Couturier Jennifer, Pellegrini Danielle, Grennan Laura, Nicula Maria, Miller Catherine, Agar Paul, Webb Cheryl, Anderson Kristen, Barwick Melanie, Dimitropoulos Gina, Findlay Sheri, Kimber Melissa, McVey Gail, Paularinne Rob, Nelson Aylee, DeGagne Karen, Bourret Kerry, Restall Shelley, Rosner Jodi, Hewitt-McVicker Kim, Pereira Jessica, McLeod Martha, Shipley Caitlin, Miller Sherri, Boachie Ahmed, Engelberg Marla, Martin Samantha, Holmes-Haronitis Jennifer, Lock James
McMaster University, Hamilton, ON, Canada.
McMaster Children's Hospital, 1200 Main St W, Hamilton, ON, L8N 3Z5, Canada.
J Eat Disord. 2022 Jul 26;10(1):111. doi: 10.1186/s40337-022-00631-9.
During the COVID-19 pandemic, outpatient eating disorder care, including Family-Based Treatment (FBT), rapidly transitioned from in-person to virtual delivery in many programs. This paper reports on the experiences of teams and families with FBT delivered by videoconferencing (FBT-V) who were part of a larger implementation study.
Four pediatric eating disorder programs in Ontario, Canada, including their therapists (n = 8), medical practitioners (n = 4), administrators (n = 6), and families (n = 5), participated in our study. We provided FBT-V training and delivered clinical consultation. Therapists recorded and submitted their first four FBT-V sessions. Focus groups were conducted with teams and families at each site after the first four FBT-V sessions. Focus group transcripts were transcribed verbatim and key concepts were identified through line-by-line reading and categorizing of the text. All transcripts were double-coded. Focus group data were analyzed using directed and summative qualitative content analysis.
Analysis of focus group data from teams and families revealed four overarching categories-pros of FBT-V, cons of FBT-V, FBT-V process, and suggestions for enhancing and improving FBT-V. Pros included being able to treat more patients and developing a better understanding of family dynamics by being virtually invited into the family's home (identified by teams), as well as convenience and comfort (identified by families). Both teams and families recognized technical difficulties as a potential con of FBT-V, yet teams also commented on distractions in family homes as a con, while families expressed difficulties in developing therapeutic rapport. Regarding FBT-V process, teams and families discussed the importance and challenge of patient weighing at home. In terms of suggestions for improvement, teams proposed assessing a family's suitability or motivation for FBT-V to ensure it would be appropriate, while families strongly suggested implementing hybrid models of FBT in the future which would include some in-person and some virtual sessions.
Team and family perceptions of FBT-V were generally positive, indicating acceptability and feasibility of this treatment. Suggestions for improved FBT-V practices were made by both groups, and require future investigation, such as examining hybrid models of FBT that involve in-person and virtual elements. Trial registration ClinicalTrials.gov NCT04678843 .
在新冠疫情期间，许多项目中的门诊饮食失调护理，包括基于家庭的治疗（FBT），迅速从面对面服务转变为虚拟服务。本文报告了参与一项更大规模实施研究的团队和家庭采用视频会议进行FBT（FBT-V）的经验。
加拿大安大略省的四个儿科饮食失调项目，包括其治疗师（n = 8）、医生（n = 4）、管理人员（n = 6）和家庭（n = 5）参与了我们的研究。我们提供了FBT-V培训并进行临床咨询。治疗师记录并提交了他们的前四次FBT-V治疗。在前四次FBT-V治疗后，在每个地点对团队和家庭进行了焦点小组访谈。焦点小组访谈记录逐字转录，并通过逐行阅读和对文本进行分类来确定关键概念。所有记录都进行了双重编码。使用定向和总结性定性内容分析法对焦点小组数据进行分析。
对团队和家庭焦点小组数据的分析揭示了四个总体类别——FBT-V的优点、FBT-V的缺点、FBT-V的过程以及改进和完善FBT-V的建议。优点包括能够治疗更多患者，以及通过虚拟进入家庭更好地了解家庭动态（团队指出），还有便利性和舒适性（家庭指出）。团队和家庭都认识到技术困难是FBT-V的一个潜在缺点，但团队也提到家庭环境中的干扰是一个缺点，而家庭则表示难以建立治疗融洽关系。关于FBT-V的过程，团队和家庭讨论了患者在家中称重的重要性和挑战。在改进建议方面，团队提议评估家庭对FBT-V的适用性或积极性，以确保其合适，而家庭强烈建议未来实施FBT的混合模式，包括一些面对面和一些虚拟治疗。
团队和家庭对FBT-V的看法总体上是积极的，表明这种治疗方法具有可接受性和可行性。两组都提出了改进FBT-V实践的建议，需要未来进行调查，例如研究涉及面对面和虚拟元素的FBT混合模式。试验注册ClinicalTrials.gov NCT04678843 。
