Treatment Targets and Strategies for Eating Disorders Recovery: A Delphi Consensus With Lived Experience, Carers, Researchers, and Clinicians

IF 4.7 2区医学 Q1 NUTRITION & DIETETICS

International Journal of Eating Disorders Pub Date : 2024-10-14 DOI:10.1002/eat.24304

Lauren Hanegraaf, Alexandra Anderson, Erica Neill, Emily Giddens, Evelyn Boon, Emma Bryant, Shannon Calvert, Bronwyn Carroll, Fernando Fernandez-Aranda, Sam Ikin, Maya Luna, Fiona Mitchell, Rebecca Murphy, Andrea Phillipou, Julian Robinson, Christina Wierenga, Simon Wilksch, Sarah Maguire, Antonio Verdejo-Garcia

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引用次数: 0

Abstract

Objective

Long-term recovery rates following eating disorders (EDs) treatment remain low. This might be partly due to a lack of agreement between key stakeholder groups, including people with lived experience, carers, clinicians, and researchers, regarding optimal therapeutic targets and strategies. We aimed to reach a consensus across these diverse groups on the most valued treatment targets and strategies for fostering ED recovery.

Method

We used the Delphi method with two phases: (i) Survey development and (ii) Expert rating. The survey development phase included the design of an initial set of items through scoping review and feedback from a committee of 14 experts. During the survey rating, we engaged a larger panel of 185 experts who comprised the stakeholder groups: Individuals with lived ED experience (n = 49), carers (n = 44), researchers (n = 46), and clinicians (n = 46).

Results

Thirty-one targets and 29 strategies reached consensus (> 70% agreement over three rounds). Psychological-emotional–social targets including quality of life, sense of purpose, and emotion regulation, along with ED behaviors, reached the highest agreement (> 90%). Strategies reflecting an individualized approach to treatment (i.e., considering diversity, assessing comorbidities, and enhancing rapport) achieved the highest agreement (> 90%). Responses across groups were similar, except researchers leaning more towards consideration of weight- and eating-related targets.

Discussion

Holistic targets and individualized therapeutic strategies have consistent support from the different stakeholder groups involved in ED treatment. The agreed set of targets/strategies may be used, in triangulation with other sources of evidence, to design and evaluate coproduced and personalized interventions.

Abstract Image

查看原文本刊更多论文

进食障碍康复的治疗目标和策略：与生活经验者、照顾者、研究人员和临床医生达成的德尔菲共识。

目的：饮食失调症（EDs）治疗后的长期康复率仍然很低。其部分原因可能是主要利益相关群体（包括有生活经验者、护理者、临床医生和研究人员）对最佳治疗目标和策略缺乏共识。我们的目标是让这些不同的群体就促进 ED 恢复的最有价值的治疗目标和策略达成共识：我们采用德尔菲法，分为两个阶段：(i) 调查开发阶段和 (ii) 专家评级阶段。调查开发阶段包括通过范围审查和由 14 位专家组成的委员会提供的反馈意见设计一套初步的项目。在调查评级期间，我们邀请了由 185 位专家组成的更大范围的利益相关者小组：有 ED 生活经验的个人（49 人）、护理人员（44 人）、研究人员（46 人）和临床医生（46 人）：结果：31 项目标和 29 项策略达成了共识（三轮共识率大于 70%）。包括生活质量、目标感和情绪调节在内的心理-情感-社会目标以及 ED 行为的共识度最高（> 90%）。反映个体化治疗方法的策略（即考虑多样性、评估合并症和增强亲和力）的一致性最高（> 90%）。除了研究人员更倾向于考虑与体重和饮食相关的目标外，各组的反应相似：讨论：整体目标和个性化治疗策略得到了参与 ED 治疗的不同利益相关群体的一致支持。在与其他证据来源进行三角测量时，可以使用商定的目标/策略集来设计和评估共同制定的个性化干预措施。

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来源期刊

International Journal of Eating Disorders 医学-精神病学

CiteScore

10.00

自引率

12.70%

发文量

204

审稿时长

4-8 weeks

期刊介绍： Articles featured in the journal describe state-of-the-art scientific research on theory, methodology, etiology, clinical practice, and policy related to eating disorders, as well as contributions that facilitate scholarly critique and discussion of science and practice in the field. Theoretical and empirical work on obesity or healthy eating falls within the journal’s scope inasmuch as it facilitates the advancement of efforts to describe and understand, prevent, or treat eating disorders. IJED welcomes submissions from all regions of the world and representing all levels of inquiry (including basic science, clinical trials, implementation research, and dissemination studies), and across a full range of scientific methods, disciplines, and approaches.