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Kulwicka K, Gasiorowska A. Depression literacy and misconceptions scale (DepSter): a new two-factorial tool for measuring beliefs about depression. BMC Psychiatry 2023; 23:300. [PMID: 37127570 PMCID: PMC10150464 DOI: 10.1186/s12888-023-04796-8] [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: 07/13/2022] [Accepted: 04/18/2023] [Indexed: 05/03/2023] Open
Abstract
BACKGROUND Depression literacy has received extensive attention within mental health research. It has been studied by different social groups and professions in Western and non-Western cultures. The importance of this topic stems from the fact that depression literacy is strongly related to attitudes toward people who are diagnosed with depression, the tendency to stigmatize this mental disorder, and to the propensity to undertake help-seeking behaviors. Therefore, understanding and promoting depression literacy is crucial in contemporary mental health prevention and promotion. We propose a new two-factorial tool measuring beliefs about depression. This 14-item self-report measure captures how people vary across two dimensions of beliefs about depression-depression literacy and misconceptions about depression. METHODS In ten studies with a total sample of over 4,600 participants from three countries, we demonstrated the two-factorial structure of the Depression Literacy and Misconceptions Scale (DepSter) in Polish (Studies 1 and 2), American (Study 4), and British (Study 5) samples. We showed measurement equivalence for the Polish and English versions of the scale (Study 3). Furthermore, we tested the discriminant meaning of the two dimensions of beliefs about depression analyzing its association with health literacy, mental health literacy, and prejudice toward people with mental illness (Study 4), depression literacy and depression stigma (Study 5), empathetic concerns (Study 7), social dominance orientation (Study 8), and the Big Five personality traits (Study 9). We also investigated whether individuals with formal education in psychology and direct or indirect experience with depression demonstrate a higher level of depression literacy and a lower level of misconceptions about depression (Study 6). Our measure showed high stability for two dimensions of beliefs about depression (Study 10), in both its Polish and English versions, with the measurement conducted after three weeks and three months. DISCUSSION We conclude that the proposed approach to beliefs about depression capturing both depression literacy and misconceptions about depression measured with the DepSter scale can easily be applied in clinical and social settings, especially in studies concerning the perception of those diagnosed with depression.
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Affiliation(s)
- Katarzyna Kulwicka
- Faculty of Psychology in Wroclaw, SWPS University of Social Sciences and Humanities, Warszawa, Poland.
| | - Agata Gasiorowska
- Faculty of Psychology in Wroclaw, SWPS University of Social Sciences and Humanities, Warszawa, Poland
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2
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Graham MR, Tierney S, Chisholm A, Fox JRE. The lived experience of working with people with eating disorders: A meta-ethnography. Int J Eat Disord 2020; 53:422-441. [PMID: 31904870 DOI: 10.1002/eat.23215] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/10/2022]
Abstract
OBJECTIVE Working with people with eating disorders (EDs) is known to elicit strong emotional reactions, and the therapeutic alliance has been shown to affect outcomes with this clinical population. As a consequence, it is important to understand healthcare professionals' (HCPs') experiences of working with this client group. METHOD A meta-synthesis was conducted of qualitative research on HCPs' lived experiences of working with people with EDs. The results from the identified studies were analyzed using Noblit and Hare's meta-ethnographic method. Data were synthesized using reciprocal translation, and a line of argument was developed. RESULTS Thirty-seven studies met the inclusion criteria. Reciprocal translation resulted in a key concept: "Coping with caring without curing." This was underpinned by the following third-order concepts: (a) "The dissonance and discomfort of being a helper struggling to help," (b) "Defending against the dissonance," and (c) "Accepting the dissonance to provide safe and compassionate care." These concepts were used to develop a line-of-argument synthesis, which was expressed as a new model for understanding HCPs' experiences of working with people who have an ED. DISCUSSION Although the conflict associated with being a helper struggling to help led some HCPs to avoid and blame people with EDs, others adopted a compassionate stance characterized by humanity, humility, balance, and awareness.
