Provincial Specialized Eating Disorders Program for Children and Adolescents, BC Children's Hospital, Vancouver, British Columbia, Canada.
Department of Psychiatry, University of British Columbia, Vancouver, British Columbia, Canada.
Int J Eat Disord. 2021 Apr;54(4):587-594. doi: 10.1002/eat.23438. Epub 2020 Dec 10.
The current study explored the experience and familiarity of pediatric health professionals with avoidant/restrictive food intake disorder (ARFID), and assessed the application of diagnostic criteria in a series of clinical vignettes.
Pediatric health professionals were invited to complete an online survey. Data from 93 health professionals from medical and allied health roles who completed the survey were analyzed.
Respondents providing care for pediatric feeding/eating disorders were more likely to report familiarity with ARFID than those not typically providing care for feeding/eating disorders. Clinicians who had provided care for pediatric ARFID reported more confidence in clinical management of ARFID than did those who had not yet provided care for ARFID, though there were overall relatively low levels of confidence in providing care for ARFID. Respondents to the clinical vignettes were more likely to confer a diagnosis of ARFID when there were symptoms of both psychosocial impairment and weight loss than when there was psychosocial impairment alone.
The results suggest variability in current application of diagnostic criteria for ARFID, low confidence in clinical management of ARFID, and ambiguity in clinicians' judgments regarding whether psychosocial impairment is sufficient to meet a diagnosis of ARFID.
本研究探讨了儿科医护人员对回避/限制型食物摄入障碍(ARFID)的经验和熟悉程度,并评估了在一系列临床病例中应用诊断标准的情况。
邀请儿科医护人员完成在线调查。对完成调查的 93 名来自医疗和相关健康角色的医护人员的数据进行了分析。
提供儿科喂养/进食障碍护理的受访者比那些通常不提供喂养/进食障碍护理的受访者更有可能报告熟悉 ARFID。有过儿科 ARFID 护理经验的临床医生比没有提供过 ARFID 护理的临床医生对 ARFID 的临床管理更有信心,但总体而言,对提供 ARFID 护理的信心相对较低。在出现心理社会障碍和体重减轻的症状时,临床病例中的受访者更有可能诊断为 ARFID,而仅出现心理社会障碍时则不太可能。
结果表明,目前 ARFID 诊断标准的应用存在差异,对 ARFID 的临床管理缺乏信心,以及临床医生在判断心理社会障碍是否足以满足 ARFID 诊断时存在模糊性。