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Heafala A, Rundle-Thiele S, Ball L, Mitchell LJ. Cocreating eating disorder education solutions: A design thinking approach to dietetics curricula in Australia. J Hum Nutr Diet 2024; 37:1219-1230. [PMID: 38856699 DOI: 10.1111/jhn.13333] [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: 01/10/2024] [Revised: 05/22/2024] [Accepted: 05/24/2024] [Indexed: 06/11/2024]
Abstract
BACKGROUND As the prevalence of eating disorders continues to increase, there is an urgent need to equip the emerging dietetics workforce to provide care to this growing population. The present study aimed to describe a five-step design thinking process that was applied to brainstorm ideas and develop and test solutions for consideration in the future. METHODS A pragmatic, five-step design thinking approach was used during a 1-day, in-person design thinking retreat. Purposive sampling was used to identify key stakeholders, including subject matter, learning and teaching, as well as lived experience experts, dietetics students and recent graduates. Reflexive thematic analysis was used to analyse brainstormed and design solution ideas. RESULTS Seventeen participants attended the design thinking retreat in April 2023. Four education prototypes were developed and tested by stakeholders including: (1) a change to accreditation requirements for dietetics curricula; (2) a multimodal learning package for penultimate year students; (3) embedding disordered eating and eating disorder content into existing curriculum and upskilling educators; and (4) codesigning an eating disorder module. CONCLUSIONS The design thinking retreat engaged a variety of stakeholders in curriculum design resulting in an array of prototype approaches that aimed to embed eating disorder content into university curricula. Further research is needed to test the prototypes and understand what impact this has on dietetics students' feelings of preparedness to provide care to people seeking this support.
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Affiliation(s)
- Alana Heafala
- School of Health Sciences and Social Work, Gold Coast Campus, Griffith University, Southport, QLD, Australia
- Menzies Health Institute Queensland, Gold Coast Campus, Griffith University, Southport, QLD, Australia
| | - Sharyn Rundle-Thiele
- Social Marketing @ Griffith, Griffith Business School, Griffith University, Nathan, QLD, Australia
| | - Lauren Ball
- Centre for Community Health and Wellbeing, University of Queensland, St Lucia, QLD, Australia
| | - Lana J Mitchell
- School of Health Sciences and Social Work, Gold Coast Campus, Griffith University, Southport, QLD, Australia
- Menzies Health Institute Queensland, Gold Coast Campus, Griffith University, Southport, QLD, Australia
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Heafala A, Ball L, Rundle-Thiele S, Mitchell LJ. 'Through education, we can make change': A design thinking approach to entry-level dietetics education regarding eating disorders. Nutr Diet 2024. [PMID: 38804016 DOI: 10.1111/1747-0080.12885] [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: 10/04/2023] [Revised: 03/27/2024] [Accepted: 05/07/2024] [Indexed: 05/29/2024]
Abstract
AIMS To co-create strategies and identify opportunities to integrate eating disorder content within dietetics curricula at one Australian university with stakeholders using a design thinking approach. METHODS A pragmatic mixed-methods, participatory design approach was used. An online survey explored the learning needs of dietetic students and recent graduates regarding eating disorders. Following the survey, a one-day design thinking retreat was held with stakeholders who were identified from the research team's professional networks. Eating disorder dietitians, learning experts, dietetic students, graduates, and those with lived experience were asked to identify strategies to enhance students' confidence and competence to provide care for people living with eating disorders. Quantitative data were analysed using descriptive statistics and qualitative data were analysed using inductive coding and reflexive thematic analysis. RESULTS Sixty-four students (n = 55, 86%) and recent graduates (n = 9, 14%) completed the online survey (26% response). Seventeen stakeholders attended the retreat. Four themes were identified: (1) changing perceptions of eating disorder care from specialist to 'core business'; (2) desiring and advocating for a national change to dietetics curricula; (3) importance of lived experience at the centre of curriculum design and delivery; and (4) collaborating to co-design and deliver eating disorder content at university. CONCLUSION Raising awareness, upskilling students and educators, enhanced collaboration between universities and stakeholders, and the inclusion of lived experience were key to preparing students to provide care to people seeking support for eating disorders. Further research is needed to assess the impact these strategies have on dietetic students' confidence and competence.
