Canadian pediatric eating disorder programs and virtual care during the COVID-19 pandemic: a mixed-methods approach to understanding clinicians’ perspectives

Abstract

Background As a result of the public health measures put in place during the COVID-19 pandemic in Canada, many health services, including those for the treatment of eating disorders, were provided at a distance. This study aims to describe the adaptations made in specialized pediatric eating disorder programs in Canada and the impact of these adaptations on health professionals’ experience of providing care. Methods A mixed-methods design was used to survey healthcare professionals working in specialized pediatric eating disorder programs about adaptations to treatment made during the pandemic and the impact of these adaptations on their experience of providing care. Data were collected between October 2021 and March 2022 using a cross-sectional survey comprising 25 questions and via semi-structured interviews. Quantitative data were summarized using descriptive statistics and qualitative data were interpreted using qualitative content analysis. Results Eighteen healthcare professionals in Canada completed the online survey, of whom six also participated in the semi-structured interviews. The cross-sectional survey confirmed that, unlike in pre-pandemic times, the majority of participants provided medical care (15/18) and mental health care (17/18) at a distance during the pandemic, with most participants using telephone (17/18) and videoconferencing (17/18). Most (16/18) health professionals indicated that virtual care would continue to be used as a tool in pediatric ED treatment after the pandemic. Participants used a combination of virtual and in-person care, with most reporting weighing patients both in clinic (16/18) and virtually (15/18). Qualitative content analysis generated five themes: (1) responding to increased demand with insufficient resources; (2) adapting to changes in care due to the COVID-19 pandemic; (3) dealing with uncertainty and apprehension; (4) virtual care as an acceptable and useful clinical tool, and (5) optimal conditions and future expectations. Most interview participants (5/6) had globally positive views of virtual care. Conclusions Providing virtual multidisciplinary treatment for children and adolescents with eating disorders seemed feasible and acceptable to professionals during the pandemic. Moving forward, focusing on health professionals’ perspectives and providing appropriate training in virtual interventions is essential given their central role in successful implementation and continued use of virtual and hybrid care models.

Mental Health and Well-being of Healthcare Professionals Amid the COVID-19 Pandemic in Canada

“…10 A study of 18 clinicians in Canadian Pediatric Eating Disorder programs during the COVID-19 pandemic revealed significant challenges in managing increased patient volumes without adequate resources. 20 Consequently, the workload for these professionals substantially increased during the pandemic, which is consistent with other studies. 10,12 Additionally, HCPs such as physicians, nurses, occupational therapists, and respiratory therapists were reported to face potentially morally injurious events when the community transmission of COVID-19 significantly escalated, resulting in a drastic increase in their workload and limited ability to provide quality care.…”

“…Numerous Canadian studies have investigated the connection between HCPs' distress and organizational change. 6,7,10,12,18,20,21 Canadian nurses have reported experiencing anxiety, worry, distress, or fear attributed to various organizational factors, such as frequent policy changes, ambiguous communication, and difficulty reconciling conflicting messages from different departments. 7 In addition, various HCPs working in long-term care homes and hospitals have identified inconsistencies in organizational policies and barriers to implementing necessary changes amidst the COVID-19 pandemic.…”

“…6 As such, these studies demonstrate an association between HCPs' organizational conditions and the adverse impact on their mental health. 6,7,10,12,18,20,21 Thus, implementing organizational support measures can effectively enhance the mental well-being of HCPs.…”

Exploring the impact of Instagram like visibility on self-confidence

“…The researcher also interviewed for qualitative data, which were then compared with the analyzed data to enhance the overall results. Qualitative data were narratively interpreted (Novack et al, 2023).…”