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Affiliation(s)
- Meghan R Graham
- Department of Psychology, Royal Holloway, University of London, Egham, UK
| | - Stephanie Tierney
- Nuffield Department of Primary Care Health Sciences, University of Oxford, Oxford, UK
| | - Amy Chisholm
- Vincent Square Eating Disorder Service, Central and North West London NHS Foundation Trust, London, UK
| | - John R E Fox
- South Wales Doctoral Programme in Clinical Psychology, School of Psychology, Cardiff University, Cardiff, UK
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3
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Bullivant B, Rhydderch S, Griffiths S, Mitchison D, Mond JM. Eating disorders "mental health literacy": a scoping review. J Ment Health 2020; 29:336-349. [PMID: 32041463 DOI: 10.1080/09638237.2020.1713996] [Citation(s) in RCA: 35] [Impact Index Per Article: 8.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022]
Abstract
Background: While it is apparent that much has been learned about "mental health literacy" (MHL) relating to certain mental health problems, such as depression, in recent years, what has been learned about MHL relating to eating disorders (ED-MHL) is unclear.Aims: A scoping review was conducted to inform the current state of knowledge in this field.Methods: A systematic search of relevant literature published between 1997 and 2017 was followed by a narrative synthesis of the findings.Results: The number of eligible studies increased from 32 in 1997-2001 to 98 in 2012-2017 (total = 264). Most studies originated from North America or Europe, recruited individuals with EDs receiving treatment or college students and included both female and male or only female participants. The majority of studies examined MHL relating to anorexia nervosa or bulimia nervosa and examined attitudes which facilitate recognition and appropriate help-seeking and knowledge and beliefs about professional help available.Conclusion: Interest in ED-MHL is increasing and there is now a considerable body of research addressing some aspects of ED-MHL in a range of study populations. Notable gaps in the literature exist, including a paucity of information about ED-MHL relating to EDs other than anorexia nervosa and bulimia nervosa, ED behaviour in males and the use of self-help interventions. We hope the findings will provide an incentive to further research in these and other aspects of ED-MHL.
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Affiliation(s)
- Bianca Bullivant
- Faculty of Medicine, Boden Institute of Obesity, Nutrition, Exercise and Eating Disorders, The University of Sydney, Sydney, Australia.,Department of Psychology, Macquarie University, Sydney, Australia
| | - Suzie Rhydderch
- Department of Psychology, Macquarie University, Sydney, Australia
| | - Scott Griffiths
- Melbourne School of Psychological Sciences, University of Melbourne, Melbourne, Australia
| | - Deborah Mitchison
- Department of Psychology, Macquarie University, Sydney, Australia.,School of Medicine, Western Sydney University, Sydney, Australia
| | - Jonathan M Mond
- Department of Psychology, Macquarie University, Sydney, Australia.,Centre for Rural Health, University of Tasmania, Launceston, Australia
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4
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Bullivant B, Denham AR, Stephens C, Olson RE, Mitchison D, Gill T, Maguire S, Latner JD, Hay P, Rodgers B, Stevenson RJ, Touyz S, Mond JM. Elucidating knowledge and beliefs about obesity and eating disorders among key stakeholders: paving the way for an integrated approach to health promotion. BMC Public Health 2019; 19:1681. [PMID: 31842820 PMCID: PMC6916014 DOI: 10.1186/s12889-019-7971-y] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/20/2019] [Accepted: 11/19/2019] [Indexed: 12/22/2022] Open
Abstract
Background Understanding the knowledge and beliefs of key stakeholders is crucial in developing effective public health interventions. Knowledge and beliefs about obesity and eating disorders (EDs) have rarely been considered, despite increasing awareness of the need for integrated health promotion programs. We investigated key aspects of knowledge and beliefs about obesity and EDs among key stakeholders in Australia. Methods Using a semi-structured question guide, eight focus groups and seven individual interviews were conducted with 62 participants including health professionals, personal trainers, teachers and consumer group representatives. An inductive thematic approach was used for data analysis. Results The findings suggest that, relative to obesity, EDs are poorly understood among teachers, personal trainers, and certain health professionals. Areas of commonality and distinction between the two conditions were identified. Integrated health promotion efforts that focus on shared risk (e.g., low self-esteem, body dissatisfaction) and protective (e.g., healthy eating, regular exercise) factors were supported. Suggested target groups for such efforts included young children, adolescents and parents. Conclusions The findings indicate areas where the EDs and obesity fields have common ground and can work together in developing integrated health promotion programs.
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Affiliation(s)
- Bianca Bullivant
- Boden Institute of Obesity, Nutrition, Exercise and Eating Disorders, Faculty of Medicine, The University of Sydney, Sydney, NSW, 2006, Australia. .,Macquarie University, Sydney, New South Wales, Australia.
