 2018; 43: 892-902
        • Dipasquale S.
        • Pariante C.M.
        • Dazzan P.
        • Aguglia E.
        • McGuire P.
        • Mondelli V.
        The dietary pattern of patients with schizophrenia: A systematic review.
        Journal of Psychiatric Research. 2013; 47: 197-207
        • Dodd K.J.
        • Duffy S.
        • Stewart J.A.
        • Impey J.
        • Taylor N.
        A small group aerobic exercise programme that reduces body weight is feasible in adults with severe chronic schizophrenia: A pilot study.
        Disability and Rehabilitation. 2011; 33: 1222-1229
        • Erbaba H.
        Obez adolesanlarda beslenme, fiziksel aktivite ve menstürel semptomlara yönelik verilen eğitimin sağlıklı yaşam biçimi davranışları ve menstürel semptomlara etkisinin değerlendirilmesi. Ankara Yıldırım Beyazıt Üniversitesi, Sağlık Bilimleri Enstitüsü, Hemşirelik Anabilim Dalı, Doktora Tezi. Ankara.
        • Erginer D.
        • Günüşen N.
        Determination of physical health status and healthy lifestyle behaviors of individuals with mental illness.
        Perspectives in Psychiatric Care. 2018; 54: 371-379
        • Erkal Aksoy Y.
        • Özentürk M.G.
        Prekonsepsiyonel Dönemdeki Kadınların Sağlık Davranışları Değişim Aşamaları (Transteoretik Model): Randomize Kontrollü Çalışma.
        Genel Tıp Dergisi. 2021; 31: 330-338
        • Erol S.
        • Erdoğan S.
        Sağlık Davranışlarını Geliştirmek ve değiştirmek için transteoretik modelin kullanılması.
        Atatürk Üniversitesi Hemşirelik Yüksekokulu Dergisi. 2007; 10: 2
        • Firth J.
        • Siddiqi N.
        • Koyanagi A.I.
        • Siskind D.
        • Rosenbaum S.
        • Galletly C.
        • Stubbs B.
        The lancet psychiatry commission: A blueprint for protecting physical health in people with mental illness.
        The Lancet Psychiatry. 2019; 6: 675-712
        • Fusar-Poli P.
        • De Marco L.
        • Cavallin F.
        • Bertorello A.
        • Nicolasi M.
        • Politi P.
        Lifestyles and cardiovascular risk in individuals with functional psychoses.
        Perspectives in Psychiatric Care. 2009; 45: 87-99
        • Gandhi S.
        • Gurusamy J.
        • Ragupathy S.K.
        • Damodharan D.
        • Ganesan V.
        • Marimuthu P.
        Healthy lifestyle behavior and personal control in people with schizophrenia with healthy controls: A cross-sectional comparative study.
        Asian Journal of Psychiatry. 2019; 45: 95-98
        • Gerçik E.
        Kronik Psikiyatri Hastalarında Sağlıklı Yaşam Biçimi Davranışları İle Öz Bakım Gücü Arasındaki İlişki. Üsküdar Üniversitesi Sağlık Bilimleri Enstitüsü Hemşirelik Anabilim Dalı Psikiyatri Hemşireliği Yüksek Lisans Programı Yüksek Lisans Tezi.
        • Göhner W.
        • Dietsche C.
        • Fuchs R.
        Increasing physical activity in patients with mental illness-a randomized controlled trial.
        Patient Education and Counseling. 2015; 98: 1385-1392
        • Gomes E.
        • Bastos T.
        • Probst M.
        • Ribeiro J.C.
        • Silva G.
        • Corredeira R.
        Effects of a group physical activity program on physical fitness and quality of life in individuals with schizophrenia.
        Mental Health and Physical Activity. 2014; 7: 155-162
        • Gong J.
        • Chen X.
        • Li S.
        Efficacy of a community-based physical activity program KM2H2 for stroke and heart attack prevention among senior hypertensive patients: A cluster randomized controlled phase-II trial.
        PLoS One. 2015; 1
        • Gothefors D.
        • Adolfsson R.
        • Attvall S.
        • Erlinge D.
        • Jarbin H.
        • Lindstrom K.
        • Osby U.
        Swedish clinical guidelines— Prevention and management of metabolic risk in patients with severe psychiatric disorders.
        Nordic Journal of Psychiatry. 2010; 64: 294-302
        • Gümüş Ersoy M.
        Ruhsal Bozukluğu Olan Bireylerde Motivasyonel Görüşmenin Sigara İçme Davranışı Üzerine Etkisi. Marmara Üniversitesi Tıp Fakültesi Aile Hekimliği Anabilim Dalı, Uzmanlık Tezi. İstanbul.
