Barnet, Enfield and Haringey Mental Health NHS Trust, Enfield, UK.
Florence Nightingale Faculty of Nursing, Midwifery & Palliative Care, King's College London, London, UK.
Eur Eat Disord Rev. 2024 Jul;32(4):731-747. doi: 10.1002/erv.3081. Epub 2024 Mar 11.
To systematically review the literature on clinicians' and patients' experiences of supported mealtimes in the treatment of anorexia nervosa.
This systematic review was conducted in accordance with PRISMA guidelines and registered on PROSPERO (CRD42022372565). PsycINFO, MEDLINE and Embase were searched up to the 20 of November 2023 for qualitative articles investigating the perspectives of healthcare professionals and patients on clinician-supported meals across all clinical settings. Data were analysed using thematic synthesis. The Critical Appraisal Skills Programme was used to evaluate the quality of selected studies.
This review comprised of 26 studies; eight concerned with the perspectives of clinicians only, 16 addressing patients' views, and two studies exploring the views of both groups. Experiences of both groups were generally negative, and three overlapping themes were identified: lack of consistency in care provided, high levels of negative emotions and an uncomfortable power dynamic.
This review suggests that supported mealtimes are experienced more positively by patients when rules are clear and consistently enforced, and when clinicians make informal conversation and supportive comments. Our findings highlight the need for best practice guidelines and clinician training to improve the delivery of supported mealtimes. Such guidelines and training should be coproduced in collaboration with patients and carers.
系统综述临床医生和患者在治疗神经性厌食症中支持用餐的体验。
本系统评价按照 PRISMA 指南进行，并在 PROSPERO（CRD42022372565）上进行了注册。截至 2023 年 11 月 20 日，通过 PsycINFO、MEDLINE 和 Embase 检索了所有临床环境中调查医疗保健专业人员和患者对临床医生支持的膳食的观点的定性文章。使用主题合成法对数据进行分析。使用批判性评估技能计划来评估选定研究的质量。
本综述包括 26 项研究；8 项研究关注临床医生的观点，16 项研究探讨了患者的观点，2 项研究探讨了两组的观点。两组的经验普遍负面，确定了三个重叠的主题：提供的护理缺乏一致性、负面情绪水平高以及令人不舒服的权力动态。
本综述表明，当规则明确并始终得到执行，并且临床医生进行非正式对话和提供支持性评论时，患者对支持用餐的体验更为积极。我们的研究结果强调了制定最佳实践指南和临床医生培训的必要性，以改善支持用餐的实施。此类指南和培训应与患者和护理人员合作共同制定。
