• impact of sickness;
  • mental illness;
  • mixed methods;
  • photography;
  • rehabilitation;
  • stigmatization

sitvast j.e., abma t.a. & widdershoven g.a.m. (2011) Living with severe mental illness: perception of sickness. Journal of Advanced Nursing 67(9), 2170–2179.


Aim.  This article is a report of a study on how participation in photo groups influenced the perception of the impact of sickness on daily life.

Background.  Living with severe mental illness can have a strong impact on daily life and the experience of self. In combination with self-stigmatization, this can lead to a sense of being no more than a patient.

Method.  A mixed-methods design was used to measure the perception of sickness impact. Consumers of psychiatric services participated in photography groups that aimed at integration of illness and developing new goals in life. These groups were conducted by nurses and data were collected between the years 2005 and 2009.

The Sickness Impact Profile (SIP) questionnaires were completed by the respondents before and after intervention. The SIP was used to differentiate between respondents who perceived less impact of illness on their daily lives after following a photogroup and those who did not perceive so or remained the same. A sample of these three groups was used to complement the quantitative findings with in-depth interviews with consumers and mentor nurses.

Results.  Findings indicated absence of important changes in the sickness impact scores except in the domain of mobility. Consumers did, however, show signs of progress in terms of increasing openness, understanding of their feelings and situation and abilities to cope with them.

Conclusion.  Participating in photo groups can help patients get along with their life and make it more bearable. No signs of demoralization and self-stigmatization were found.