Perception of family members of people with eating disorders about treatment: a metasynthesis of the literature<sup>,</sup>

Gil, Mariana; Simões, Michel da Matta; Oliveira-Cardoso, Érika Arantes de; Pessa, Rosane Pilot; Leonidas, Carolina; Santos, Manoel Antônio dos

doi:10.1590/0102.3772e38417.en

Acessibilidade / Reportar erro

Brasil

Psicologia: Teoria e Pesquisa

Español English

Brasil

Español English

sumário « anterior atual seguinte »

Sumário

Clinical Psychology and Culture • Psic.: Teor. e Pesq. 38 • 2022 • https://doi.org/10.1590/0102.3772e38417.en copy

Perception of family members of people with eating disorders about treatment: a metasynthesis of the literature^* 1 This article was based on the first author's Master's Thesis. ^,^** 2 Acknowledgements: CNPq, Research Productivity Scholarship (PQ-1A) and CNPq, Master's Scholarship

Authorship SCIMAGO INSTITUTIONS RANKINGS

Abstract

Family relationships seem to have a relevant contribution to the etiopathogenesis of eating disorders (EDs), which makes the international treatment guidelines recommend family participation. This study aimed to synthesize and reinterpret the findings of primary qualitative studies about the perception of family of people with EDs about treatment. The search strategy was organized using the SPIDER tool, and the analyzes were carried out by two independent reviewers. From 1115 studies originally retrieved from six databases (CINAHL, LILACS, PsycINFO, PubMed, Scopus and Web of Science), 19 articles were selected. The results converge to the recognition that the family is part of the process and also needs to be considered as a care recipient, not just as a coadjuvant/companion for the patient. Since family dynamics have a relevant contribution in the development and maintenance of EDs, it is necessary to invest in the transformation of family relationships so that more effective and lasting gains in treatment can be obtained.

Keywords:
eating disorders; anorexia nervosa; bulimia; family, treatment

Acronym	Descriptors/Entry terms/keywords
S Sample	"Feeding and Eating Disorders"[Mesh] OR “Feeding Disorders” OR “Disorder, Feeding” OR “Disorders, Feeding” OR “Feeding Disorder” OR “Eating Disorders” OR “Disorder, Eating” OR “Disorders, Eating” OR “Eating Disorder” OR “Appetite Disorders” OR “Appetite Disorder” OR "Feeding and Eating Disorders of Childhood"[Mesh] OR "Anorexia Nervosa"[Mesh] OR "Bulimia Nervosa"[Mesh]
Pi Phenomenon of interest	"Therapeutics"[Mesh] OR “Therapeutic” OR “Therapy” OR “Therapies” OR “Treatment” OR “Treatments” OR “ Psychotherapy, Group"[Mesh] OR “Therapy, Group” OR “Group Therapy” OR "Self-Help Groups"[Mesh] OR “Group, Self-Help” OR “Groups, Self-Help” OR “Self Help Groups” OR “Self-Help Group” OR “Support Groups” OR “Group, Support” OR “Groups, Support” OR “Support Group” OR "Psychodrama"[Mesh] OR “Drama Therapy” OR “Therapy, Drama” OR “Dramatherapy” OR "Art Therapy"[Mesh] OR “Therapy, Art” OR “Art Therapies” OR “Therapies, Art” OR "Psychotherapy"[Mesh] OR “Psychotherapies” OR “Psychotherapists” OR “Psychotherapist” OR "Psychotherapeutic Processes"[Mesh] OR “Process, Psychotherapeutic” OR “Psychotherapeutic Process” OR “Processes, Psychiatric Therapeutic” OR “Therapeutic Processes, Psychiatric” OR “Psychiatric Therapeutic Process” OR “Psychiatric Therapeutic Processes” OR “Therapeutic Process, Psychiatric” OR “Process, Psychiatric Therapeutic” OR “Processes, Psychotherapeutic” OR "Counseling"[Mesh] OR "Helping Behavior"[Mesh] OR "Health Facilities"[Mesh] OR “Facilities, Health” OR “Facility, Health” OR “Health Facility” OR "Group Structure"[Mesh] OR “Structure, Group” OR “Structures, Group”
D Design	"Focus Groups"[Mesh] OR “Focus Group” OR “Group, Focus” OR "Anthropology, Medical"[Mesh] OR “Medical Anthropology” OR "Grounded Theory"[Mesh] OR “Theory, Grounded” OR Culture OR “Thematic synthesis” OR "Hermeneutics"[Mesh] OR Hermeneutic OR Ethnographic OR “ethnographic research” OR Phenomenology OR “phenomenological research” OR Narrative OR "Interviews as Topic"[Mesh] OR Interviewers OR Interviewer OR Interviewees OR “Group Interviews” OR “Group Interview” OR “Interview, Group” OR “Interviews, Group” OR “in-depth interview” OR “qualitative interview” OR “content analysis” OR “semantic analysis”
E Evaluation	“Experience” OR “Experiences” OR “Sense” OR “Senses” OR “Meaning” OR “Meanings” OR “Life Change Events”[Mesh] OR “Event, Life Change” OR “Events, Life Change” OR “Life Change Event” OR “Life Experiences” OR “Experience, Life” OR “Experiences, Life” OR “Life Experience” OR “perspective” OR “perspectives” OR “Subjectivities” OR “Perception/psychology” [Mesh]
R Types of research	“Qualitative Research”[Mesh] OR “Research, Qualitative” OR “Qualitative studies” OR “Qualitative” OR "Empirical Research"[Mesh] OR “Research, Empirical”