| | - Aaron R Denham
- Macquarie University, Sydney, New South Wales, Australia
| | - Clare Stephens
- Macquarie University, Sydney, New South Wales, Australia
| | - Rebecca E Olson
- The University of Queensland, St. Lucia, Queensland, Australia
| | - Deborah Mitchison
- Macquarie University, Sydney, New South Wales, Australia.,Western Sydney University, Penrith, New South Wales, Australia
| | - Timothy Gill
- Boden Institute of Obesity, Nutrition, Exercise and Eating Disorders, Faculty of Medicine, The University of Sydney, Sydney, NSW, 2006, Australia
| | - Sarah Maguire
- Boden Institute of Obesity, Nutrition, Exercise and Eating Disorders, Faculty of Medicine, The University of Sydney, Sydney, NSW, 2006, Australia
| | | | - Phillipa Hay
- Western Sydney University, Penrith, New South Wales, Australia
| | - Bryan Rodgers
- Australian National University, Canberra, Australian Capital Territory, Australia
| | | | - Stephen Touyz
- Boden Institute of Obesity, Nutrition, Exercise and Eating Disorders, Faculty of Medicine, The University of Sydney, Sydney, NSW, 2006, Australia
| | - Jonathan M Mond
- Western Sydney University, Penrith, New South Wales, Australia.,University of Tasmania, Launceston, Tasmania, Australia
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5
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Worsfold KA, Sheffield JK. The perceived knowledge, skill and clinical practice of psychologists, naturopaths and fitness instructors when working with eating disorders. Early Interv Psychiatry 2019; 13:1263-1270. [PMID: 30488566 DOI: 10.1111/eip.12764] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/15/2018] [Revised: 09/14/2018] [Accepted: 11/04/2018] [Indexed: 11/30/2022]
Abstract
AIMS When it comes to working with eating disorders (EDs), few studies have explored: the clinical practice; service provision barriers; and self-perceptions of knowledge/skill and the ability to detect EDs in practice against measured ability to do so, of common health providers including psychologists, naturopaths and fitness instructors. METHODS Of the 115 participants, 90.4% were female with a mean age of 40.77 years (SD = 10.80 years) and comprised: 35 psychologists, 50 naturopathic and 30 fitness practitioners. Participants completed a 23-item survey measuring clinical practice behaviours including assessment and early intervention services, practitioner service barriers, perceived ED knowledge and skill. RESULTS Only 1 in 20 indicated using standardized surveys to screen for EDs, with 72% indicating reluctance to universally screen clients, with a key barrier being that ED symptoms were typically not the presenting issue. For practitioners who missed detecting EDs in practice, 53.6% indicated this was because weight fell within the normal range or because the client did not present with an ED so they did not think to screen for one (39.29%). In terms of interventions, most (79%) were providing services to clients with EDs, with over one-third providing weight-loss advice, potentially contributing to a harmful weight-centric/dieting treatment approach. Despite most practitioners delivering services, 85.7% felt unable to treat some clients appropriately, primarily due to a lack of skill (52.6%). CONCLUSIONS Further training is imperative to improve universal screening and evidence-based early intervention practices, which may be particularly helpful for naturopaths and fitness instructors who more commonly perceived their knowledge to be low.
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Affiliation(s)
- Kate A Worsfold
- School of Psychology, The University of Queensland, Brisbane, Queensland, Australia.,Compass Health Group, Gold Coast, Queensland, Australia
| | - Jeanie K Sheffield
- School of Psychology, The University of Queensland, Brisbane, Queensland, Australia
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6
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Johns G, Taylor B, John A, Tan J. Current eating disorder healthcare services - the perspectives and experiences of individuals with eating disorders, their families and health professionals: systematic review and thematic synthesis. BJPsych Open 2019; 5:e59. [PMID: 31530301 PMCID: PMC6646967 DOI: 10.1192/bjo.2019.48] [Citation(s) in RCA: 57] [Impact Index Per Article: 11.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/27/2023] Open
Abstract
BACKGROUND Eating disorders have the highest mortality rate of mental disorders and a high incidence of morbidity, but if diagnosed and treated promptly individuals can benefit from full recovery. However, there are numerous problems at the healthcare interface (i.e. primary and secondary care) for eating disorders. It is important to examine these to facilitate appropriate, seamless treatment and improve access to specialist care. AIMS To examine the current literature on the experiences and perspectives of those across healthcare interfaces for eating disorders, to include individuals with eating disorders, people close to or caring for those with eating disorders such as family and friends, and health professionals. METHOD To identify relevant papers, a systematic search of electronic databases was conducted. Other methods, including hand-searching, scanning reference lists and internet resources were also used. Papers that met inclusion criteria were analysed using a systematic methodology and synthesised using an interpretative thematic approach. RESULTS Sixty-three papers met the inclusion criteria. The methodological quality was relatively good. The included papers were of both qualitative (n = 44) and quantitative studies (n = 24) and were from ten different countries. By synthesising the literature of these papers, three dominant themes were identified, with additional subthemes. These included: 'the help-seeking process at primary care'; 'expectations of care and appropriate referrals' and 'opposition and collaboration in the treatment of and recovery from eating disorders'. CONCLUSIONS This review identifies both facilitators and barriers in eating disorder healthcare, from the perspectives of those experiencing the interface first hand. The review provides recommendations for future research and practice. DECLARATION OF INTEREST None.