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Affiliation(s)
- Alana Heafala
- School of Health Sciences and Social Work, Gold Coast Campus, Griffith University, Southport, Queensland, Australia
- Menzies Health Institute Queensland, Gold Coast Campus, Griffith University, Southport, Queensland, Australia
| | - Lauren Ball
- Centre for Community Health and Wellbeing, University of Queensland, St Lucia, Queensland, Australia
| | - Sharyn Rundle-Thiele
- Social Marketing @ Griffith, Griffith Business School, Griffith University, Nathan, Queensland, Australia
| | - Lana J Mitchell
- School of Health Sciences and Social Work, Gold Coast Campus, Griffith University, Southport, Queensland, Australia
- Menzies Health Institute Queensland, Gold Coast Campus, Griffith University, Southport, Queensland, Australia
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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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Parker EK, Ashley MA, Harris DM, Stefoska-Needham A. Exploring the eating disorder curricula of accredited university dietetic programs in Australia and New Zealand. J Eat Disord 2023; 11:63. [PMID: 37081558 PMCID: PMC10116702 DOI: 10.1186/s40337-023-00788-x] [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: 12/06/2022] [Accepted: 04/12/2023] [Indexed: 04/22/2023] Open
Abstract
BACKGROUND Dietitians are viewed as integral members of the multidisciplinary treatment team for people with eating disorders (EDs). However, low levels of perceived confidence, competence, and willingness to practice in this clinical area, have been reported by dietitians and student dietitians. As the extent of ED-specific knowledge and skills-based training within tertiary accredited dietetic programs is currently unknown, this research aimed to: (1) obtain insights into the current ED-specific knowledge base and training content of dietetic curricula in both Australian and New Zealand universities; (2) understand the perspectives of course convenors regarding the role of dietitians in ED treatment and their employment opportunities; and (3) identify gaps and opportunities for improving university programs and the dietetic workforce. METHODS Course convenors (or their nominated representative) of Australian and New Zealand accredited dietetic programs were invited to participate in a semi-structured virtual interview. A purpose-built question guide was developed to explore the inclusion and/or integration of ED-specific content into the curricula, and the perspectives of course convenors toward the role of dietitians in the treatment of EDs, and their employment opportunities. The interviews were audio recorded, transcribed verbatim, and analysed qualitatively using inductive thematic analysis. RESULTS Thirteen participants who represented 14 universities and 19 individual accredited dietetic programs, were interviewed, with some participants representing more than one university. Three dominant themes emerged: (1) varying ED-specific content and training in dietetic programs; (2) unclear dietitian's role in the treatment of EDs, and (3) contrasting views regarding ED clinical practice and employment. CONCLUSIONS ED-specific content was embedded within all the dietetic programs investigated in this study. However, this content was generally limited to an introductory level, with notable variations found between the depth of content and the type of training provided. Risk-mitigation skill development, such as screening for EDs, and early identification of symptoms, also varied between programs. Therefore, it is recommended that ED-specific skill development and knowledge is enhanced within Australian and New Zealand university programs, to support effective, safe, and timely care for people with EDs. This research has implications for current and future university dietetic program development and the broader dietetic workforce.
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Affiliation(s)
- Elizabeth Kumiko Parker
- Department of Dietetics and Nutrition, Westmead Hospital, Westmead, NSW, 2145, Australia.
