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饮食失调治疗中自主性的丧失:患者视角

The Loss of Autonomy in Eating Disorder Treatment: A Patient Perspective.

作者信息

Healey Hannah

机构信息

Health and Rehabilitation Sciences, Western University, London, Ontario, Canada.

出版信息

J Psychiatr Ment Health Nurs. 2025 Apr;32(2):482-486. doi: 10.1111/jpm.13132. Epub 2024 Nov 1.

DOI:10.1111/jpm.13132
PMID:39485021
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC11891432/
Abstract

INTRODUCTION

In this text, the author's lived experiences as a youth with anorexia nervosa, anxiety, and depression are explored. Experiences with accessing North American health services, both in specialized eating disorder (ED) and disordered eating (DE) settings, as well as in healthcare more broadly are shared.

AIM

This work seeks to shed light on a patient perspective in mental health and to draw attention to some of the ways that the current framings of EDs and DE within the biomedical system might perpetuate harm.

METHODS

In this piece, a collection of the author's lived-experiences and interactions with the healthcare system are explored.

FINDINGS

The medical framing of EDs as a defect of both mind and body can jeopardize one's autonomy and contribute to a sense of hopelessness. As mental health treatment increasingly prioritizes evidence-based approaches and standardized practices, there is a growing concern that this shift risks undermining the autonomy of those it aims to support. The dualistic conceptualizations of mental and physical health in ED/DE treatment, at times, can cause harm, particularly for those who do not present with the physical manifestations of an ED/DE but remain largely affected in day-to-day life.

DISCUSSION

The imposition of rigid treatment regimens can inadvertently diminish personal agency, overshadowing the nuanced, individualized needs and preferences of patients. Lived experience narratives encompass the personal, subjective insights of individuals navigating mental health challenges, in turn, providing invaluable insight that conventional methods may overlook.

摘要

引言

本文探讨了作者作为一名患有神经性厌食症、焦虑症和抑郁症的青少年的生活经历。分享了在北美专门的饮食失调(ED)和饮食紊乱(DE)环境以及更广泛的医疗保健环境中获得医疗服务的经历。

目的

这项工作旨在揭示心理健康方面的患者视角,并提请注意生物医学系统中当前对饮食失调和饮食紊乱的界定方式可能会延续伤害的一些方式。

方法

在这篇文章中,探讨了作者的生活经历以及与医疗保健系统的互动。

研究结果

将饮食失调医学界定为身心缺陷可能会危及一个人的自主权,并导致绝望感。随着心理健康治疗越来越优先考虑循证方法和标准化做法,人们越来越担心这种转变有可能损害其旨在支持的人的自主权。饮食失调/饮食紊乱治疗中对心理健康和身体健康的二元概念化有时可能会造成伤害,特别是对于那些没有饮食失调/饮食紊乱的身体表现但在日常生活中仍受到很大影响的人。

讨论

强加严格的治疗方案可能会无意中削弱个人能动性,使患者细微的、个性化的需求和偏好黯然失色。生活经历叙事包含了个人在应对心理健康挑战时的主观见解,反过来提供了传统方法可能忽略的宝贵见解。

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本文引用的文献

1
"You Don't Look Anorexic": Atypical anorexia patient experiences of weight stigma in medical care.“你看起来不像是厌食症患者”:医疗中非典型厌食症患者的体重污名体验。
Body Image. 2023 Sep;46:48-61. doi: 10.1016/j.bodyim.2023.04.008. Epub 2023 May 24.
2
Food for Thought: A Dissonance Between Healthcare Utilization Costs and Research Funding for Eating Disorders in Canada.值得思考的问题:加拿大饮食失调症的医疗利用成本与研究资金之间的不协调
J Can Acad Child Adolesc Psychiatry. 2021 Aug;30(3):197-203. Epub 2021 Aug 1.
3
Disparities in eating disorder diagnosis and treatment according to weight status, race/ethnicity, socioeconomic background, and sex among college students.大学生中根据体重状况、种族/民族、社会经济背景和性别存在的饮食失调诊断和治疗差距。
Int J Eat Disord. 2018 Jun;51(6):518-526. doi: 10.1002/eat.22846. Epub 2018 Mar 2.