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医疗服务提供者和领导者对饮食失调筛查的看法以及退伍军人健康管理局临床路径的重要性:一项定性研究。

Provider and leader perspectives on eating disorder screening and the importance of a clinical pathway in the Veterans Health Administration: A qualitative study.

作者信息

Maguen Shira, Snow Jennifer L, Siegel Sarah E, Munro Lindsay Fenn, Huggins Joy, Hamilton Alison B, Masheb Robin M

机构信息

Mental Health Service, San Francisco Veterans Affairs Health Care System.

Veterans Affairs Connecticut Healthcare System.

出版信息

Psychol Serv. 2025 Jun 30. doi: 10.1037/ser0000967.

Abstract

We explored U.S. provider and leader perspectives on eating disorder screening, implementation, and clinical pathways in the Veterans Health Administration using qualitative interviews with 10 medical providers and seven leaders from Veterans Health Administration's National Program Offices ( = 17). Providers included two frontline primary care medical support staff, two nurses, two primary care providers, one dietitian, one women's health provider, one health psychologist, and one weight management program provider. We asked about the utility of screening for eating disorders and potential implementation challenges. The tool was in development at the time the qualitative interviews were conducted so that feedback could be taken into consideration. Rapid qualitative analysis was used to identify themes. Three themes were identified. First, a gap was identified in eating disorder screening, with acknowledgement that there is not a uniform way to systemically screen patients. Second, most agreed that a brief tool such as the one we developed could be helpful in a large health care system, especially a tool with language that was mindful of stigma issues. Third, there was agreement that a screening tool would need to be part of a more extensive clinical pathway that included diagnosis and treatment within the larger health care system. While participants supported the need for an eating disorder screening tool, their perspectives varied on how such a tool would be implemented in a national health care system. Specific recommendations were made for ensuring that there was a clear clinical pathway from the tool to treatment referral to best serve veterans with eating disorders. (PsycInfo Database Record (c) 2025 APA, all rights reserved).

摘要

我们通过对10名医疗服务提供者和退伍军人健康管理局国家项目办公室的7名负责人(共17人)进行定性访谈,探讨了美国医疗服务提供者和负责人对退伍军人健康管理局饮食失调筛查、实施及临床路径的看法。医疗服务提供者包括两名一线初级保健医疗支持人员、两名护士、两名初级保健提供者、一名营养师、一名女性健康提供者、一名健康心理学家和一名体重管理项目提供者。我们询问了饮食失调筛查的效用以及潜在的实施挑战。在进行定性访谈时,该工具正在开发中,以便能够考虑反馈意见。采用快速定性分析来确定主题。确定了三个主题。首先,发现饮食失调筛查存在差距,大家承认没有统一的系统方法来筛查患者。其次,大多数人认为,像我们开发的这种简短工具在大型医疗系统中可能会有所帮助,尤其是一种考虑到污名化问题的语言工具。第三,大家一致认为,筛查工具需要成为更广泛临床路径的一部分,该路径应包括在更大的医疗系统内进行诊断和治疗。虽然参与者支持需要一种饮食失调筛查工具,但他们对于如何在国家医疗系统中实施这样一种工具的看法各不相同。针对确保从工具到治疗转诊有明确的临床路径以最好地服务患有饮食失调症的退伍军人,提出了具体建议。(PsycInfo数据库记录(c)2025美国心理学会,保留所有权利)

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本文引用的文献

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Development and validation of the BRief Eating Disorder Screener (BREDS) for US veterans in healthcare and community settings.
Gen Hosp Psychiatry. 2025 Mar-Apr;93:1-8. doi: 10.1016/j.genhosppsych.2024.12.021. Epub 2024 Dec 27.

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