ABSTRACT
BACKGROUND: Educational interventions are a key element in the care of young patients with feeding and eating disorders, forming part of the majority of therapeutic approaches. The aim of this review is to evaluate the impact of educational interventions in adolescents with feeding and eating disorders. METHODS: Following the PRISMA recommendations electronic databases were searched up to 29 June 2023. Studies related to educational interventions in young population diagnosed with feeding and eating disorders (anorexia nervosa, avoidant/restrictive food intake disorder, bulimia nervosa, pica and ruminative disorders and binge- eating disorder) in Spanish and English language, without temporal limitation, were located in the databases: PubMed, Scopus, CINAHL, Cochrane Library, PsycINFO, CUIDEN, DIALNET, and ENFISPO. A search in the databases of grey literature was performed in OpenGrey and Teseo. The review protocol was registered in PROSPERO (CRD42020167736). RESULTS: A total of 191 articles were selected from the 9744 citations screened. Ten publications were included. The results indicated variability between educational programs, including individual and group interventions, learning techniques and various research methodologies. Variables such as learning, attitudinal and perceptual changes, anthropometric parameters, symptom improvement, normalization of eating patterns, evaluation of the program and cognitive flexibility were identified. The risk of bias was high due to the low methodological quality of a large number of studies analyzed. CONCLUSION: The results indicate that educational interventions can influence the improvement of knowledge level and have a positive effect on health outcomes. Although education is a common practice in the treatment of these pathologies, high-quality studies were not identified. Thus, this review concludes that additional evidence is needed to evaluate the effectiveness of educational programs, with further research studies, especially randomized controlled trials, to confirm these results. LEVEL OF EVIDENCE: Level I: Systematic review.
Subject(s)
Anorexia Nervosa , Avoidant Restrictive Food Intake Disorder , Binge-Eating Disorder , Bulimia Nervosa , Feeding and Eating Disorders , Humans , Adolescent , Feeding and Eating Disorders/therapyABSTRACT
La pandemia de COVID-19 ha supuesto un desafío para los sistemas sanitarios, incluida la atención a la salud mental. Ha sido necesaria la adaptación constante de la práctica asistencial habitual según la situación epidemiológica poblacional. Se recoge la actividad asistencial prestadapor la Red de Salud Mental de Navarra durante los años 2019, 2020 y 2021. Se registra una disminución en el número de consultas ambulatorias realizadas durante 2020 y su recuperación en2021, con un incremento de la demanda en la población femenina. Se han producido variacionesen la ocupación y estancias medias de los recursos de hospitalización, así como una reestructuración funcional y estructural. En el ámbito residencial se produjo el fallecimiento del 9,8% delos usuarios debido al COVID-19. Las tasas de suicidio durante 2020 se mantuvieron similaresa 2019, incrementándose un 36% en 2021. La pandemia ha impactado en la continuidad de losplanes de tratamiento, en la evolución clínica, psicopatológica y emocional de las personasatendidas. Las repercusiones negativas pueden extenderse a lo largo de los próximos años. Porello, será fundamental el desarrollo de estrategias sanitarias, sociales y de salud pública dirigidas a la promoción de la salud y la prevención de los problemas de salud mental.(AU)
Subject(s)
Humans , Male , Female , Pandemics , Coronavirus Infections/epidemiology , Mental Health , Mental Disorders , Severe acute respiratory syndrome-related coronavirus , Patient Care , Spain , Epidemiology, Descriptive , Referral and Consultation , Quality of Health Care , Medical Care , Ambulatory CareABSTRACT
Feeding and eating disorders represent a serious problem especially in young population. Nutritional education is essential in its treatment and prevention.
