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饮食失调治疗从面对面到线上的突然转变:对COVID-19封锁期间患者观点的初步考察

The abrupt transition from face-to-face to online treatment for eating disorders: a pilot examination of patients' perspectives during the COVID-19 lockdown.

作者信息

Lewis Yael Doreen, Elran-Barak Roni, Grundman-Shem Tov Rinat, Zubery Eynat

机构信息

Hadarim Eating Disorders Treatment Center, Shalvata Mental Health Center, Hod Hasharon, Israel.

Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel.

出版信息

J Eat Disord. 2021 Mar 5;9(1):31. doi: 10.1186/s40337-021-00383-y.


DOI:10.1186/s40337-021-00383-y
PMID:33673876
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC7934980/
Abstract

BACKGROUND: Studies investigating patients' perspectives towards an abrupt transition from face-to-face to online treatment in eating disorders (EDs) are scarce. The current study aimed to (1) conduct a preliminary assessment of patients' perspectives regarding this transition, and (2) explore potential demographic, clinical, and treatment-related factors associated with these perspectives. METHODS: Sixty-three patients with EDs whose treatment was moved to an online format, were surveyed during the COVID-19 lockdown (April-May 2020). A 6-item measure was developed to examine their perspectives toward this transition. Exploratory factor analyses (EFAs) were conducted to confirm the rational-theoretical structure of the measure (Eigenvalue = 3.745, explaining 62.4% of variance). The Cronbach's alpha value was excellent (α = 0.878). Validated questionnaires were used to measure ED symptoms, general psychopathology, therapeutic alliance, and pandemic anxiety, and their associations with our transition-focused scale and telemedicine satisfaction were examined. RESULTS: Mixed views were found regarding the transition, with the majority (68%) stating that they would not choose to continue online therapy given the option. Longer duration of treatment (r = 0.291, p = 0.022), stronger therapeutic alliance (r = 0.293, p = 0.028), and higher COVID-19 anxiety (r = 0.276, p = 0.029) were linked with more positive views towards the transition. CONCLUSIONS: Analyses suggest that patients' perspectives towards the transition can be measured using a Likert-type 6-item scale. Findings highlight the various responses to online treatment and indicate a need to identify patients who may face difficulties in the transition to this newly ubiquitous treatment mode. Clinicians should be cognizant of these potential difficulties and consider appropriate modes of treatment in the ongoing pandemic situation.

摘要

背景:关于饮食失调(EDs)患者对从面对面治疗突然转变为在线治疗的看法的研究很少。本研究旨在:(1)对患者关于这种转变的看法进行初步评估;(2)探索与这些看法相关的潜在人口统计学、临床和治疗相关因素。 方法:在2020年4月至5月新冠疫情封锁期间,对63名治疗方式转为在线形式的饮食失调患者进行了调查。开发了一个包含6个条目的量表来检查他们对这种转变的看法。进行探索性因素分析(EFA)以确认该量表的合理理论结构(特征值 = 3.745,解释了62.4%的方差)。克朗巴哈α值极佳(α = 0.878)。使用经过验证的问卷来测量饮食失调症状、一般精神病理学、治疗联盟和大流行焦虑,并检查它们与我们以转变为重点的量表和远程医疗满意度之间的关联。 结果:对于这种转变存在不同看法,大多数(68%)表示如果有选择,他们不会选择继续在线治疗。治疗时间较长(r = 0.291,p = 0.022)、治疗联盟更强(r = 0.293,p = 0.028)以及对新冠疫情的焦虑程度更高(r = 0.276,p = 0.029)与对这种转变更积极的看法相关。 结论:分析表明,可以使用一个6项李克特式量表来测量患者对这种转变的看法。研究结果突出了对在线治疗的各种反应,并表明需要识别出在向这种新的普遍治疗模式转变过程中可能面临困难的患者。临床医生应认识到这些潜在困难,并在当前的疫情形势下考虑适当的治疗方式。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/bd8e/7936497/7c466627f3fe/40337_2021_383_Fig1_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/bd8e/7936497/7c466627f3fe/40337_2021_383_Fig1_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/bd8e/7936497/7c466627f3fe/40337_2021_383_Fig1_HTML.jpg

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本文引用的文献

[1]
Challenges and opportunities for enhanced cognitive behaviour therapy (CBT-E) in light of COVID-19.

Cogn Behav Therap. 2020-5-4

[2]
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Eur Eat Disord Rev. 2020-9-20

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Int J Eat Disord. 2020-8-25

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Eur Eat Disord Rev. 2020-8-7

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Int J Environ Res Public Health. 2020-7-27

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Int J Eat Disord. 2020-7-28

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Eat Disord. 2022

[8]
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Eur Eat Disord Rev. 2020-7-9

[9]
Factors associated with depression, anxiety, and PTSD symptomatology during the COVID-19 pandemic: Clinical implications for U.S. young adult mental health.

Psychiatry Res. 2020-6-1

[10]
Eating disorders in the age of COVID-19.

Psychiatry Res. 2020-5-29

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