        • Güngörmüş Z.
        • Yılmaz Karabulutlu E.
        Üniversite öğrencilerinin genel sağlık ölçümlerinin değişim aşamalarına göre değerlendirilmesi.
        Gümüşhane University Journal of Health Sciences. 2012; 1: 165-178
        • Hardy S.
        • Gray R.
        Adapting the severe mental illness physical health improvement profile for use in primary care.
        International Journal of Mental Health Nursing. 2010; 19: 350-355
        • Hashemzadeh M.
        • Rahimi A.
        • Zare-Farashbandi F.
        • Alavi-Naeini A.M.
        • Daei A.
        Transtheoretical model of health behavioral change: A systematic review.
        Iranian J Nursing Midwifery Res. 2019; 24: 83-90
        • Holt R.I.G.
        • et al.
        Structured lifestyle education for people with schizophrenia, schizoaffective disorder and first-episode psychosis (STEPWISE): Randomised controlled trial.
        The British Journal of Psychiatry. 2019; 214: 63-73
        • İlhan N.
        • Batmaz M.
        • Utaş Akhan L.
        Üniversite Öğrencilerinin Sağlıklı Yaşam Biçimi Davranışları.
        Maltepe Üniversitesi Hemşirelik Bilim ve Sanatı Dergisi. 2010; 3: 35-43
        • İpekçioğlu D.
        • Kök Kendirlioğlu B.
        Şizofreni Hastalarında Fiziksel Hastalık Ek Tanıları ve Ölüm Nedenleri: Geriye Dönük Tanımlayıcı Bir Çalışma.
        Bakırköy Tıp Dergisi. 2019; 15: 103-109
        • Jakobsen A.S.
        • Speyer H.
        • Nørgaard H.C.B.
        • Karlsen M.
        • Hjorthøj C.
        • Krogh J.
        • amp
        • et al.
        Dietary patterns and physical activity in people with schizophrenia and increased waist circumference.
        Schizophrenia Research. 2018; 199: 109-115
        • Kim Y.
        • Cardinal B.J.
        • Lee J.
        Understanding exercise behavior among Korean adults: A test of the transtheoretical model.
        International Journal of Behavioral Medicine. 2006; 13: 295-303
        • Kol E.
        Türkiye’de Sağlık Reformlarının Sağlık Hakkı Açısından Değerlendirilmesi.
        SGD-Sosyal Güvenlik Dergisi. 2015; 5 (Retrieved from): 135-164
        • Li X.
        • Yang S.
        • Wang Y.
        • Yang B.
        • Zhang J.
        Effects of a transtheoretical model - based intervention and motivational interviewing on the management of depression in hospitalized patients with coronary heart disease: A randomized controlled trial.
        BMC Public Health. 2020; 20: 420
        • Loh S.Y.
        • Abdullah A.
        • Bakar A.K.A.
        • Jaafar N.R.N.
        Structured walking and chronic institutionalized schizophrenia inmates: a pilot RCT study on quality of life.
        Global Journal of Health Science. 2015; 8: 238-248
        • Lundström S.
        • Ahlström B.H.
        • Jormfeldt H.
        • Eriksson H.
        • Skärsäter I.
        The meaning of the lived experience of lifestyle changes for people with severe mental illness.
        Issues in Mental Health Nursing. 2017; 38: 717-725
        • Malchow B.
        • Reich-Erkelenz D.
        • Oertel-Knöchel V.
        • Keller K.
        • Hasan A.
        • Schmitt A.
        • et al.
        The effects of physical exercise in schizophrenia and affective disorders.
        European Archives of Psychiatry and Clinical Neuroscience. 2013; 263: 451-467
        • Malhotra N.
        • Kulhara P.
        • Chakrabarti S.
        • Grover S.
        Lifestyle related factors and impact of metabolic syndrome on quality of life, level of functioning and self-esteem in patients with bipolar disorder and schizophrenia.
        Indian Journal of Medical Research. 2016; 143: 434-442
        • Masa-Font R.
        • Fernández-San-Martín M.I.
        • Martín López L.M.
        • Alba Muñoz A.M.
        • Oller Canet S.
        • Martín Royo J.
        • amp
        • et al.
        The effectiveness of a program of physical activity and diet to modify cardiovascular risk factors in patients with severe mental illness after 3- month follow-up: CAPiCOR randomized clinical trial.
