Patients' and therapists' experiences with a new treatment programme for eating disorders that combines physical exercise and dietary therapy: the PED-t trial. A qualitative study protocol

Gunn Pettersen, Jan H Rosenvinge, Maria Bakland, Rolf Wynn, Therese Fostervold Mathisen, Jorunn Sundgot-Borgen, Gunn Pettersen, Jan H Rosenvinge, Maria Bakland, Rolf Wynn, Therese Fostervold Mathisen, Jorunn Sundgot-Borgen

Abstract

Introduction: Women with bulimia nervosa and binge eating disorder often suffer for many years before they seek professional help. Evidence-based treatments like cognitive-behavioural therapy (CBT) might be poorly accessible, and about 50% of those who receive CBT respond to it. Such outcome may reflect the heterogeneous nature of eating disorders, and addressing this heterogeneity calls for expanding the portfolio of treatment options. In particular, it is important to explore such options' acceptability, tolerability and affordability expressed through experiences with the treatment. This protocol outlines the rationale and design of a qualitative study. It captures experiences from patients and therapists who were involved in a randomised controlled trial (RCT) exploring the efficacy of a new group-based treatment programme combining physical exercise and dietary therapy.

Methods and analysis: 15 patients with bulimia nervosa or binge eating disorder, 10 therapists (physical trainers and dietitians) and 6-10 patients who dropped out of the RCT will be semistructurally interviewed. All interviews will be analysed using a systematic text condensation approach.

Ethics and dissemination: Results will be presented in peer-reviewed international journals, and at relevant international conferences. Key findings will be available to study participants as well as to patient organisations and health authorities. The overall study meets the intent and requirements of the Health Research Act and the Declaration of Helsinki. It is approved by the regional committee for medical research ethics (2013/1871).

Trial registration number: NCT02079935; Pre-results.

Keywords: eating disorders; mental health.

Conflict of interest statement

Competing interests: None declared.

© Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2018. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

