Bommen, S;
Nicholls, H;
Billings, J;
(2023)
‘Helper’ or ‘punisher’? A qualitative study exploring staff experiences of treating severe and complex eating disorder presentations in inpatient settings.
Journal of Eating Disorders
, 11
(1)
, Article 216. 10.1186/s40337-023-00938-1.
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Abstract
Background: Eating disorders have been described as challenging to treat, with the most severe cases requiring inpatient admission. Previous studies have explored staff’s perspectives on eating disorders and service provision. However, little is currently known about how staff experience working with severe and complex eating disorder presentations in inpatient settings and how they may be impacted by their work. Aims: This study aimed to explore the experiences of staff who contribute towards the treatment of severe and complex eating disorder presentations in inpatient settings. Methods: Participants were recruited purposively via clinical contacts and a private hospital group in the UK. Semi-structured interviews were conducted, recorded, transcribed verbatim, and analysed guided by the principles of reflexive thematic analysis. Results: Interviews were completed with twelve staff members, including frontline nursing staff and multidisciplinary team (MDT) staff, from both private and public specialist settings. Participants expressed uncertainty about the treatment approach for service-users with severe and complex presentations. As service-users often resisted treatment, participants felt positioned as a ‘punisher’ rather than a ‘helper’ in initial treatment stages. Many had experienced physically and emotionally impactful events at work, including violence and aggression, as well as serious incidents of self-harm and suicide attempts. Participants generally found support in their colleagues, however considered organisational support insufficient. Conclusions: This research highlights an urgent need to consider the wellbeing of staff who works in eating disorder inpatient settings, as well as their support needs. Retention and recruitment strategies should be reviewed to reduce staff turnover and improve patient care. Further research should investigate whether specialist inpatient staff are impacted by symptoms of vicarious or direct trauma, moral injury and compassion fatigue.
| Type: | Article |
|---|---|
| Title: | ‘Helper’ or ‘punisher’? A qualitative study exploring staff experiences of treating severe and complex eating disorder presentations in inpatient settings |
| Open access status: | An open access version is available from UCL Discovery |
| DOI: | 10.1186/s40337-023-00938-1 |
| Publisher version: | http://dx.doi.org/10.1186/s40337-023-00938-1 |
| Language: | English |
| Additional information: | © The Author(s) 2023. Open Access This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article’s Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article’s Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated in a credit line to the data. |
| Keywords: | Eating disorders, Mental health, Staf wellbeing, Qualitative, Interview, Refexive thematic analysis, Inpatient, Trauma |
| UCL classification: | UCL UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Brain Sciences UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Brain Sciences > Division of Psychiatry UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Brain Sciences > Division of Psychiatry > Epidemiology and Applied Clinical Research |
| URI: | https://discovery.ucl.ac.uk/id/eprint/10184807 |
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