Factors impacting treatment and recovery in Anorexia Nervosa: qualitative findings from an online questionnaire

Abstract

BackgroundAnorexia nervosa (AN) is characterised by restriction of energy intake, fear of gaining weight and severe disturbances in weight or shape. Recovery from AN is a complicated and often multifaceted experience that can take many years to achieve. Qualitative research has found that support, being understood, hope, desire for recovery, positive experiences in treatment, self-efficacy, motivation and relationships are important in recovery from AN. The experience of treatment for patients with an eating disorder is an important aspect of recovery with the potential to enhance recovery or hinder it. The aim of the questionnaire was to better understand factors impacting the care experiences during treatment and or recovery from self-reported Anorexia Nervosa (AN).MethodAn online questionnaire was developed and administered to past or current sufferers of Anorexia Nervosa, ≥18 years of age. Participants were recruited through eating disorder organisations both in Australia and the United Kingdom. The questionnaire was a mixture of quantitative and qualitative questions. The quantitative data was analysed using descriptive statistics and the qualitative data was analysed using conventional content analysis (CCA).ResultsOf those who responded, most currently experienced self-reported AN. The quantitative results identified that most participants had trust and confidence in their health care provider and felt listened to and supported yet on the subject of the suitability of treatment this had varied opinions. Being understood, hope (life after AN) and self-acceptance were considered the top three important factors in the treatment and recovery from Anorexia Nervosa. The qualitative results revealed the factors hindering or benefiting treatment and recovery, and individuals’ needs during the four phases of recovery.ConclusionFactors were identified that could either hinder or benefit treatment and recovery and these included whether treatment supported the individual to cope with change, whether the individual found the treatment to be appropriate for their personal needs and whether treatment addressed underlying factors. Individuals’ needs differed during the four phases of recovery. The findings of the study may help treatment providers address key factors involved in recovery at the right stage of treatment however by the nature of the qualitative methodology conclusions are putative and further definitive research is indicated.

Getting Well Is More Than Gaining Weight – Patients’ Experiences of a Treatment Program for Anorexia Nervosa Including Ear Acupuncture

“…In this theme, the participants expressed that true recovery meant a long process involving a lot more than just gaining weight. This supports research showing the need for multifaceted care that can cover somatic as well as psychological and psychosocial issues (Clark & Nayar, 2012;Fogarty & Ramjan, 2016). Needs are different in different states of recovery from AN (Fogarty & Ramjan, 2016).…”

“…This supports research showing the need for multifaceted care that can cover somatic as well as psychological and psychosocial issues (Clark & Nayar, 2012;Fogarty & Ramjan, 2016). Needs are different in different states of recovery from AN (Fogarty & Ramjan, 2016). At a very low BMI physical health, when self-efficacy, and even lives are in danger, out-patient care is not sufficient and a higher level of care is needed (Hilbert et al, 2017;Murray et al, 2019;Strober & Johnson, 2012).…”

“…Their stories of different treatments during many years of illness illustrated the complexity and the long and intense suffering that came with AN. The patients expressed gratitude for the treatment program, but also a lack of an individualized care which is worrying as this factor is important for recovery from AN (Fogarty & Ramjan, 2016;Strober & Johnson, 2012). Participants demanded personalization of treatments and to be able to make choices about their therapeutic process, which is connected to a growing feeling of well-being (Roberti di Sarsina, Alivia, & Guadagni, 2012).…”

Exploring nurses’ and patients’ perceptions of hope and hope‐engendering nurse interventions in an eating disorder facility: A descriptive cross‐sectional study

“…Although hope has been associated with better outcomes for patients with EDs (Acharya & Agius, ; Fogarty & Ramjan, ; Jewell, Blessitt, Stewart, Simic, & Eisler, ; Las Hayas et al, ; Pivarunas, ; Ramjan et al, ), there is limited literature on hope‐engendering actions used by healthcare professionals and the efficacy of those actions. It has been established that hope and suicidality must be addressed in the treatment of those with EDs (Berglund et al, ; Wright, ); however, limited data are available about hope in this patient population and the influence of hope‐engendering nurse actions.…”

“…Herth () considers hope to be multidimensional, contributing to coping, and influencing wellness. Researchers have demonstrated that treatment which engenders hope and connectedness is essential to recovery from EDs (Fogarty & Ramjan, ; Pivarunas, ; Ramjan, Fogarty, Nicholls, & Hay, ).…”