Abstract
Anorexia nervosa (AN) is an illness with a large impact on an individual’s quality of life, affecting relationships with friends and family, social inclusion, employment, personal development, and physical health, among other domains. However, most QoL studies primarily focus on health-related QoL without paying attention to the psychosocial and subjective aspects of QoL. In this study, QoL in persons with AN is investigated from a broad perspective. More specifically, this study aims at (1) gaining insight into the personal meaning of QoL of persons recovering from AN, (2) specifying the indicators of the QoL model of Schalock (J Intellect Disabil Res 48(3):203–216, 2004) for persons with AN, and (3) exploring the relationship between a specific treatment program and the perception on QoL of persons with AN. Therefore, in-depth interviews were conducted with 17 persons recovering from AN, who are supported by Empathie, a therapeutic center in Flanders, using solution-focused therapy and client-centered therapy, combined with a systemic orientation. The participants spontaneously mentioned the following themes when asked which elements are important to have a good QoL: interpersonal relationships, personal development, being able to relax, self-determination, and having a healthy lifestyle. Each domain of the QoL model of Schalock was operationalized into specific indicators for persons with AN. These indicators can help service providers to tailor their support strategies to the needs of each patient. The participants reported that being in therapy had positively influenced the following domains: interpersonal relationships, emotional well-being, self-determination, and social inclusion.
Similar content being viewed by others
References
Berg, K., & Wonderlich, S. (2013). Emerging psychological treatments in the field of eating disorders. Current Psychiatry Reports, 15(11), 1–9. doi:10.1007/s11920-013-0407-y.
Bernheim, J. L., Theuns, P., Mazaheri, M., Hofmans, J., Fliege, H., & Rose, M. (2006). The potential of Anamnestic Comparative Self-Assessment (ACSA) to reduce bias in the measurement of subjective well-being. Journal of Happiness Studies, 7(2), 227–250. doi:10.1007/s10902-005-4755-0 [Article].
Braun, V., & Clarke, V. (2006). Using thematic analysis in psychology. Qualitative Research in Psychology, 3(2), 77–101. doi:10.1191/1478088706qp063oa.
Claes, C., Van Hove, G., Vandevelde, S., van Loon, J., & Schalock, R. (2012). The influence of supports strategies, environmental factors, and client characteristics on quality of life-related personal outcomes. Research in Developmental Disabilities, 33(1), 96–103. doi:10.1016/j.ridd.2011.08.024.
Claes, C., Van Hove, G., Vandevelde, S., van Loon, J., & Schalock, R. L. (2010). Person-centered planning: analysis of research and effectiveness. Intellectual and Developmental Disabilities, 48(6), 432–453.
de la Rie, S., Noordenbos, G., Donker, M., & van Furth, E. (2007). The patient’s view on quality of life and eating disorders. International Journal of Eating Disorders, 40(1), 13–20. doi:10.1002/eat.20338 [Article].
De Ruysscher, C., Annicq, P., Vandevelde, S., & Claes, C. (2015). Anorexia Nervosa: een integratief behandelmodel. Tijdschrift voor Psychotherapie, 41(2), 87--100.
Engel, S., Adair, C., Hayas, C., & Abraham, S. (2009). Health-related quality of life and eating disorders: a review and update. The International Journal of Eating Disorders, 42(2), 179–187.
Fairburn, C. G. (2005). Evidence-based treatment of anorexia nervosa. International Journal of Eating Disorders, 37(S1), S26–S30. doi:10.1002/eat.20112.
Flick, U. (2009). An introduction to qualitative research. London: Sage.
Guarda, A. S. (2008). Treatment of anorexia nervosa: insights and obstacles. Physiology & Behavior, 94(1), 113–120. doi:10.1016/j.physbeh.2007.11.020.
Hoek, H. W. (2006). Incidence, prevalence and mortality of anorexia nervosa and other eating disorders. Current Opinion in Psychiatry, 19(4), 389–394.
Howitt, D. (2010). Introduction to qualitative methods in psychology. New Jersey: Prentice Hall.
Isaacs, B., Clark, C., Correia, S., & Flannery, J. (2009). Utility of logic models to plan quality of life outcome evaluations. Journal of Policy and Practice in Intellectual Disabilities, 6(1), 52–61.
Jenkins, P., Hoste, R., Meyer, C., & Blissett, J. (2011). Eating disorders and quality of life: a review of the literature. Clinical Psychology Review, 31, 113–121.
