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Wolfe H, Shepherd CB, Boswell RG, Genet J, Oliver-Pyatt W. Discovering a "sense of community": patient experiences of connection in intentionally remote eating disorder care. J Eat Disord 2024; 12:171. [PMID: 39478567 PMCID: PMC11523882 DOI: 10.1186/s40337-024-01127-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/18/2024] [Accepted: 10/10/2024] [Indexed: 11/03/2024] Open
Abstract
BACKGROUND While some findings indicate high levels of patient satisfaction with remote eating disorder treatment, others reflect feelings of disconnection due to unique telehealth treatment challenges. The COVID-19 pandemic presented circumstances that likely impacted the findings established thus far. As such, the present study sought to understand patient experiences of connection in an intentionally remote eating disorder treatment program, specifically in a context outside of pandemic transition. METHODS A secondary analysis of de-identified qualitative data previously obtained for quality improvement purposes via a client satisfaction survey was conducted. Adult patient responses (N = 38) were analyzed via reflexive thematic analysis within a critical realist framework. RESULTS Four themes were generated from the data: (1) Embracing one's humanity paves the way for connection, (2) Discovering a "sense of community" in remote care, (3) "They made me feel I was worth recovering": connection as a vehicle for healing, and (4) Aligning expectations and reality: reconceptualizing the journey to connection in remote eating disorder care. CONCLUSIONS Overall, findings suggest that it is possible for patients to form strong, impactful connections in remote treatment. Importantly, patient perspectives indicated that there were shifts in how these connections were experienced as a result of the remote care environment (e.g., how support could be provided and by whom). Considerations unique to remote care (e.g., offering training to improve clients' comfort with technology) may be important to fostering connection, thereby contributing to improved patient experiences and treatment outcomes.
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Affiliation(s)
| | - Caitlin B Shepherd
- Within Health, Coconut Grove, FL, USA.
- Department of Psychology, Smith College, Northampton, MA, USA.
| | - Rebecca G Boswell
- Princeton Center for Eating Disorders, Penn Medicine, Plainsboro, NJ, USA
- Department of Psychology, Princeton University, Princeton, NJ, USA
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Dann KM, Harrison A, Veldre A, Hay P, Touyz S. Embracing a different outlook: Strengths and goals of individuals currently in treatment for anorexia nervosa. Eat Weight Disord 2024; 29:63. [PMID: 39358628 PMCID: PMC11447091 DOI: 10.1007/s40519-024-01689-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/22/2024] [Accepted: 08/30/2024] [Indexed: 10/04/2024] Open
Abstract
PURPOSE Developing personal goals beyond weight and shape, and promoting the agency to pursue those goals, could aid in treatment and recovery from anorexia nervosa (AN). This research explores the strengths, interests and goals of individuals currently receiving treatment for AN and evaluates how treatment services are supporting them to work towards personal goals across all areas of everyday life. METHOD A total of 58 community-dwelling adults currently receiving treatment for anorexia nervosa at any stage of recovery completed the Client Assessment of Strengths, Interests and Goals Self-Report (CASIG-SR). Participants reported their goals for accommodation, work and study, interpersonal relationships, recreational activities, spirituality, religion or life purpose, physical health and mental health, and the personal strengths and supports needed to achieve those goals. Concordance scores were calculated between importance of personal goals and level of support from current services regarding these goals. RESULTS Themes identified across goals, strengths and supports were Connection, Independence & Confidence, Meaning & Self: The Real Me, and Stability & Balance. Work and study goals and strengths were identified strongly. The key support needed was stability from the current treatment team to provide a stable base for change. Concordance scores indicate support provided for personal goals was less than the importance of the goal to the individual. CONCLUSION Results suggest goals for everyday living are critical to recovery in anorexia nervosa. Specific clinical considerations to increase motivation and hope are increased access to peer support, a focus on increasing positive affect, supporting safe exercise and promoting outdoor experiences and connection with nature. LEVEL III Evidence obtained from well-designed cohort or case-control analytic studies.
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Affiliation(s)
- Kelly M Dann
- School of Psychology, The University of Sydney, Sydney, Australia.