Ref No.	First author, Year, country	Study objectives	Research design / data collection / data analysis	Number of family members participating	Relationship of participants	Type of treatment or intervention to which the study refers
1	McArdle, 2019McArdle, S. (2019). Parents’ experiences of health services for the treatment of eating disorders: A qualitative study. Journal of Mental Health, 28(4), 404-409. https://doi.org/10.1080/09638237.2017.1417558 https://doi.org/10.1080/09638237.2017.14... , Ireland	Explore parents 'experiences after contacting health services to treat their daughters' eating disorders	Generic qualitative study; focus groups or semi-structured individual interviews; interpretative thematic analysis	N = 15	12 mothers and 3 fathers	Multiprofessional outpatient treatment or hospitalization
2	Mitrofan, 2019Mitrofan, O., Petkova, H., Janssens, A., Kelly, J., Edwards, E., Nicholls, D. McNicholas, F., Simic, M., Eisler, I., Ford, T., & Byford, S. (2019). Care experiences of young people with eating disorders and their parents: Qualitative study. BJPsych Open, 5(1). https://doi.org/10.1192/bjo.2018.78 https://doi.org/10.1192/bjo.2018.78... , United Kingdom	Explore the perspectives of patients and parents on positive and negative aspects of the care offered to young people with eating disorders	Generic qualitative study; online focus groups; thematic content analysis	N = 11	9 mothers and 2 fathers	Multiprofessional outpatient treatment or hospitalization
3	Sun, 2019Sun, K. S., Lam, T. P., Kwok, K. W., Chong, K. Y., Poon, M. K., & Wu, D. (2019). Treatment of Chinese adolescents with anorexia nervosa in Hong Kong: The gap between treatment expectations and outcomes. PLOS ONE, 14(5), e0216582. https://doi.org/10.1371/journal.pone.0216582 https://doi.org/10.1371/journal.pone.021... , China	To analyze the search for help and the results of treatment for anorexia nervosa in a sample of family members.	Generic qualitative study; semi-structured group interview; content analysis	N = 6	4 mothers and 2 fathers	Multiprofessional outpatient treatment or hospitalization
4	Toubøl, 2019Toubøl, A., Koch‐Christensen, H., Bruun, P., & Nielsen, D. S. (2019). Parenting skills after participation in skills‐based training inspired by the New Maudsley Method: A qualitative study in an outpatient eating disorder setting. Scandinavian Journal of Caring Sciences, 33(4), 959-968. https://doi.org/10.1111/scs.12694 https://doi.org/10.1111/scs.12694... , Denmark	Examine the perception of parents of patients with eating disorders about their new skills after participating in skills-based training inspired by Maudsley's New Method.	Generic qualitative study; focus groups; deductive thematic content analysis	N = 21	11 fathers and 10 mothers	Skills training for parents of outpatient patients
5	Wufong, 2019Wufong, E., Rhodes, P., & Conti, J. (2019). “We don’t really know what else we can do”: Parent experiences when adolescent distress persists after the Maudsley and family-based therapies for anorexia nervosa. Journal of Eating Disorders, 7(5). https://doi.org/10.1186/s40337-019-0235-5 https://doi.org/10.1186/s40337-019-0235-... , Australia	Build an understanding of how parents of people with eating disorders assign meaning to their experiences and negotiate their identities in the context of multifamily therapy.	Generic qualitative study; semi-structured interviews; critical discursive analysis	N = 13	9 mothers and 4 fathers	Family therapy
6	Berends, 2018Berends, T., van de Lagemaat, M., van Meijel, B., Coenen, J., Hoek, H. W., & van Elburg, A. A. (2018). Relapse prevention in anorexia nervosa: Experiences of patients and parents. International Journal of Mental Health Nursing, 27, 1546-1555. https://doi.org/10.1111/inm.12456 https://doi.org/10.1111/inm.12456... , The Netherlands	Understand how patients and their parents experience work with Guideline Relapse Prevention, a guide to relapse prevention designed for the context of treatment of eating disorders.	Generic qualitative study; semi-structured interviews; thematic content analysis	N = 12	6 mothers and 6 fathers	Use of a relapse prevention guide at a center specializing in eating disorders
7	Langenberg, 2018Van Langenberg, T., Duncan, R. E., Allen, J. S., Sawyer, S. M., Le Grange, D., & Hughes, E. K. (2018). “They don’t really get heard”: A qualitative study of sibling involvement across two forms of family-based treatment for adolescent anorexia nervosa. Eating Disorders, 26(4), 373-387. https://doi.org/10.1080/10640266.2018.1453632 https://doi.org/10.1080/10640266.2018.14... , Australia	Explore the experience of families about the involvement of sisters and brothers in the treatment of eating disorders, from the perspective of siblings, patients and parents.	Generic qualitative study; semi-structured interviews; thematic analysis	N = 26	13 mothers, 12 siblings and 1 father	Outpatient family treatment