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Affiliation(s)
- Gemma Johns
- Research Assistant, School of Medicine, Swansea University, UK
| | - Bridget Taylor
- Retired Psychiatric Nurse and currently a Lay Representative, Department of Medicine, Swansea University, UK
| | - Ann John
- Professor in Public Health and Psychiatry, Population Psychiatry, Suicide and Informatics, Swansea University Medical School, UK
| | - Jacinta Tan
- Clinical Associate Professor of Psychiatry, School of Medicine, Swansea University, UK
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7
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Maguire S, Li A, Cunich M, Maloney D. Evaluating the effectiveness of an evidence-based online training program for health professionals in eating disorders. J Eat Disord 2019; 7:14. [PMID: 31110761 PMCID: PMC6513519 DOI: 10.1186/s40337-019-0243-5] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/18/2018] [Accepted: 04/17/2019] [Indexed: 12/25/2022] Open
Abstract
BACKGROUND Early detection and treatment are essential to ensuring the best possible health outcomes for people with eating disorders (EDs). However, low diagnostic accuracy and a lack of specific ED training are common workforce challenges in Australia and internationally. Online learning provides a potential solution in facilitating the access to evidence-based training programs. The InsideOut Institute has developed the first online clinical training program in EDs to assist with educating health professionals in the identification, assessment, and management of EDs. The aim of the study is to evaluate the effectiveness of the online training program, The Essentials, in mitigating barriers to health professionals treating patients with EDs. METHODS Pre and post training questionnaires assessed participants' attitudes, knowledge, and skills in relation to treating people with EDs. Demographic and work-related information (gender, discipline, work setting, practice length and remoteness) and participants' ratings of the online learning experience and satisfaction on completion were collected. The Wilcoxon signed rank test was applied to test for changes in learning outcomes before and after completion of the program. A multivariate linear regression model was estimated for each of the learning outcomes with personal and work-related characteristics as covariates. RESULTS Among 1813 health professionals who registered for The Essentials program between 1 October 2013 and 31 July 2018, 1160 completed at least 80% of the five learning modules. There were significant improvements in confidence, knowledge, skills to treat EDs and a reduction in stigmatised beliefs among the 480 participants who completed both pre and post assessments. Results from the regression models suggest that psychologists, dieticians, and those working in rural areas were more willing to treat EDs after completing the program. Additionally, those working in hospitals and regional or rural areas experienced the largest improvement in confidence for treating patients with EDs. CONCLUSIONS The Essentials program represents a new and effective way of meeting the educational needs of partaking health professionals working with ED patients. Greater investment in the development and testing of evidence-based online training programs for EDs may help to address some of the considerable workforce development challenges in EDs.
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Affiliation(s)
- Sarah Maguire
- 1InsideOut Institute, Charles Perkins Centre, The University of Sydney, Camperdown, Sydney, 2006 NSW Australia
| | - Ang Li
- 2The Boden Institute of Obesity, Nutrition, Exercise & Eating Disorders, Faculty of Medicine and Health, Sydney Health Economics, Sydney Local Health District, Charles Perkins Centre, The University of Sydney, Camperdown, Sydney, 2006 NSW Australia
| | - Michelle Cunich
- 2The Boden Institute of Obesity, Nutrition, Exercise & Eating Disorders, Faculty of Medicine and Health, Sydney Health Economics, Sydney Local Health District, Charles Perkins Centre, The University of Sydney, Camperdown, Sydney, 2006 NSW Australia
| | - Danielle Maloney
- 1InsideOut Institute, Charles Perkins Centre, The University of Sydney, Camperdown, Sydney, 2006 NSW Australia
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8
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Davidson AR, Braham S, Dasey L, Reidlinger DP. Physicians' perspectives on the treatment of patients with eating disorders in the acute setting. J Eat Disord 2019; 7:1. [PMID: 30647918 PMCID: PMC6327410 DOI: 10.1186/s40337-018-0231-1] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/19/2018] [Accepted: 12/05/2018] [Indexed: 11/23/2022] Open
Abstract
BACKGROUND Hospitalisation for an eating disorder is rare, however treatment in the acute medical setting can be a life-saving admission. While the multidisciplinary team delivers overall patient care, medical decisions are the responsibility of the treating physicians. Treatment decisions directly impact on patient care and outcomes. This study aimed to explore the considerations that influence the medical decisions of physicians when treating patients with eating disorders in the acute setting. METHOD Semi-structured interviews were conducted with ten medical physicians who had previously treated eating disorders on a general medical unit in two Australian tertiary hospitals. An interview schedule, based on the literature and four relevant domains from the Consolidated Framework for Implementation Research, was developed. Interviews were audio recorded, transcribed verbatim and analyzed thematically. Coding and interim themes and sub-themes were developed by two dietitian researchers; these were further refined through researcher discussion and triangulation with two additional dietitian researchers. RESULTS Ten doctors were interviewed (3 consultants (1 adult general medical and 2 paediatricians: 13-16 years medical experience), 2 registrars (4-7 years experience), 1 resident (1 year experience), and 4 interns (< 1 year experience). Doctors described memorable patient cases, related to hospital stays over several weeks. Interviews ranged in length from 58 min to 91 min. Four themes (with five sub-themes) were developed: 1) navigating uncertainty (focusing on processes and goals and seeking information), 2) being "the good doctor" (doing the right thing), 3) seeing the big picture (depending on key players and considering short and long-term), and 4) involving family and patient. CONCLUSIONS Non-specialist physicians described challenges in the treatment of eating disorders in the inpatient setting. They take a holistic approach that considers both short and longer-term goals, relying on specialist colleagues, the wider multidisciplinary team and sometimes family members to guide treatment decisions during admissions on general medical wards. Additional support, education and training centered on the key themes may increase physicians' confidence and ability to make effective treatment decisions for this patient group. The results are relevant to all health professionals working in this field to better understand the priorities of medical physicians and to support them to achieve positive outcomes in the inpatient treatment of patients with eating disorders.