- Faculty of Medicine and Health, InsideOut Institute for Eating Disorders, The University of Sydney and Sydney Local Area Health District, Charles Perkins Centre, Sydney, NSW, 2006, Australia.
| | - Amy Harrison
- Department of Psychology and Human Development, University College London, London, UK
| | - Aaron Veldre
- Graduate School of Health, University of Technology Sydney, Sydney, Australia
| | - Phillipa Hay
- School of Medicine, Translational Health Research Institute, Western Sydney University, Sydney, Australia
- Mental Health Services, SWSLHD, Camden and Campbelltown Hospitals, Liverpool, NSW, Australia
| | - Stephen Touyz
- Faculty of Medicine and Health, InsideOut Institute for Eating Disorders, The University of Sydney and Sydney Local Area Health District, Charles Perkins Centre, Sydney, NSW, 2006, Australia
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Webb H, Griffiths M, Schmidt U. Experiences of intensive treatment for people with eating disorders: a systematic review and thematic synthesis. J Eat Disord 2024; 12:115. [PMID: 39143589 PMCID: PMC11323622 DOI: 10.1186/s40337-024-01061-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/17/2024] [Accepted: 07/09/2024] [Indexed: 08/16/2024] Open
Abstract
BACKGROUND Eating disorders are complex difficulties that impact the individual, their supporters and society. Increasing numbers are being admitted to intensive treatment settings (e.g., for inpatient treatment, day-patient treatment or acute medical treatment). The lived experience perspectives of what helps and hinders eating disorder recovery during intensive treatment is an emerging area of interest. This review aims to explore patients' perspectives of what helps and hinders recovery in these contexts. METHODS A systematic review was conducted to identify studies using qualitative methods to explore patients' experiences of intensive treatment for an eating disorder. Article quality was assessed using the Critical Appraisal Skill Programme (CASP) checklist and thematic synthesis was used to analyse the primary research and develop overarching analytical themes. RESULTS Thirty articles met inclusion criteria and were included in this review. The methodological quality was mostly good. Thematic synthesis generated six main themes; collaborative care supports recovery; a safe and terrifying environment; negotiating identity; supporting mind and body; the need for specialist support; and the value of close others. The included articles focused predominantly on specialist inpatient care and were from eight different countries. One clear limitation was that ethnicity data were not reported in 22 out of the 30 studies. When ethnicity data were reported, participants predominantly identified as white. CONCLUSIONS This review identifies that a person-centred, biopsychosocial approach is necessary throughout all stages of eating disorder treatment, with support from a sufficiently resourced and adequately trained multidisciplinary team. Improving physical health remains fundamental to eating disorder recovery, though psychological support is also essential to understand what causes and maintains the eating disorder and to facilitate a shift away from an eating disorder dominated identity. Carers and peers who instil hope and offer empathy and validation are valuable additional sources of support. Future research should explore what works best for whom and why, evaluating patient and carer focused psychological interventions and dietetic support during intensive treatment. Future research should also explore the long-term effects of, at times, coercive and distressing treatment practices and determine how to mitigate against potential iatrogenic harm.
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Affiliation(s)
- Hannah Webb
- Salomons Institute for Applied Psychology, Canterbury Christ Church University, Tunbridge Wells, TN1 2YG, UK.
| | - Maria Griffiths
- Salomons Institute for Applied Psychology, Canterbury Christ Church University, Tunbridge Wells, TN1 2YG, UK
| | - Ulrike Schmidt
- Centre for Research in Eating and Weight Disorders, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, UK
- South London and Maudsley NHS Foundation Trust, Maudsley Hospital, Denmark Hill, London, SE5 8AZ, UK
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4
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Zugai JS, Gill K, Hay P, Ramjan L. Supporting autonomy in mental healthcare: A response to the World Health Organization and United Nations guidelines. Int J Ment Health Nurs 2024; 33:1151-1154. [PMID: 38356187 DOI: 10.1111/inm.13307] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/31/2024] [Accepted: 02/05/2024] [Indexed: 02/16/2024]
Affiliation(s)
- Joel Sebastian Zugai
- School of Nursing, University of Wollongong, Liverpool, New South Wales, Australia
| | - Katherine Gill
- Consumer Led Research Network, The University of Sydney, Campbelltown, New South Wales, Australia
| | - Phillipa Hay
- Translational Health Research Institute (THRI), School of Medicine, Western Sydney University, Penrith, New South Wales, Australia
- Mental Health Services, SWSLHD, Campbelltown, New South Wales, Australia
| | - Lucie Ramjan
- School of Nursing, University of Wollongong, Liverpool, New South Wales, Australia
