A day treatment program for adults with eating disorders: staff and patient experiences in implementation

Journal of Eating Disorders

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[1] 0000 0000 9320 7537, grid.1003.2, Psychology, University of Queensland, 4067, St Lucia, Australia;0000 0001 0688 4634, grid.416100.2, Royal Brisbane and Women’s Hospital, Nutrition and Dietetics, Level 2 James Mayne Building, RBWH, 4006, Herston, Australia;Royal Brisbane and Women’s Hopsital, Mental Health Centre, J Floor, 4006, Herston, Australia;

关键词: Eating disorders;    Anorexia nervosa;    Day treatment program;    Patient experience;    Service provider experience;   

DOI  :  10.1186/s40337-019-0252-4

来源: publisher

【 摘 要 】

BackgroundEating disorders are serious conditions which are increasing in prevalence internationally. The causes of these conditions are complex and incompletely understood, and clinical presentations can vary over time. The complexity of these conditions can also complicate treatment. Therefore, stepped care treatment comprising a hierarchy of interventions, including access to day treatment programs (DTPs), is recommended. While studies have examined patient outcomes and provided narrative accounts of these programs, no published studies describe DTP development. This study aims to address this gap by examining development and implementation of a DTP from service providers and patients’ perspectives.MethodsThis study utilised a mixed-methods design to examine the design and implementation of a publicly funded, closed group DTP in Australia. Data from service records and documents were analysed, alongside interviews with patients and interview and focus groups with service providers conducted between June 2016 and July 2017. Quantitative data were analysed using descriptive statistics. Qualitative data were analysed using the Framework Approach.ResultsSeventeen service providers (n = 4 in managerial and n = 13 clinical positions, with clinical experience of 3 months to 20 years) and 11 patients (100% F, 17-33 years) were interviewed. The service providers reported that implementation was a stressful undertaking due to tight timeframes to achieve multiple tasks. Patients had diverse opinions regarding the DTP content and the group treatment experience. Despite this, all patients reported benefits from attending the DTP, varying from improvements in mood, weight gain, development of personal skills and strengths, to living independently. For further benefit, patients suggested that programs could be shaped and targets towards differing patient groups, with fewer breaks throughout treatment.ConclusionsDesigning and implementing a DTP is a challenge and can be a time-intensive undertaking, however the result can be beneficial for both service providers and patients. The closed group format was beneficial in creating a supportive environment, though may have led to increases in additional eating disordered behaviours. While the current structure of this DTP may require reconsideration, organisations considering implementing a new DTP may find usefulness in the overall design described in this study, alongside learning from the issues experienced.

【 授权许可】

CC BY