        European Psychiatry. 2015; 30: 1028-1036
        • Mc Kenna H.P.
        • Slevin O.D.
        Vital notes for nurses: Nursing models, theories and practice.
        1st ed. Blackwell Publishing, United Kingdam2008
        • Meepring S.
        • Chien W.T.
        • Gray R.
        • Bressington D.
        Effects of the thai health improvement profile intervention on the physical health and health behaviours of people with schizophrenia: A quasi-experimental study.
        International Journal of Mental Health Nursing. 2018; 27: 126-137
        • Mohebbi B.
        • Tafaghodi B.
        • Sadaghi R.
        • Tol A.
        • Yekanenejad M.S.
        Factors predicting nutritional knowledge, illness perceptions, and dietary adherence among hypertensive middle-aged women: Application of transtheoretical model.
        Journal of Education Health Promotion. 2021; 10: 1-7
        • Murphy J.A.
        • Oliver G.
        • Ng C.H.
        • Wain C.
        • Magennis J.
        • Opie R.S.
        • et al.
        Pilot-testing of “Healthy body healthy Mind”: An integrative lifestyle program for patients with a mental illness and co-morbid metabolic syndrome.
        Front. Psychiatry. 2019; 10: 91
        • National Mental Health Commission
        Equally well consensus statement: Improving the physical health and wellbeing of people living with mental illness in Australia. Sydney: Australian Government.
        • Nigg C.R.
        Explaining adolescent exercise behavior change: A longitudinal application of the transteoratical model.
        Annals of Behavioral Medicne. 2001; 23: 11-20
        • Nordentoft M.
        • Wahlbeck K.
        • Westman J.
        • Osby U.
        • Alinaghizadeh H.
        • H€allgren J.
        • Laursen T.M.
        Excess mortality, causes of death and life expectancy in 270,770 patients with recent onset of mental disorders in Denmark, Finland and Sweden.
        PLoS One. 2013; 8e55176-11
        • Oflaz F.
        Toplum ruh sağlığı hemşireliği.
        in: Townsend M.C. Özcan C.T. Gürhan N. Toplum ruh sağlığı hemşireliği. Ruh sağlığı ve psikiyatri hemşireliğinin temelleri kanıta dayalı uygulama bakım kavramları. 6th ed. Akademisyen Tıp Kitabevi, Ankara2016
        • Ohlsen R.I.
        • Peacock G.
        • Smith S.
        Developing a service to monitor and improve physical health in people with serious mental ilness.
        Journal of Psychiatric and Mental Health Nursing. 2005; 12: 614-619
        • Öyekçin D.G.
        Bir grup şizofreni ve şizoaffektif bozukluk hastasında metabolik sendrom sıklığı.
        Anadolu Psikiyatri Dergisi. 2009; 10: 26-33
        • Özyazıcıoğlu N.
        • Kılıç M.
        • Erdem N.
        • Yavuz C.
        • Afacan S.
        Hemşirelik öğrencilerinin sağlıklı yaşam biçimi davranışlarının belirlenmesi.
        Uluslararası İnsan Bilimleri Dergisi. 2011; 2: 278-332
        • Pallant J.
        SPSS Kullanma Kılavuzu, Çev: Sibel Balcı ve Berat Ahi, 2. Baskı, Anı Yayıncılık, Ankara.
        • Pan Y.-J.
        • Yeh L.-L.
        • Chan H.-Y.
        • Chang C.-K.
        Excess mortality and shortened life expectancy in people with major mental illnesses in Taiwan.
        Epidemiology and Psychiatric Sciences. 2020; 29: 1-11
        • Patel V.
        Universal health coverage for schizophrenia: A global mental health priority.
        Schizophrenia Bulletin. 2016; 42
        • Petzold M.B.
        • Mumm J.L.M.
        • Bischoff S.
        • Große J.
        • Plag J.
        • Brand R.
        • Ströhle A.
        Increasing physical activity and healthy diet in outpatients with mental disorders: A randomized-controlled evaluation of two psychological interventions.
        European Archives of Psychiatry and Clinical Neuroscience. 2018; 1–14
        • Prapavessis H.
        • Maddison R.
        • Brading F.
        Understanding exercise behavior among New Zealand adolescents: A test of the transteoretical model.
        Journal Adolescent Health. 2004; 35: 17-27
        • Prochaska J.O.
        • DiClemente C.C.
        Transtheoretical therapy: toward a more integrative model of change.
        Psychology and Psychotherapy: Theory, Research and Practice. 1982; 19: 276-288
        • Prochaska J.O.
        • Redding C.A.