Jones, A., Evans, M., Bamford, B., & Ford, H. (2008). Exploring quality of life for eating-disordered patients. European Eating Disorders Review, 16(4), 276–286. doi:10.1002/erv.852 [Article].
Mitchison, D., Hay, P., Engel, S., Crosby, R., Grange, D., Lacey, H., et al. (2013). Assessment of quality of life in people with severe and enduring anorexia nervosa: a comparison of generic and specific instruments. BMC Psychiatry, 13(1), 284.
Mond, J., Hay, P., Rodgers, B., Owen, C., & Beumont, P. (2005). Assessing quality of life in eating disorder patients. Quality of Life Research, 14, 171–178.
Padierna, A., Quintana, J., Arostegui, I., Gonzalez, N., & Horcajo, M. (2002). Changes in health related quality of life among patients treated for eating disorders. Quality of Life Research, 11, 545–552.
Ratnasuriya, R. H., Eisler, I., Szmukler, G. I., & Russell, G. F. (1991). Anorexia nervosa: outcome and prognostic factors after 20 years. British Journal of Psychiatry, 158, 495–502.
Schalock, R. L. (2004). The concept of quality of life: what we know and do not know. Journal of Intellectual Disability Research, 48(3), 203–216.
Schalock, R. L., Bonham, G. S., & Verdugo, M. A. (2008). The conceptualization and measurement of quality of life: implications for program planning and evaluation in the field of intellectual disabilities. Evaluation and Program Planning, 31(2), 181–190. doi:10.1016/j.evalprogplan.2008.02.001.
Schalock, R. L., Brown, I., Brown, R., Cummins, R. A., Felce, D., Matikka, L., et al. (2002). Conceptualization, measurement, and application of quality of life for persons with intellectual disabilities: report of an international panel of experts. Mental Retardation, 40(6), 457–470. doi:10.1352/0047-6765(2002)040<0457:CMAAOQ>2.0.CO;2.
Schalock, R. L., Keith, K. D., Verdugo, M. A., & Gomez, L. E. (2009). Quality of life model development and use in the field of intellectual disability. In R. Kober (Ed.), Enhancing the quality of life of people with intellectual disability: from theory to practice. New York: Springer.
Schmidt, U., Wade, T. D., & Treasure, J. (2014). The Maudsley Model of Anorexia Nervosa Treatment for Adults (MANTRA): development, key features, and preliminary evidence. Journal of Cognitive Psychotherapy: An International Quarterly, 28(1). doi:10.1891/0889-8391.28.1.1.
Steinhausen, H. C. (2009). Outcome of eating disorders. Child and Adolescent Psychiatric Clinics of North America, 18(1), 225–242. doi:10.1016/j.chc.2008.07.013.
Verdugo, M. A., Navas, P., Gómez, L. E., & Schalock, R. L. (2012). The concept of quality of life and its role in enhancing human rights in the field of intellectual disability. Journal of Intellectual Disability Research, 56(11), 1036–1045. doi:10.1111/j.1365-2788.2012.01585.x.
Verdugo, M. A., Schalock, R. L., Keith, K. D., & Stancliffe, R. J. (2005). Quality of life and its measurement: important principles and guidelines. Journal of Intellectual Disability Research, 49(10), 707–717. doi:10.1111/j.1365-2788.2005.00739.x [Article].
Williams, K., Dobney, T., & Geller, J. (2010). Setting the eating disorder aside: an alternative model of care. European Eating Disorders Review, 18(2), 90–96.
Acknowledgments
This article is based on a study that was financed by Empathie.
Conflict of Interest
The researchers (CD, CC, and SV) declare that they have no competing interests. The fourth author (PA) is connected to Empathie as she is the director of the program. She has been involved in the study design, the interpretation of the findings based on the data that were first made anonymous, and the drafting of the article. The data analysis has been carried out independently by the researchers.
Author information
Authors and Affiliations
Corresponding author
Rights and permissions
About this article
Cite this article
De Ruysscher, C., Annicq, P., Vandevelde, S. et al. The Perception of Persons with Anorexia Nervosa on Quality of Life: an Initial Investigation. Applied Research Quality Life 11, 613–630 (2016). https://doi.org/10.1007/s11482-015-9425-8
Received:
Accepted:
Published:
Issue Date:
DOI: https://doi.org/10.1007/s11482-015-9425-8