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Affiliation(s)
- Alexandra R Davidson
- 1Faculty of Health Sciences and Medicine, Bond University, University Drive, Robina, QLD 4226 Australia
| | - Sarah Braham
- 2Gold Coast Hospital and Health Services, Southport, Australia
| | - Lauren Dasey
- 2Gold Coast Hospital and Health Services, Southport, Australia
| | - Dianne P Reidlinger
- 1Faculty of Health Sciences and Medicine, Bond University, University Drive, Robina, QLD 4226 Australia
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9
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Thapliyal P, Hay P, Conti J. Role of gender in the treatment experiences of people with an eating disorder: a metasynthesis. J Eat Disord 2018; 6:18. [PMID: 30123504 PMCID: PMC6088416 DOI: 10.1186/s40337-018-0207-1] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/07/2018] [Accepted: 07/11/2018] [Indexed: 12/23/2022] Open
Abstract
BACKGROUND Traditionally perceived as a disorder of women, Eating Disorders (EDs) are known to have impacts on people irrespective of their gender. This study is designed to synthesise the available qualitative research studies to more broadly understand the diverse experiences of ED and their treatment, specifically in relationship to issues of gender. METHODS The methodology involved a systematic search and quality appraisal of the literature published after 1980 using terms that aimed to represent the primary concepts of "role of gender" and "treatment experiences" and "eating disorders". Nine qualitative studies met the inclusion criteria. Meta-themes were inductively generated through a synthesis of data across themes from the relevant included papers. RESULTS Analysis of data was constructed around three meta-themes, each with subthemes. The first meta-theme "Out of sight, out of mind" depicted the experience of gender issues that were marginalised in treatment. More specifically for transgender people, when gender issues were ignored by treatment providers, this frequently led to non-disclosure of their gender identity. Furthermore, men were less likely to be assessed for an eating disorder and within this context; diagnosis of an ED and referral to specialist treatment was frequently hindered. The second meta-theme "Lack of literacy among health care providers" focused on issues related to misdiagnosis of EDs, and the question of whether this was related to a lack of health literacy amongst health professionals. The final theme "Pathways into treatment that address stigma and other barriers" highlighted the need for the development of future treatment interventions address the complex social reality of the experiencing person, including questions of gender. CONCLUSION Gender issues impact upon the ED experience and require broader consideration in the development and evaluation of ED treatment interventions, including the further development of gender-informed interventions. TRIAL REGISTRATION Protocol registered on PROSPERO 2017 CRD42017082616.
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Affiliation(s)
- Priyanka Thapliyal
- Translational Health Research Institute (THRI), School of Medicine, Western Sydney University, Sydney, NSW Australia
| | - Phillipa Hay
- Translational Health Research Institute (THRI), School of Medicine, Western Sydney University, Sydney, NSW Australia
| | - Janet Conti
- School of Social Sciences and Psychology, Western Sydney University, Sydney, NSW Australia
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10
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Seah XY, Tham XC, Kamaruzaman NR, Yobas PK. Nurses' perception of knowledge, attitudes and reported practice towards patients with eating disorders: A concurrent mixed-methods study. Arch Psychiatr Nurs 2018; 32:133-151. [PMID: 29413064 DOI: 10.1016/j.apnu.2017.11.011] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/27/2017] [Revised: 11/04/2017] [Accepted: 11/05/2017] [Indexed: 10/18/2022]
Abstract
Eating disorders are complex disorders requiring specialised care, thus knowledge and attitudes are crucial for management. This study aims to examine nurses' knowledge, attitudes, reported practice, and perceptions towards patients with eating disorders in Singapore. A concurrent mixed-methods study was carried out in Southeast Asia's only psychiatric unit with eating disorders programme. Twenty nurses were recruited using census sampling. Quantitative data were analysed with descriptive and inferential statistics, while qualitative data were analysed with content and thematic analysis. Certain personal factors were associated with nurses' levels of perceived knowledge. Different attitudes towards managing these patients were identified during interview sessions.
