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“众人拾柴火焰高”:饮食失调住院治疗患者的生活经历

'It takes a village': patient lived experiences of residential treatment for an eating disorder.

作者信息

Rankin Rebekah, Conti Janet, Ramjan Lucie, Hay Phillipa

机构信息

Translational Health Research Institute, School of Medicine, Western Sydney University, Sydney, Australia.

School of Psychology, Western Sydney University, Sydney, Australia.

出版信息

BJPsych Open. 2025 Feb 3;11(2):e30. doi: 10.1192/bjo.2024.849.

Abstract

BACKGROUND

Residential treatment facilities for eating disorders are becoming increasingly common and purport to provide recovery-orientated care in a less restrictive environment than traditional hospital settings. However, minimal attention has focused on individuals' lived experiences of these residential services.

AIMS

This study explores participants' lived experiences of care at Australia's first residential facility for the treatment of eating disorders.

METHOD

Qualitative data were collected as part of a clinical evaluation (June 2021 to August 2023). Fifteen women participated in semi-structured interviews about their experience of treatment following discharge. Data were analysed with inductive reflexive thematic analysis.

RESULTS

Three main themes were generated from the data that included participants' journeys to treatment, experiences of treatment and the transitions associated with and following discharge. Cutting across these main themes were participants' encounters of barriers, setbacks and hope. Participant experiences of residential treatment were complex and multifaceted, marked by inherent ideological dilemmas that arose in balancing standardised treatment protocols with person-centred and recovery-oriented care. Participants also spoke of reclaiming a sense of self and identity beyond their eating disorder, emphasising the importance of relationships and consistent and collaborative care.

CONCLUSIONS

Participant accounts of residential treatment emphasised the importance of holistic, person-centred and recovery-oriented care. Despite the complexities of treatment experiences, participant narratives underscored how recovery may be more about the reclamation of a sense of identity outside of the eating disorder than merely symptom improvement. As such, adopting person-centred and recovery-oriented treatment approaches within residential treatment settings may maximise individual autonomy and promote holistic recovery pathways.

摘要

背景

饮食失调的住院治疗机构越来越普遍,旨在提供比传统医院环境限制更少的以康复为导向的护理。然而,很少有人关注个人在这些住院服务中的实际生活经历。

目的

本研究探讨参与者在澳大利亚首个饮食失调住院治疗机构的护理实际生活经历。

方法

作为临床评估(2021年6月至2023年8月)的一部分收集定性数据。15名女性参与了关于出院后治疗经历的半结构化访谈。采用归纳反思性主题分析法对数据进行分析。

结果

数据产生了三个主要主题,包括参与者的治疗历程、治疗经历以及出院时和出院后的转变。贯穿这些主要主题的是参与者遇到的障碍、挫折和希望。参与者的住院治疗经历复杂且多面,其特点是在平衡标准化治疗方案与以患者为中心和以康复为导向的护理时出现了内在的意识形态困境。参与者还谈到在饮食失调之外重新找回自我意识和身份认同,强调关系以及持续和协作护理的重要性。

结论

参与者对住院治疗的描述强调了整体、以患者为中心和以康复为导向的护理的重要性。尽管治疗经历复杂,但参与者的叙述强调,康复可能更多地是关于在饮食失调之外重新找回身份认同感,而不仅仅是症状改善。因此,在住院治疗环境中采用以患者为中心和以康复为导向的治疗方法可能会最大限度地提高个人自主性并促进整体康复途径。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/611a/11822953/81b4dbcd9c94/S2056472424008494_fig1.jpg

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