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      Resultados de la encuesta sobre unidades asistenciales y atención a trastornos de la conducta alimentaria en España. Grupo de Trabajo sobre Trastornos de la Conducta Alimentaria de SENPE Translated title: Results of the survey on care units and caring for eating disorders in Spain. SENPE Working Group on Eating Disorders

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          Abstract

          Resumen Introducción: los trastornos de la conducta alimentaria (TCA) suponen un reto terapéutico. Objetivo: describir la asistencia a los TCA desde la perspectiva de las unidades de Nutrición Clínica y Dietética (UNCyD) en relación con los recursos humanos y asistenciales, las actividades realizadas y la satisfacción con la atención en España; recoger demandas de los profesionales para mejorar la asistencia. Métodos: estudio transversal y observacional a partir de un cuestionario remitido online a socios de la Sociedad Española de Nutrición Clínica y Metabolismo (SENPE) y al Área de Nutrición de la Sociedad Española de Endocrinología y Nutrición (SEEN). Los datos se analizaron según las camas de los hospitales encuestados (< 500/≥ 500). Resultados: 23 respuestas de 8 comunidades autónomas. En el 87 % de las UNCyD se prestaba atención a los TCA; el 65,2 % contaban con un proceso específico; el 91,3 % colaboraban con Psiquiatría; el 34,8 % tenían área propia de hospitalización; el 56,5 % disponían de hospital de día pero participaban en él el 21,7 %; el 39,1 % tenían consulta monográfica; se realizaba educación nutricional en el 87 %, sobre todo por enfermería; se prescribían frecuentemente dietas individualizadas y suplementos orales en el 39,1 y el 56,5 %, respectivamente; solo los hospitales más grandes participaban en investigación sobre TCA (62,5 %); y el 21,7 % colaboraban con asociaciones de pacientes. Los hospitales con ≥ 500 camas disponían de más recursos y estaban más satisfechos. Los profesionales demandaban recursos y procesos consensuados con Psiquiatría. Conclusiones: los recursos y las prácticas asistenciales son dispares en las UNCyD encuestadas, así como la colaboración multidisciplinar. La evidencia recogida permite diseñar estrategias de mejora en este ámbito.

          Translated abstract

          Abstract Introduction: eating disorders (EDs) entail a therapeutic challenge. Objective: to describe ED care from the perspective of Nutrition Units (NU) in relation to human and care resources, the activities carried out, and satisfaction with care in Spain; to collect demands from professionals to improve assistance. Methods: a cross-sectional, observational study based on a questionnaire sent online to members of the Spanish Society of Clinical Nutrition and Metabolism (SENPE) and to the Nutrition Area of the Spanish Society of Endocrinology and Nutrition (SEEN). The data were analyzed according to number of beds of the hospitals surveyed (< 500/≥ 500). Results: 23 responses from 8 autonomous communities. In 87 % of NUs care was given to eating disorders; 65.2 % had a specific process; 91.3 % collaborated with Psychiatry; 34.8 % had their own hospitalization area; 56.5 % had a day hospital, but 21.7 % participated in it; 39.1 % had a monographic consultation office; nutritional education was carried out in 87 %, especially by nursing; individualized diets and oral supplements were frequently prescribed in 39.1 % and 56.5 %, respectively; only the largest hospitals participated in research on EDs (62.5 %), and 21.7 % collaborated with patient associations. Hospitals with ≥ 500 beds had more resources and were more satisfied. Professionals demanded resources and processes agreed with Psychiatry. Conclusions: resources and care practices are uneven in the NUs surveyed, as well as multidisciplinary collaboration. The collected evidence allows us to design improvement strategies in this area.

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          Incidence, prevalence and mortality of anorexia nervosa and bulimia nervosa

          To review the recent literature on the epidemiology of anorexia nervosa and bulimia nervosa in terms of incidence, prevalence and mortality. Recent findings Although the overall incidence rate of anorexia nervosa is considerably stable over the past decades, the incidence among younger persons (aged <15 years) has increased. It is unclear whether this reflects earlier detection or earlier age of onset. Nevertheless, it has implications for future research into risk factors and for prevention programs. For bulimia nervosa, there has been a decline in overall incidence rate over time. The lifetime prevalence rates of anorexia nervosa might be up to 4% among females and 0.3% among males. Regarding bulimia nervosa, up to 3% of females and more than 1% of males suffer from this disorder during their lifetime. While epidemiological studies in the past mainly focused on young females from Western countries, anorexia nervosa and bulimia nervosa are reported worldwide among males and females from all ages. Both eating disorders may carry a five or more times increased mortality risk. Summary Anorexia nervosa and bulimia nervosa occur worldwide among females and males of all age groups and are associated with an increased mortality risk.
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            ANZAED practice and training standards for dietitians providing eating disorder treatment

