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Minding the adolescent in family-based inpatient treatment for anorexia nervosa: a qualitative study of former inpatients’ views on treatment collaboration and staff behaviors
BMC Psychology ( IF 2.7 ) Pub Date : 2019-11-14 , DOI: 10.1186/s40359-019-0348-2
Jan-Vegard Nilsen , Trine Wiig Hage , Øyvind Rø , Inger Halvorsen , Hanne Weie Oddli

For some young persons diagnosed with anorexia nervosa, treatment will inevitably involve phases where hospitalization is required. Inspired by the encouraging evidence-base for outpatient family-based treatment for adolescent anorexia nervosa, clinicians and program developers have started to incorporate outpatient family-based treatment principles into higher levels of care. During family-based inpatient treatment, collaborative efforts are largely directed toward the parents of the adolescent. Consequently, the therapeutic focus on the young person is more of an indirect one. With this study we aimed to understand how young persons with lived experience from a family-based inpatient treatment setting, where the adolescents were admitted together with their parents, viewed therapeutic aspects related to staff-patient collaboration and staff-related behaviors. Thirty-seven semi-structured interviews of former adolescent inpatients were conducted. Participants’ post-treatment reflections were inductively analyzed by applying a thematic analytic framework. Based upon user perspectives from a treatment setting highly influenced by a family therapeutic approach, findings revealed that former inpatients prefer tailored treatment and a collaborative approach. Eight subthemes constituting two main themes emerged: 1) There are no ready-made solutions. Staff should facilitate collaboration by tailoring treatment toward the young person’s perspectives, and 2) Emphasizing skills that matter. Staff should display a non-judgmental stance, educate patients, stimulate motivation, enable activities and prevent iatrogenic effects during the stay. This study adds valuable user perspectives to the ongoing work with adapting family-based frameworks into higher levels of care. Clinicians could benefit from viewing their practice from the standpoint of the young person’s post-treatment reflections. From their unique perspectives as having lived experience and hence, “insider knowledge” with a specific treatment situation, clinicians are reminded of the importance of being mindful on the young persons’ views.

中文翻译:

考虑青少年在家庭性神经性厌食症住院治疗中的研究:定性研究原住院患者对治疗协作和员工行为的看法

对于一些被诊断患有神经性厌食症的年轻人,治疗将不可避免地涉及需要住院的阶段。受令人鼓舞的青少年神经性厌食症门诊家庭治疗依据的启发,临床医生和项目开发人员已开始将门诊家庭性治疗原则纳入更高水平的护理中。在以家庭为基础的住院治疗期间,合作努力主要针对青少年的父母。因此,对年轻人的治疗重点更多是间接的。通过这项研究,我们旨在了解如何从有家庭经验的住院治疗的年轻人那里获得生活经验,在那里他们与父母一起入住了青少年,查看了与医患合作和员工相关行为有关的治疗方面。对前青少年住院患者进行了三十七次半结构化访谈。通过应用主题分析框架对参与者的治疗后思考进行归纳分析。从用户的角度出发,从受到家庭治疗方式高度影响的治疗设置来看,研究结果表明,以前的住院患者更喜欢量身定制的治疗和协作方式。构成两个主要主题的八个子主题出现了:1)没有现成的解决方案。员工应通过针对年轻人的观点量身定制治疗方法,以促进协作,以及2)强调重要技能。工作人员应表现出非判断性的立场,教育患者,激发动力,在住宿期间进行活动并防止医源性影响。这项研究通过将基于家庭的框架调整到更高级别的护理中,为正在进行的工作增加了宝贵的用户观点。从年轻人的治疗后反思的角度来看,临床医生可以从他们的实践中受益。从其经验丰富的独特观点出发,并因此从具有特定治疗情况的“内幕知识”中,提醒临床医生注意年轻人观点的重要性。
更新日期:2019-11-14
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