Swan-Kremeier Lorraine A, Mitchell James E, Twardowski Tasha, Lancaster Kathy, Crosby Ross D
Neuropsychiatric Research Institute, Fargo, North Dakota 58107, USA.
Int J Eat Disord. 2005 Dec;38(4):367-70. doi: 10.1002/eat.20192.
The purpose of this study was to investigate the impact of the distance patients had to travel for treatment on attendance patterns and treatment attrition.
Contact information, clinical records, and/or appointment records of 209 adult patients presenting to an outpatient eating disorder treatment center over a specific period of time were reviewed. Information was obtained on demographics, diagnosis, number of appointments attended, cancelled, and failed, and termination status. Patients were classified as treatment completers or dropouts and compared on demographic, diagnostic, attendance, and distance to treatment site variables.
Treatment completer and dropout groups did not differ significantly on demographic variables, with the exception of employed patients being more likely to drop out of treatment. Although not statistically significant, patients diagnosed with bulimia nervosa (BN) and eating disorder not otherwise specified (EDNOS) were more likely to drop out of treatment prematurely. Surprisingly, distance traveled to the treatment site was not significantly different between groups and did not appear to significantly impact attendance patterns.
Results of this archival investigation were unexpected and likely limited by the design. Results can be useful in understanding motivational factors inherent in noncompliance and premature termination of treatment. A prospective study including fine-grained analysis of variables associated with eating disorder treatment attrition is indicated.
本研究旨在调查患者接受治疗所需的就诊距离对就诊模式和治疗中断情况的影响。
回顾了特定时间段内到门诊饮食失调治疗中心就诊的209名成年患者的联系信息、临床记录和/或预约记录。获取了有关人口统计学、诊断、就诊、取消和未就诊预约次数以及终止状态的信息。将患者分为治疗完成者或退出者，并在人口统计学、诊断、就诊情况以及到治疗地点的距离等变量方面进行比较。
治疗完成者和退出者组在人口统计学变量上没有显著差异，但在职患者更有可能退出治疗。虽然无统计学意义，但被诊断为神经性贪食症（BN）和未另行指定的饮食失调（EDNOS）的患者更有可能过早退出治疗。令人惊讶的是，两组患者到治疗地点的距离没有显著差异，且似乎对就诊模式没有显著影响。
这项档案研究的结果出乎意料，可能受研究设计的限制。这些结果有助于理解治疗不依从和过早终止治疗所固有的动机因素。有必要开展一项前瞻性研究，对与饮食失调治疗中断相关的变量进行细致分析。
