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Table 3 Illustrative sample quotations and fieldnotes according to main themes

From: The impact of exercise training complementary to early intervention in patients with first-episode psychosis: a qualitative sub-study from a randomized controlled feasibility trial

Main theme

Quotations (samples)

Fieldnotes (samples)

Motivation and expectations for enrolment

I’m ashamed of what has happened after all those years with no training. (…) I’ve gained weight and haven’t really been doing anything, also physically. So, I think if or when I complete this, I’ll feel much better about myself. It’ll be kind of a proof that I still can.

N/A

Baseline interview, P4 (male, 26)

And then I would also like to train, but I’m not that good at getting out the door, so I want to take the initiative myself. So, if I’m with someone, especially someone I know, then I want to know and get it done.

Baseline interview, P6 (female, 19)

New demands and opportunities

P5: Well, it’s kind of a better start to the day; when the training is later, you have to wait a few hours and then you start to think so many thoughts in your head about it and stuff like that. P8: Yeah, and then the day is almost gone already. P1: Yeah, you haven’t done anything and just vegged all day. P8: But in the morning, you come home at a time when you would’ve normally woken up.

In the changing room, P5 told me it was more intensive than the other training sessions with the male instructors, and that this kind of workout of the day was good because it sparked some competition. As she said: “You don’t want to be the last one finishing, so it motivates you to do it faster”.

Focus group discussion with participants

P1: I’m very pleasantly surprised because I was afraid we would start really slow, so it’s been really good. And I actually think that - I know that it sounds strange - but we haven’t been treated like sick people; sometimes you meet people who talk to you as if you were stupid. P8: Or a four-year-old child. (...) Yeah, I don’t think I’ve been treated differently.

Participant observation, 12 March 2018

When P3 and P1 entered the changing room, they talked about how tired they felt and that the training had been intensive today. Then Ellen said she was looking very much forward for Copenhagen Warrior® – “like a little child”, to which P3 replied that she was also looking very much forward to it, while P1 nodded in agreement.

Focus group discussion with participants

I think it’s nice that you don’t have to explain. We’re still very different people and have very different symptoms, but basically, we know that we’re all fighting with the same things and that really helps me. That I can just say ‘it’s just a shitty day today’ and then people don’t ask for an explanation, because ‘well I recognise that, I had that yesterday’ or something like that. Or you can say I’m in a really bad period right now and then they just know what you mean. I think that’s really nice.

Participant observation, 12 March 2018

One instructor put on a song and everyone was running around the room to the song. When a specific word was sung everyone had to do a push-up. The instructor decided on what kind of running everyone had to do (e.g. backwards or to the side) and also told everyone to drop to the ground when the word was sung. She continued to encourage the participants to keep running and to do push-ups.

Follow-up individual interview, P1 (female, 35)

You relax more instead of just sitting down and having to talk and stuff like that. Here you’re doing something together.

Looking ahead – reflections on impact

Follow-up individual interview, P5 (female, 27)

Participant observation, 14 March 2018

I’m tired in the evening. I’ve had a lot of trouble sleeping, but now I’m tired in the evening and I go to bed at a fitting time and get up early. And I also have more energy to do the work I occasionally have.

After a short break, the workout of the day was introduced and differed compared to other sessions. This time everyone had to do three rounds of the same exercises at the same time with a one-minute break in between. The round comprised 10 push-ups at end of the room and running to the next post in the middle of the room to do 20 lunges per leg before moving on to do 30 mountain climbers and then 40 steps on a step bench at the other end of the room.

Follow-up individual interview, P4 (male, 26)

I become energised. After training I can conquer the whole world. I get home and start cleaning, vacuuming, doing the dishes and the laundry, and I suddenly have the energy to do all these things. So, training definitely energises me, and after I’ve done all the things I needed to do, I go for a long walk. (…) It helps to prove it’s me who’s in control and me who decides, and it’s just something that’s in my head, it’s not real. (…) It’s my life, my body and me who’s in charge, it’s not my disease that decides over me, it’s me who decides over my illness. So, after I’ve started training I can feel I’m more in control of myself.

The male participants, P2 and P4, did the exercises very meticulously at their own pace and fell behind quite quickly. The three women accompanied one another, with P1 and P3 counting down together, encouraging each other and high-fiving each other after each exercise post, whereas P5 did the exercises and counting down by herself.

Follow-up individual interview, P3 (female, 27)

Participant observation, 12 March 2018

N/A