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与饮食障碍患者一起工作的生活体验:元民族志研究。

The lived experience of working with people with eating disorders: A meta-ethnography.

机构信息

Department of Psychology, Royal Holloway, University of London, Egham, UK.

Nuffield Department of Primary Care Health Sciences, University of Oxford, Oxford, UK.

出版信息

Int J Eat Disord. 2020 Mar;53(3):422-441. doi: 10.1002/eat.23215. Epub 2020 Jan 6.

Abstract

OBJECTIVE

Working with people with eating disorders (EDs) is known to elicit strong emotional reactions, and the therapeutic alliance has been shown to affect outcomes with this clinical population. As a consequence, it is important to understand healthcare professionals' (HCPs') experiences of working with this client group.

METHOD

A meta-synthesis was conducted of qualitative research on HCPs' lived experiences of working with people with EDs. The results from the identified studies were analyzed using Noblit and Hare's meta-ethnographic method. Data were synthesized using reciprocal translation, and a line of argument was developed.

RESULTS

Thirty-seven studies met the inclusion criteria. Reciprocal translation resulted in a key concept: "Coping with caring without curing." This was underpinned by the following third-order concepts: (a) "The dissonance and discomfort of being a helper struggling to help," (b) "Defending against the dissonance," and (c) "Accepting the dissonance to provide safe and compassionate care." These concepts were used to develop a line-of-argument synthesis, which was expressed as a new model for understanding HCPs' experiences of working with people who have an ED.

DISCUSSION

Although the conflict associated with being a helper struggling to help led some HCPs to avoid and blame people with EDs, others adopted a compassionate stance characterized by humanity, humility, balance, and awareness.

摘要

目的

与饮食失调(ED)患者合作会引起强烈的情绪反应,并且治疗联盟已被证明会影响该临床人群的治疗效果。因此,了解医疗保健专业人员(HCPs)与该客户群体合作的经验非常重要。

方法

对 HCPs 与 ED 患者合作的经验进行了定性研究的元综合分析。使用 Noblit 和 Hare 的元人种学方法对确定研究的结果进行了分析。使用相互翻译对数据进行了综合,并提出了一个论点。

结果

有 37 项研究符合纳入标准。相互翻译产生了一个关键概念:“在不治愈的情况下应对关怀。”这是由以下第三个概念支撑的:(a)“作为一个努力帮助的助手的不和谐和不适,”(b)“防御不和谐,”和(c)“接受不和谐以提供安全和富有同情心的护理。”这些概念被用来发展一个论点综合,它被表达为理解 HCPs 与 ED 患者合作经验的新模型。

讨论

尽管与作为一个努力帮助的助手相关的冲突导致一些 HCPs 回避和指责 ED 患者,但其他人则采取了富有同情心的立场,其特点是人道、谦逊、平衡和意识。

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