Gustafsson Sanna Aila, Stenström Karin, Olofsson Hanna, Pettersson Agneta, Wilbe Ramsay Karin
School of Law, Psychology and Social Work, Örebro University, University Health Care Research Center, 701 82, Örebro, Sweden.
Swedish Agency for Health Technology Assessment and Assessment of Social Services, P.O. Box 6183, 102 33, Stockholm, Sweden.
J Eat Disord. 2021 Dec 4;9(1):156. doi: 10.1186/s40337-021-00507-4.
Eating disorders are serious conditions that cause major suffering for patients and their families. Better knowledge about perceptions of eating disorders and their treatment, and which factors that facilitate or hinder recovery, is desired in order to develop the clinical work. We aimed to explore and synthesise experiences of eating disorders from the perspectives of those suffering from an eating disorder, their family members and health care professionals through an overarching meta-review of systematic reviews in the field.
A systematic literature search was conducted in the databases PubMed, PsycInfo, Scopus, and CINAHL. Inclusion criteria were systematic reviews of qualitative research on experiences, perceptions, needs, or desires related to eating disorders from the perspective of patients, family members or health care professionals. Systematic reviews that fulfilled the inclusion criteria were assessed for relevance and methodological limitations by at least two researchers independently. The key findings were analysed and synthesised into themes.
We identified 17 systematic reviews that met our inclusion criteria. Of these, 13 reviews reported on the patients' perspective, five on the family members' perspective, and three on the health care professionals' perspective. The study population in the reviews was predominantly girls and young women with anorexia nervosa, whilst systematic reviews focusing on other eating disorders were scarce. The findings regarding each of the three perspectives resulted in themes that could be synthesised into three overarching themes: 1) being in control or being controlled, 2) balancing physical recovery and psychological needs, and 3) trusting relationships.
There were several similarities between the views of patients, family members and health care professionals, especially regarding the significance of building trustful therapeutic alliances that also included family members. However, the informants sometimes differed in their views, particularly on the use of the biomedical model, which was seen as helpful by health care professionals, while patients and family members felt that it failed to address their psychological distress. Acknowledging these differences is important for the understanding of anorexia nervosa and other eating disorders, and may help clinicians to broaden treatment approaches to meet the expectations of patients and family members.
饮食失调是严重的疾病，给患者及其家人带来巨大痛苦。为了改进临床工作，需要更好地了解对饮食失调及其治疗的看法，以及哪些因素促进或阻碍康复。我们旨在通过对该领域系统评价的全面元分析，从饮食失调患者、其家庭成员和医护人员的角度探索和综合饮食失调的经验。
在PubMed、PsycInfo、Scopus和CINAHL数据库中进行系统的文献检索。纳入标准是从患者、家庭成员或医护人员的角度对与饮食失调相关的经历、看法、需求或愿望进行定性研究的系统评价。至少两名研究人员独立评估符合纳入标准的系统评价的相关性和方法学局限性。对关键发现进行分析并归纳为主题。
我们确定了17篇符合纳入标准的系统评价。其中，13篇评价报告了患者的观点，5篇报告了家庭成员的观点，3篇报告了医护人员的观点。评价中的研究对象主要是患有神经性厌食症的女孩和年轻女性，而关注其他饮食失调的系统评价很少。关于这三个观点的研究结果形成了一些主题，这些主题可以综合为三个总体主题：1）掌控或被掌控；2）平衡身体康复和心理需求；3）信任关系。
患者、家庭成员和医护人员的观点有一些相似之处，特别是在建立包括家庭成员在内的信任治疗联盟的重要性方面。然而，受访者的观点有时存在差异，特别是在生物医学模式的使用上，医护人员认为它有帮助，而患者和家庭成员则认为它未能解决他们的心理困扰。认识到这些差异对于理解神经性厌食症和其他饮食失调很重要，可能有助于临床医生拓宽治疗方法，以满足患者和家庭成员的期望。