Subject(s)
Feeding and Eating Disorders/psychology , Program Development/methods , Surveys and Questionnaires/standards , Adult , Aged , Consensus , Delphi Technique , Female , Humans , Male , Middle Aged , Validation Studies as TopicABSTRACT
Introducción. Los trastornos de la conducta alimentariarepresentan un grave, problema especialmente en poblaciónjoven. La educación nutricional es fundamental en su tratamiento y prevención.Entre las acciones desarrolladas, en España destaca la estrategia NAOS, que enmarca el programa educativo Perseodestinado a escolares. Sin embargo, existen escasos instrumentos que evalúen los conocimientos tras la realización deeste tipo de acciones. El objetivo del estudio ha sido elaborar y validar un cuestionario que permita evaluar los conocimientos tras realizar el programa Perseo en población juvenil diagnosticada de trastornos alimentarios.Metodología. Se implementó la técnica e-Delphi modificada online, en la que participaron 26 expertos de saludmental y nutrición. Evaluándose el grado de consenso enadecuación y relevancia a través de una escala Likert decuatro puntos y un campo para comentarios. Los criteriosbásicos y suplementarios del desarrollo de la técnica se establecieron previamente.Resultados. Tomando como base el programa Perseo yel cuestionario General Nutrition Knowledge Questionnaire(GNKQ) en su versión adaptada a adolescentes portugueses,se desarrolló una versión inicial del cuestionario de 30 ítemsy 4 posibles respuestas. Tras tres fases, 26 ítems alcanzaron elconsenso requerido tanto en adecuación como en relevancia.Finalmente, se obtuvo un nuevo cuestionario compuesto por26 ítems con un alto grado de consenso en opinión de losexpertos.Conclusiones. El cuestionario ha demostrado una sólidavalidez de contenido. Permitiendo evaluar una intervencióneducativa sobre nutrición, basada en el programa Perseo, enpoblación juvenil con trastornos alimentarios. (AU)
Introduction. Feeding and eating disorders represent aserious problem especially in young population. Nutritionaleducation is essential in its treatment and prevention.Among the actions developed in Spain the NAOS strategyhighlights, which frames the Perseo educational program forschoolchildren. However, there are few tools to evaluate theknowledge after these programs are implemented. The aimof the study was to create and to validate a questionnairethat allows the evaluation of the acquired knowledge onyoung population diagnosed of eating disorders after participating on Perseo program.Methodology. The on-line modified e-Delphi techniquewas applied, 26 mental health and nutrition experts tookpart, evaluating the consensus level on adequacy and relevance through a 4-points Likert scale and a field for comments. Basic and supplementary criteria for the developmentof the technique were previously established.Results. On the basis of the Perseo program and theadapted version of GNKQ for Portuguese teenagers, an initial version of the questionnaire was developed with 30 items and 4 possible answers. After three rounds 26 of theitems reached the required consensus both in adequacyand relevance.Eventually a new questionnaire of 26 items was obtainedwith a high degree of general agreement according to theexperts.Conclusions. The questionnaire has demonstrated astrong validity of content that allows to evaluate an educational intervention on nutrition based on the Perseo program, among young population with eating disorders. (AU)
Subject(s)
Humans , Adolescent , Feeding and Eating Disorders , 52503 , Therapeutics , Surveys and QuestionnairesABSTRACT
PURPOSE: The purpose of this study is to investigate whether there is an association between anticholinergic burden and mortality or rehospitalization in older adults discharged from hospital. METHODS: Prospective multicenter cohort study carried out with patients aged 65 and older discharged from seven acute care hospitals. The primary outcomes of the study were rehospitalization and mortality within 1 year after discharge. The study population was classified in three groups according to the anticholinergic exposure measured by the Anticholinergic Risk Scale (ARS) and Durán's list at the time of hospital discharge: without risk (ARS/Durán = 0), low risk (ARS/Durán = 1), and high risk (ARS/Durán ≥ 2). Predictors of hospitalizations and mortality were examined using regression models adjusting for important covariates. RESULTS: The mean age of the 921 participants was 81.2 years (SD = 7.4 years). Prevalence of exposure to medications with anticholinergic activity ranged from 19.6% with ARS to 32.1% with Durán's list. During the follow-up period, 30.4% of participants were hospitalized and 19.4% died. Multivariate regression analysis showed that low anticholinergic burden quantified according to Durán's list was significantly associated with all-cause mortality (OR 1.69, 95% CI 1.02-2.82). This association was not present after adjustment when using ARS. No statistically significant association was found between anticholinergic burden and hospitalizations. CONCLUSIONS: Taking medications with anticholinergic activity is associated with greater risk of mortality in older adults discharged from acute care hospitals. Strategies to reduce anticholinergic burden in vulnerable elders could be useful to improve health outcomes. Further research is required to assess the association between anticholinergic burden and hospitalizations in older patients.
