A systematic review of people’s lived experiences of inpatient treatment for anorexia nervosa: living in a “bubble”

Journal of Eating Disorders · 4 authors, 4 centres

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TL;DR

A qualitative meta-synthesis of 11 studies (159 participants) found that inpatient treatment for anorexia nervosa is characterised by tensions between the biomedical focus of standardised protocols and patients' desire for individualised, person-centred care. Clinical staff who recognised patients as more than their illness were associated with stronger engagement in recovery-oriented behaviours.

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This systematic review and meta-synthesis of 11 qualitative studies explored lived experiences of inpatient or residential treatment for anorexia nervosa within eating disorder-specific services, comprising 159 total participants. Four meta-themes emerged: a medical discourse perceived as non-individualised, the restrictive practice of living in a "bubble," shared experience with peers, and a desire to be seen as more than a diagnosis. Two cross-cutting themes—diversity of experience and meaning-making—connected these meta-themes. Clinical staff who individualised care strengthened patient motivation for recovery. Limitations include exclusion of non-English and grey literature, synthesis of only previously published data, underrepresentation of male participants, and limited demographic and treatment-setting descriptions across included studies.

STUDY TYPE

systematic_review

SPECIALTY

psychiatry

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100% · A

ORIGINAL PAPER

PMC10257311

A systematic review of people’s lived experiences of inpatient treatment for anorexia nervosa: living in a “bubble”

Journal of Eating Disorders

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ABSTRACT

Background Treatment for anorexia nervosa (AN) is typically delivered on a continuum of care, starting with outpatient treatment, and moving onto intensive outpatient, day or residential treatment and/or inpatient hospitalisation. However, minimal attention has been afforded to the lived experiences of persons undergoing inpatient treatment for AN. In particular, qualitative literature pertaining to the lived experiences of specialist inpatient or residential treatment of AN remains fragmented and incomplete. The aim of this review was to synthesise current literature exploring patients’ lived experiences of residential and inpatient treatment for AN within eating disorder-specific treatment services. Methods Five databases were searched and a qualitative thematic systematic review and meta-synthesis of 11 studies were conducted. Results Eleven studies of 159 participants were included. Four meta-themes were constructed from the data: (1) a medical discourse—“I don’t think it’s individualised here”; (2) restrictive practice—living in a “bubble”; (3) myself, others and “a similar demon”; and (4) I am “not just another anorexic”. The data also revealed two cross-cutting themes: (1) more than a single experience; and (2) meaning making and identity. Conclusions These findings highlight the complex and multifaceted nature of the inpatient treatment experience as well as the inherent conflicts in balancing the necessity of medical and psychological intervention with person-centred treatment approaches in the treatment of AN. Supplementary Information The online version contains supplementary material available at 10.1186/s40337-023-00820-0.

CITATION EXPORT

Rebekah Rankin, Janet Conti, Lucie Ramjan et al.. A systematic review of people’s lived experiences of inpatient treatment for anorexia nervosa: living in a “bubble”. Journal of Eating Disorders. (2023). https://doi.org/10.1186/s40337-023-00820-0

AUTHORS

4 · 4 CENTRES

Rebekah Rankin, Janet Conti, Lucie Ramjan, Phillipa Hay

1grid.1029.a0000 0000 9939 5719Translational Health Research Institute, School of Medicine, Western Sydney University, Sydney, Australia
2grid.1029.a0000 0000 9939 5719School of Psychology, Western Sydney University, Sydney, Australia
3grid.1029.a0000 0000 9939 5719School of Nursing and Midwifery, Western Sydney University, Sydney, Australia
4grid.410692.80000 0001 2105 7653Campbelltown Hospital, South West Sydney Local Health District (SWSLHD), Sydney, Australia