Davey Emily, Micali Nadia, Bryant-Waugh Rachel, Bennett Sophie D, Lau Charmayne, Shafran Roz
UCL Great Ormond Street Institute of Child Health, University College London, 30 Guilford Street, London, WC1N 1EH, UK.
Center for Eating and Feeding Disorders Research (CEDaR), Mental Health Services of the Capital Region of Denmark, Ballerup Psychiatric Centre, Copenhagen, Denmark.
J Eat Disord. 2024 Sep 30;12(1):149. doi: 10.1186/s40337-024-01113-w.
There is a significant unmet treatment need for children and young people (CYP) with eating disorders. Guided self-help interventions have the potential to expand access to evidence-based treatments. Guided self-help is a type of low intensity psychological intervention where individuals engage with a workbook or online programme, with the support of a health professional. Its primary aim is to equip patients and/or their caregivers with self-management skills. However, little is currently known about the acceptability and suitability of guided self-help interventions for CYP with eating disorders. This study aimed to explore the perspectives of three key stakeholder groups - CYP with lived experience of eating disorders, parents/carers, and healthcare professionals - on guided self-help for this population.
Qualitative focus groups and semi-structured interviews were conducted with 11 CYP (aged 13-19 years) with lived experience of eating disorders, 12 parents/carers, and 10 healthcare professionals. The study comprised a total of seven focus groups (including 2 with CYP, 3 with parent/carers, and 2 with healthcare professionals), as well as four semi-structured interviews (including 3 with CYP and 1 with a parent/carer). Discussion topics included past experiences of using/delivering guided self-help, the suitability of guided self-help for CYP with eating disorders, and preferences towards the content, structure and modes of guided self-help. Data were analysed using reflexive thematic analysis.
Three themes were generated across all three stakeholder groups. Theme one, Bridging the gap, highlighted the role of guided self-help in increasing access to psychological support for CYP with eating disorders. Theme two, Timing matters, considered the suitability of guided self-help for CYP with eating disorders at different stages of illness and the care pathway. Theme three, One size does not fit all, emphasised the heterogeneity of eating disorders and the need for a personalised and flexible approach in guided self-help.
Findings from this study lay a foundation for the future design and delivery of guided self-help interventions for CYP with eating disorders. Future work must consider these findings in the context of best available research evidence to optimise the potential utility of guided self-help for this population.
患有饮食失调症的儿童和青少年（CYP）存在重大未满足的治疗需求。指导性自助干预措施有可能扩大基于证据的治疗方法的可及性。指导性自助是一种低强度心理干预，个体在健康专业人员的支持下使用工作手册或在线程序。其主要目的是使患者和/或其照顾者具备自我管理技能。然而，目前对于患有饮食失调症的CYP而言，指导性自助干预措施的可接受性和适用性知之甚少。本研究旨在探讨三个关键利益相关者群体——有饮食失调症亲身经历的CYP、父母/照顾者以及医疗保健专业人员——对该人群指导性自助的看法。
对11名有饮食失调症亲身经历的CYP（年龄在13 - 19岁之间）、12名父母/照顾者和10名医疗保健专业人员进行了定性焦点小组和半结构化访谈。该研究总共包括七个焦点小组（包括2个CYP小组、3个父母/照顾者小组和2个医疗保健专业人员小组）以及四次半结构化访谈（包括3次CYP访谈和1次父母/照顾者访谈）。讨论主题包括过去使用/提供指导性自助的经历、指导性自助对患有饮食失调症的CYP的适用性以及对指导性自助内容、结构和模式的偏好。使用反思性主题分析法对数据进行了分析。
在所有三个利益相关者群体中产生了三个主题。主题一，弥合差距，强调了指导性自助在增加患有饮食失调症的CYP获得心理支持方面的作用。主题二，时机很重要，考虑了指导性自助在疾病和护理途径不同阶段对患有饮食失调症的CYP的适用性。主题三，一刀切并不适用，强调了饮食失调症的异质性以及在指导性自助中采用个性化和灵活方法的必要性。
本研究结果为未来针对患有饮食失调症的CYP设计和提供指导性自助干预措施奠定了基础。未来的工作必须在现有最佳研究证据的背景下考虑这些结果，以优化指导性自助对该人群的潜在效用。