- School of Nursing and Midwifery, Western Sydney University, Penrith, New South Wales, Australia
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Cripps S, Serpell L, Pugh M. Processes of change in family therapies for anorexia nervosa: a systematic review and meta-synthesis of qualitative data. J Eat Disord 2024; 12:104. [PMID: 39054560 PMCID: PMC11270895 DOI: 10.1186/s40337-024-01037-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/26/2024] [Accepted: 05/31/2024] [Indexed: 07/27/2024] Open
Abstract
OBJECTIVE To synthesise young person and family member perspectives on processes of change in family therapy for anorexia nervosa (AN), including systemic family therapy and manualised family-based treatments, to obtain an understanding of what helps and hinders positive change. METHOD A systematic search of the literature was conducted to identify qualitative studies focussing on experiences of therapeutic change within family therapies for AN from the perspectives of young people and their families. Fifteen studies met inclusion criteria and underwent quality appraisal following which they were synthesised using a meta-synthesis approach. RESULTS Six overarching themes were generated: "A holistic focus on the young person's overall development"; "The therapeutic relationship as a vehicle for change"; "The therapist's confinement to a script and its impact on emotional attunement"; "A disempowering therapeutic context"; "Externalisation of the eating disorder (ED)"; and "The importance of family involvement". Positive change was helped by understanding and support given to the young person's overall development including their psychological, emotional, social and physical wellbeing, positive therapeutic relationships, relational containment within the family system and externalising conversations in which young people felt seen and heard. Positive change was hindered by inflexibility in the treatment approach, counter-effects of externalisation, negative experiences of the therapist, a narrow focus on food-intake and weight, as well as the neglect of family difficulties, emotional experiences, and psychological factors. CONCLUSIONS Positive change regarding the young person's eating-related difficulties ensued in the context of positive relational changes between the young person, their family members, the therapist and treatment team, highlighting the significance of secure and trusting relationships. The findings of this review can be utilised by ED services to consider how they may adapt to the needs of young people and their families in order to improve treatment satisfaction, treatment outcomes, and in turn reduce risk for chronicity in AN.
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Affiliation(s)
- Sophie Cripps
- Research Department of Clinical, Educational and Health Psychology, University College London, Gower Street, London, WC1E 6BT, UK
| | - Lucy Serpell
- Research Department of Clinical, Educational and Health Psychology, University College London, Gower Street, London, WC1E 6BT, UK.
| | - Matthew Pugh
- Research Department of Clinical, Educational and Health Psychology, University College London, Gower Street, London, WC1E 6BT, UK
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İnce B, Phillips MD, Zenasni Z, Shearer J, Dalton B, Irish M, Mercado D, Webb H, McCombie C, Au K, Kern N, Clark-Stone S, Connan F, Johnston AL, Lazarova S, Zadeh E, Newell C, Pathan T, Wales J, Cashmore R, Marshall S, Arcelus J, Robinson P, Byford S, Landau S, Lawrence V, Himmerich H, Treasure J, Schmidt U. Autopsy of a failed trial part 2: Outcomes, challenges, and lessons learnt from the DAISIES trial. EUROPEAN EATING DISORDERS REVIEW 2024; 32:476-489. [PMID: 38109218 DOI: 10.1002/erv.3058] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/05/2023] [Revised: 11/03/2023] [Accepted: 11/23/2023] [Indexed: 12/20/2023]
Abstract
OBJECTIVE The relative merits of inpatient or day-treatment for adults with anorexia nervosa (AN) are unknown. The DAISIES trial aimed to establish the non-inferiority of a stepped-care day patient treatment (DPT) approach versus inpatient treatment as usual (IP-TAU) for improving body mass index (BMI) at 12 months in adults with AN. The trial was terminated due to poor recruitment. This paper presents outcomes and investigates the reasons behind the trial's failure. METHOD Fifteen patients with AN (of 53 approached) participated and were followed-up to 6 or 12 months. Summary statistics were calculated due to low sample size, and qualitative data concerning treatment experiences were analysed using thematic analysis. RESULTS At baseline, participants in both trial arms rated stepped-care DPT as more acceptable. At 12 months, participants' BMIs had increased in both trial arms. Qualitative analysis highlighted valued and challenging aspects of care across settings. Only 6/12 sites opened for recruitment. Among patients approached, the most common reason for declining participation was their treatment preference (n = 12/38). CONCLUSIONS No conclusions can be drawn concerning the effectiveness of IP-TAU and stepped-care DPT, but the latter was perceived more positively. Patient-related, service-related and systemic factors (COVID-19) contributed to the trial's failure. Lessons learnt can inform future studies.
