Rankin Rebekah, Conti Janet, Ramjan Lucie, Hay Phillipa
Translational Health Research Institute, School of Medicine, Western Sydney University, Sydney, Australia.
School of Psychology, Western Sydney University, Sydney, Australia.
J Eat Disord. 2023 Jun 9;11(1):95. doi: 10.1186/s40337-023-00820-0.
Treatment for anorexia nervosa (AN) is typically delivered on a continuum of care, starting with outpatient treatment, and moving onto intensive outpatient, day or residential treatment and/or inpatient hospitalisation. However, minimal attention has been afforded to the lived experiences of persons undergoing inpatient treatment for AN. In particular, qualitative literature pertaining to the lived experiences of specialist inpatient or residential treatment of AN remains fragmented and incomplete. The aim of this review was to synthesise current literature exploring patients' lived experiences of residential and inpatient treatment for AN within eating disorder-specific treatment services.
Five databases were searched and a qualitative thematic systematic review and meta-synthesis of 11 studies were conducted.
Eleven studies of 159 participants were included. Four meta-themes were constructed from the data: (1) a medical discourse-"I don't think it's individualised here"; (2) restrictive practice-living in a "bubble"; (3) myself, others and "a similar demon"; and (4) I am "not just another anorexic". The data also revealed two cross-cutting themes: (1) more than a single experience; and (2) meaning making and identity.
These findings highlight the complex and multifaceted nature of the inpatient treatment experience as well as the inherent conflicts in balancing the necessity of medical and psychological intervention with person-centred treatment approaches in the treatment of AN.
神经性厌食症（AN）的治疗通常是在连续的护理过程中进行的，从门诊治疗开始，然后过渡到强化门诊、日间或住院治疗和/或住院治疗。然而，对于接受AN住院治疗的患者的生活经历关注甚少。特别是，关于AN专科住院或住院治疗生活经历的定性文献仍然零散且不完整。本综述的目的是综合当前文献，探讨在饮食失调特定治疗服务中患者接受住院和住院治疗的生活经历。
检索了五个数据库，并对11项研究进行了定性主题系统综述和元综合分析。
纳入了11项研究，共159名参与者。从数据中构建了四个元主题：（1）医学话语——“我认为这里没有个性化治疗”；（2）限制性做法——生活在“泡沫”中；（3）我自己、他人和“类似的恶魔”；（4）我“不只是另一个厌食症患者”。数据还揭示了两个贯穿各领域的主题：（1）不止一种经历；（2）意义建构与身份认同。
这些发现凸显了住院治疗经历的复杂性和多面性，以及在AN治疗中平衡医学和心理干预的必要性与人本位治疗方法之间的内在冲突。