        • Harlow L.L.
        • Rossi J.S.
        • Velicer W.F.
        The transtheoretical model and HIV prevention: A review.
        Health Education Quarterly. 1994; 21: 471-486
        • Prochaska J.O.
        • Velicer W.F.
        The transtheoretical model of behavior change.
        American Journal of Health Promotion. 1997; 12: 38-48
        • Rahimdel T.
        • Morowatisharifabad M.A.
        • Salehi-Abargouei A.
        • Mirzaei M.
        • Fallahzadeh H.
        Evaluation of an education program based on the theory of planned behavior for salt intake in individuals at risk of hypertension.
        Health Education Research. 2019; 34: 268-278
        • Ratliff J.C.
        • Palmese L.B.
        • Reutenauer E.L.
        • Liskov E.
        • Grilo C.M.
        • Tek C.
        The effect of dietary and physical activity pattern on metabolic profile in individuals with schizophrenia: A cross-sectional study.
        Comprehensive Psychiatry. 2012; 53: 1028-1033
        • Saxena S.
        • Maj M.
        Physical health of people with severe mental disorders: Leave no one behind.
        World Psychiatry: Official Journal of the World Psychiatric Association (WPA). 2017; 16: 1-2
        • Selçuk Tosun A.
        • Zincir H.
        Tip 2 Diabetes Mellitus’ta Sağlık Davranış Değişiminde Transteoretik Model Temelli Motivasyonel Görüşme Tekniği.
        Psikiyatride Güncel Yaklaşımlar-Current Approaches in Psychiatry. 2016; 8: 32-34
        • Sharifirad G.R.
        • Eslami A.A.
        • Charkazi A.
        • Mostafavi F.
        • Shahnazi H.
        The effect of individual counseling, line follow-up, and free nicotine replacement therapy on smoking cessation in the samples of Iranian smokers: Examination of transtheoretical model.
        Journal of Research in Medical Sciences. 2012; (PMID: 23853630): 1128-1136
        • Sharma M.
        Multi-theory model (MTM) for health behavior change.
        WebmedCentral Behaviour. 2015; 6
        • Shinitzky E.H.
        • Kub J.
        The art of motivating behavior change: The use of motivational interviewing to promote health.
        Public Health Nursing. 2001; 18: 178-185
        • Silva B.A.E.
        • Cassılhas R.C.
        • Attux C.
        • Cordeıro Q.
        • Gadelha A.L.
        • Telles B.A.
        • amp c.
        • et al.
        A 20-week program of resistance or concurrent exercise improves symptoms of schizophrenia: results of a blind, randomized controlled trial.
        Revista Brasileira de Psiquiatria. 2015; 37: 271-279
        • Simonelli-Munoz A.J.
        • Fortea M.I.
        • Salorio P.
        • Gallego-Gomez J.I.
        • SanchezBautista S.
        • Balanza S.
        Dietary habits of patients with schizophrenia: A selfreported questionnaire survey.
        International Journal of Mental Health Nursing. 2012; 21: 220-228
        • Spencer L.
        • Adams T.B.
        • Malone S.
        • Roy L.
        • Yost E.
        Applying the transtheoretical model to exercise: A systematic and comprehensive review of the literatüre.
        Health Promotion Practice. 2006; 7: 428-443
        • Strassnig M.
        • Clarke J.
        • Mann S.
        • Ramington G.
        • Ganguli R.
        Body composition, pre‐diabetes and cardiovascular disease risk in early schizophrenia.
        Early intervention in psychiatry. 2017; 11: 229-236
        • Stubbs B.
        • Vancampfort D.
        • De Hert M.
        • Mitchell A.J.
        The prevalence and predictors of type two diabetes mellitus in people with schizophrenia: A systematic review and comparative meta‐analysis.
        Acta Psychiatrica Scandinavica. 2015; 132: 144-157
        • Stubbs B.
        • Williams J.
        • Shannon J.
        • Gaughran F.
        • Craig T.
        Peer support interventions seeking to improve physical health and lifestyle behaviours among people with serious mental illness: A systematic review.
        International Journal of Mental Health Nursing. 2016; 25: 484-495
        • Sungur C.
        • Kar A.
        • Kıran Ş.
        • Macit M.
        Sağlıklı Yaşam Biçimi Davranışlarının Değerlendirilmesi: Klinik Sağlık hizmeti Alan hastalar Üzerinde bir Araştırma.
        Balkan Sosyal Bilimler Dergisi. 2019; 8: 43-52
        • Tanyeri B.
