成年胃肠疾病患者的回避/限制性食物摄入障碍:一种运用进化方法的概念分析

Avoidant/Restrictive Food Intake Disorder in Adult Patients with Gastrointestinal Diseases: A Concept Analysis Using Evolutionary Approach.

作者信息

Che Yunqiu, Li Shuhua, Hu Xiaju, Hu Hongyan, Zhang Can, He Chaozhu

机构信息

School of Nursing, Jiangxi Medical College, Nanchang University, Nanchang, People's Republic of China.

The 1st Affiliated Hospital, Jiangxi Medical College, Nanchang University, Nanchang, People's Republic of China.

出版信息

Risk Manag Healthc Policy. 2025 Jun 21;18:2063-2080. doi: 10.2147/RMHP.S520802. eCollection 2025.

Abstract

BACKGROUND

Avoidant/restrictive food intake disorder is a recently introduced concept, initially focused on non-adult populations, and encompasses multiple dimensions such as physiological and psychological aspects. Due to symptom overlap, food avoidance and related symptoms in patients with gastrointestinal diseases are often overlooked or rationalized. The confusion and unclear definitions of related concepts have hindered further research and exploration.

OBJECTIVE

This study aims to clarify the concept of avoidant/restrictive food intake disorder in adults with gastrointestinal diseases and to enhance clinicians' awareness of this phenomenon.

DESIGN

Rodgers' evolutionary concept analysis.

METHODS

A systematic literature search targeting avoidant/restrictive food intake disorder in adult patients with gastrointestinal diseases was conducted using keywords and entry terms across seven databases, including PubMed, Web of Science, EBSCO, CINAHL, PsycINFO, EMBASE, and CNKI (up to September 28, 2024). A concept analysis framework was employed to identify the concept's attributes, antecedents, consequences, and other defining characteristics.

RESULTS

A total of 22 articles were included. Four attributes of avoidant/restrictive food intake disorder in adult patients with gastrointestinal diseases were extracted and identified: exclusionary/selective diet status, non-body image-related, negative/fearful response, and mixed/independent motivation. Antecedents include gastrointestinal diseases and symptoms, traumatic events and experiences, dietary adversities history, and nutritional misconceptions. Consequences involved nutritional/psychological consequences, poor overall health, complex disease management, and reduced quality of life.

CONCLUSION

We found that avoidant/restrictive food intake disorder in the context of gastrointestinal diseases is a state of disordered eating characterized by food exclusion and selectivity, which may progress into a disorder when its impact on physical or psychological functioning exceeds adaptive threshold. This study clarifies the concept, and the findings provide a basis for developing assessment tools, guiding dietary management, and informing the implementation of targeted interventions in GI patients.

摘要

背景

回避/限制型食物摄入障碍是一个最近引入的概念,最初主要关注非成人人群,涵盖生理和心理等多个维度。由于症状重叠,胃肠道疾病患者的食物回避及相关症状常被忽视或合理化。相关概念的混淆和定义不明确阻碍了进一步的研究和探索。

目的

本研究旨在阐明胃肠道疾病成人患者中回避/限制型食物摄入障碍的概念,并提高临床医生对这一现象的认识。

设计

采用罗杰斯的进化概念分析法。

方法

使用关键词和检索词,在包括PubMed、Web of Science、EBSCO、CINAHL、PsycINFO、EMBASE和中国知网(截至2024年9月28日)在内的七个数据库中,对胃肠道疾病成年患者的回避/限制型食物摄入障碍进行系统的文献检索。采用概念分析框架来确定该概念的属性、前因、后果及其他定义特征。

结果

共纳入22篇文章。提取并确定了胃肠道疾病成年患者回避/限制型食物摄入障碍的四个属性:排他性/选择性饮食状态、与身体形象无关、消极/恐惧反应以及混合/独立动机。前因包括胃肠道疾病及症状、创伤性事件和经历、饮食逆境史以及营养误解。后果涉及营养/心理后果、整体健康状况不佳、复杂的疾病管理以及生活质量下降。

结论

我们发现,胃肠道疾病背景下的回避/限制型食物摄入障碍是一种以食物排除和选择性为特征的饮食紊乱状态,当其对身体或心理功能的影响超过适应阈值时,可能会发展成一种疾病。本研究阐明了这一概念,研究结果为开发评估工具、指导饮食管理以及为胃肠疾病患者实施针对性干预提供了依据。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/4b12/12191178/ba53cabc90b2/RMHP-18-2063-g0001.jpg

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