Clinicians’ perspectives on supporting individuals with severe anorexia nervosa in specialist eating disorder intensive treatment settings during the COVID-19 pandemic

Hannah Webb, Bethan Dalton, Madeleine Irish, Daniela Mercado, Catherine McCombie, Gemma Peachey, Jon Arcelus, Katie Au, Hubertus Himmerich, A. Louise Johnston, Stanimira Lazarova, Tayeem Pathan, Paul Robinson, Janet Treasure, Ulrike Schmidt*, Vanessa Lawrence

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

6 Citations (Scopus)
77 Downloads (Pure)

Abstract

Background

The COVID-19 pandemic has significantly affected intensive treatment settings (i.e., inpatient [IP] and day patient [DP]) in specialist eating disorder services. However, the impact on clinicians working in these services is largely unknown. We therefore explored the perspectives of those supporting individuals with severe anorexia nervosa (AN) in intensive treatment settings during the pandemic.

Methods

Between May 2020 and June 2021, we interviewed clinicians (n = 21) who delivered IP and/or DP treatment to patients with severe AN in four specialist eating disorder services in the United Kingdom. Data relating to experiences during COVID-19 were analysed using reflexive thematic analysis.

Results

We identified six themes: Disruptions to Routine Treatment; Introduction of Virtual Treatment; Separation from Treatment, Others and the World; Impact on Recovery; Impact on Staff; and Pressure on Referral Pathways. COVID-19 posed significant challenges to IP and DP services: forcing closures, operating with restrictions and virtual treatment, and impacting delivery of essential treatment components, referral pathways, clinician wellbeing, risk management, and patient isolation and recovery trajectories. Opportunities arose, in particular in DP services offering virtual support.

Conclusions

COVID-19 challenged the continuation of multidisciplinary treatment. The findings underline the necessity for medical, psychological, practical, and nutritional support, as well as carer involvement and fostering social connections to remain at the forefront of intensive treatment for severe AN. They also emphasise the uncertainty surrounding which intensive treatment may be best suited to which patient when, particularly within the context of virtual DP support.

Original languageEnglish
Article number30
JournalJournal of Eating Disorders
Volume10
Issue number1
Early online date24 Feb 2022
DOIs
Publication statusPublished - Feb 2022

Keywords

  • Anorexia nervosa
  • Clinicians
  • COVID-19
  • Day patient
  • Eating disorders
  • Inpatient
  • Intensive treatment
  • Qualitative research
  • Telemedicine

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