        Fazla Kilolu Yetişkinlere Transteoretik Modele Göre Verilen Eğitimin Beden İmajı ve Egzersiz Davranışı Üzerine Etkisi. Fırat Üniversitesi Sağlık Bilimleri Enstitüsü Hemşirelik Anabilim Dalı Yüksek Lisans Tezi. Elazığ.
        • Tosun S.A.
        Tip 2 Diabetes Mellitus'u Olan Bireylerde Transteoretik Model Temelli Motivasyonel Görüşmenin Öz-Etkililik, Metabolik Kontrol ve Sağlık Davranışına Etkisi. Erciyes Üniversitesi Sağlık Bilimleri Enstitüsü, Hemşirelik Anabilim Dalı, Halk Sağlığı Hemşireliği Bilim Dalı, Doktora Tezi,Kayseri.
        • Uğur M.
        Atipik antipsikotik ilaçlar ve psikozlu hastalarda ortaya çıkan metabolik sendrom.
        Sempozyum Dizisi. 2008; 66: 51-59
        • Van Citters A.D.
        • Pratt S.I.
        • Jue K.
        • Williams G.
        • Miller P.T.
        • Xie H.
        • Bartels S.J.
        A pilot evaluation of the in SHAPE individualized health promotion intervention for adults with mental illness.
        Community Mental Health Journal. 2010; 46: 540-552
        • Van Nes M.
        • Sawatzky J.A.
        Improving cardiovascular health with motivational interviewing: A nurse practioner perspective.
        Journal of the American Academy of Nurse Practitioners. 2010; 22: 654-660
        • Vancampfort D.
        • Firth J.
        • Schuch F.B.
        • Rosenbaum S.
        • Mugisha J.
        • Hallgren M.
        • Probst M.
        • Ward P.B.
        • Gaughran F.
        • De Hert M.
        • Carvalho A.F.
        • Stubbs B.
        Sedentary behavior and physical activity levels in people with schizophrenia, bipolar disorder and major depressive disorder: a global systematic review and meta-analysis.
        World psychiatry: Official Journal of the World Psychiatric Association (WPA). 2017; 16: 308-315
        • Vancampfort D.
        • Stubbs B.
        • Sienaert P.
        • Wyckaert S.
        • De Hert M.
        • Soundy A.
        • Probst M.
        A comparison of physical fitness in patientswith bipolar disorder, schizophrenia and healthy controls.
        Disability and Rehabilitation. 2016; 38: 2047-2051
        • Walker E.R.
        • McGee R.E.
        • Druss B.G.
        Mortality in mental disorders and global disease burden implications. A systematic review and metaanalysis.
        JAMA Psychiatry. 2015; 72: 334-341
        • Walker S.N.
        • Sechrist K.R.
        • Pender N.J.
        The health promoting lifestyle profile development and psychometric characteristics.
        Nursing Research. 1987; 36 (PMID: 3644262): 76-80
        • Walker S.N.
        • Sechrist K.R.
        • Pender N.J.
        Health Promotion Model - Instruments to Measure Health Promoting Lifestyle: Health-Promoting Lifestyle Profile [HPLP II] (Adult Version).
        • World Health Organization
        The world health report 2006: Working together for health.
        (Retrieved from)
        • World Health Organization
        (Retrieved from)
        • World Health Organization
        Premature death among people with severe mental disorders.
        (Retrieved from)
        • World Health Organization
        monitoring health for the SDGs, sustainable development goals. Geneva: Licence: CC BY-NC-SA 3.0 IGO.
        (Retrieved From)
        • Yalçınöz Baysal H.
        Fazla kilolu Kadınlara transteoretik model temelli verilen Eğitim ve izlemin egzersiz Davranışı Kazandırmaya etkisi. Atatürk Üniversitesi Sağlık bilimleri Enstitüsü. Halk Sağlığı Hemşireliği anabilim Dalı.
        Doktora Tezi. Erzurum. 2013; (Unpublished Doctoral thesis)
        • Yaşar Y.
        • Yıldız M.
        Şizofrenide 10 Yıllık Ölüm Oranı ve risk etmenlerinin Değerlendirmesi.
        Türk Psikiyatri Dergisi. 2021; 32: 151-159
        • Zhang J.-P.
        • Lencz T.
        • Zhang R.X.
        • Nitta M.
        • Maayan L.
        • John M.
        • Correll C.U.
        Pharmacogenetic associations of antipsychotic drug-related weight gain: A systematic review and metaanalysis.
        Schizophrenia Bulletin. 2016; 42: 1418-1437