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Affiliation(s)
- Xin Yi Seah
- Singapore General Hospital, Outram Road, 169608, Singapore.
| | - Xiang Cong Tham
- Buangkok Green Medical Park, 10 Buangkok View, 539747, Singapore
| | | | - Piyanee Klainin Yobas
- Alice Lee Centre for Nursing Studies, Yong Loo Lin School of Medicine, National University of Singapore, Clinical Research Centre (MD 11), 10 Medical Drive, 117597, Singapore.
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11
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Cain B, Buck K, Fuller-Tyszkiewicz M, Krug I. Australian Healthcare Professionals' Knowledge of and Attitudes toward Binge Eating Disorder. Front Psychol 2017; 8:1291. [PMID: 28824484 PMCID: PMC5545598 DOI: 10.3389/fpsyg.2017.01291] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/22/2017] [Accepted: 07/14/2017] [Indexed: 01/08/2023] Open
Abstract
Objective: This study aimed to investigate Australian healthcare practitioners’ knowledge and attitudes toward binge eating disorder (BED). Method: Participants were 175 healthcare professionals, who were randomized to one of two conditions that assessed diagnostic and treatment knowledge of either comorbid BED and obesity or only obesity via case vignette, as well as weight bias toward obese patients. Results: Results suggested that participants demonstrated a reluctance to diagnose comorbid BED and obesity, that their knowledge of physical complications associated with BED was limited, and that they indicated a narrow range of evidence-based treatment options. When compared with levels of weight bias expressed by healthcare professionals in previous international studies, Australian clinicians were significantly less biased, however, still largely endorsed ‘negative’ attitudes toward obesity. Conclusion: Findings suggest that future clinical training in eating disorders should therefore focus not only on diagnostic criteria, physical complications and treatment options, but also on practitioner attitudes toward eating and weight.
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Affiliation(s)
- Belinda Cain
- Melbourne School of Psychological Sciences, The University of Melbourne, MelbourneVIC, Australia
| | - Kimberly Buck
- Melbourne School of Psychological Sciences, The University of Melbourne, MelbourneVIC, Australia
| | - Matthew Fuller-Tyszkiewicz
- School of Psychology, Deakin University, BurwoodVIC, Australia.,Centre for Social and Early Emotional Development, Deakin University, BurwoodVIC, Australia
| | - Isabel Krug
- Melbourne School of Psychological Sciences, The University of Melbourne, MelbourneVIC, Australia
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12
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Knowledge, Attitudes and Challenges of Healthcare Professionals Managing People With Eating Disorders: A Literature Review. Arch Psychiatr Nurs 2017; 31:125-136. [PMID: 28104050 DOI: 10.1016/j.apnu.2016.09.002] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/19/2016] [Revised: 09/04/2016] [Accepted: 09/04/2016] [Indexed: 11/23/2022]
Abstract
This review consolidates findings regarding knowledge and attitudes of healthcare professionals, together with challenges faced while caring for patients with eating disorders. A rigorous and systematic approach was taken to identify 21 articles, which include 12 quantitative, 7 qualitative, and 2 mixed-method papers. Healthcare professionals' knowledge and attitudes toward patients with eating disorders will be discussed, while identifying if factors like age, gender, work experience or profession have an impact on these two variables. Challenges faced during care provision will also be examined. Methodological limitations and knowledge gaps from these articles will be discussed, together with implications of this review.
