‘Helper’ or ‘punisher’? A qualitative study exploring staff experiences of treating severe and complex eating disorder presentations in inpatient settings
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 wor...
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| Format: | Article |
| Language: | English |
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BMC
2023-12-01
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| Series: | Journal of Eating Disorders |
| Subjects: | |
| Online Access: | https://doi.org/10.1186/s40337-023-00938-1 |
| _version_ | 1797398201699926016 |
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| author | Sienna Bommen Helen Nicholls Jo Billings |
| author_facet | Sienna Bommen Helen Nicholls Jo Billings |
| author_sort | Sienna Bommen |
| collection | DOAJ |
| description | 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. |
| first_indexed | 2024-03-09T01:22:24Z |
| format | Article |
| id | doaj.art-563acdfe955e4a55a818d340b160f4b9 |
| institution | Directory Open Access Journal |
| issn | 2050-2974 |
| language | English |
| last_indexed | 2024-03-09T01:22:24Z |
| publishDate | 2023-12-01 |
| publisher | BMC |
| record_format | Article |
| series | Journal of Eating Disorders |
| spelling | doaj.art-563acdfe955e4a55a818d340b160f4b92023-12-10T12:04:06ZengBMCJournal of Eating Disorders2050-29742023-12-0111111310.1186/s40337-023-00938-1‘Helper’ or ‘punisher’? A qualitative study exploring staff experiences of treating severe and complex eating disorder presentations in inpatient settingsSienna Bommen0Helen Nicholls1Jo Billings2Division of Psychiatry, University College LondonDivision of Psychiatry, University College LondonDivision of Psychiatry, University College LondonAbstract 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.https://doi.org/10.1186/s40337-023-00938-1Eating disordersMental healthStaff wellbeingQualitativeInterviewReflexive thematic analysis |
| spellingShingle | Sienna Bommen Helen Nicholls Jo Billings ‘Helper’ or ‘punisher’? A qualitative study exploring staff experiences of treating severe and complex eating disorder presentations in inpatient settings Journal of Eating Disorders Eating disorders Mental health Staff wellbeing Qualitative Interview Reflexive thematic analysis |
| title | ‘Helper’ or ‘punisher’? A qualitative study exploring staff experiences of treating severe and complex eating disorder presentations in inpatient settings |
| title_full | ‘Helper’ or ‘punisher’? A qualitative study exploring staff experiences of treating severe and complex eating disorder presentations in inpatient settings |
| title_fullStr | ‘Helper’ or ‘punisher’? A qualitative study exploring staff experiences of treating severe and complex eating disorder presentations in inpatient settings |
| title_full_unstemmed | ‘Helper’ or ‘punisher’? A qualitative study exploring staff experiences of treating severe and complex eating disorder presentations in inpatient settings |
| title_short | ‘Helper’ or ‘punisher’? A qualitative study exploring staff experiences of treating severe and complex eating disorder presentations in inpatient settings |
| title_sort | helper or punisher a qualitative study exploring staff experiences of treating severe and complex eating disorder presentations in inpatient settings |
| topic | Eating disorders Mental health Staff wellbeing Qualitative Interview Reflexive thematic analysis |
| url | https://doi.org/10.1186/s40337-023-00938-1 |
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