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Affiliation(s)
- Başak İnce
- Centre for Research in Eating and Weight Disorders (CREW), Department of Psychological Medicine, Institute of Psychiatry, Psychology, and Neuroscience, King's College London, London, UK
| | - Matthew D Phillips
- Centre for Research in Eating and Weight Disorders (CREW), Department of Psychological Medicine, Institute of Psychiatry, Psychology, and Neuroscience, King's College London, London, UK
| | - Zohra Zenasni
- Department of Biostatistics and Health Informatics, Institute of Psychiatry, Psychology, and Neuroscience, King's College London, London, UK
| | - James Shearer
- Department of Health Service & Population Research, Institute of Psychiatry, Psychology, and Neuroscience, King's College London, London, UK
| | - Bethan Dalton
- Centre for Research in Eating and Weight Disorders (CREW), Department of Psychological Medicine, Institute of Psychiatry, Psychology, and Neuroscience, King's College London, London, UK
| | - Madeleine Irish
- The Oxford Institute of Clinical Psychology Training and Research, University of Oxford, Oxford, UK
| | - Daniela Mercado
- Centre for Research in Eating and Weight Disorders (CREW), Department of Psychological Medicine, Institute of Psychiatry, Psychology, and Neuroscience, King's College London, London, UK
| | - Hannah Webb
- Centre for Research in Eating and Weight Disorders (CREW), Department of Psychological Medicine, Institute of Psychiatry, Psychology, and Neuroscience, King's College London, London, UK
| | - Catherine McCombie
- Department of Health Service & Population Research, Institute of Psychiatry, Psychology, and Neuroscience, King's College London, London, UK
| | - Katie Au
- South London and Maudsley NHS Foundation Trust, London, UK
| | - Nikola Kern
- South London and Maudsley NHS Foundation Trust, London, UK
| | - Sam Clark-Stone
- Gloucestershire Health and Care NHS Foundation Trust, Gloucester, UK
| | - Frances Connan
- Central and North West London NHS Foundation Trust, London, UK
| | | | | | - Ewa Zadeh
- South West London and St George's Mental Health NHS Trust, London, UK
| | - Ciarán Newell
- Dorset HealthCare University NHS Foundation Trust, Poole, UK
| | - Tayeem Pathan
- Surrey and Borders Partnership NHS Foundation Trust, Leatherhead, UK
| | - Jackie Wales
- Leicestershire Adult Eating Disorders Service, Leicestershire Partnership NHS Trust, Bennion Centre, Glenfield Hospital, Leicester, UK
| | - Rebecca Cashmore
- Leicestershire Adult Eating Disorders Service, Leicestershire Partnership NHS Trust, Bennion Centre, Glenfield Hospital, Leicester, UK
| | - Sandra Marshall
- Leicestershire Adult Eating Disorders Service, Leicestershire Partnership NHS Trust, Bennion Centre, Glenfield Hospital, Leicester, UK
| | - Jon Arcelus
- Institute of Mental Health, University of Nottingham, Nottingham, UK
- Bellvitge Biomedical Research Institute (IDIBELL), Hospitalet del Llobregat, Barcelona, Spain
| | - Paul Robinson
- Division of Medicine, University College London, London, UK
| | - Sarah Byford
- Department of Health Service & Population Research, Institute of Psychiatry, Psychology, and Neuroscience, King's College London, London, UK
| | - Sabine Landau
- Department of Biostatistics and Health Informatics, Institute of Psychiatry, Psychology, and Neuroscience, King's College London, London, UK
| | - Vanessa Lawrence
- Department of Health Service & Population Research, Institute of Psychiatry, Psychology, and Neuroscience, King's College London, London, UK
| | - Hubertus Himmerich
- Centre for Research in Eating and Weight Disorders (CREW), Department of Psychological Medicine, Institute of Psychiatry, Psychology, and Neuroscience, King's College London, London, UK
- South London and Maudsley NHS Foundation Trust, London, UK
| | - Janet Treasure