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13
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Tseng MCM, Chen KY, Chang CH, Liao SC, Chen HC. Variables influencing presenting symptoms of patients with eating disorders at psychiatric outpatient clinics. Psychiatry Res 2016; 238:338-344. [PMID: 27086254 DOI: 10.1016/j.psychres.2016.02.013] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/19/2015] [Revised: 12/02/2015] [Accepted: 02/11/2016] [Indexed: 10/22/2022]
Abstract
Eating disorders (EDs) have been underdiagnosed in many clinical settings. This study investigates the influence of clinical characteristics on presenting symptoms of patients with EDs. Psychiatric outpatients, aged 18-45, were enrolled sequentially and received a two-phase survey for EDs in August 2010-January 2013. Their primary reasons for seeking psychiatric help were obtained at their first encounter with outpatient psychiatrists. Patients' clinical and demographic characteristics were compared according to presenting symptoms with or without eating/weight problems. Of 2140 patients, 348 (16.3%) were diagnosed with an ED (22.6% of women and 6.3% of men). The three most common reasons for seeking psychiatric help were eating/weight problems (46.0%), emotional problems (41.3%), and sleep disturbances (19.3%). The multivariate analyses suggest that when patients with EDs presented symptoms that were less related to eating/weight problems, they were significantly more likely to be those having diagnoses other than anorexia nervosa or bulimia nervosa and less severe degree of binge-eating. Further, patients with EDs who demonstrated more impulsive behaviors and poorer functioning were less likely to report their eating problems when visiting psychiatric clinics. Thus, ED should be assessed routinely in patients with complex psychopathology to facilitate comprehensive treatment.
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Affiliation(s)
- Mei-Chih Meg Tseng
- Department of Psychiatry, Far Eastern Memorial Hospital, New Taipei City 22060, Taiwan; Department of Psychiatry, National Taiwan University College of Medicine, Taipei 10051, Taiwan; Department of Psychiatry, National Taiwan University Hospital, Taipei 10002, Taiwan.
| | - Kuan-Yu Chen
- Department of Psychiatry, Taipei City Hospital, Songde Branch, Taipei 11080, Taiwan
| | - Chin-Hao Chang
- Department of Medical Research, National Taiwan University Hospital, Taipei 10055, Taiwan
| | - Shih-Cheng Liao
- Department of Psychiatry, National Taiwan University College of Medicine, Taipei 10051, Taiwan; Department of Psychiatry, National Taiwan University Hospital, Taipei 10002, Taiwan
| | - Hsi-Chung Chen
- Department of Psychiatry, National Taiwan University College of Medicine, Taipei 10051, Taiwan; Department of Psychiatry, National Taiwan University Hospital, Taipei 10002, Taiwan
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Swami V, Knowles V. Mental health literacy of negative body image: symptom recognition and beliefs about body image in a British community sample. ACTA ACUST UNITED AC 2013. [DOI: 10.1080/17542863.2013.769611] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022]
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Darby AM, Hay PJ, Mond JM, Quirk F. Community recognition and beliefs about anorexia nervosa and its treatment. Int J Eat Disord 2012; 45:120-4. [PMID: 22170023 DOI: 10.1002/eat.20886] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 10/07/2010] [Indexed: 11/06/2022]
Abstract
OBJECTIVE Mental Health Literacy (MHL), namely recognition, and beliefs about treatment concerning Anorexia Nervosa (AN) were examined in a community sample of male and female (n = 983) aged 15-94 years. METHOD A vignette describing a women suffering from the symptoms of AN was presented, followed by a respondent-based structured interview concerning recognition of the problem and treatment beliefs. RESULTS The majority of participants could identify the problem as that of an eating disorder, although only 16.1% could specifically identify it as AN. Many also believed the problem was primarily one of low self-esteem (32.5%). General practitioners and psychiatrists or psychologists were considered the most helpful treatment providers, while obtaining information about the problem and available services, followed by family therapy, were considered the most helpful treatments. Less than one-third of participants believed complete recovery was possible. Better AN MHL was found in younger, higher educated, and metropolitan domiciled females. DISCUSSION This study offers encouraging results in regard to AN MHL. In particular, there was moderate regard for the use of mental health specialists in the treatment of the disorder. However, there appears to be a misconception that AN is largely the manifestation of low self-esteem and confusion concerning the distinction between AN and bulimia nervosa. AN MHL was poorer in males and those with higher social and health disadvantage.
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Affiliation(s)
- Anita M Darby
- School of Medicine, James Cook University, Townsville, Australia
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Abstract
BACKGROUND Twenty years ago, Price published a survey identifying knowledge deficits of school counselors regarding eating disorders. Our study surveys current school counselors to determine whether knowledge has increased and determine the availability of school-based prevention programming. METHODS School counselors from a single metropolitan area were surveyed prior to a mandatory in-service on eating disorders. RESULTS Of the 109 respondents, 55% felt eating disorders were a problem in their school. Very few felt "very competent" identifying (6%) or helping (2%) students with eating disorders. Today's school counselors were more likely to know a symptom of anorexia nervosa (AN) is missing at least three consecutive menstrual cycles and malnutrition is not a common cause of death for bulimia nervosa (BN). CONCLUSIONS While knowledge of AN and BN appear to have increased, school counselors still lack some basic understanding and report very low confidence in identifying and helping students with eating disorders.
