The Role of the Dietitian Within a Day Programme for Adolescent Anorexia Nervosa: A Reflexive Thematic Analysis of Child and Adolescent Eating Disorder Clinician Perspectives

IF 2.9 3区医学 Q3 NUTRITION & DIETETICS

Journal of Human Nutrition and Dietetics Pub Date : 2025-05-28 DOI:10.1111/jhn.70070

Cliona Brennan, Georgia Green, Abigail Morgan, Julian Baudinet

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引用次数: 0

Abstract

Background

Family therapy for anorexia nervosa (FT-AN) is the first-line outpatient treatment for young people with anorexia nervosa (AN) in the UK. However, some require more intensive interventions, such as day programmes (DPs), which provide structured multidisciplinary care, including nutritional rehabilitation. Despite the integral role of dietitians in DPs, their specific responsibilities remain under-researched. This study explores clinician perspectives on the role of dietitians in adolescent AN treatment to inform future research and consensus guidelines.

Methods

A qualitative study using semi-structured interviews was conducted with 11 clinicians working in one DP for young people with AN. Participants were recruited from the Intensive Treatment Programme at the Maudsley Centre for Child and Adolescent Eating Disorders. Reflexive thematic analysis identified key themes regarding dietitians' contributions to treatment.

Results

Clinicians emphasised the dietitian's role in early treatment containment, reinforcing therapeutic approaches and empowering parents in meal planning and nutritional rehabilitation. Dietitians were seen as crucial in personalising treatment based on cultural and sensory needs and adapting meal plans as young people progressed. They also played a key role in guiding transitions between treatment phases, particularly from weight restoration to maintenance. However, challenges included an over-reliance on dietitians for nutritional decisions and a ‘good cop, bad cop’ dynamic, where therapists avoided difficult conversations about food.

Discussion

Findings highlight dietitians' essential role in DP treatment for AN but suggest that excessive reliance may limit therapist autonomy. Strengthening collaboration through shared decision-making and bidirectional learning is recommended. Further research should explore these dynamics across diverse settings.

查看原文本刊更多论文

营养学家在青少年神经性厌食症的一天计划中的作用：儿童和青少年饮食失调临床医生观点的反思性专题分析

背景：家庭治疗神经性厌食症（FT-AN）是英国年轻人神经性厌食症（AN）的一线门诊治疗方法。然而，有些需要更密集的干预措施，如日间方案（DPs），提供有组织的多学科护理，包括营养康复。尽管营养师在DPs中扮演着不可或缺的角色，但他们的具体职责仍未得到充分研究。本研究探讨了临床医生对营养师在青少年AN治疗中的作用的看法，为未来的研究和共识指南提供信息。方法采用半结构化访谈的方法，对11名从事青少年AN治疗的临床医生进行定性研究。参与者是从莫兹利儿童和青少年饮食失调中心的强化治疗项目中招募的。反思性主题分析确定了关于营养师对治疗的贡献的关键主题。结果临床医生强调营养师在早期治疗控制中的作用，加强治疗方法，并在膳食计划和营养康复中赋予父母权力。在根据文化和感官需求进行个性化治疗以及随着年轻人的发展调整膳食计划方面，营养师被视为至关重要的。它们还在指导治疗阶段之间的过渡中发挥了关键作用，特别是从体重恢复到维持。然而，挑战包括过度依赖营养师做出营养决定，以及“唱红脸，唱白脸”的动态，治疗师避免就食物进行艰难的对话。研究结果强调了营养师在AN的DP治疗中的重要作用，但也表明过度依赖可能会限制治疗师的自主性。建议通过共同决策和双向学习加强协作。进一步的研究应该在不同的环境中探索这些动态。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Journal of Human Nutrition and Dietetics 医学-营养学

CiteScore

5.30

自引率

15.20%

发文量

133

审稿时长

6-12 weeks

期刊介绍： Journal of Human Nutrition and Dietetics is an international peer-reviewed journal publishing papers in applied nutrition and dietetics. Papers are therefore welcomed on: - Clinical nutrition and the practice of therapeutic dietetics - Clinical and professional guidelines - Public health nutrition and nutritional epidemiology - Dietary surveys and dietary assessment methodology - Health promotion and intervention studies and their effectiveness - Obesity, weight control and body composition - Research on psychological determinants of healthy and unhealthy eating behaviour. Focus can for example be on attitudes, brain correlates of food reward processing, social influences, impulsivity, cognitive control, cognitive processes, dieting, psychological treatments. - Appetite, Food intake and nutritional status - Nutrigenomics and molecular nutrition - The journal does not publish animal research The journal is published in an online-only format. No printed issue of this title will be produced but authors will still be able to order offprints of their own articles.