Hannon Julia, Eunson Lindsey, Munro Calum
a Anorexia Nervosa Intensive Treatment Team , NHS Lothian , Edinburgh , Scotland , UK.
b Department of Psychiatry , University of Edinburgh , Edinburgh , Scotland , UK.
Eat Disord. 2017 Jul-Sep;25(4):279-296. doi: 10.1080/10640266.2017.1318626. Epub 2017 Apr 27.
This study explores experiences of intensive community treatment, illness, and change among patients with severe anorexia nervosa (sAN), particularly seeking to understand the processes involved in change and inability to change. A qualitative design with purposive semi-stratified sampling, using semi-structured interviews and interpretive phenomenological analysis, investigated in detail the experiences of five participants. Participants all had sAN at the start of treatment and represented a spectrum of outcomes from deterioration to full recovery. Six super-ordinate themes emerged from the analysis: treatment experience, function of anorexia, self-criticism versus self-acceptance, isolation versus connection, hopelessness versus hope, and stuckness versus change. Results describe the valued function of the illness, barriers to change, the lengthy struggle for change, and how this can be supported by intensive community-based treatment. Necessary ingredients in the process of change, arising from the analysis, are proposed. We conclude that the experiences of these patients reflect the particular functions of AN for each individual, and that both clinical deterioration and full recovery can occur with prolonged intensive community treatment.
本研究探讨了重度神经性厌食症（sAN）患者在强化社区治疗、疾病及改变方面的经历，尤其旨在了解改变过程及无法改变的原因。采用目的半分层抽样的质性设计，通过半结构化访谈和解释现象学分析，详细调查了五名参与者的经历。参与者在治疗开始时均患有sAN，代表了从病情恶化到完全康复的一系列结果。分析得出六个超ordinate主题：治疗经历、厌食症的作用、自我批评与自我接纳、孤立与联系、绝望与希望、停滞与改变。结果描述了疾病的重要作用、改变的障碍、漫长的改变斗争，以及强化社区治疗如何提供支持。分析提出了改变过程中的必要因素。我们得出结论，这些患者的经历反映了神经性厌食症对每个个体的特殊作用，并且通过长期强化社区治疗，临床恶化和完全康复都可能发生。