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Evans EJ, Hay PJ, Mond J, Paxton SJ, Quirk F, Rodgers B, Jhajj AK, Sawoniewska MA. Barriers to help-seeking in young women with eating disorders: a qualitative exploration in a longitudinal community survey. Eat Disord 2011; 19:270-85. [PMID: 21516551 DOI: 10.1080/10640266.2011.566152] [Citation(s) in RCA: 77] [Impact Index Per Article: 5.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Abstract
Few with eating disorders (EDs) access evidence-based treatments. We conducted a prospective exploration of help-seeking by 57 community women with bulimic-type EDs using the Framework approach of familiarization, identifying themes, indexing, charting and mapping and interpretation. The mean age of the sample was 33 years. Results found women sought help for concerns regarding perceived (over) weight rather than for eating, although many women would have welcomed questions from professionals regarding eating behaviours. Empathy, providing information and hope were considered important features of health professionals to provide a positive experience of help-seeking. Specific personal barriers to treatment included low motivation, fear of stigma, and cost. Greater clinician and community awareness of and action on these issues would likely help close "the gap" for effective help-seeking by those with EDs.
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Affiliation(s)
- Elizabeth J Evans
- Department of Developmental Disability and Neuropsychiatry, School of Psychiatry, University of New South Wales, Sydney, Australia
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Mond JM, Hay PJ, Paxton SJ, Rodgers B, Darby A, Nillson J, Quirk F, Owen C. Eating disorders "mental health literacy" in low risk, high risk and symptomatic women: implications for health promotion programs. Eat Disord 2010; 18:267-85. [PMID: 20603729 DOI: 10.1080/10640266.2010.490115] [Citation(s) in RCA: 50] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Abstract
Attitudes and beliefs concerning the nature and treatment of bulimia nervosa (BN) were compared among young adult women at low risk of an eating disorder (n = 332), at high risk (n = 83), or already showing symptoms (n = 94). Participants completed a self-report questionnaire that included a measure of eating disorder symptoms. A vignette of a fictional person suffering from BN was presented, followed by a series of questions addressing the nature and treatment of the problem described. High-risk and symptomatic participants were more likely than low-risk participants to report that they would not approach anyone for advice or help, were they to have BN or a similar problem, because they would not want anyone to know. Symptomatic participants were more likely to believe that someone with BN would be discriminated against, more likely to consider bulimic behaviors to be acceptable, and more likely to view BN as being common among women in the community, than low-risk participants, participants in the high-risk group being intermediate on each of these questions. The findings suggest that the attitudes and beliefs of individuals with eating disorder symptoms differ systematically from those of individuals at high risk, but who do not yet have symptoms, and from those at low risk. They also indicate specific attitudes and beliefs that may need to be addressed in prevention and early intervention programs. The potential benefits of assessing individuals' attitudes and beliefs concerning the nature and treatment of eating-disordered behaviour and tailoring program content accordingly may be worthy of investigation.
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Affiliation(s)
- Jonathan M Mond
- School of Biomedical and Health Sciences, University of Western Sydney, Campbelltown, New South Wales, Australia
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Ranahan P. Mental Health Literacy: A Conceptual Framework for Future Inquiry into Child and Youth Care Professionals’ Practice with Suicidal Adolescents. CHILD & YOUTH CARE FORUM 2009. [DOI: 10.1007/s10566-009-9087-5] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
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Mond JM, Hay PJ, Rodgers B, Owen C. Health service utilization for eating disorders: findings from a community-based study. Int J Eat Disord 2007; 40:399-408. [PMID: 17497708 DOI: 10.1002/eat.20382] [Citation(s) in RCA: 135] [Impact Index Per Article: 7.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Abstract
BACKGROUND Prior use of health services was examined in a community sample of women with bulimic-type eating disorders. METHOD Participants (n = 159) completed a structured interview for the assessment of eating disorder psychopathology as well as questions concerning treatment-seeking and type of treatment received. RESULTS Whereas a minority (40.3%) of participants had received treatment for an eating problem, most had received treatment for a general mental health problem (74.2%) and/or weight loss (72.8%), and all had used one or more self-help treatments. Where treatment was received for an eating or general mental health problem, this was from a primary care practitioner in the vast majority of cases. Only half of those participants who reported marked impairment associated with an eating problem had ever received treatment for such a problem and less than one in five had received such treatment from a mental health professional. CONCLUSION Women with bulimic-type eating disorders rarely receive treatment for an eating problem, but frequently receive treatment for a general mental health problem and/or for weight loss. The findings underscore the importance of programs designed to improve the detection and management of eating disorders in primary care.
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Affiliation(s)
- Jonathan M Mond
- School of Psychological Science, La Trobe University, Bundoore VIC 3083, Australia.
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