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Anorexia nervosa: treatment satisfaction
Örebro University, Department of Clinical Medicine. Anorexia-Bulimia Unit, Queen Silvia Children’s Hospital, Göteborg, Sweden.
Örebro University, Department of Clinical Medicine. Child and Adolescent Psychiatry Centre, Queen Silvia Children’s Hospital, Göteborg, Sweden.
Örebro University, Department of Clinical Medicine.
2006 (English)In: Journal of Family Therapy, ISSN 0163-4445, E-ISSN 1467-6427, Vol. 28, no 3, 293-306 p.Article in journal (Refereed) Published
Abstract [en]

Patient satisfaction plays a central role in treatment alliance and outcome. Investigating patient expectations and experiences of treatment sheds light on its importance. This study examines adolescent anorexia nervosa patients and their parents' satisfaction with family-based treatment. Patients and parents answered a questionnaire at the eighteen-month follow-up focusing on expectations and experiences of treatment, therapists, aims of treatment and accomplishment. The results show that 73 per cent of the patients and 83 per cent of the parents felt that their pre-treatment expectations had been fulfilled. The majority agreed that individual patient sessions and parental sessions were of great help, while the patients valued family therapy sessions as being less helpful than did parents. In overall terms, parents were more pleased with the therapists than were the patients. These data suggest that family-based treatment with individual sessions for patients, in parallel with parental sessions combined with family sessions, corresponds well to patients' and parents' treatment expectations.

Place, publisher, year, edition, pages
Oxford, United Kingdom: Blackwell , 2006. Vol. 28, no 3, 293-306 p.
National Category
Psychiatry Medical and Health Sciences
Research subject
Psychiatry; Medicine
Identifiers
URN: urn:nbn:se:oru:diva-12041DOI: 10.1111/j.1467-6427.2006.00353.xISI: 000239008500006Scopus ID: 2-s2.0-33745965685OAI: oai:DiVA.org:oru-12041DiVA: diva2:355103
Note

Gunilla Paulson-Karlsson is also affiliated to Queen Silvia Childrens Hosp, Anorexia Bulimia Unit, SE-41685 Gothenburg, Sweden

Ingemar Engström is also affiliated to Child andAdolescent Psychiatry Centre, Queen Silvia Children’s Hospital, Go¨teborg, Sweden

Available from: 2010-10-05 Created: 2010-10-05 Last updated: 2017-12-12Bibliographically 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.
Series
Örebro Studies in Medicine, ISSN 1652-4063 ; 76
Keyword
Anorexia nervosa, treatment, adolescents, adults, expectations, outcome, predictors, weight increase, satisfaction
National Category
Medical and Health Sciences
Research subject
Medicine
Identifiers
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)
Opponent
Supervisors
Available from: 2012-10-09 Created: 2012-10-09 Last updated: 2017-10-17Bibliographically approved

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Paulson-Karlsson, GunillaNevonen, LauriEngström, Ingemar

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