8	Prior, 2018Prior, A.-L., Woodward, D., Hoefkens, T., Clayton, D., Thirlaway, K., & Limbert, C. (2018). Telephone helplines as a source of support for eating disorders: Service user, carer, and health professional perspectives. Eating Disorders, 26(2), 164-184. https://doi.org/10.1080/10640266.2017.1364934 https://doi.org/10.1080/10640266.2017.13... , United Kingdom	Gain insight into the perspectives of those who may use or refer others to use an eating disorder telephone helpline, to identify the requirements and potentials of this service.	Generic qualitative study; focus groups and individual interviews; inductive thematic analysis	N = 4	Not specified	Telephone lines to support family members and patients with eating disorders
9	Wallis, 2017Wallis, A., Rhodes, P., Dawson, L., Miskovic-Wheatley, J., Madden, S., & Touyz, S. (2017). Relational containment: Exploring the effect of family-based treatment for anorexia on familial relationships. Journal of Eating Disorders, 5(1), 5-27. https://doi.org/10.1186/s40337-017-0156-0 https://doi.org/10.1186/s40337-017-0156-... , Austrália	To investigate the process of change in family relationships of adolescents with anorexia nervosa and their parents, who participated in a family treatment.	Constructionist approach; individual interviews; analysis according to data-based theory	N = 27	15 mothers and 12 fathers	Family post-hospitalization treatment of patients with eating disorders
10	Engman-Bredvik, 2016Engman-Bredvik, S., Carballeira Suarez, N., Levi, R., & Nilsson, K. (2016). Multi-family therapy in anorexia nervosa: A qualitative study of parental experiences. Eating Disorders, 24(2), 186-197. https://doi.org/10.1080/10640266.2015.1034053 https://doi.org/10.1080/10640266.2015.10... , Sweden	To investigate the experience of parents of patients with anorexia nervosa in multifamily therapy.	Generic qualitative study; individual interviews; phenomenological analysis	N = 12	6 mothers and 6 fathers	Multifamily therapy for families of patients in multi-professional outpatient or inpatient treatment
11	Macdonald, 2014MacDonald, P., Rhind, C., Hibbs, R., Goddard, E., Raenker, S., Todd, G., Schmidt, U., & Treasure, J. (2014). Carers’ assessment, skills and information sharing (CASIS) trial: A qualitative study of the experiential perspective of caregivers and patients. European Eating Disorders Review, 22(6), 430-438. https://doi.org/10.1002/erv.2320 https://doi.org/10.1002/erv.2320... , United Kingdom	Explore the perception of patients and their caregivers about the quality of the relationship between them after the caregivers have received a skills training intervention.	Generic qualitative study; written questionnaires; thematic content analysis	N = 115	Unspecified (mostly mothers)	Skills training for caregivers of people with eating disorders undergoing hospitalization
12	Patel, 2014, USA	Understand how a child's eating disorder affects the parents' life and well-being; understand the main barriers and motivations that parents experience to engage in adaptive coping behaviors; determine what are the reactions to messages that encourage self-care.	Generic qualitative study; focus groups; comparative analysis	N = 19	15 mothers and 4 fathers	Self-care messages for parents of people with eating disorders undergoing outpatient or hospital treatment
13	Ma, 2012Ma, J. L. C. (2012). Perceived process of change in family therapy for eating disorders in Shenzhen, China: A qualitative study. Journal of Family Psychotherapy, 23(3), 184-201. https://doi.org/10.1080/08975353.2012.705638 https://doi.org/10.1080/08975353.2012.70... , China	Identify the symptomatic cycle of family interactions that maintained the symptoms of the eating disorder; find out if the family therapist, in his role as facilitator, promoted contextual changes in the family; understand the roles of the family and the therapist in these changes.	Generic qualitative study; semi-structured family interviews and transcription analysis of recorded therapeutic sessions; content analysis	N = 20	10 mothers and 10 fathers	Family therapy offered at a family treatment center for eating disorders
