Diagnosing and managing anorexia nervosa in UK primary care: a focus group study

Hunt, Daniel; Churchill, Dick

doi:10.1093/fampra/cmt013

Cited by 16 publications

(34 citation statements)

References 15 publications

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“…In total, 63 papers met the inclusion criteria for the review. 21 – 83 Table 1 provides the quality assessment scoring of the 63 selected papers and Fig. 1 provides an overview of the selection process as a flow diagram.…”

Section: Resultsmentioning

confidence: 99%

Current eating disorder healthcare services – the perspectives and experiences of individuals with eating disorders, their families and health professionals: systematic review and thematic synthesis

et al. 2019

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Background Eating disorders have the highest mortality rate of mental disorders and a high incidence of morbidity, but if diagnosed and treated promptly individuals can benefit from full recovery. However, there are numerous problems at the healthcare interface (i.e. primary and secondary care) for eating disorders. It is important to examine these to facilitate appropriate, seamless treatment and improve access to specialist care. Aims To examine the current literature on the experiences and perspectives of those across healthcare interfaces for eating disorders, to include individuals with eating disorders, people close to or caring for those with eating disorders such as family and friends, and health professionals. Method To identify relevant papers, a systematic search of electronic databases was conducted. Other methods, including hand-searching, scanning reference lists and internet resources were also used. Papers that met inclusion criteria were analysed using a systematic methodology and synthesised using an interpretative thematic approach. Results Sixty-three papers met the inclusion criteria. The methodological quality was relatively good. The included papers were of both qualitative (n = 44) and quantitative studies (n = 24) and were from ten different countries. By synthesising the literature of these papers, three dominant themes were identified, with additional subthemes. These included: ‘the help-seeking process at primary care’; ‘expectations of care and appropriate referrals’ and ‘opposition and collaboration in the treatment of and recovery from eating disorders’. Conclusions This review identifies both facilitators and barriers in eating disorder healthcare, from the perspectives of those experiencing the interface first hand. The review provides recommendations for future research and practice. Declaration of interest None.

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Section: Resultsmentioning

confidence: 99%

Current eating disorder healthcare services – the perspectives and experiences of individuals with eating disorders, their families and health professionals: systematic review and thematic synthesis

et al. 2019

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“…A similar small qualitative study of six GPs similarly identified a lack of confidence in GPs interviewed when distinguishing Anorexia Nervosa (AN) from less pathological disordered eating and using a diagnosis of ED rather than AN to ‘label’ patients in some cases (Hunt & Churchill, 2013). …”

Section: Gps Are Not Poor At Identifying the Eds: Nadiamentioning

confidence: 99%

“…In a small qualitative study focusing on AN, GPs highlighted two sides to this process, despite the GP being confident about the patient needing a referral, the difficulties of the patients themselves accepting a referral to specialist care and attending their appointments in specialist care (Hunt & Churchill, 2013). A recent study on care pathways highlighted differences in number of cases of adolescent EDs presenting to secondary/tertiary care per year in areas with specialist ED services or specialist Child and Adolescent Mental Health Services (CAMHS) compared to non-specialist CAMHS, suggesting that GPs might be less likely to refer onwards if they do not have a specialist team available in their area (House et al, 2012).…”

Section: Gps Are Not Poor At Identifying the Eds: Nadiamentioning

confidence: 99%

“…Several of the above studies have shown that participants (GPs) reported a desire for training in EDs (Banas et al, 2013; Hunt & Churchill, 2013; Linville, Brown, & O'Neil, 2012; Reid et al, 2010). Several courses for GPs are available in the UK and Australia.…”

Section: Gps Are Not Poor At Identifying the Eds: Nadiamentioning

confidence: 99%

“…However, the research and experience that she cites do not really address the issue of identification in any way that makes me more optimistic. For example, the findings of Hunt and Churchill (2013) give an idea of how complex the issue of diagnosis is, both clinically and interpersonally – answer: ‘very'. As I said earlier, some GPs are great at this work and I have met a good number of that sort.…”

Section: A Bit Of a Rebuttal: Glennmentioning

confidence: 99%

See 2 more Smart Citations

General Practitioners are poor at identifying the eating disorders

Waller

Micali

James

2014

Advances in Eating Disorders

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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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Diagnosing and managing anorexia nervosa in UK primary care: a focus group study

Abstract: Overcoming patient repudiation and securing referrals are particular challenges with this patient group. Successfully negotiating these problems appears to require advanced communication skills.

Cited by 16 publications

References 15 publications

Current eating disorder healthcare services – the perspectives and experiences of individuals with eating disorders, their families and health professionals: systematic review and thematic synthesis

Current eating disorder healthcare services – the perspectives and experiences of individuals with eating disorders, their families and health professionals: systematic review and thematic synthesis

General Practitioners are poor at identifying the eating disorders

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

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