            Introduction Dietitians involved in eating disorder treatment are viewed as important members of the multidisciplinary team. However, the skills and knowledge that they require are not well characterised. Therefore, as part of a broader project to identify the key principles and clinical practice and training standards for mental health professionals and dietitians providing eating disorder treatment, the Australia & New Zealand Academy for Eating Disorders (ANZAED) sought to identify the key practice and training standards specific to dietitians. An expert working group of dietitians was convened to draft the initial dietetic standards. After expert review, feedback on the revised standards was then provided by 100 health professionals working within the eating disorder sector. This was collated into a revised version made available online for public consultation, with input received from treatment professionals, professional bodies and consumer/carer organisations. Recommendations Dietitians providing treatment to individuals with an eating disorder should follow ANZAED’s general principles and clinical practice standards for mental health professionals and dietitians. In addition, they should also be competent in the present eating disorder-specific standards based around the core dietetic skills of screening, professional responsibility, assessment, nutrition diagnosis, intervention, monitoring and evaluation. Conclusions These standards provide guidance on the expectations of dietetic management to ensure the safe and effective treatment of individuals with an eating disorder. Implications for professional development content and training providers are discussed, as well as the importance of clinical supervision to support professional self-care and evidence-informed and safe practice for individuals with an eating disorder.
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              Intensive Treatments in Adolescent Anorexia Nervosa

              Approximately one-fifth to one-third of patients with adolescent anorexia nervosa (AN) need intensive care in the course of their illness. This article provides an update and discussion on different levels of intensive care (inpatient treatment (IP), day patient treatment (DP) and home treatment (HoT)) in different health care systems based on recently published literature. Important issues discussed in this article are new recommendations for the refeeding process and the definition of target weight as well as principles of medical stabilization and psychotherapeutic approaches. The pros and cons of longer or shorter hospitalization times are discussed, and the advantages of stepped care and day patient treatment are described. A new promising intensive treatment method involving the patient, their caregivers and the direct home environment is introduced. Parents and caregivers should be included in treatment research to foster collaborative work with the attending clinicians. There is an urgent need to evaluate the mid- to long-term outcomes of various intensive treatment programs to compare their effectiveness and costs across different health care systems. This could help policy makers and other stakeholders, such as public and private insurances, to enhance the quality of eating disorder care.
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                Author and article information

                Journal
                nh
                Nutrición Hospitalaria
                Nutr. Hosp.
                Grupo Arán (Madrid, Madrid, Spain )
                0212-1611
                1699-5198
                February 2023
                : 40
                : 1
                : 213-221
                Affiliations
                [3] Madrid Madrid orgnameUniversidad Complutense de Madrid orgdiv1Facultad de Farmacia orgdiv2Departamento de Nutrición y Ciencias de los Alimentos Spain
                [6] Santiago de Compostela orgnameÁrea de Medicina de la Universidade de Santiago de Compostela orgdiv1Instituto de Investigación Sanitaria de Santiago de Compostela (IDIS). CIBERObn (INS CARLOS III) orgdiv2Servicio de Endocrinología y Nutrición. Área Sanitaria de Santiago de Compostela España
                [8] Málaga orgnameHospital Regional Universitario de Málaga orgdiv1Unidad de Gestión Clínica de Endocrinología y Nutrición España
                [2] Valladolid Castilla y León orgnameUniversidad de Valladolid orgdiv1Facultad de Enfermería orgdiv2Departamento de Nutrición y Dietética Spain
                [9] A Coruña orgnameComplexo Hospitalario Universitario de A Coruña orgdiv1Servicio de Endocrinología y Nutrición orgdiv2Unidad de Nutrición Clínica y Dietética España
                [4] Madrid orgnameHospital Puerta de Hierro Majadahonda orgdiv1Servicio de Endocrinología y Nutrición España
                [1] Madrid Madrid orgnameUniversidad Complutense de Madrid orgdiv1Instituto de Investigación Sanitaria San Carlos orgdiv2Servicio de Endocrinología y Nutrición. Hospital Clínico San Carlos Spain
                [7] Salamanca Castilla y León orgnameUniversidad de Salamanca orgdiv1Hospital Universitario de Salamanca orgdiv2Servicio de Endocrinología y Nutrición Spain
                [5] Madrid Madrid orgnameUniversidad Autónoma de Madrid orgdiv1Hospital Universitario La Paz. Instituto de Investigación Biomédica del Hospital Universitario La Paz orgdiv2Unidad de Nutrición Clínica y Dietética Spain
                Article
                S0212-16112023000100025 S0212-1611(23)04000100025
                10.20960/nh.04500
                dd944c41-ca32-43aa-8675-71384816640f

                This work is licensed under a Creative Commons Attribution-NonCommercial-ShareAlike 4.0 International License.

                History
                : 01 November 2022
                : 25 October 2022
                Page count
                Figures: 0, Tables: 0, Equations: 0, References: 23, Pages: 9
                Product

                SciELO Spain

                Categories
                Grupo de Trabajo SENPE

                Hospitalization,Trastornos del comportamiento alimentario,Encuesta y cuestionarios,Tratamiento ambulatorio,Hospitalización,Tratamiento nutricional,Eating disorders,Surveys and questionnaires,Ambulatory care,Nutrition therapy

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