Vinchenzo Cecilia, Lawrence Vanessa, McCombie Catherine
Department of Health Services and Population Research, Institute of Psychiatry, Psychology and Neuroscience, King's College London, The David Goldberg Centre, De Crespigny Lane, PO26, London, SE5 8AF, UK.
J Eat Disord. 2022 Mar 16;10(1):39. doi: 10.1186/s40337-022-00568-z.
High rates of premature treatment termination are a well-reported issue in eating disorder treatment, and present a significant barrier for treatment effectiveness and longer term health outcomes of patients with eating disorders. Understanding patient perspectives on this phenomenon is essential in improving treatment completion rates and informing research and intervention development. The aim of this review is to synthesise qualitative literature on patient perspectives of premature termination of eating disorder treatment and to summarise the key issues leading to discontinuation of treatment.
A systematic review of 1222 articles was conducted to identify studies using qualitative methods to investigate patient experiences of prematurely terminating eating disorder treatment. Ten articles were included in the review, with thematic synthesis used to analyse the primary research and develop overarching analytical themes.
Conflict around enmeshment of eating disorder with identity, and lack of support with reconstructing a sense of self without the eating disorder; challenges of managing pressures of social and clinical relationships while feeling unheard and misunderstood by both; expectations and disappointments around treatment; and dissatisfaction with progress were key themes behind premature termination of treatment.
The findings of this review demonstrate the key issues influencing the decision to end treatment early, highlighting the contribution of individual, environmental, and service-level factors. Implications of these factors are discussed and suggestions raised for future research and service development.
在饮食失调治疗中，过早终止治疗的比例很高，这是一个已有充分报道的问题，并且对治疗效果以及饮食失调患者的长期健康结果构成了重大障碍。了解患者对这一现象的看法对于提高治疗完成率以及为研究和干预措施的制定提供信息至关重要。本综述的目的是综合关于患者对饮食失调治疗过早终止看法的定性文献，并总结导致治疗中断的关键问题。
对1222篇文章进行了系统综述，以确定使用定性方法调查患者过早终止饮食失调治疗经历的研究。该综述纳入了10篇文章，采用主题综合法分析主要研究并形成总体分析主题。
饮食失调与身份认同交织方面的冲突，以及在没有饮食失调的情况下重建自我意识缺乏支持；在感觉未被社会和临床关系中的双方倾听和理解的同时，应对这些关系压力的挑战；对治疗的期望和失望；以及对进展的不满，是治疗过早终止背后的关键主题。
本综述的结果表明了影响提前结束治疗决定的关键问题，突出了个体、环境和服务层面因素的作用。讨论了这些因素的影响，并对未来研究和服务发展提出了建议。
