Admission and goodbye letters from adolescents with anorexia nervosa in a day hospital.

Abstract

Background: Care providers working with adolescents with anorexia nervosa (AN) encounter difficulties inherent in the illness (denial, ambivalence) and those related to the fact that it is most often the parents who bring adolescents to care units. Our aim was to study attitudes towards care among adolescents with AN treated in a specialised day hospital using an analysis of letters written before and after treatment.

Methods: Adolescents (12-20 years old) treated for AN in a specialised day hospital, providing multidisciplinary care while enabling a return to schooling inside the facility were included. We analysed 50 admission letters and 23 goodbye letters using general inductive analysis. A mirror analysis was conducted.

Results: In the admission letters, symptoms, calls for help, and reports on the adolescents' care trajectories were central themes. Among the categories noted in both the admission and the goodbye letters, some were similar, some mirrored others and a few differed.

Conclusions: This study highlights how ambivalence and motivations towards care, recovery and illness all interact. It also shows the evolution of the adolescents' positions via their narratives on their experience of care, the constraints involved and its benefits for them. The results are discussed in a care perspective.