14	Whitney, 2012Whitney, J., Currin, L., Murray, J., & Treasure, J. (2012). Family work in anorexia nervosa: A qualitative study of carers’ experiences of two methods of family intervention. European Eating Disorders Review, 20(2), 132-141. https://doi.org/10.1002/erv.1077 https://doi.org/10.1002/erv.1077... , United Kingdom	Explore the perception of the effectiveness of treatment, caregiver satisfaction and the change process in caregivers of people with anorexia nervosa who participated in individual family work or in multi-family workshops	Generic qualitative study; individual interviews; Interpretative Phenomenological Analysis	N = 23	17 parents, 4 siblings, 1 husband and 1 daughter	Family therapy or multifamily workshops for families of patients in hospital
15	Ma, 2006Ma, J. L. C., & Lai, K. (2006). Perceived treatment effectiveness of family therapy for chinese patients suffering from anorexia nervosa: A qualitative inquiry. Journal of Family Social Work, 10(2), 59-74. https://doi.org/10.1300/J039v10n02_04 https://doi.org/10.1300/J039v10n02_04... , China	Explore the perception of patients with anorexia nervosa and their families about family therapy	Generic qualitative study; family interviews; thematic analysis	N = 24 families	Parents (unspecified quantities)	Family therapy at a treatment center for eating disorders
16	Highet, 2005Highet, N., Thompson, M., & King, R. M. (2005). The experience of living with a person with an eating disorder: The impact on the carers. Eating Disorders, 13(4), 327-344. https://doi.org/10.1080/10640260591005227 https://doi.org/10.1080/1064026059100522... , Australia	Identify the experiences and difficulties of caregivers of people with eating disorders throughout the disease process up to the point of accessing treatment	Generic qualitative study; focus groups and individual interviews; thematic analysis	N = 24	Parents and partners (unspecified quantities)	Treatment in specialized services for eating disorders
17	Tierney, 2005Tierney, S. (2005). The treatment of adolescent anorexia nervosa: A qualitative study of the views of parents. Eating Disorders, 13(4), 369-379. https://doi.org/10.1080/10640260591005254 https://doi.org/10.1080/1064026059100525... , United Kingdom	Investigate the perspective of parents of people with eating disorders on treatment	Generic qualitative study; semi-structured interviews; thematic analysis	N = 14	8 mothers and 6 fathers	Multiprofessional outpatient treatment or hospitalization
18	McMaster, 2004McMaster, R., Beale, B., Hillege, S., & Nagy, S. (2004). The parent experience of eating disorders: Interactions with health professionals. International Journal of Mental Health Nursing, 13(1), 67-73. https://doi.org/10.1111/j.1447-0349.2004.00310.x https://doi.org/10.1111/j.1447-0349.2004... , Australia	Explore the interactions between parents of people with eating disorders and health professionals	Generic qualitative study; individual interviews; thematic analysis	N = 22	19 mothers and 3 fathers	Multiprofessional outpatient treatment or hospitalization
19	Winn, 2004Winn, S., Perkins, S., Murray, J., Murphy, R., & Schmidt, U. (2004). A qualitative study of the experience of caring for a person with bulimia nervosa. Part 2: Carers’ needs and experiences of services and other support. International Journal of Eating Disorders, 36(3), 269-279. https://doi.org/10.1002/eat.20068 https://doi.org/10.1002/eat.20068... , United Kingdom	Determine the extent to which health services meet the support needs of caregivers of people with bulimia nervosa and whether they feel the need to seek help for themselves.	Generic qualitative study; telephone interviews; thematic content analysis	N = 20	14 Mothers, 1 father and 5 emotional partners	Multiprofessional outpatient treatment or hospitalization

Instituto de Psicologia, Universidade de Brasília Instituto de Psicologia, Universidade de Brasília, 70910-900 - Brasília - DF - Brazil, Tel./Fax: (061) 274-6455 - Brasília - DF - Brazil
E-mail: revistaptp@gmail.com

Acompanhe os números deste periódico no seu leitor de RSS

[1] *** Correspondence regarding this article can be sent to marigil561@gmail.com.

Brasil

Brasil

Perception of family members of people with eating disorders about treatment: a metasynthesis of the literature* 1 This article was based on the first author's Master's Thesis. ,** 2 Acknowledgements: CNPq, Research Productivity Scholarship (PQ-1A) and CNPq, Master's Scholarship

Abstract

Perception of family members of people with eating disorders about treatment: a metasynthesis of the literature^* 1 This article was based on the first author's Master's Thesis. ^,^** 2 Acknowledgements: CNPq, Research Productivity Scholarship (PQ-1A) and CNPq, Master's Scholarship