References

    1. Rosenvinge JH, Pettersen G. Epidemiology of eating disorders part II: an update with a special reference to the DSM-5. Adv Eat Disord 2015;3:198–220. 10.1080/21662630.2014.940549
    1. Fairburn CG, Harrison PJ. Eating disorders. Lancet 2003;361:407–16. 10.1016/S0140-6736(03)12378-1
    1. Treasure J. Eating disorders. Lancet 2010;367:1376–7.
    1. NICE. Eating disordeders: recognition and treatment. 2017.
    1. American Psychiatric Association (APA). Practice guideline for the treatment of patients with eating disorders. Am J Psychiatry 2006;163:4–54.
    1. The Norwegian Directorate of Health. National guidelines for treating eating disorders. 2017.
    1. Wilson GT, Grilo CM, Vitousek KM. Psychological treatment of eating disorders. Am Psychol 2007;62:199–216. 10.1037/0003-066X.62.3.199
    1. Herpertz S, Hagenah U, Vocks S, et al. . The diagnosis and treatment of eating disorders. DeutscheÄrzeblatt Int 2011;108:678–85.
    1. Waller G, Stringer H, Meyer C. What cognitive behavioral techniques do therapists report using when delivering cognitive behavioral therapy for the eating disorders? J Consult Clin Psychol 2012;80:171–5. 10.1037/a0026559
    1. Kosmerly S, Waller G, Lafrance Robinson A. Clinician adherence to guidelines in the delivery of family-based therapy for eating disorders. Int J Eat Disord 2015;48:223–9. 10.1002/eat.22276
    1. Fairburn CG, Wilson GT. The dissemination and implementation of psychological treatments: problems and solutions. Int J Eat Disord 2013;46:516–21. 10.1002/eat.22110
    1. Sundgot-Borgen J, Rosenvinge JH, Bahr R, et al. . The effect of exercise, cognitive therapy, and nutritional counseling in treating bulimia nervosa. Med Sci Sports Exerc 2002;34:190–5. 10.1097/00005768-200202000-00002
    1. Mathisen TF, Rosenvinge JH, Pettersen G, et al. . The PED-t trial protocol: The effect of physical exercise -and dietary therapy compared with cognitive behavior therapy in treatment of bulimia nervosa and binge eating disorder. BMC Psychiatry 2017;17:180 10.1186/s12888-017-1312-4
    1. Pettersen G, Rosenvinge JH, Wynn R. Eating disorders and psychoeducation-patients’ experiences of healing processes. Scand J Caring Sci 2011;25:12–18. 10.1111/j.1471-6712.2010.00783.x
    1. Pettersen G, Thune-Larsen KB, Wynn R, et al. . Eating disorders: challenges in the later phases of the recovery process: a qualitative study of patients’ experiences. Scand J Caring Sci 2013;27:92–8. 10.1111/j.1471-6712.2012.01006.x
    1. Beresin EV, Gordon C, Herzog DB. The process of recovering from anorexia nervosa. J Am Acad Psychoanal 1989;17:103–30. 10.1521/jaap.1.1989.17.1.103
    1. Vanderlinden J, Buis H, Pieters G, et al. . Which elements in the treatment of eating disorders are necessary ‘ingredients’ in the recovery process?–A comparison between the patient’s and therapist’s view. Eur Eat Disord Rev 2007;15:357–65. 10.1002/erv.768
    1. Clinton D, Björck C, Sohlberg S, et al. . Patient satisfaction with treatment in eating disorders: cause for complacency or concern? Eur Eat Disord Rev 2004;12:240–6. 10.1002/erv.582
    1. Rosenvinge JH, Klusmeier AK. Treatment for eating disorders from a patient satisfaction perspective: a Norwegian replication of a British study. Eur Eat Disord Rev 2000;8:293–300. 10.1002/1099-0968(200008)8:4<293::AID-ERV346>;2-4
    1. Newton JT, Robinson PH, Hartley P. Treatment for eating disorders in the United Kingdom. Part II. Experiences of treatment: a survey of members of the eating disorders association. Eur Eat Disord Rev 1993;1:10–21. 10.1002/erv.2400010104
    1. Newton T, Hartley P, Sturmey P. Treatment evaluation for eating disorders by clients with eating disorders. Behavioural Psychotherapy 1993;21:371–4. 10.1017/S1352465800011693
    1. Lkg H, Crisp AH, Callender JS. Recoveryin anorexia nervosa - the patient’s perspective. Int J Eat Disord 1992;11:341–50.
    1. Bell L. What can we learn from consumer studies and qualitative research in the treatment of eating disorders? Eat Weight Disord 2003;8:181–7. 10.1007/BF03325011
    1. Paulson-Karlsson G, Nevonen L, Engstrom I. Anorexia nervosa: treatment satisfaction. J Fam Ther 2006;28:293–306. 10.1111/j.1467-6427.2006.00353.x
    1. Nishizono-Maher A, Escobar-Koch T, Ringwood S, et al. . What are the top five essential features of a high quality eating disorder service? A comparison of the views of US and UK eating disorder sufferers, carers and health professionals. Eur Eat Disord Rev 2011;19:411–6. 10.1002/erv.1062
    1. de la Rie S, Noordenbos G, Donker M, et al. . Evaluating the treatment of eating disorders from the patient’s perspective. Int J Eat Disord 2006;39:667–76. 10.1002/eat.20317
    1. Escobar-Koch T, Banker JD, Crow S, et al. . Service users’ views of eating disorder services: an international comparison. Int J Eat Disord 2010;43:549–59. 10.1002/eat.20741
    1. Poulsen S, Lunn S, Sandros C. Client experience of psychodynamic psychotherapy for bulimia nervosa: An interview study. Psychother Theory Res Pract 2010;47:469–83. 10.1037/a0021178
    1. Krautter T, Lock J. Is manualized family-based treatment for adolescent anorexia nervosa acceptable to patients? Patient satisfaction at the end of treatment. J Fam Ther 2004;26:66–82. 10.1111/j.1467-6427.2004.00267.x
    1. Money C, Genders R, Treasure J, et al. . A brief emotion focused intervention for inpatients with anorexia nervosa: a qualitative study. J Health Psychol 2011;16:947–58. 10.1177/1359105310396395
    1. Sánchez-Ortiz VC, House J, Munro C, et al. . ‘A computer isn’t gonna judge you’: a qualitative study of users’ views of an internet-based cognitive behavioural guided self-care treatment package for bulimia nervosa and related disorders. Eat Weight Disord 2011;16:e93–e101. 10.1007/BF03325314
    1. Lose A, Davies C, Renwick B, et al. . Process evaluation of the maudsley model for treatment of adults with anorexia nervosa trial. Part II: Patient experiences of two psychological therapies for treatment of anorexia nervosa. Eur Eat Disord Rev 2014;22:131–9. 10.1002/erv.2279
    1. Thompson-Brenner H, Satir DA, Franko DL, et al. . Clinician reactions to patients with eating disorders: a review of the literature. Psychiatr Serv 2012;63:73–8. 10.1176/appi.ps.201100050
    1. Puschner B, Bauer S, Kraft S, et al. . [Patient and therapist satisfaction in outpatient psychotherapy]. Psychother Psychosom Med Psychol 2005;55:517–26. 10.1055/s-2005-867050
    1. Chorpita BF, Park A, Tsai K, et al. . Balancing effectiveness with responsiveness: therapist satisfaction across different treatment designs in the child STEPs randomized effectiveness trial. J Consult Clin Psychol 2015;83:709–18. 10.1037/a0039301
    1. Najavits LM, Ghinassi F, Van Horn A, et al. . Therapist satisfaction with four manual-based treatments on a national multisite trial: An exploratory study. Psychother Theory Res Pract 2004;41:26–37. 10.1037/0033-3204.41.1.26
    1. Pettersen G, Thune-Larsen KB, Wynn R, et al. . Clinical competence and confidence following an interprofessional educational program on eating disorders for nurses and other health care professionals. J Multidiciplin Healthcare 2012;5:201–5.
    1. Whitney J, Currin L, Murray J, et al. . Family work in anorexia nervosa: a qualitative study of carers’ experiences of two methods of family intervention. Eur Eat Disord Rev 2012;20:132–41. 10.1002/erv.1077
    1. Waterman-Collins D, Renwick B, Lose A, et al. . Process evaluation of the MOSAIC Trial, Part I: therapist experiences of delivering two psychological therapies for treatment of anorexia nervosa. Eur Eat Disord Rev 2014;22:122–30. 10.1002/erv.2278
    1. Malterud K. Systematic text condensation: a strategy for qualitative analysis. Scand J Public Health 2012;40:795–805. 10.1177/1403494812465030
    1. Malterud K. Qualitative research: standards, challenges, and guidelines. Lancet 2001;358:483–8. 10.1016/S0140-6736(01)05627-6
    1. Tong A, Sainsbury P, Craig J. Consolidated criteria for reporting qualitative research (COREQ): a 32-item checklist for interviews and focus groups. Int J Qual Health Care 2007;19:349–57. 10.1093/intqhc/mzm042
    1. Orri M, Sibeoni J, Labey M, et al. . Qualitative approach to patient-reported outcomes in oncology: protocol of a French study. BMJ Open 2015;5:e008042 10.1136/bmjopen-2015-008042
    1. Oliver S, Liabo K, Stewart R, et al. . Public involvement in research: making sense of the diversity. J Health Serv Res Policy 2015;20:45–51. 10.1177/1355819614551848

Source: PubMed

3
구독하다