- Sydney School of Health Sciences, Faculty of Medicine and Health, The University of Sydney, Sydney, NSW, 2006, Australia.
| | - Mellisa Anne Ashley
- Department of Dietetics and Nutrition, Westmead Hospital, Westmead, NSW, 2145, Australia
- Adult Eating Disorder Service, Western Sydney Local Health District, Sydney, NSW, 2145, Australia
| | - Deanne Maree Harris
- Department of Nutrition and Dietetics, Tamworth Rural Referral Hospital, Tamworth, NSW, 2340, Australia
| | - Anita Stefoska-Needham
- Nutrition and Dietetics, School of Medical, Indigenous and Health Sciences, Health Impacts Research Centre, Illawarra Health and Medical Research Institute, University of Wollongong, Wollongong, NSW, 2522, Australia
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Diet, Digestion, and the Dietitian: A Survey of Clinicians' Knowledge, Attitudes and Practices to Advance the Treatment of Gastrointestinal Disturbances in Individuals with Anorexia Nervosa. J Clin Med 2022; 11:jcm11195833. [PMID: 36233700 PMCID: PMC9573322 DOI: 10.3390/jcm11195833] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/17/2022] [Revised: 09/27/2022] [Accepted: 09/29/2022] [Indexed: 11/05/2022] Open
Abstract
Despite advances in treatment of anorexia nervosa (AN), current therapeutic approaches do not fully consider gastrointestinal disturbances (GID), often present in AN. Addressing GID, both symptoms and disorders, is likely to improve treatment adherence and outcomes in people with AN. GID are complex and are linked to a range of factors related to eating disorder symptomology and can be impacted by nutritional treatment. It is not known which dietetic practices are currently used to address GID in AN. Therefore, this survey aimed to explore the perceived knowledge, attitudes, and practices (KAP) of Australian dietitians treating AN and co-occurring GID. Seventy dietitians participated by completing an online survey. Knowledge scores were calculated based on correct responses to knowledge items (total: 12 points); and two groups were generated: higher knowledge (≥10 points, n = 31) and lower knowledge (≤9 points, n = 39). A greater proportion of dietitians with higher knowledge recognized the role of GID in pathogenesis of AN (p = 0.002) and its impact on quality of life (p = 0.013) and screened for GID (p ≤ 0.001), compared with those with lower knowledge. These results suggest that attitudes and practices toward patients presenting with AN and GID differ depending on level of knowledge. This may have important implications for treatment outcomes for individuals with AN and GID.
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Parker EK, Ashley MA, Moretti C, Harris DM, Stefoska-Needham A. Exploring perceived training and professional development needs of Australian dietetic students and practising dietitians in the area of eating disorders: a focus group study. J Eat Disord 2022; 10:40. [PMID: 35303959 PMCID: PMC8934001 DOI: 10.1186/s40337-022-00567-0] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/26/2021] [Accepted: 03/07/2022] [Indexed: 01/02/2023] Open
Abstract
BACKGROUND Timely diagnosis and treatment of eating disorders (EDs) are essential for achieving the best possible outcomes, and dietitians have an important role in the multidisciplinary team. ED-specific training has been shown to enhance the knowledge, mental health literacy and confidence of health professionals in providing patient treatment. However, the ED-specific training needs of dietitians have yet to be determined. This study aimed to explore the perceived readiness of dietitians and student dietitians to treat patients with EDs; to identify the key training components that would enhance their confidence in delivering ED-specific treatment; and to examine any barriers associated with engagement in ED-specific professional development. METHODS A semi-structured question guide was developed by researchers to elicit information from six virtual focus groups consisting of a purposive sample of practising dietitians and student dietitians enrolled in their final year of an Australian tertiary accredited dietetic program. Members of professional organisations were approached to participate via email; and a recruitment flyer was promoted on various social media platforms. Discussions were recorded, transcribed verbatim and analysed qualitatively using inductive thematic analysis. RESULTS Thirty-eight participants (26 dietitians, 12 student dietitians) were recruited, mean age of 32.5 years ± 11 SD. Three major themes emerged: (1) reluctance to practice in EDs, which was associated with limited ED-specific training at university, lack of clinical guidelines, mental health complexities of patients with an ED, ambiguity regarding the dietitian's role, systemic complexities with ED care, and beliefs of health professionals; (2) the need for additional ED-specific training and clinical supervision both during and after university, with the focus on identification, assessment, management and treatment, mental health literacy, and counselling skills, identified as an essential component to improving professional confidence and competence; (3) limited awareness and access/supply of ED-specific training opportunities were found, which