Development of a clinical pathway for screening and integrated care of eating disorders in a rural substance use treatment setting

Abstract

Eating and substance use disorders frequently co-occur in clinical samples. This comorbidity presents a particular challenge due to increased medical complications, higher relapse rates, psychiatric comorbidity, and poorer overall outcomes for both disorders, and is associated with specific medical and psychiatric difficulties that contribute to complexity in diagnosis and treatment. However, patients with co-occurring substance use and eating disorders do not widely receive structured standardized assessment or treatment for eating disorders in substance use treatment settings. Focus groups were conducted to seek clinician's knowledge and perceptions of screening and care planning for eating disorder presentations in a rural substance use treatment setting. The study adheres to COREQ guidelines. To analyse the focus group data, the authors utilized thematic analysis and three major themes emerged as follows: beliefs about clients (stereotypical views, complexity of comorbidity, client expectations), understanding of self (lack of knowledge/skills, professional role), and organizational barriers and enablers. Whilst identifying a significant number of clinician and organizational barriers to providing screening and treatment of eating disorders in a substance use treatment setting, focus group discussions also highlighted a number of potential enablers. Most notably clinicians identified a willingness to provide screening and care planning if they were provided with education, a clinical pathway and access to screening tools. A consensus conferencing approach facilitated construction of a clinical pathway to enable the service to provide screening, assessment, and treatment planning for clients with comorbid eating disorder.

Effect Analysis of Clinical Pathway Nursing Combined with Humanized Nursing in Cerebral Infarction

“…We optimize the clinical nursing process, clarify the specific nursing operation in each time period, implement targeted and planned nursing intervention, effectively identify and prevent emergencies in nursing, and then reduce the occurrence of emergencies. Moreover, it can actively guide patients to actively cooperate with the development of treatment and nursing and ultimately effectively shorten the recovery process of patients' physical health [ 17 , 18 ]. Clinical pathway nursing was practiced in patients suffering from cerebral infarction; the first is to carry out health education for patients and promote the understanding of the disease and treatment of patients so that they actively cooperate with the development of treatment and nursing.…”

A scoping review of the barriers and facilitators to accessing and utilising mental health services across regional, rural, and remote Australia

“…Limited resources. Across the studies, the most considerable barrier was limited resources [ 18 , 33 – 36 , 38 , 39 , 42 , 45 , 50 – 56 , 58 – 66 , 71 , 74 , 75 , 78 – 80 , 82 ]. This key concept considered limited resources at the healthcare provider and service user level.…”

“…System complexity and navigation. The complexity in using and navigating the system was a common aspatial barrier [ 18 , 33 , 36 , 40 – 42 , 45 , 46 , 51 – 53 , 57 – 59 , 61 , 63 , 65 , 66 , 69 , 73 , 74 , 78 , 80 ], which affected healthcare providers in coordinating patient care and service users in utilising such care. These issues were most frequently reflected in reports on extended wait times and delays in assessment and diagnosis [ 34 , 40 , 46 , 53 , 55 , 57 , 58 , 62 , 66 , 78 , 80 ].…”

Emerging trends and patterns in healthcare-seeking behavior: A systematic review

“…In terms of the geographical distribution of scientific achievements (as shown in Table 1), the United States has the highest number of publications, with 82 documents, followed by China (34), Australia (6), and the United Kingdom (5). This may reflect the attention and investment of these countries in the field of healthcare and medical research over the past few decades.…”

“…[1,2] The study of healthcare-seeking behavior can date back to the 1950s when the rise of medical sociology began. Medical Behavior initial research mainly focuses on the decisionmaking process of medical behavior, mainly in psychology and sociology research, [3,4] with time, medical behavior research content and research methods are also developing, involving clinical medicine, [5,6] economics, [7,8] public health, [9][10][11] and other disciplines, research content mainly involves the influencing factors of medical behavior, [12] different groups [13] or disease types [14,15] public medical characteristics, etc. The deep integration of Internet technology and the medical industry is an important direction for the development of the medical industry, and hospitals are moving towards interconnection, sharing, mobile, collaboration, and wisdom.…”