9
views
0
recommends
+1 Recommend
0 collections
    0
    shares
      • Record: found
      • Abstract: found
      • Article: found
      Is Open Access

      A systematic review of people’s lived experiences of inpatient treatment for anorexia nervosa: living in a “bubble”

      research-article

      Read this article at

      Bookmark
          There is no author summary for this article yet. Authors can add summaries to their articles on ScienceOpen to make them more accessible to a non-specialist audience.

          Abstract

          Background

          Treatment for anorexia nervosa (AN) is typically delivered on a continuum of care, starting with outpatient treatment, and moving onto intensive outpatient, day or residential treatment and/or inpatient hospitalisation. However, minimal attention has been afforded to the lived experiences of persons undergoing inpatient treatment for AN. In particular, qualitative literature pertaining to the lived experiences of specialist inpatient or residential treatment of AN remains fragmented and incomplete. The aim of this review was to synthesise current literature exploring patients’ lived experiences of residential and inpatient treatment for AN within eating disorder-specific treatment services.

          Methods

          Five databases were searched and a qualitative thematic systematic review and meta-synthesis of 11 studies were conducted.

          Results

          Eleven studies of 159 participants were included. Four meta-themes were constructed from the data: (1) a medical discourse—“I don’t think it’s individualised here”; (2) restrictive practice—living in a “bubble”; (3) myself, others and “a similar demon”; and (4) I am “not just another anorexic”. The data also revealed two cross-cutting themes: (1) more than a single experience; and (2) meaning making and identity.

          Conclusions

          These findings highlight the complex and multifaceted nature of the inpatient treatment experience as well as the inherent conflicts in balancing the necessity of medical and psychological intervention with person-centred treatment approaches in the treatment of AN.

          Supplementary Information

          The online version contains supplementary material available at 10.1186/s40337-023-00820-0.

          Abstract

          Treatment for anorexia nervosa (AN) is typically delivered on a continuum of care, starting with outpatient treatment, and moving onto intensive outpatient, day or residential treatment and/or inpatient hospitalisation. However, not much is known about the lived experiences of people going through inpatient treatment for AN. An improved understanding of individuals’ treatment experiences is essential in informing the development of new models of care with the potential to improve outcomes. In this systematic review, we examined the lived experiences of individuals going through inpatient treatment for AN available in the current literature. Searching in scientific databases resulted in 10,666 articles, 11 of which met the rigorous inclusion criteria. Four meta-themes and two cross-cutting themes were observed in patient experiences across the studies reviewed. These themes provide insight into the complex and multifaceted nature of the inpatient treatment experience as well as the inherent conflicts in balancing the necessity of medical and psychological intervention with person-centred treatment approaches in the treatment of AN.

          Supplementary Information

          The online version contains supplementary material available at 10.1186/s40337-023-00820-0.

          Related collections

          Most cited references73

          • Record: found
          • Abstract: not found
          • Article: not found

          Thematic Analysis

            Bookmark
            • Record: found
            • Abstract: found
            • Article: found
            Is Open Access

            Methods for the thematic synthesis of qualitative research in systematic reviews

            Background There is a growing recognition of the value of synthesising qualitative research in the evidence base in order to facilitate effective and appropriate health care. In response to this, methods for undertaking these syntheses are currently being developed. Thematic analysis is a method that is often used to analyse data in primary qualitative research. This paper reports on the use of this type of analysis in systematic reviews to bring together and integrate the findings of multiple qualitative studies. Methods We describe thematic synthesis, outline several steps for its conduct and illustrate the process and outcome of this approach using a completed review of health promotion research. Thematic synthesis has three stages: the coding of text 'line-by-line'; the development of 'descriptive themes'; and the generation of 'analytical themes'. While the development of descriptive themes remains 'close' to the primary studies, the analytical themes represent a stage of interpretation whereby the reviewers 'go beyond' the primary studies and generate new interpretive constructs, explanations or hypotheses. The use of computer software can facilitate this method of synthesis; detailed guidance is given on how this can be achieved. Results We used thematic synthesis to combine the studies of children's views and identified key themes to explore in the intervention studies. Most interventions were based in school and often combined learning about health benefits with 'hands-on' experience. The studies of children's views suggested that fruit and vegetables should be treated in different ways, and that messages should not focus on health warnings. Interventions that were in line with these suggestions tended to be more effective. Thematic synthesis enabled us to stay 'close' to the results of the primary studies, synthesising them in a transparent way, and facilitating the explicit production of new concepts and hypotheses. Conclusion We compare thematic synthesis to other methods for the synthesis of qualitative research, discussing issues of context and rigour. Thematic synthesis is presented as a tried and tested method that preserves an explicit and transparent link between conclusions and the text of primary studies; as such it preserves principles that have traditionally been important to systematic reviewing.
              Bookmark
              • Record: found
              • Abstract: found
              • Article: not found

              The PRISMA 2020 statement: An updated guideline for reporting systematic reviews

              The Preferred Reporting Items for Systematic reviews and Meta-Analyses (PRISMA) statement, published in 2009, was designed to help systematic reviewers transparently report why the review was done, what the authors did, and what they found. Over the past decade, advances in systematic review methodology and terminology have necessitated an update to the guideline. The PRISMA 2020 statement replaces the 2009 statement and includes new reporting guidance that reflects advances in methods to identify, select, appraise, and synthesise studies. The structure and presentation of the items have been modified to facilitate implementation. In this article, we present the PRISMA 2020 27-item checklist, an expanded checklist that details reporting recommendations for each item, the PRISMA 2020 abstract checklist, and the revised flow diagrams for original and updated reviews.
                Bookmark

                Author and article information

                Contributors
                r.rankin3@westernsydney.edu.au
                Journal
                J Eat Disord
                J Eat Disord
                Journal of Eating Disorders
                BioMed Central (London )
                2050-2974
                9 June 2023
                9 June 2023
                2023
                : 11
                : 95
                Affiliations
                [1 ]GRID grid.1029.a, ISNI 0000 0000 9939 5719, Translational Health Research Institute, School of Medicine, , Western Sydney University, ; Sydney, Australia
                [2 ]GRID grid.1029.a, ISNI 0000 0000 9939 5719, School of Psychology, , Western Sydney University, ; Sydney, Australia
                [3 ]GRID grid.1029.a, ISNI 0000 0000 9939 5719, School of Nursing and Midwifery, , Western Sydney University, ; Sydney, Australia
                [4 ]GRID grid.410692.8, ISNI 0000 0001 2105 7653, Campbelltown Hospital, , South West Sydney Local Health District (SWSLHD), ; Sydney, Australia
                Article
                820
                10.1186/s40337-023-00820-0
                10257311
                64c305f7-6e07-4265-9444-5359a6cc3981
                © The Author(s) 2023

                Open Access This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/. The Creative Commons Public Domain Dedication waiver ( http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated in a credit line to the data.

                History
                : 15 March 2023
                : 6 June 2023
                Categories
                Research
                Custom metadata
                © BioMed Central Ltd., part of Springer Nature 2023

                eating disorder,anorexia nervosa,inpatient treatment,systematic review,meta-synthesis,qualitative,therapy,intervention,refeeding,lived experience

                Comments

                Comment on this article

                scite_

                Similar content545

                Most referenced authors1,350