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饮食失调治疗中的协作式照护:探讨临床医生的痛苦、自我同情及对他人的同情所起的作用。

Collaborative care in eating disorders treatment: exploring the role of clinician distress, self-compassion, and compassion for others.

作者信息

Geller Josie, Fernandes Avarna, Kelly Allison C, Samson Lindsay, Srikameswaran Suja

机构信息

St. Paul's Hospital Eating Disorders Program, 1081 Burrard Street, Vancouver, BC, V6Z 1Y6, Canada.

Department of Psychiatry, University of British Columbia, Vancouver, Canada.

出版信息

J Eat Disord. 2023 Apr 6;11(1):57. doi: 10.1186/s40337-023-00741-y.

Abstract

BACKGROUND

Collaborative care is described as showing curiosity and concern for patient experiences, providing choices, and supporting patient autonomy. In contrast, in directive care, the clinician has authority and the patient is expected to adhere to a treatment plan over which they have limited influence. In the treatment of eating disorders, collaborative care has been shown to be more acceptable and produce better outcomes than directive care. Despite widespread patient and clinician preference for collaborative care, it is common for clinicians to be directive in practice, resulting in negative patient attitudes toward treatment and poor adherence. There is a need to understand factors which contribute to its use.

PURPOSE

This study examined the contribution of clinicians' experience of distress and how they relate to themselves and others in times of difficulty (self-compassion and compassion for others), to their use of collaborative support.

METHOD

Clinicians working with individuals with eating disorders from diverse professional backgrounds (N = 123) completed an online survey.

RESULTS

Whereas clinician distress was not associated with use of collaborative or directive support behaviours, self-compassion and compassion for others were. Regression analyses indicated that compassion for others was the most important determinant of collaborative care.

DISCUSSION

Relating to their own and others' distress with compassion was most important in determining clinicians' use of collaborative support. Understanding how to cultivate conditions that foster compassion in clinical environments could promote the delivery of collaborative care.

摘要

背景

协作式护理被描述为对患者体验表现出好奇心和关切、提供选择并支持患者自主性。相比之下,在指导性护理中,临床医生拥有权威,患者需遵循他们影响力有限的治疗计划。在饮食失调的治疗中,协作式护理已被证明比指导性护理更易被接受且效果更好。尽管患者和临床医生普遍倾向于协作式护理,但临床医生在实践中采用指导性方式很常见,这导致患者对治疗持消极态度且依从性差。有必要了解促成这种做法的因素。

目的

本研究考察了临床医生的痛苦体验以及他们在困难时期如何与自己及他人相处(自我同情和对他人的同情)对其使用协作式支持的影响。

方法

来自不同专业背景、治疗饮食失调患者的临床医生(N = 123)完成了一项在线调查。

结果

临床医生的痛苦与使用协作式或指导性支持行为无关,而自我同情和对他人的同情则与之相关。回归分析表明,对他人的同情是协作式护理的最重要决定因素。

讨论

以同情的方式对待自己和他人的痛苦在决定临床医生使用协作式支持方面最为重要。了解如何营造在临床环境中培养同情心的条件可能会促进协作式护理的实施。

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