Skip to main content

Advertisement

SpringerLink
Log in

Inpatient medical stabilization for adolescents with eating disorders: patient and parent perspectives

  • Original Article
  • Published:
Eating and Weight Disorders - Studies on Anorexia, Bulimia and Obesity Aims and scope Submit manuscript

Abstract

Purpose

The serious physical complications of eating disorders in adolescents may necessitate inpatient medical stabilization, yet little is known about how patients and their parents perceive the hospitalization experience.

Methods

We identified 82 patients admitted to a large urban hospital for medical stabilization between January 1, 2010 and June 30, 2013. Twenty-three patients and 32 parents completed directed telephone interviews. Respondents rated components of the inpatient protocol using five-point Likert scales and answered open-ended questions regarding hospitalization. Quantitative and qualitative analyses were performed.

Results

The mean age of patients at admission was 14.9 years (range 9–21) and the average stay was 8.4 days (range 2–25). Patients rated “massage therapy” most helpful and “cell phone limits” least helpful. Parents rated “nursing staff” most helpful and “seeing other patients in the hospital” least helpful. Protocol components viewed differently by parents and patients included parents more strongly endorsing “staff supervision of meals” (4.34 vs 2.82, p < 0.001) and “limits on physical activity” (4.34 vs 3.23, p = 0.001). The two most common themes identified in open-ended questions were need for hospitalization as a signifier of eating disorder severity and desire for mental health services on the medical unit. Parents emphasized the value of dietician-directed meal planning.

Conclusions

Inpatient medical stabilization for adolescent eating disorders may play an important role not only in addressing acute medical complications, but also in activating the patient and family regarding the need for ongoing treatment. Parents particularly appreciate staff supervision of meals and having a respite from meal planning.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Similar content being viewed by others

Abbreviations

AN:

Anorexia nervosa

BN:

Bulimia nervosa

NG:

Nasogastric

References

  1. Hudson JI, Hiripi E, Pope HG, Kessler RC (2007) The prevalence and correlates of eating disorders in the National Comorbidity Survey replication. Biol Psychiatr 61:348–358. doi:10.1016/j.biopsych.2006.03.040

    Article  Google Scholar 

  2. Westwood LM, Kendal SE (2012) Adolescent client views towards the treatment of anorexia nervosa: a review of the literature. J Psychiatr Ment Health Nurs 19:500–508. doi:10.1111/j.1365-2850.2011.01819.x

    Article  CAS  PubMed  Google Scholar 

  3. Guarda AS, Pinto AM, Coughlin JW, Hussain S, Haug NA, Heinberg LJ (2007) Perceived coercion and change in perceived need for admission in patients hospitalized for eating disorders. Am J Psychiatr 164:108–114. doi:10.1176/appi.ajp.164.1.108

    Article  PubMed  Google Scholar 

  4. Rosen DS, American Academy of Pediatrics Committee on Adolescence (2010) Identification and management of eating disorders in children and adolescents. Pediatrics 126:1240–1253. doi:10.1542/peds.2010-2821

    Article  PubMed  Google Scholar 

  5. Schwartz BI, Mansbach JM, Marion JG, Katzman DK, Forman SF (2008) Variations in admission practices for adolescents with anorexia nervosa: a North American sample. J Adolesc Health 43:425–431. doi:10.1016/j.jadohealth.2008.04.010

    Article  PubMed  Google Scholar 

  6. Gaudiani JL, Sabel AL, Mascolo M, Mehler PS (2012) Severe anorexia nervosa: outcomes from a medical stabilization unit. Int J Eat Disord 45:85–92. doi:10.1002/eat.20889

    Article  PubMed  Google Scholar 

  7. Salbach-Andrae H, Schneider N, Seifert K, Pfeiffer E, Lenz K, Lehmkuhl U et al (2009) Short-term outcome of anorexia nervosa in adolescents after inpatient treatment: a prospective study. Eur Child Adolesc Psychiatr 18:701–704. doi:10.1007/s00787-009-0024-9

    Article  Google Scholar 

  8. Sylvester CJ, Forman SF (2008) Clinical practice guidelines for treating restrictive eating disorder patients during medical hospitalization. Curr Opin Pediatr 20:390–397. doi:10.1097/MOP.0b013e32830504ae

    Article  PubMed  Google Scholar 

  9. Bravender T (2011) Eating Disorders. In: Berlan EB, Bravender T (eds) Adolescent medicine today: a guide to caring for the adolescent patient. World Scientific Publishing, Singapore, pp 269–290

    Chapter  Google Scholar 

  10. Bradley EH, Curry LA, Devers KJ (2007) Qualitative data analysis for health services research: developing taxonomy, themes, and theory. Health Serv Res 42:1758–1772. doi:10.1111/j.1475-6773.2006.00684.x

    Article  PubMed  PubMed Central  Google Scholar 

  11. Offord A, Turner H, Cooper M (2006) Adolescent inpatient treatment for anorexia nervosa: a qualitative study exploring young adults’ retrospective views of treatment and discharge. Eur Eat Disord Rev 14:377–387. doi:10.1002/erv.687

    Article  Google Scholar 

  12. Tierney S (2008) The individual with a condition: a qualitative study of young people’s reflections on being treated for anorexia nervosa. J Am Psychiatr Nurses Assoc 13:368–375. doi:10.1177/1078390307309215

    Article  PubMed  Google Scholar 

  13. Tan JO, Hope T, Stewart A (2003) Anorexia nervosa and personal identity: the accounts of patients and their parents. Int J Law Psychiatr 26:533–548. doi:10.1016/S0160-2527(03)00085-2

    Article  Google Scholar 

  14. Boughtwood D, Halse C (2010) Other than obedient: girls’ constructions of doctors and treatment regimes for anorexia nervosa. J Community Appl Soc Psychol 20:83–94. doi:10.1002/casp.1016

    Article  Google Scholar 

  15. Colton A, Pistrang N (2004) Adolescents’ experiences of inpatient treatment for anorexia nervosa. Eur Eat Disord Rev 12:307–316. doi:10.1002/erv.587

    Article  Google Scholar 

  16. Zaitsoff SL, Tayor A (2009) Factors related to motivation for change in adolescents with eating disorders. Eur Eat Disord Rev 17:227–233. doi:10.1002/erv.915

    Article  PubMed  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Division of Adolescent Medicine, Department of Pediatrics, University of Michigan, 1500 E. Medical Center Drive, D2215, Ann Arbor, MI, 48109-5318, USA

    Terrill Bravender

  2. The Ohio State University College of Medicine, 410 W 10th Avenue, Columbus, OH, 43210, USA

    Hannah Elkus

  3. The Research Institute at Nationwide Children’s Hospital, 700 Children’s Drive, Columbus, OH, 43202, USA

    Hannah Lange

Authors
  1. Terrill Bravender
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Hannah Elkus
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Hannah Lange
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Terrill Bravender.

Ethics declarations

Conflict of interest

The authors have no conflicts of interest to declare.

Ethical approval

All procedures performed in this study were in accordance with the ethical standards of the Nationwide Children's Hospital Institutional Review Board and with the 1964 Helsinki declaration and its later amendments.

Informed consent

Informed consent was obtained from all participants who were 18 years and older. For minors, a parent provided informed consent and the adolescent provided assent to participate.

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Bravender, T., Elkus, H. & Lange, H. Inpatient medical stabilization for adolescents with eating disorders: patient and parent perspectives. Eat Weight Disord 22, 483–489 (2017). https://doi.org/10.1007/s40519-016-0270-z

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s40519-016-0270-z

Keywords

Search

Navigation