Harshita H Jaiprakash, Amy MacKinnon, Sarah Arnaud, Jacob P Neal
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引用次数: 0
摘要
目的:出于伦理、认识论和实用主义的原因,本文主张在饮食失调症(ED)的诊断和治疗中纳入患者的观点。我们以本刊最近发表的一篇社论的观点为基础。作者以饮食失调症为例,反对以 DSM 为导向的主流方法,而主张更加注重了解患者的主观体验。我们认为,他们的分析过早地停止了对如何整合 ED 第一人称和第三人称叙述的实用性和可操作性见解的发展:方法:采用情境分析法来论证患者观点:结果:我们以神经性厌食症(AN)为例,说明整合患者的表现和声音如何为改善患者诊断和治疗提供了一种可行的方法。我们建议接受与承诺疗法(ACT)可以通过协调厌食症患者的价值观与临床医生的护理责任所产生的价值观,为厌食症患者提供支持:我们的结论是,没有充分的科学理由将第一人称视角的ED排除在精神病学之外:V级:基于临床经验的观点。
Valuing patient perspectives in the context of eating disorders.
Purpose: This paper advocates for the inclusion of patient perspectives in the diagnosis and treatment of eating disorders (EDs) for ethical, epistemological, and pragmatic reasons. We build upon the ideas of a recent editorial published in this journal. Using EDs as their example, the authors argue against dominant DSM-oriented approaches in favor of an increased focus on understanding patients' subjective experiences. We argue that their analysis stops too soon for the development of practical-and actionable-insights into how to effect the integration of first-person and third-person accounts of EDs.
Methods: Contextual analysis was used to make the case for patient perspectives.
Results: We use anorexia nervosa (AN) as an example to demonstrate how the integration of patient manifestations and voices offers a promising methodology to improve patient diagnosis and treatment. We suggest that Acceptance and Commitment Therapy (ACT) can support patients with AN by reconciling their values with the values that arise from a clinician's duty of care.
Conclusions: We conclude that there are no good scientific reasons to exclude first-person perspectives of EDs in psychiatry.
Level of evidence: Level V: Opinions based on clinical experience.
期刊介绍:
Eating and Weight Disorders - Studies on Anorexia, Bulimia and Obesity is a scientific journal whose main purpose is to create an international forum devoted to the several sectors of eating disorders and obesity and the significant relations between them. The journal publishes basic research, clinical and theoretical articles on eating disorders and weight-related problems: anorexia nervosa, bulimia nervosa, subthreshold eating disorders, obesity, atypical patterns of eating behaviour and body weight regulation in clinical and non-clinical populations.