Breland Jessica Y, Donalson Rosemary, Dinh Julie, Nevedal Andrea, Maguen Shira
Center for Innovation to Implementation, VA Palo Alto Health Care System, Menlo Park, California; Department of Psychiatry and Behavioral Sciences, Stanford University, Stanford, California.
San Francisco VA Medical Center, San Francisco, California.
Womens Health Issues. 2016 Jul-Aug;26(4):429-36. doi: 10.1016/j.whi.2016.04.006. Epub 2016 Jun 2.
Disordered eating, which includes subclinical and clinical maladaptive eating behaviors, is common among women, including those served by the Veterans Health Administration (VA). We used qualitative methods to determine whether and how women veterans want to receive treatment for disordered eating.
Women veterans participated in one of seven focus groups/interviews and completed in-person demographic and psychological questionnaires. We used thematic analysis of focus groups/interviews to understand preferences for disordered eating treatment.
Participants (n = 20) were mostly women of color (55%); mean age was 48 (SD = 15) and 65% had significant psychological symptoms. Few participants described being assessed for disordered eating, but all thought VA should provide treatment for disordered eating. Through thematic analysis, we identified six preferences: 1) treatment for disordered eating should be provided in groups, 2) treatment for disordered eating should provide concrete skills to facilitate the transition out of structured military environments, 3) treatment for disordered eating should address the relationship between eating and mental health, 4) disordered eating can be treated with mindfulness and cognitive-behavioral therapy, 5) disordered eating treatment providers should be experienced and take an interactive approach to care, but can come from diverse disciplines, and 6) referrals to treatment for disordered eating should be open ended, occur early, and allow for ongoing, flexible access to treatment.
Women veterans are interested in treatment for disordered eating. Preferred treatments align with existing treatments, could be offered in conjunction with weight loss or primary care services, and should provide social support and interactive learning.
饮食失调,包括亚临床和临床适应不良的饮食行为,在女性中很常见,包括那些接受退伍军人健康管理局(VA)服务的女性。我们采用定性方法来确定女性退伍军人是否以及希望如何接受饮食失调治疗。
女性退伍军人参加了七个焦点小组/访谈中的一个,并完成了现场人口统计学和心理问卷。我们对焦点小组/访谈进行主题分析,以了解饮食失调治疗的偏好。
参与者(n = 20)大多是有色人种女性(55%);平均年龄为48岁(标准差 = 15),65%有明显的心理症状。很少有参与者描述接受过饮食失调评估,但所有人都认为VA应该提供饮食失调治疗。通过主题分析,我们确定了六个偏好:1)饮食失调治疗应以小组形式提供;2)饮食失调治疗应提供具体技能,以促进从结构化军事环境中过渡;3)饮食失调治疗应解决饮食与心理健康之间的关系;4)饮食失调可以通过正念和认知行为疗法治疗;5)饮食失调治疗提供者应经验丰富,并采取互动式护理方法,但可以来自不同学科;6)饮食失调治疗的转诊应该是开放式的,尽早进行,并允许持续、灵活地获得治疗。
女性退伍军人对饮食失调治疗感兴趣。首选治疗方法与现有治疗方法一致,可以与减肥或初级保健服务一起提供,并且应该提供社会支持和互动式学习。