Nurses' perception of knowledge, attitudes and reported practice towards patients with eating disorders: A concurrent mixed-methods study

Seah, Xin Yi; Tham, Xiang Cong; Kamaruzaman, Netty Ryanie Binte; Klainin‐Yobas, Piyanee

doi:10.1016/j.apnu.2017.11.011

Cited by 10 publications

(14 citation statements)

References 40 publications

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“…Participants described feeling awkward about intently monitoring service users to prevent ED behaviors: “They have to have somebody sitting in their room all day long with them….I feel uncomfortable for them” (nurse; Harken et al, , p. e38). Some noted that this entailed a lot of work: “General psychiatric is easier…there's [fewer things] to look out for…Compared to the ED is how you eat, what you eat, what you drink, how much you drink, where are you, what you doing…everything” (nurse; Seah et al, , p. 141). Participants articulated a feeling that their behaviors and/or appearance were scrutinized by service users, resulting in fear about saying or doing the wrong thing, particularly when inexperienced.…”

Section: Resultsmentioning

confidence: 99%

“…I am a model of relationships, and if I am doing that…that is not therapeutic” (therapist; Oyer et al, , p. 132). Some HCPs mindfully observed and positively framed the watchfulness of service users as an opportunity to model a healthy relationship with one's body (Palmer, ; Seah et al, ). Meanwhile, certain HCPs with a personal history of ED emphasized the need for self‐awareness, including knowing one's residual symptoms (Williams & Haverkamp, ).…”

Section: Resultsmentioning

confidence: 99%

“…as an opportunity to model a healthy relationship with one's body (Palmer, 2015;Seah et al, 2018). Meanwhile, certain HCPs with a personal history of ED emphasized the need for self-awareness, including knowing one's residual symptoms (Williams & Haverkamp, 2015).…”

Section: Mindful Awareness Acceptance and Self-observationmentioning

confidence: 99%

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The lived experience of working with people with eating disorders: A meta‐ethnography

Graham

Tierney

Chisholm

et al. 2020

Intl J Eating Disorders

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Objective Working with people with eating disorders (EDs) is known to elicit strong emotional reactions, and the therapeutic alliance has been shown to affect outcomes with this clinical population. As a consequence, it is important to understand healthcare professionals' (HCPs') experiences of working with this client group. Method A meta‐synthesis was conducted of qualitative research on HCPs' lived experiences of working with people with EDs. The results from the identified studies were analyzed using Noblit and Hare's meta‐ethnographic method. Data were synthesized using reciprocal translation, and a line of argument was developed. Results Thirty‐seven studies met the inclusion criteria. Reciprocal translation resulted in a key concept: “Coping with caring without curing.” This was underpinned by the following third‐order concepts: (a) “The dissonance and discomfort of being a helper struggling to help,” (b) “Defending against the dissonance,” and (c) “Accepting the dissonance to provide safe and compassionate care.” These concepts were used to develop a line‐of‐argument synthesis, which was expressed as a new model for understanding HCPs' experiences of working with people who have an ED. Discussion Although the conflict associated with being a helper struggling to help led some HCPs to avoid and blame people with EDs, others adopted a compassionate stance characterized by humanity, humility, balance, and awareness.

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Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

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The lived experience of working with people with eating disorders: A meta‐ethnography

Graham

Tierney

Chisholm

et al. 2020

Intl J Eating Disorders

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“…It is well documented that health professional’s attitudes directly impact upon the quality and provision of care provided to individuals with eating disorders (McNicholas et al 2016; Seah et al 2017; Seah et al 2018). A systematic review of the knowledge, attitudes, and challenges of healthcare professionals managing people with eating disorders identified common findings of knowledge gaps, low levels of confidence in capability to manage eating disorder patients, and a tendency for the majority of healthcare professionals to view patients with eating disorders in a negative manner (Seah et al 2017).…”

Section: Introductionmentioning

confidence: 99%

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

Evans¹,

Horn²,

Cowan³

et al. 2020

Int J Mental Health Nurs

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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.

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“…Staff often find it challenging to work with people with eating disorders (EDs) (Davey, Arcelus, & Munir, ; Pemberton & Fox, ; Seah, Tham, Kamaruzaman, & Yobas, ). One factor that has been associated with improved recovery is a positive therapeutic relationship between health care professionals (HCPs) and people with an ED; this can be achieved by staff expressing feelings of solidarity, being open, and engendering trust (Salzmann‐Erikson & Dahlen, ).…”

Section: Introductionmentioning

confidence: 99%

Perceptions of the “anorexic voice”: A qualitative study of health care professionals

Graham

Tierney

Chisholm³

et al. 2019

Clin Psychology and Psychoth

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People with anorexia nervosa (AN) often report experiencing a highly critical inner voice (AV) focused on their eating, shape, and weight. There are promising preliminary findings for its role in the treatment of AN, and the support of staff is vital for the AV to be embedded in treatment, but their views remain unknown. The aims of this study were to undertake a qualitative exploration of the perceptions of the AV among health care professionals (HCPs) in specialist eating disorder services. A thematic analysis was applied to interviews with 15 HCPs, including nurses, therapists, psychiatrists, health care assistants, psychologists, and dietitians. Two overarching themes were identified: "The AV is a vehicle for increasing compassion" and "It's not a one-size-fits-all." The AV was seen as a means of developing and sustaining compassion, but participants noted that it does not resonate for all clients. All HCPs in this study believed that there was potential benefit in utilizing the AV in their work with people with AN, and it is likely that doing so would help to reduce burnout and frustration within clinical teams.

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Nurses' perception of knowledge, attitudes and reported practice towards patients with eating disorders: A concurrent mixed-methods study

Cited by 10 publications

References 40 publications

The lived experience of working with people with eating disorders: A meta‐ethnography

The lived experience of working with people with eating disorders: A meta‐ethnography

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

Perceptions of the “anorexic voice”: A qualitative study of health care professionals

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