Coelho Jennifer S, Suen Janet, Marshall Sheila, Burns Alex, Lam Pei-Yoong, Geller Josie
Provincial Specialized Eating Disorders Program for Children and Adolescents, BC Children's Hospital, 4500 Oak St., Box 150, Vancouver, BC, V6H 3N1, Canada.
Department of Psychiatry, University of British Columbia, Vancouver, BC, Canada.
J Eat Disord. 2021 Jul 27;9(1):92. doi: 10.1186/s40337-021-00449-x.
Parents are integral in the treatment of pediatric eating disorders. The current study was conducted to further understand the barriers and facilitators that parents experience in accessing specialized, tertiary level eating disorder treatment for children and adolescents. The goals of the study were to understand the processes leading to diagnosis and treatment, perceived barriers and facilitators to accessing care, and parents' experiences over the course of their child's eating disorder treatment.
Ten parents whose children were admitted to a Canadian tertiary level specialized pediatric eating disorders program took part in an exit interview upon their child's completion of treatment in the program. In-depth semi-structured interviews were combined with a visual timeline. Interpretive induction was performed to generate high-level concepts that emerged from the interviews.
Five high-level concepts were identified: (1) delays in identifying eating disorder symptoms, (2) challenges in accessing eating disorder services, (3) the right treatment at the right time, (4) emotional impact on parents, and (5) parental expertise and involvement.
Several barriers were identified by parents that interfered with treatment, including system-related challenges when accessing specialized eating disorder treatment, concerns about a lack of appropriate mental health support for their child, and difficulties with transitioning between community and tertiary level care. Negative emotions, including guilt and self-blame, were common early in the treatment journey. Themes of parental involvement throughout treatment, and parents taking charge of their child's recovery, emerged across interviews. The results of this study suggest the importance of early identification of eating disorder symptoms, facilitating smoother transitions between levels of care (e.g., community services and hospital-based eating disorder care), and improving clinical decision-making to ensure children and adolescents with eating disorders receive the most appropriate treatment based on their clinical presentation.
父母在小儿饮食失调的治疗中不可或缺。本研究旨在进一步了解父母在为儿童和青少年寻求专科三级饮食失调治疗时所遇到的障碍和促进因素。该研究的目的是了解导致诊断和治疗的过程、获得护理的感知障碍和促进因素，以及父母在孩子饮食失调治疗过程中的经历。
10名孩子被加拿大三级专科小儿饮食失调项目收治的父母，在孩子完成该项目治疗后接受了出院访谈。深入的半结构化访谈与视觉时间线相结合。进行解释性归纳以生成访谈中出现的高层次概念。
确定了五个高层次概念：（1）饮食失调症状识别延迟，（2）获得饮食失调服务的挑战，（3）在正确的时间得到正确的治疗，（4）对父母的情感影响，以及（5）父母的专业知识和参与度。
父母指出了几个妨碍治疗的障碍，包括在获得专科饮食失调治疗时与系统相关的挑战、对孩子缺乏适当心理健康支持的担忧，以及在社区护理和三级护理之间过渡的困难。在治疗初期，内疚和自责等负面情绪很常见。在整个访谈中都出现了父母在整个治疗过程中的参与以及父母主导孩子康复的主题。本研究结果表明，早期识别饮食失调症状、促进不同护理级别（如社区服务和医院饮食失调护理）之间更顺畅的过渡，以及改善临床决策以确保患有饮食失调的儿童和青少年根据其临床表现获得最合适的治疗非常重要。
