Yim See Heng, Schmidt Ulrike
South London and Maudsley NHS Foundation Trust, London, UK.
Institute of Psychiatry, Psychology and Neuroscience, Department of Psychological Medicine, King's College London, De Crespigny Park, Box P059, London, SE5 8AF, UK.
J Eat Disord. 2024 Aug 20;12(1):120. doi: 10.1186/s40337-024-01070-4.
Although there have been qualitative meta-syntheses on experiences of eating disorders treatments, there is a paucity of syntheses specifically examining the perspectives and experiences of eating disorders treatments (ED) in East Asia (EA). Such synthesis could facilitate a better understanding of culture-specific perspectives and experiences. This review complements a quantitative scoping review published on ED treatments in EA (Yim & Schmidt, 2023), where most interventions reviewed focused on cognitive behavioural therapy (CBT) and internet interventions. The present meta-synthesis summarises stakeholders' views on treatments and to synthesise clinical and research recommendations.
A systematic search of five databases and a citation search were conducted to identify relevant studies and data were analysed using thematic synthesis. Out of the 301 studies found, a total of 12 papers were included in the analysis.
A diverse range of treatments, such as family therapy, paediatric/psychiatric inpatient care, CBT, and counselling, were discussed. Three overarching themes were identified: Delineating Physical and Psychological Recovery; 'I am not alone in this battle'; and Barriers to Change. The themes further delve into the various obstacles to recovery, including financial concerns and limited access to professionals and services. Culture-specific factors include family obligations and promoting family harmony. Balancing interdependence and independence from one's family, as well as understanding family body ideals versus broader societal body ideals, are important considerations in ED interventions.
Some themes paralleled other qualitative syntheses, highlighting improved family relationships, perceived authoritarianism in treatments, and financial barriers. The review extends beyond the previous findings, revealing nuanced factors like family roles, cultural values, and norms. Clinical recommendations include incorporating family context in treatment and considering cultural influences on body image ideals. Capacity building through telemedicine and increased training is essential for advancing ED treatment in East Asia. Continued research is needed to better understand and treat people affected by ED in EA.
尽管已有关于饮食失调治疗经验的定性元综合研究，但专门审视东亚地区饮食失调治疗观点和经验的综合研究却很匮乏。这样的综合研究有助于更好地理解特定文化背景下的观点和经验。本综述对已发表的关于东亚地区饮食失调治疗的定量范围综述（Yim & Schmidt，2023年）起到补充作用，在该综述中，所审查的大多数干预措施都集中在认知行为疗法（CBT）和网络干预上。本元综合研究总结了利益相关者对治疗的看法，并综合了临床和研究建议。
对五个数据库进行系统检索，并进行引文检索以识别相关研究，然后使用主题综合分析法对数据进行分析。在所发现的301项研究中，共有12篇论文纳入分析。
讨论了多种治疗方法，如家庭治疗、儿科/精神科住院治疗、认知行为疗法和咨询。确定了三个总体主题：界定身体和心理康复；“这场战斗中我并不孤单”；以及改变的障碍。这些主题进一步深入探讨了康复过程中的各种障碍，包括经济担忧以及获得专业人员和服务的机会有限。特定文化因素包括家庭义务和促进家庭和谐。在饮食失调干预中，平衡与家庭的相互依存和独立，以及理解家庭身体理想与更广泛社会身体理想之间的关系是重要的考量因素。
一些主题与其他定性综合研究相似，突出了改善家庭关系、治疗中感知到的专制以及经济障碍。本综述超越了先前的研究结果，揭示了家庭角色、文化价值观和规范等细微因素。临床建议包括在治疗中纳入家庭背景，并考虑文化对身体形象理想的影响。通过远程医疗进行能力建设和增加培训对于推进东亚地区的饮食失调治疗至关重要。需要持续进行研究，以更好地理解和治疗东亚地区受饮食失调影响的人群。