included the financial cost of training/clinical supervision, and limited access to suitable clinical supervision. CONCLUSION Dietitians currently practising in the workplace and dietetic students perceive that enhanced ED-specific training during university and after graduation is essential to work with patients confidently and competently with EDs. This research has implications for Australian university dietetic programs and workforce development. This study aimed to explore the perceptions and readiness of dietitians and student dietitians to treat patients with eating disorders (EDs); to identify the key training components that would enhance their confidence and competence in delivering treatment; and to examine any barriers associated with engaging in ED-specific professional development. Twenty-six dietitians and twelve dietetic students participated in six virtual focus group discussions, which identified three main themes: (1) reluctance to practice which was associated with limited ED-specific training at university, lack of clinical guidelines, mental health complexities of patients with an ED, ambiguity regarding the dietitian's role, systemic complexities with ED care, and beliefs of health professionals; (2) the importance of engaging in ED-specific training, beyond an introductory level, during university and after graduation to confidently and competently work with patients with EDs; (3) barriers to accessing further ED-specific training and clinical supervision were found, including poor awareness of training opportunities, high financial cost of training/clinical supervision, and limited access to obtaining suitable clinical supervision. Results from this study provide insight into the ED-specific training needs of practising and student dietitians. This research has value for university programs and workforce development.
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Affiliation(s)
- Elizabeth Kumiko Parker
- Department of Dietetics and Nutrition, Westmead Hospital, P.O. Box 533, Wentworthville, Westmead, NSW, 2145, Australia. .,Sydney School of Health Sciences, Faculty of Medicine and Health, The University of Sydney, Sydney, NSW, 2006, Australia.
| | - Mellisa Anne Ashley
- Department of Dietetics and Nutrition, Westmead Hospital, P.O. Box 533, Wentworthville, Westmead, NSW, 2145, Australia.,Adult Eating Disorder Service, Western Sydney Local Health District, North Parramatta, NSW, 2145, Australia
| | - Courtney Moretti
- SMART Foods Centre, Illawarra Health and Medical Research Institute, School of Medicine, Faculty of Science, Medicine and Health, University of Wollongong, Wollongong, NSW, 2522, Australia
| | - Deanne Maree Harris
- Department of Nutrition & Dietetics, Tamworth Rural Referral Hospital, Tamworth, NSW, 2340, Australia
| | - Anita Stefoska-Needham
- SMART Foods Centre, Illawarra Health and Medical Research Institute, School of Medicine, Faculty of Science, Medicine and Health, University of Wollongong, Wollongong, NSW, 2522, Australia
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Heafala A, Ball L, Rayner J, Mitchell LJ. What role do dietitians have in providing nutrition care for eating disorder treatment? An integrative review. J Hum Nutr Diet 2021; 34:724-735. [PMID: 34031923 DOI: 10.1111/jhn.12927] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/25/2021] [Revised: 04/16/2021] [Accepted: 05/07/2021] [Indexed: 12/28/2022]
Abstract
BACKGROUND Dietitians are recognised as experts in nutrition care and essential members of multidisciplinary healthcare teams. However, the role of dietitians in caring for people with eating disorders is not well understood. The present review aimed to identify, critically appraise and synthesise the current evidence exploring the views and experiences of dietitians, other health professionals, patients and carers regarding the role of dietitians in the treatment of eating disorders. METHODS CINAHL, MEDLINE, Embase, Scopus and PsycINFO were searched in April 2020 and again in February 2021. Studies were included if they were original research; explored views and experiences of the role of dietitians in the treatment of eating disorders, including perceptions of patients, carers and other health professionals regarding nutrition care for eating disorders; and the full-text article was available in English. Title and abstract screening, full-text screening, quality assessment and data extraction were completed in duplicate. Quality assessment was conducted using the Mixed Methods Assessment Tool. Thematic synthesis was used for data analysis. RESULTS Fourteen studies met the inclusion criteria. Quantitative, qualitative and mixed-methods study designs were included. Four themes emerged inductively from the data: (i) dietitians as collaborators, educators and counsellors; (ii) dietitians individualising care and desiring a holistic approach; (iii) opportunities for dietitians to gain confidence; and (iv) experiencing nutrition care as a patient or carer. CONCLUSIONS This review suggests that dietitians have a varied role in eating disorder treatment but desire further training. Understanding the training needs of dietitians can identify practice gaps and opportunities to enhance clinician confidence.
