Spigel Rebecca, Lin Jessica A, Milliren Carly E, Freizinger Melissa, Vitagliano Julia A, Woods Elizabeth R, Forman Sara F, Richmond Tracy K
Division of Adolescent and Young Adult Medicine, Boston Children's Hospital, 300 Longwood Ave, Boston, MA, 02115, USA.
Department of Pediatrics, Harvard Medical School, 25 Shattuck Street, Boston, MA, 02115, USA.
J Eat Disord. 2021 Jun 10;9(1):69. doi: 10.1186/s40337-021-00421-9.
Shelter-in-place orders and social distancing guidelines, in response to the COVID-19 pandemic, have limited traditional face-to-face interactions and led to many clinical providers transitioning to the use of videoconferencing platforms. The present study aims to assess how the COVID-19 pandemic has impacted adolescents'/young adults' (AYA) eating disorder (ED)-related care, and how access to, changes in, perceived disruptions to, and quality of care are associated with ED thoughts and behaviors.
AYA enrolled in the RECOVERY study, a pre-existing web-based longitudinal study, and completed a COVID-19-specific survey (n = 89). We examined bivariate associations of four markers of care: i) access to care, ii) changes in care, iii) perceived disruption to care, and iv) quality of care. Using multiple logistic regression, we examined the associations of pandemic-related markers of care with changes in ED thoughts and behaviors. We excluded those not engaged in treatment pre-pandemic (n = 16).
In the remaining 73 participants, reported access to care was high, with 92% of respondents continuing care with at least one ED provider during the pandemic; however, 47% stopped some treatment during the pandemic. Nearly one-third (32%) perceived a disruption in treatment. Quality of care remained high with 67% reporting care to be better than or as good as pre-pandemic. Respondents acknowledged heightened symptomatology: 81% reported increased ED thoughts and 81% reported increased ED behaviors due to COVID-19-related factors. However, none of the markers of care described were significantly associated with ED thoughts or behaviors in regression analyses adjusting for demographic variables and baseline characteristics, except our quality of care measure which was approaching significance (p = 0.07).
Our findings show the majority of AYA who had care prior to the pandemic continued receiving some element of their multi-disciplinary ED treatment and perceived their care as high quality. None of the markers of care described were statistically associated with increased ED thoughts and behaviors.
为应对新冠疫情，居家隔离令和社交距离指导方针限制了传统的面对面互动，导致许多临床医疗服务提供者转而使用视频会议平台。本研究旨在评估新冠疫情如何影响青少年/青年（AYA）的饮食失调（ED）相关护理，以及护理的可及性、变化、感知到的干扰和质量与饮食失调的想法和行为之间的关联。
参与“康复”研究（一项现有的基于网络的纵向研究）的青少年/青年完成了一项针对新冠疫情的调查（n = 89）。我们研究了护理的四个指标的双变量关联：i）护理的可及性，ii）护理的变化，iii）感知到的护理干扰，以及iv）护理质量。使用多元逻辑回归，我们研究了与疫情相关的护理指标与饮食失调想法和行为变化之间的关联。我们排除了疫情前未接受治疗的参与者（n = 16）。
在其余73名参与者中，报告的护理可及性较高，92%的受访者在疫情期间继续接受至少一名饮食失调治疗提供者的护理；然而，47%的人在疫情期间停止了一些治疗。近三分之一（32%）的人认为治疗受到了干扰。护理质量仍然很高，67%的人报告护理比疫情前更好或一样好。受访者承认症状有所加重：81%的人报告由于与新冠疫情相关的因素，饮食失调的想法增加，81%的人报告饮食失调行为增加。然而，在对人口统计学变量和基线特征进行调整的回归分析中，所描述的护理指标均与饮食失调的想法或行为无显著关联，除了我们的护理质量指标接近显著水平（p = 0.07）。
我们的研究结果表明，大多数在疫情前接受护理的青少年/青年继续接受多学科饮食失调治疗的某些部分，并认为他们得到了高质量的护理。所描述的护理指标均与饮食失调想法和行为的增加无统计学关联。
