Cummings Melinda Parisi, Alexander Robbi K, Boswell Rebecca G
Graduate Counseling Psychology Department, Holy Family University, Philadelphia, Pennsylvania, USA.
Princeton Center for Eating Disorders, Penn Medicine Princeton Medical Center, Plainsboro, New Jersey, USA.
Int J Eat Disord. 2023 Dec;56(12):2273-2282. doi: 10.1002/eat.24058. Epub 2023 Sep 21.
Approximately 25% of individuals with anorexia nervosa (AN) experience a chronic form of the disorder, referred to as severe and enduring anorexia nervosa (SE-AN). Although the classification of SE-AN remains preliminary, there have been increasing calls for a harm reduction-based, collaborative treatment model for these patients. To provide such care for patients with SE-AN, it is critical to listen to and learn from their lived experiences.
Patients (N = 17) admitted to an inpatient eating disorders program who met initial criteria for SE-AN completed semi-structured interviews about the course of their illness and prior treatment episodes. Interviews were audio recorded and transcribed. Data were analyzed using an inductive, reflexive approach to thematic analysis that examined common themes within and across interviews.
Three themes were identified focused on (1) the all-encompassing nature of SE-AN, (2) treatment experiences, and (3) living with chronic illness. Within these themes, there were subthemes. Overall, individuals noted clear insight about their condition, both negative and positive experiences with previous treatment, and hope for better quality of life despite their illness.
Individuals with SE-AN describe their illness as a chronic condition and hope for a harm reduction-based treatment. Future work, including the lived experiences of individuals with SE-AN, is important to build our understanding of the classification and clinical characteristics of SE-AN and to develop treatment approaches that may best serve these individuals.
Many people with anorexia nervosa do not achieve a full recovery despite repeated treatment episodes throughout their lifespan. Understanding the lived experiences of individuals with SE-AN may help to inform future treatment development efforts that could improve eating disorder and quality of life outcomes for these patients.
约25%的神经性厌食症（AN）患者经历该疾病的慢性形式，即重度及持续性神经性厌食症（SE-AN）。尽管SE-AN的分类仍处于初步阶段，但越来越多的人呼吁为这些患者建立一种基于减少伤害的协作治疗模式。为了为SE-AN患者提供此类护理，倾听并了解他们的生活经历至关重要。
入住住院饮食失调项目且符合SE-AN初步标准的患者（N = 17）完成了关于其疾病病程和既往治疗经历的半结构化访谈。访谈进行了录音和转录。采用归纳性、反思性主题分析方法对数据进行分析，以检查访谈内部和之间的共同主题。
确定了三个主题，重点关注（1）SE-AN的全面性，（2）治疗经历，以及（3）与慢性病共存。在这些主题中，还有子主题。总体而言，患者对自己的病情有清晰的认识，对先前治疗有负面和正面的经历，并且尽管患病仍希望提高生活质量。
SE-AN患者将他们的疾病描述为一种慢性病，并希望采用基于减少伤害的治疗方法。未来的工作，包括SE-AN患者的生活经历，对于增进我们对SE-AN的分类和临床特征的理解以及开发最适合这些患者的治疗方法很重要。
许多神经性厌食症患者尽管在其一生中经历了多次治疗，但仍未完全康复。了解SE-AN患者的生活经历可能有助于为未来的治疗发展努力提供信息，从而改善这些患者的饮食失调状况和生活质量结果。