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Affiliation(s)
- Alana Heafala
- School of Allied Health Sciences, Griffith University, Southport, QLD, Australia.,Menzies Health Institute Queensland, Griffith University, Southport, QLD, Australia
| | - Lauren Ball
- School of Allied Health Sciences, Griffith University, Southport, QLD, Australia.,Menzies Health Institute Queensland, Griffith University, Southport, QLD, Australia
| | - Jessica Rayner
- School of Allied Health Sciences, Griffith University, Southport, QLD, Australia.,Menzies Health Institute Queensland, Griffith University, Southport, QLD, Australia
| | - Lana J Mitchell
- School of Allied Health Sciences, Griffith University, Southport, QLD, Australia.,Menzies Health Institute Queensland, Griffith University, Southport, QLD, Australia
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Denman E, Parker EK, Ashley MA, Harris DM, Halaki M, Flood V, Stefoska-Needham A. Understanding training needs in eating disorders of graduating and new graduate dietitians in Australia: an online survey. J Eat Disord 2021; 9:27. [PMID: 33602327 PMCID: PMC7891015 DOI: 10.1186/s40337-021-00380-1] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/27/2020] [Accepted: 02/09/2021] [Indexed: 12/12/2022] Open
Abstract
BACKGROUND Following recent reforms by the Australian Government to the Medicare Benefits Schedule, people living with a diagnosed eating disorder (ED) in Australia have greater access to dietetic services. However, new graduate dietitians anecdotally lack confidence to provide appropriate interventions to support patients with an ED. Therefore, this cross-sectional study aims to explore the perceived confidence, and educational and professional development needs of student dietitians and new graduate dietitians in the area of EDs. METHODS An online survey with 17 questions was designed, consisting of a combination of discrete (yes/no) questions, free text, ordered scales and 5-point Likert scales. Student dietitians, and first- and second- year graduates (n = 1456) were approached via email as potential participants, from the professional organisation Dietitians Australia member list. Survey data was analysed using descriptive statistics and odds ratios. RESULTS In total, 150 surveys were completed, with a response rate of 10.3%. Respondents reported a lack of confidence in managing patients with an ED and implementing ED treatment approaches (81 and 95%, respectively). However, participants previously exposed to patients with an ED, such as anorexia nervosa, were 4.7 times (95% CI 1.72, 12.97) more likely to be confident compared to those not exposed to patients with an ED. The majority of respondents (37%) stated they would seek assistance from other dietitians, and develop their skills via online webinars (27%) and workshops (25%). CONCLUSIONS This survey identified that final year dietetics students and new graduate dietitians perceive lower levels of confidence to practice in the area of EDs. The desire for further ED-specific training and education was reported.
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Affiliation(s)
- Elyse Denman
- SMART Foods Centre, Illawarra Health and Medical Research Institute, School of Medicine, Faculty of Science, Medicine and Health, University of Wollongong, Wollongong, NSW, 2522, Australia
| | - Elizabeth Kumiko Parker
- Department of Dietetics & Nutrition, Westmead Hospital, Westmead, NSW, 2145, Australia. .,Sydney School of Health Sciences, Faculty of Medicine and Health, The University of Sydney, Sydney, NSW, 2006, Australia.
