Ali Kathina, Farrer Louise, Fassnacht Daniel B, Gulliver Amelia, Bauer Stephanie, Griffiths Kathleen M
Centre for Mental Health Research, the Australian National University, Canberra, Australia.
Research School of Psychology, the Australian National University, Canberra, Australia.
Int J Eat Disord. 2017 Jan;50(1):9-21. doi: 10.1002/eat.22598. Epub 2016 Aug 16.
To systematically review the literature on perceived barriers and facilitators of help-seeking for eating disorders.
Three databases (PubMed, PsychInfo, Cochrane) were searched using keywords and Medical Subject Headings (MeSH) terms. Retrieved abstracts (N = 3493) were double screened and relevant papers (n = 13) were double coded. Qualitative and quantitative studies were included if they reported perceived barriers and facilitators towards seeking help for eating disorders. Barriers and facilitators were extracted from the included papers and coded under themes. The most prominent barriers and facilitators were determined by the number of studies reporting each theme.
Eight qualitative, three quantitative, and two mixed-methods studies met the inclusion criteria for the current review. The most prominent perceived barriers to help-seeking were stigma and shame, denial of and failure to perceive the severity of the illness, practical barriers (e.g., cost of treatment), low motivation to change, negative attitudes towards seeking help, lack of encouragement from others to seek help and lack of knowledge about help resources. Facilitators of help-seeking were reported in six studies, with the most prominent themes identified as the presence of other mental health problems or emotional distress, and concerns about health.
Programs targeting prevention and early intervention for eating disorders should focus on reducing stigma and shame, educating individuals about the severity of eating disorders, and increasing knowledge around help-seeking pathways for eating disorders. © 2016 Wiley Periodicals, Inc. (Int J Eat Disord 2017; 50:9-21).
系统回顾关于饮食失调求助过程中感知到的障碍和促进因素的文献。
使用关键词和医学主题词（MeSH）在三个数据库（PubMed、PsychInfo、Cochrane）中进行检索。对检索到的摘要（N = 3493）进行两轮筛选，对相关论文（n = 13）进行两轮编码。纳入报告饮食失调求助过程中感知到的障碍和促进因素的定性和定量研究。从纳入的论文中提取障碍和促进因素，并按主题进行编码。根据报告每个主题的研究数量确定最突出的障碍和促进因素。
八项定性研究、三项定量研究和两项混合方法研究符合本次综述的纳入标准。求助过程中最突出的感知障碍是耻辱感和羞耻感、否认并未能认识到疾病的严重性、实际障碍（如治疗费用）、改变的动力低、对寻求帮助持消极态度、缺乏他人鼓励寻求帮助以及对求助资源缺乏了解。六项研究报告了求助的促进因素，最突出的主题是存在其他心理健康问题或情绪困扰以及对健康的担忧。
针对饮食失调预防和早期干预的项目应侧重于减少耻辱感和羞耻感，教育个人了解饮食失调的严重性，并增加关于饮食失调求助途径的知识。© 2016威利期刊公司（《国际进食障碍杂志》2017年；50:9 - 21）
