Transitions from intensive eating disorder treatment settings: qualitative investigation of the experiences and needs of adults with anorexia nervosa and their carers.

Anorexia nervosa carers eating disorders in-patient treatment out-patient treatment

Journal

BJPsych open
ISSN: 2056-4724
Titre abrégé: BJPsych Open
Pays: England
ID NLM: 101667931

Informations de publication

Date de publication:
20 Jul 2022
Historique:
entrez: 20 7 2022
pubmed: 21 7 2022
medline: 21 7 2022
Statut: epublish

Résumé

Relapse rates for individuals with anorexia nervosa after intensive hospital treatment (in-patient or full-time day care) are high. Better knowledge about the difficulties and opportunities that arise during this transition is needed to identify factors that support or hinder continued recovery upon discharge. The aim of this study was to explore the experiences of adult patients and their chosen carers on the process of transitioning from intensive eating disorder treatment settings to the community. Semi-structured interviews were conducted with patients with anorexia nervosa ( Four interrelated themes were identified for both groups. For patients, themes were continuity of care, ambivalence about continued recovery, the value of social support and a call for enhanced transition support. For carers, themes were the impact of the eating disorder on themselves and the family, perceptions of recovery and support post-discharge, the impact of previous treatment and care experiences, and desire to create a supportive transition process. The study provides an insight into the unique challenges that individuals with anorexia nervosa face upon leaving intensive treatment. A lack of post-discharge planning, support system and identity formation outside of anorexia nervosa were perceived as barriers to continued recovery. Patients and carers advocated for transition support that incorporates a phased, inclusive approach with accessible professional and social support in the community.

Sections du résumé

BACKGROUND BACKGROUND
Relapse rates for individuals with anorexia nervosa after intensive hospital treatment (in-patient or full-time day care) are high. Better knowledge about the difficulties and opportunities that arise during this transition is needed to identify factors that support or hinder continued recovery upon discharge.
AIMS OBJECTIVE
The aim of this study was to explore the experiences of adult patients and their chosen carers on the process of transitioning from intensive eating disorder treatment settings to the community.
METHOD METHODS
Semi-structured interviews were conducted with patients with anorexia nervosa (
RESULTS RESULTS
Four interrelated themes were identified for both groups. For patients, themes were continuity of care, ambivalence about continued recovery, the value of social support and a call for enhanced transition support. For carers, themes were the impact of the eating disorder on themselves and the family, perceptions of recovery and support post-discharge, the impact of previous treatment and care experiences, and desire to create a supportive transition process.
CONCLUSIONS CONCLUSIONS
The study provides an insight into the unique challenges that individuals with anorexia nervosa face upon leaving intensive treatment. A lack of post-discharge planning, support system and identity formation outside of anorexia nervosa were perceived as barriers to continued recovery. Patients and carers advocated for transition support that incorporates a phased, inclusive approach with accessible professional and social support in the community.

Identifiants

pubmed: 35856250
doi: 10.1192/bjo.2022.535
pii: S205647242200535X
pmc: PMC9347315
doi:

Types de publication

Journal Article

Langues

eng

Pagination

e137

Subventions

Organisme : Health Technology Assessment Programme
ID : 14/68/09

Références

Eur Eat Disord Rev. 2021 May;29(3):371-392
pubmed: 33548148
Eur Eat Disord Rev. 2017 Nov;25(6):512-523
pubmed: 28944595
Shanghai Arch Psychiatry. 2013 Aug;25(4):212-23
pubmed: 24991159
Front Psychiatry. 2021 Jul 23;12:694223
pubmed: 34366923
J Clin Med. 2020 Feb 27;9(3):
pubmed: 32120847
J Health Psychol. 2016 Jan;21(1):16-27
pubmed: 24505059
BJPsych Open. 2022 Mar 24;8(2):e76
pubmed: 35322783
Eur Eat Disord Rev. 2020 Nov;28(6):826-835
pubmed: 32643844
J Eat Disord. 2021 Aug 17;9(1):103
pubmed: 34404490
J Eat Disord. 2020 Oct 16;8:51
pubmed: 33088566
Curr Psychiatry Rep. 2017 Jul;19(7):41
pubmed: 28540593
Front Psychiatry. 2018 May 01;9:158
pubmed: 29765338
Eur Eat Disord Rev. 2021 May;29(3):355-370
pubmed: 33687119
Psychother Psychosom Med Psychol. 2017 Sep;67(9-10):420-430
pubmed: 28511240
Int J Eat Disord. 2019 Oct;52(10):1191-1201
pubmed: 31429974
J Eat Disord. 2021 May 19;9(1):61
pubmed: 34011399
Am J Psychiatry. 2021 Sep 1;178(9):848-853
pubmed: 34154394
Psychol Med. 2020 Nov;50(15):2610-2621
pubmed: 31615581
BMC Psychol. 2020 Oct 22;8(1):110
pubmed: 33092638
Int J Eat Disord. 2020 Oct;53(10):1739-1745
pubmed: 32735053
Curr Opin Psychiatry. 2018 Nov;31(6):445-455
pubmed: 30113325
BMC Public Health. 2014 Sep 11;14:943
pubmed: 25213544
Am J Psychiatry. 2021 Sep 1;178(9):786-788
pubmed: 34516232
Clin Psychol Rev. 2017 Nov;57:1-11
pubmed: 28800416
Lancet. 2020 Mar 14;395(10227):899-911
pubmed: 32171414
Int Rev Psychiatry. 2019 Jun;31(4):382-390
pubmed: 30916597
J Eat Disord. 2020 Dec 2;8(1):69
pubmed: 33292619
Eur Eat Disord Rev. 2016 Mar;24(2):122-30
pubmed: 26695507
Acad Med. 2014 Sep;89(9):1245-51
pubmed: 24979285

Auteurs

Danielle Clark Bryan (D)

Department of Psychological Medicine, Institute of Psychiatry, Psychology & Neuroscience, King's College London, UK.

Pamela Macdonald (P)

Department of Psychological Medicine, Institute of Psychiatry, Psychology & Neuroscience, King's College London, UK.

Valentina Cardi (V)

Department of Psychological Medicine, Institute of Psychiatry, Psychology & Neuroscience, King's College London, UK.
Department of General Psychology, University of Padova, Italy.

Katie Rowlands (K)

Department of Psychological Medicine, Institute of Psychiatry, Psychology & Neuroscience, King's College London, UK.

Suman Ambwani (S)

Department of Psychology, Dickinson College, Pennsylvania, USA.

Jon Arcelus (J)

Institute of Mental Health, University of Nottingham, UK.

Eva-Maria Bonin (EM)

Care Policy and Evaluation Centre, Department of Health Policy, London School of Economics and Political Science, UK.

Sabine Landau (S)

Department of Biostatistics and Health Informatics, King's College London, UK.

Ulrike Schmidt (U)

Department of Psychological Medicine, Institute of Psychiatry, Psychology & Neuroscience, King's College London, UK.
South London and Maudsley NHS Foundation Trust, Maudsley Hospital, UK.

Janet Treasure (J)

Department of Psychological Medicine, Institute of Psychiatry, Psychology & Neuroscience, King's College London, UK.

Classifications MeSH