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针对暴饮暴食症和神经性贪食症的虚拟交付式引导自助:一项服务评估的结果

Virtually delivered guided self-help for binge eating disorder and bulimia nervosa: findings from a service evaluation.

作者信息

Dalton Bethan, Davies Molly R, Flynn Michaela, Hutchings-Hay Chloe, Potterton Rachel, Breen O'Byrne Eleanor, Kilonzo Charmaine, Belli Stefano R, Gallop Lucy, Gordon Gemma, Keeler Johanna, Minnock Imelda, Phillips Matthew, Robinson Lauren, Snashall Emma, Toloza Cindy, Walo Luiza, Cole Jason, Schmidt Ulrike

机构信息

South London and Maudsley NHS Foundation Trust, Maudsley Hospital, Denmark Hill, London, UK.

Department of Psychological Medicine, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, UK.

出版信息

Behav Cogn Psychother. 2024 May;52(3):211-225. doi: 10.1017/S1352465823000607. Epub 2024 Jan 24.

Abstract

BACKGROUND

Timely intervention is beneficial to the effectiveness of eating disorder (ED) treatment, but limited capacity within ED services means that these disorders are often not treated with sufficient speed. This service evaluation extends previous research into guided self-help (GSH) for adults with bulimic spectrum EDs by assessing the feasibility, acceptability, and preliminary effectiveness of virtually delivered GSH using videoconferencing.

METHOD

Patients with bulimia nervosa (BN), binge eating disorder (BED) and other specified feeding and eating disorders (OSFED) waiting for treatment in a large specialist adult ED out-patient service were offered virtually delivered GSH. The programme used an evidence-based cognitive behavioural self-help book. Individuals were supported by non-expert coaches, who delivered the eight-session programme via videoconferencing.

RESULTS

One hundred and thirty patients were allocated to a GSH coach between 1 September 2020 and 30 September 2022; 106 (82%) started treatment and 78 (60%) completed treatment. Amongst completers, there were large reductions in ED behaviours and attitudinal symptoms, measured by the ED-15. The largest effect sizes for change between pre- and post-treatment were seen for binge eating episode frequency ( = -0.89) and concerns around eating ( = -1.72). Patients from minoritised ethnic groups were over-represented in the non-completer group.

CONCLUSIONS

Virtually delivered GSH is feasible, acceptable and effective in reducing ED symptoms amongst those with bulimic spectrum disorders. Implementing virtually delivered GSH reduced waiting times, offering a potential solution for long waiting times for ED treatment. Further research is needed to compare GSH to other brief therapies and investigate barriers for patients from culturally diverse groups.

摘要

背景

及时干预有利于饮食失调(ED)治疗的效果,但ED服务能力有限意味着这些疾病往往得不到足够快的治疗。这项服务评估通过评估使用视频会议虚拟提供的引导式自助(GSH)对贪食症谱系ED成人患者的可行性、可接受性和初步有效性,扩展了先前对GSH的研究。

方法

在一家大型成人专科ED门诊等待治疗的神经性贪食症(BN)、暴饮暴食症(BED)和其他特定的喂养和进食障碍(OSFED)患者接受了虚拟提供的GSH。该项目使用了一本基于证据的认知行为自助书籍。个体由非专业教练提供支持,教练通过视频会议提供为期八节的课程。

结果

在2020年9月1日至2022年9月30日期间,130名患者被分配给一名GSH教练;106名(82%)开始治疗,78名(60%)完成治疗。在完成治疗的患者中,通过ED-15测量,ED行为和态度症状有大幅减少。治疗前后变化的最大效应量出现在暴饮暴食发作频率(=-0.89)和对饮食的担忧(=-1.72)方面。少数族裔患者在未完成治疗的群体中占比过高。

结论

虚拟提供的GSH在减少贪食症谱系障碍患者的ED症状方面是可行、可接受且有效的。实施虚拟提供的GSH减少了等待时间,为ED治疗的长时间等待提供了一个潜在的解决方案。需要进一步研究将GSH与其他简短疗法进行比较,并调查来自不同文化群体患者的障碍。

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