- Centre for Research in Eating and Weight Disorders (CREW), Department of Psychological Medicine, Institute of Psychiatry, Psychology, and Neuroscience, King's College London, London, UK
- South London and Maudsley NHS Foundation Trust, London, UK
| | - Ulrike Schmidt
- Centre for Research in Eating and Weight Disorders (CREW), Department of Psychological Medicine, Institute of Psychiatry, Psychology, and Neuroscience, King's College London, London, UK
- South London and Maudsley NHS Foundation Trust, London, UK
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Yang Y, Conti J, McMaster CM, Piya MK, Hay P. "I Need Someone to Help Me Build Up My Strength": A Meta-Synthesis of Lived Experience Perspectives on the Role and Value of a Dietitian in Eating Disorder Treatment. Behav Sci (Basel) 2023; 13:944. [PMID: 37998690 PMCID: PMC10669240 DOI: 10.3390/bs13110944] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/06/2023] [Revised: 11/13/2023] [Accepted: 11/14/2023] [Indexed: 11/25/2023] Open
Abstract
Dietitians are included in eating disorder (ED) treatment teams for their expertise in nutrition. However, little is known about an individual's experience of dietetic intervention as part of their ED treatment and what they value as part of dietetic care. Therefore, the aim of this review was to synthesise the available qualitative literature to understand the role and value of a dietitian in ED treatment from the perspective of individuals with lived experience. Six databases and Google Scholar were searched and a thematic synthesis and meta-synthesis of fifteen studies were conducted. Four themes were constructed from the data: (1) "guidance and structure"-Provision of nutrition knowledge and skills; (2) "having all my bases covered"-Dietitians as part of a multidisciplinary team; (3) Challenges in nutritional treatment; and (4) "it was my treatment and my recovery"-Person-centred dietetic treatment. Across all identified themes was the cross-cutting theme of a shared treatment journey between the dietitian and the individual receiving treatment. These findings support dietitians having a role that is not limited only to the provision of nutrition treatment in ED care and illustrates the importance of dietitians engaging with clients by centring on the individual's needs and preferences. Further understanding helpful dietetic treatment components and identifying gaps in training is needed to develop these broader roles for dietetic care.
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Affiliation(s)
- Yive Yang
- Translational Health Research Institute, School of Medicine, Western Sydney University, Campbelltown, NSW 2560, Australia; (Y.Y.); (J.C.); (M.K.P.)
| | - Janet Conti
- Translational Health Research Institute, School of Medicine, Western Sydney University, Campbelltown, NSW 2560, Australia; (Y.Y.); (J.C.); (M.K.P.)
- School of Psychology, Western Sydney University, Penrith, NSW 2750, Australia
| | - Caitlin M. McMaster
- Sydney School of Health Sciences, Faculty of Medicine and Health, University of Sydney, Camperdown, NSW 2050, Australia;
- Eating Disorder and Nutrition Research Group (ENRG), Translational Health Research Institute, Faculty of Medicine, Western Sydney University, Campbelltown, NSW 2560, Australia
- South Western Sydney Local Health District, Liverpool, NSW 2170, Australia
- Ingham Institute for Applied Medical Research, Liverpool, NSW 2170, Australia
| | - Milan K. Piya
- Translational Health Research Institute, School of Medicine, Western Sydney University, Campbelltown, NSW 2560, Australia; (Y.Y.); (J.C.); (M.K.P.)
- Camden and Campbelltown Hospitals, South Western Sydney Local Health District, Liverpool, NSW 2560, Australia
| | - Phillipa Hay
- Translational Health Research Institute, School of Medicine, Western Sydney University, Campbelltown, NSW 2560, Australia; (Y.Y.); (J.C.); (M.K.P.)
