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饮食失调经历及其病因认知:一项为遗传咨询实践提供信息的定性研究。

Experiences of having an eating disorder and perceptions of its etiology: A qualitative study to inform genetic counseling practice.

作者信息

Wang Cecily, Slomp Caitlin, Austin Jehannine J

机构信息

Genetic Counseling Program, MGH Institute of Health Professions, Boston, Massachusetts, USA.

Department of Psychiatry, University of British Columbia, Vancouver, British Columbia, Canada.

出版信息

J Genet Couns. 2025 Aug;34(4):e70086. doi: 10.1002/jgc4.70086.

DOI:10.1002/jgc4.70086
PMID:40734264
Abstract

There has been limited research regarding how people with eating disorders (EDs) perceive the causes of these conditions. We conducted an interpretive description study to explore the perceived causes of EDs among individuals with a history of EDs, and to examine how healthcare professionals (HCPs) can provide better care for people with these conditions. We interviewed 15 diverse individuals, with emphasis on gender and racial diversity, with a history of EDs about their perceived etiologies of their EDs, what they wished the public and HCPs knew about EDs, and their thoughts on a 3-min video explaining the multifactorial etiology of EDs. After "line-by-line" coding, themes were used to inductively develop a model to describe individuals' experiences of EDs. Participants' narrative about their experiences of their EDs focused on the condition arising from multiple identity- and environment-related causes, which contributed to a negative cycle of emotions that led to feelings of isolation. Perceptions of the cause of EDs and access to treatment were influenced by systemic issues (e.g., racism, sexism), lack of knowledge about, and stigma associated with EDs. Participants wanted personalized care that acknowledges the factors they perceive to contribute to their ED. Our findings support previous work-showing that the causes of EDs are perceived to be complex, and that shame, stigma, guilt, and self-denial are barriers to treatment. It is important for HCPs to provide holistic, empathic care for people with EDs and acknowledge the systemic issues that affect EDs.

摘要

关于饮食失调症(EDs)患者如何看待这些病症的成因,相关研究有限。我们开展了一项诠释性描述研究,以探究有饮食失调症病史的个体对饮食失调症成因的认知,并考察医疗保健专业人员(HCPs)如何能为患有这些病症的人提供更好的护理。我们采访了15名不同的个体,重点关注性别和种族多样性情况,这些个体都有饮食失调症病史,并询问了他们对自身饮食失调症病因学的认知、他们希望公众和医疗保健专业人员了解的关于饮食失调症的内容、以及他们对一段解释饮食失调症多因素病因学的3分钟视频的看法。经过“逐行”编码后,利用主题归纳出一个模型,以描述个体饮食失调症的经历。参与者讲述他们饮食失调症经历时聚焦于该病症源于多种与身份和环境相关的原因,这些原因导致了负面情绪循环,进而产生孤立感 。对饮食失调症病因的认知以及获得治疗的机会受到系统性问题(如种族主义、性别歧视)、对饮食失调症缺乏了解以及与饮食失调症相关的污名化观念等影响 。参与者希望得到个性化护理,并认可他们认为导致自身饮食失调症的因素。我们的研究结果支持了此前的研究——表明饮食失调症的病因被认为很复杂;羞耻感、污名化观念、内疚感以及自我否定是治疗的障碍。医疗保健专业人员为饮食失调症患者提供全面、共情的护理,并认识到影响饮食失调症的系统性问题,这很重要

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本文引用的文献

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Behavioral Changes after Psychiatric Genetic Counseling: An Exploratory Study.精神疾病遗传咨询后的行为改变:一项探索性研究。
Public Health Genomics. 2023;26(1):35-44. doi: 10.1159/000530366. Epub 2023 Apr 5.
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It's not all about control: challenging mainstream framing of eating disorders.这并非完全关乎控制:挑战饮食失调的主流框架。
J Eat Disord. 2023 Feb 19;11(1):25. doi: 10.1186/s40337-023-00752-9.
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Considerations for the use of qualitative methodologies in genetic counseling research.基因咨询研究中定性方法的使用考量
J Genet Couns. 2023 Apr;32(2):300-314. doi: 10.1002/jgc4.1644. Epub 2022 Oct 22.
4
What next for eating disorder genetics? Replacing myths with facts to sharpen our understanding.进食障碍遗传学的下一步是什么?用事实取代神话,以加深我们的理解。
Mol Psychiatry. 2022 Oct;27(10):3929-3938. doi: 10.1038/s41380-022-01601-y. Epub 2022 May 20.
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Weight stigma in healthcare settings is detrimental to health and must be eradicated.医疗环境中的体重歧视对健康有害,必须予以消除。
Nat Rev Endocrinol. 2022 Jul;18(7):387-388. doi: 10.1038/s41574-022-00686-3.
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Gender differences in symptom presentation and treatment outcome in children and youths with eating disorders.患有饮食失调症的儿童和青少年在症状表现及治疗结果方面的性别差异。
J Eat Disord. 2021 Sep 15;9(1):113. doi: 10.1186/s40337-021-00468-8.
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Eating Disorders in the Adolescent Patient.青少年患者中的饮食失调症。
Dent Clin North Am. 2021 Oct;65(4):689-703. doi: 10.1016/j.cden.2021.06.009. Epub 2021 Aug 2.
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Eating disorder symptomatology in transgender patients: Differences across gender identity and gender affirmation.跨性别患者的饮食障碍症状:性别认同和性别肯定的差异。
Int J Eat Disord. 2021 Aug;54(8):1493-1499. doi: 10.1002/eat.23539. Epub 2021 May 15.
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