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How do women describe the conventional treatment experience for anorexia nervosa? : a thematic descriptive study MacDonald-Emes, Janet Barbara

Abstract

This study was undertaken in order to describe and explore the conventional treatment experiences that women with Anorexia Nervosa (AN) undergo from the perspective of the women themselves. The impetus for the study grew from the literature indicating that there is a strong consumer critique of various aspects of conventional treatment approaches. Furthermore, conventional treatments have been almost entirely guided by clinical opinion rather than by research; many approaches are having limited success rates in terms of long-term outcome. In addition, more nurses are caring for women with AN in all settings and yet the nursing care is orchestrated in accordance with ineffective approaches. Finally, the perspectives of practitioners are often different than those of the consumers of health care services. Thus, more practitioners are understanding the importance of not only giving a voice to consumers, but actually conducting research concerning the views of consumers in order to improve efficacy of treatments. Freed from the confines of an orthodox methodology, the thematic descriptive approach to guide this study was composed. Five informants were chosen by virtue of their ability to convey their treatment experience for AN. Data collection and data analysis was carried out simultaneously using an approach adapted from Field and Morse (1985) and Giorgi (1985). The findings from this study revealed that the quality of the treatment experience was contingent upon: the qualities possessed by the practitioners; the nature of the setting; the degree to which informants experienced difficulty in accessing programs and practitioners; and the predominance of a quantifiable focus on treatment that ascertains recovery in terms of weight gain; all at the expense of long-term psychosocial well-being. The conclusions drawn from the findings are tenfold: 1) Conventional treatments may not meet the needs of consumers; 2) Many treatments for AN tend to reflect a medical modality; 3) Conventional treatments include some elements that may be counterproductive to recovery from AN; 4) Conventional treatments may exclude some elements that facilitate recovery; 5) The need to establish recovery within a quantifiable context may be contingent upon the severity of the AN; 6) Treatment philosophies may be inconsistent and poorly coordinated within and between settings; 7) Women with AN believe that the behaviors and ideologies practitioners possess are critical to the success of treatment programs; 8) This study reiterates claims made by consumers and advocates of AN that conventional treatments alone are ineffective; 9) The demand for conventional treatments persist possibly because of the eternal hope they symbolize; and 10) The views of recipients for care of AN are invaluable in understanding the implications of conventional treatments. These conclusion have far-reaching implications for nursing research, practice, education, and social policy.

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