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Anorexia nervosa: treatment expectations – a qualitative study
Örebro University, School of Health and Medical Sciences, Örebro University, Sweden. Anorexia-Bulimia Unit, Child and Adolescent Psychiatry Centre, Queen Silvia Children’s Hospital, Göteborg, Sweden.
Örebro University, School of Health and Medical Sciences, Örebro University, Sweden.ORCID iD: 0000-0002-8598-4015
2012 (English)In: Journal of Multidisciplinary Healthcare, ISSN 1178-2390, E-ISSN 1178-2390, Vol. 5, 169-177 p.Article in journal (Refereed) Published
Abstract [en]

Background: Anorexia nervosa is a serious illness with a high mortality rate, a poor outcome, and no empirically supported treatment of choice for adults. Patients with anorexia nervosa strive for thinness in order to obtain self-control and are ambivalent toward change and toward treatment. In order to achieve a greater understanding of patients’ own understanding of their situation, the aim of this study was to examine the expectations of potential anorexic patients seeking treatment at a specialized eating-disorder unit.

Methods: A qualitative study design was used. It comprised 15 women between 18 and 25 years of age waiting to be assessed before treatment. The initial question was, “What do you expect, now that you are on the waiting list for a specialized eating-disorder unit?” A content analysis was used, and the text was coded, categorized according to its content, and further interpreted into a theme. Results: From the results emerged three main categories of what participants expected: “treatment content,” “treatment professionals,” and “treatment focus.” The overall theme, “receiving adequate therapy in a collaborative therapeutic relationship and recovering,” described how the participants perceived that their expectations could be fulfilled./p>

Discussion: Patients’ expectations concerning distorted thoughts, eating behaviors, a normal, healthy life, and meeting with a professional with knowledge and experience of eating disorders should be discussed before treatment starts. In the process of the therapeutic relationship, it is essential to continually address patients’ motivations, in order to understand their personal motives behind what drives their expectations and their desire to recover.

Place, publisher, year, edition, pages
Macclesfield, United kingdom: Dove Medical Press Ltd. (Dovepress) , 2012. Vol. 5, 169-177 p.
Keyword [en]
Anorexia nervosa, expectations, treatment, qualitative research
National Category
Health Sciences Nursing
Research subject
Health and Medical Care Research
URN: urn:nbn:se:oru:diva-26296DOI: 10.2147/JMDH.S33658PubMedID: 22888259ScopusID: 2-s2.0-84874772962OAI: diva2:561858
Available from: 2012-10-22 Created: 2012-10-22 Last updated: 2016-04-19Bibliographically approved
In thesis
1. Anorexia nervosa: treatment expectations, outcome and satisfaction
Open this publication in new window or tab >>Anorexia nervosa: treatment expectations, outcome and satisfaction
2012 (English)Doctoral thesis, comprehensive summary (Other academic)
Abstract [en]

Anorexia nervosa is a serious mental disorder with high mortality. It has the lowest prevalence compared with other eating-disorder diagnoses and the onset is related to adolescence, with a majority of female patients. The focus of this thesis is anorexia nervosa and the aim is to study adolescent and adult patients' comprehension and the course of treatment in order to make a contribution to the clinical work relating to these patients. The areas that were studied are expectations of treatment, outcome, predictors of outcome and satisfaction with treatment. Four research papers are included; three originate from work at a specialist eating-disorder unit at Queen Silvia Children's Hospital, Göteborg, Sweden and one from a multicentre study comprising 15 specialised eating-disorder units in Sweden.

Paper I has a qualitative design, where participants, 18-25 years of age, were interviewed about their expectations while on the waiting list at a specialist eating-disorder unit. Three main categories of expectations emerged: "Treatment content," "Treatment professionals" and "Treatment focus." The participants expected to receive the appropriate therapy in a collaborative therapeutic relationship and to recover. Paper II evaluated the outcome of a family-based treatment for adolescent patients, 13-18 years old, and their parents. The results indicate that the treatment that is offered appears to be effective, as 78% of the patients were in full remission with less distance and a less chaotic family climate at the 36-month follow-up. Paper III examined the importance of motivation to change eating behaviour, treatment expectationsand experiences, ED symptomatology, self-image and treatment alliance for predicting weight increase in adult patients, 18-46 years of age. Patients' motivation to change eating habits, social relations, self-image, body image and duration of illness were found to predict weight increase both in both the short term (six months) and the long term (36 months). PaperIV studied adolescent patients' and their parents' satisfaction with a family-based treatment a tan 18-month follow-up. The majority of patients (73%) and parents (83%) stated that their expectations had been fulfilled and individual sessions for patients and parents respectively were of great help. Family-based treatment with a combination of individual and family sessions corresponds well to patients' and parents' treatment expectations.

Young adult patients' expectations before treatment are multifaceted and should be taken into account in the therapeutic relationship. From the start of treatment, issues relating to patients' motivation, self-image, body image and social relationships should be continuously addressed in order to establish positive collaboration and a weight increase. Anorexia nervosa treatment for adolescents and their parents should be family-based and include family sessions as well as individual sessions for patients and parents. In addition, prevention programmes with the emphasis on early detection should be a prioritised area.

Place, publisher, year, edition, pages
Örebro: Örebro universitet, 2012. 119 p.
Örebro Studies in Medicine, ISSN 1652-4063 ; 76
Anorexia nervosa, treatment, adolescents, adults, expectations, outcome, predictors, weight increase, satisfaction
National Category
Medical and Health Sciences
Research subject
urn:nbn:se:oru:diva-26142 (URN)978-91-7668-900-4 (ISBN)
Public defence
2012-11-23, Hörsal P2, Prismahuset, Örebro universitet, Fakultetsgatan 1, Örebro, 13:00 (English)
Available from: 2012-10-09 Created: 2012-10-09 Last updated: 2013-05-17Bibliographically approved

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