Abstract
Literature Review: How Acceptable are Eating Disorders Care Pathway Interventions to Children, Young People, and their Families? A Systematic Review and NarrativeSynthesis
Objective: Acceptability is an important yet inconsistently defined construct within healthcare research. Understanding service users’ views on the acceptability of the interventions they are receiving is thought to improve healthcare services care pathways, in turn increasing their success in terms of clinical outcomes. This systematic review aimed to determine which current eating disorders care pathway interventions for children, young people and their families assess acceptability and how this is being measured. In addition, it assessed whether specific care pathway interventions or aspects of care pathway interventions were deemed more acceptable than others.
Method: A systematic search of five electronic databases identified N= 987 potential studies, of which N= 56 underwent full-text screening. A total of N= 28 studies were included in the review.
Results: Four care pathways were identified as measuring acceptability: community, inpatient, outpatient, and combined pathways. Within those care pathways there were a wide range of treatment interventions (N= 19) being implemented. Studies varied in how they measured acceptability ranging from standardised to non-standardised questionnaires and qualitative interviews. Care pathway interventions were synthesised and compared to determine which (aspects of) care pathways and their interventions were most acceptable.
Discussion: Findings indicate that outpatient and combined care pathway interventions were the most acceptable to families. Inpatient care pathway interventions were least
acceptable. Specific aspects of interventions such as collaboration, active listening and being treated with respect were deemed important to families. Further research is required to develop a core method for defining and measuring acceptability within healthcare interventions.
Service-Related Project: A Clinical Audit of the Quality of Recording of Individual and Team Formulation on Rio within a Community Rehabilitation Team
Objective: Formulation is a tool used by mental health professionals to develop a shared understanding of a persons’ mental health difficulties. It also helps to inform service user care plans. It is important that formulations are developed collaboratively and shared with service users and other professionals. This service-related project aimed to understand how formulation was being developed, recorded, and shared within a community rehabilitation team by examining how formulations were recorded on services users care records (Rio).
Method: A clinical audit, which adapted the HQIP (2011) quality improvement cycle, was conducted to analyse the quality of the formulations recorded on Rio. Individual and team formulations were compared to the NHS Trust’s best practice guidelines for developing and recording formulations.
Results: 62% of the service’s caseload had formulations recorded in the formulation tab on Rio. All ‘6Ps’ of the Trust’s recommended ‘6Ps formulation’, were present in 29% of service users records. In 2% of service users records, formulations were recorded as being developed collaboratively and in 1% of records, recorded as being shared with service users. 48% of the formulations recorded on Rio had been updated within the last year.
Discussion: The audit identified the extent to which the team was adhering to Trust best practice guidelines for developing and recording formulations on Rio. Methods of improving the quality of recording of formulations on Rio were identified. Recommendations for implementing stages 3 and 4 of the HQIP (2011) cycle are discussed. This includes consulting with staff on the audit outcomes and repeating the audit cycle once changes have been implemented within the service.
Main Research Project: “There is No Magic Wand to be Waved”: A Qualitative Exploration of Parents’ Experiences of Receiving Home-based Meal Support for Young People Diagnosed with Anorexia Nervosa
Objective: Meal support (MS) is integral to Maudsley family-based treatment for anorexia nervosa (AN) in young people (YP). Home-based treatment (HT) is deemed a cost-effective way to increase families’ engagement with treatment and improve AN symptomology. This study aimed to investigate caregivers’ experiences of receiving home-based meal support (MS HT), including aspects of MS HT which help to facilitate an ‘effective’ mealtime alongside advantages and/ or disadvantages of MS HT.
Methods: A qualitative design was employed. Semi-structured interviews were conducted with N= 12 parents of N= 11 YP diagnosed with AN, who received MS HT. Interview recordings were transcribed and reflexive thematic analysis was used to analyse the data.
Results: Three themes were identified; 1) ‘A Love/ Hate Relationship’, 2) ‘The Struggle at Mealtimes’ and 3) ‘You Don’t Know What Works… Until You Know!’ along with N= 8 subthemes. Overall, MS HT was viewed as a helpful intervention.
Conclusion: Techniques specific to MS HT reportedly helped families facilitate ‘effective’ mealtimes. Findings highlight the need for individual MS for parents. Service improvement recommendations include ensuring MS interventions are delivered early on in treatment, using a structured, goal-orientated approach. Parents valued flexible, collaborative, and individualised approaches to MS HT.
| Date of Award | 10 Oct 2022 |
|---|---|
| Original language | English |
| Awarding Institution |
|
| Supervisor | Josie Millar (Supervisor) & Melissa Atkinson (Supervisor) |
Cite this
- Standard