- Camden and Campbelltown Hospitals, South Western Sydney Local Health District, Liverpool, NSW 2560, Australia
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Maia BB, Campelo FG, Rodrigues ECG, Oliveira-Cardoso ÉA, Santos MAD. Perceptions of health professionals in providing care for people with anorexia nervosa and bulimia nervosa: a systematic review and meta-synthesis of qualitative studies. CAD SAUDE PUBLICA 2023; 39:e00223122. [PMID: 37585904 PMCID: PMC10494704 DOI: 10.1590/0102-311xen223122] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/22/2022] [Revised: 05/04/2023] [Accepted: 05/25/2023] [Indexed: 08/18/2023] Open
Abstract
This study sought to synthesize and reinterpret findings from primary qualitative studies on the experience of health professionals in caring for people with anorexia nervosa and bulimia nervosa. We conducted a systematic review of the literature with the SPIDER search strategy assessing six databases. A meta-synthesis was performed with data from qualitative studies. Two independent reviewers screened and assessed the articles, extracted data from the articles and elaborated thematic synthesis. Nineteen articles met the inclusion/exclusion criteria. The meta-synthesis revealed three descriptive themes: Going outside the comfort zone: hard relational experiences of health professionals in providing care for people with anorexia nervosa and bulimia nervosa; Reflecting on treatment: relevance of discussion, communication, and flexibility in health professionals' work with anorexia nervosa and bulimia nervosa; and Dealing with ambivalences: experiences of health professionals with family members of people with anorexia nervosa and bulimia nervosa. We elaborated two analytical themes: Making work with eating disorders palatable: malleability necessary for health professionals in bonding with people with anorexia and bulimia nervosa and their families; and Leaving the professional comfort zone: transition from multi to interdisciplinary. Thus, mental health professionals who work with people diagnosed with anorexia and bulimia nervosa cope with hard emotional experiences that makes them feel out of their comfort zone, requiring flexibility to benefit a good therapeutic alliance, but there are still difficulties in promoting interdisciplinarity.
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Affiliation(s)
- Bruna Bortolozzi Maia
- Faculdade de Filosofia, Ciências e Letras de Ribeirão Preto, Universidade de São Paulo, Ribeirão Preto, Brasil
| | - Felipe Gonçalves Campelo
- Faculdade de Filosofia, Ciências e Letras de Ribeirão Preto, Universidade de São Paulo, Ribeirão Preto, Brasil
| | | | | | - Manoel Antonio Dos Santos
- Faculdade de Filosofia, Ciências e Letras de Ribeirão Preto, Universidade de São Paulo, Ribeirão Preto, Brasil
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Peebles I, Cronje JL, Clark L, Sharpe H, Duffy F. Experiences of inpatient eating disorder admissions: A systematic review and meta-synthesis. Eat Behav 2023; 50:101753. [PMID: 37329771 DOI: 10.1016/j.eatbeh.2023.101753] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/08/2022] [Revised: 03/22/2023] [Accepted: 05/18/2023] [Indexed: 06/19/2023]
Abstract
OBJECTIVE There has been a significant increase in the number of inpatient admissions for individuals with eating disorders and, with the most critical cases requiring inpatient treatment, it is essential that we continue to improve associated outcomes. The aim of the study was to synthesise the available qualitative literature on the experiences of inpatient admissions for eating disorders to understand individuals' experiences and identify areas that may require further research and/or service development. METHOD Searches were performed on the following online databases: PsycINFO, PsycArticles, PsycTherapy MEDLINE, Embase, CINAHL, ASSIA, Scopus and Proquest Open Access Theses. Only papers with qualitative data regarding individuals' experiences of inpatient eating disorder treatment were considered. The CASP qualitative checklist was used to assess studies and relevant data items were extracted. Thematic synthesis was used to integrate the findings in the identified studies. GRADE-CERQual was used to rate the confidence in the findings. RESULTS Twenty-eight studies were identified which the CASP assessment considered to be adequate. The synthesis produced 5 main themes; 'Care and control', 'Inpatient bubble', 'Being supported and understood', 'Challenges of living with others' eating disorders' and finally 'Relationship to eating disorder'. The GRADE CERQual framework rated findings with high or moderate confidence. CONCLUSIONS Findings reaffirmed the importance of patient-centred care and the significant impact of being separated from normal life with others also experiencing an eating disorder.
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Affiliation(s)
- Imogen Peebles
- University of Edinburgh, United Kingdom of Great Britain and Northern Ireland; CAMHS NHS Lothian, United Kingdom of Great Britain and Northern Ireland.
| | - Jamie-Lee Cronje
- CAMHS NHS Lothian, United Kingdom of Great Britain and Northern Ireland.
| | - Lilli Clark
- University of Edinburgh, United Kingdom of Great Britain and Northern Ireland.
| | - Helen Sharpe
- University of Edinburgh, United Kingdom of Great Britain and Northern Ireland.
| | - Fiona Duffy
- University of Edinburgh, United Kingdom of Great Britain and Northern Ireland; CAMHS NHS Lothian, United Kingdom of Great Britain and Northern Ireland.
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