| | - Mellisa Anne Ashley
- Department of Dietetics & Nutrition, Westmead Hospital, Westmead, NSW, 2145, Australia.,Adult Eating Disorder Service, Western Sydney Local Health District, Sydney, NSW, 2145, Australia
| | - Deanne Maree Harris
- Department of Dietetics & Nutrition, Tamworth Rural Referral Hospital, Tamworth, NSW, 2340, Australia
| | - Mark Halaki
- Sydney School of Health Sciences, Faculty of Medicine and Health, The University of Sydney, Sydney, NSW, 2006, Australia
| | - Victoria Flood
- Sydney School of Health Sciences, Faculty of Medicine and Health, The University of Sydney, Sydney, NSW, 2006, Australia.,Western Sydney Local Health District, Sydney, NSW, 2145, Australia
| | - Anita Stefoska-Needham
- SMART Foods Centre, Illawarra Health and Medical Research Institute, School of Medicine, Faculty of Science, Medicine and Health, University of Wollongong, Wollongong, NSW, 2522, Australia
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Heruc G, Hart S, Stiles G, Fleming K, Casey A, Sutherland F, Jeffrey S, Roberton M, Hurst K. ANZAED practice and training standards for dietitians providing eating disorder treatment. J Eat Disord 2020; 8:77. [PMID: 33317617 PMCID: PMC7737344 DOI: 10.1186/s40337-020-00334-z] [Citation(s) in RCA: 24] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/05/2020] [Accepted: 10/02/2020] [Indexed: 02/06/2023] Open
Abstract
INTRODUCTION Dietitians involved in eating disorder treatment are viewed as important members of the multidisciplinary team. However, the skills and knowledge that they require are not well characterised. Therefore, as part of a broader project to identify the key principles and clinical practice and training standards for mental health professionals and dietitians providing eating disorder treatment, the Australia & New Zealand Academy for Eating Disorders (ANZAED) sought to identify the key practice and training standards specific to dietitians. An expert working group of dietitians was convened to draft the initial dietetic standards. After expert review, feedback on the revised standards was then provided by 100 health professionals working within the eating disorder sector. This was collated into a revised version made available online for public consultation, with input received from treatment professionals, professional bodies and consumer/carer organisations. RECOMMENDATIONS Dietitians providing treatment to individuals with an eating disorder should follow ANZAED's general principles and clinical practice standards for mental health professionals and dietitians. In addition, they should also be competent in the present eating disorder-specific standards based around the core dietetic skills of screening, professional responsibility, assessment, nutrition diagnosis, intervention, monitoring and evaluation. CONCLUSIONS These standards provide guidance on the expectations of dietetic management to ensure the safe and effective treatment of individuals with an eating disorder. Implications for professional development content and training providers are discussed, as well as the importance of clinical supervision to support professional self-care and evidence-informed and safe practice for individuals with an eating disorder.
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Affiliation(s)
- Gabriella Heruc
- Executive Committee, Australia & New Zealand Academy for Eating Disorders, Sydney, Australia.
- School of Medicine, Western Sydney University, Campbelltown, Australia.
- Eating Disorder Service, Northern Sydney Local Health District, Sydney, Australia.
| | - Susan Hart
- Nutrition and Dietetics, St Vincent's Hospital, Darlinghurst, Australia
- The Boden Collaboration of Obesity, Nutrition, Exercise and Eating Disorders, The University of Sydney, Sydney, Australia
| | - Garalynne Stiles
- School of Sport, Exercise and Nutrition, College of Health, Massey University, Auckland, New Zealand
| | | | - Anjanette Casey
- Centre for Psychotherapy, Hunter New England Local Health District, Newcastle, Australia
| | - Fiona Sutherland
- Executive Committee, Australia & New Zealand Academy for Eating Disorders, Sydney, Australia
- The Mindful Dietitian, Melbourne, Australia
| | - Shane Jeffrey
- Executive Committee, Australia & New Zealand Academy for Eating Disorders, Sydney, Australia
- River Oak Health, Brisbane, Australia
- Royal Brisbane and Women's Hospital, Brisbane, Australia
| | - Michelle Roberton
- Victorian Centre of Excellence in Eating Disorders, Parkville, Australia
| | - Kim Hurst
- Executive Committee, Australia & New Zealand Academy for Eating Disorders, Sydney, Australia
- Eating Disorder Service, Robina Private Hospital, Robina, Australia
- Griffith University, Gold Coast, Australia
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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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