Thapliyal Priyanka, Hay Phillipa, Conti Janet
1Translational Health Research Institute (THRI), School of Medicine, Western Sydney University, Sydney, NSW Australia.
2School of Social Sciences and Psychology, Western Sydney University, Sydney, NSW Australia.
J Eat Disord. 2018 Aug 13;6:18. doi: 10.1186/s40337-018-0207-1. eCollection 2018.
Traditionally perceived as a disorder of women, Eating Disorders (EDs) are known to have impacts on people irrespective of their gender. This study is designed to synthesise the available qualitative research studies to more broadly understand the diverse experiences of ED and their treatment, specifically in relationship to issues of gender.
The methodology involved a systematic search and quality appraisal of the literature published after 1980 using terms that aimed to represent the primary concepts of "role of gender" and "treatment experiences" and "eating disorders". Nine qualitative studies met the inclusion criteria. Meta-themes were inductively generated through a synthesis of data across themes from the relevant included papers.
Analysis of data was constructed around three meta-themes, each with subthemes. The first meta-theme "Out of sight, out of mind" depicted the experience of gender issues that were marginalised in treatment. More specifically for transgender people, when gender issues were ignored by treatment providers, this frequently led to non-disclosure of their gender identity. Furthermore, men were less likely to be assessed for an eating disorder and within this context; diagnosis of an ED and referral to specialist treatment was frequently hindered. The second meta-theme "Lack of literacy among health care providers" focused on issues related to misdiagnosis of EDs, and the question of whether this was related to a lack of health literacy amongst health professionals. The final theme "Pathways into treatment that address stigma and other barriers" highlighted the need for the development of future treatment interventions address the complex social reality of the experiencing person, including questions of gender.
Gender issues impact upon the ED experience and require broader consideration in the development and evaluation of ED treatment interventions, including the further development of gender-informed interventions.
Protocol registered on PROSPERO 2017 CRD42017082616.
饮食失调（EDs）传统上被认为是女性的疾病，但现在已知它会对任何性别的人产生影响。本研究旨在综合现有的定性研究，以更广泛地了解饮食失调及其治疗的多样经历，特别是与性别问题相关的方面。
该方法包括对1980年后发表的文献进行系统检索和质量评估，使用旨在代表“性别角色”“治疗经历”和“饮食失调”等主要概念的术语。九项定性研究符合纳入标准。通过综合相关纳入论文各主题的数据，归纳得出元主题。
数据分析围绕三个元主题构建，每个元主题都有子主题。第一个元主题“眼不见，心不烦”描述了在治疗中被边缘化的性别问题经历。更具体地说，对于跨性别者，当治疗提供者忽视性别问题时，这常常导致他们不透露自己的性别身份。此外，男性被评估为饮食失调的可能性较小，在此背景下，饮食失调的诊断和转介至专科治疗常常受到阻碍。第二个元主题“医疗保健提供者缺乏知识素养”关注与饮食失调误诊相关的问题，以及这是否与卫生专业人员缺乏健康素养有关。最后一个主题“解决耻辱感和其他障碍的治疗途径”强调了未来治疗干预措施的发展需要解决患者复杂的社会现实问题，包括性别问题。
性别问题会影响饮食失调的经历，在饮食失调治疗干预措施的开发和评估中需要更广泛的考虑，包括进一步开发考虑性别的干预措施。
方案已在PROSPERO 2017上注册，注册号为CRD42017082616。
