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Therapeutic alliance, anorexia nervosa and the inpatient setting: A mixed methods study
Author(s) -
Zugai Joel S.,
SteinParbury Jane,
Roche Michael
Publication year - 2018
Publication title -
journal of advanced nursing
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.948
H-Index - 155
eISSN - 1365-2648
pISSN - 0309-2402
DOI - 10.1111/jan.13410
Subject(s) - alliance , anorexia nervosa , context (archaeology) , thematic analysis , therapeutic relationship , medicine , psychology , psychotherapist , nursing , clinical psychology , psychiatry , qualitative research , eating disorders , paleontology , social science , sociology , political science , law , biology
Aims The aim of this study was to understand the context of the inpatient setting for the treatment of anorexia nervosa and the implications for the therapeutic alliance between nurses and consumers. Background The nature of the therapeutic alliance is dependent on the contextual factors that influence interactions. The inpatient setting for the treatment of anorexia nervosa is one such setting where the therapeutic alliance is operative, yet challenging and poorly understood. Design A two‐phase explanatory sequential design was employed. Descriptive statistics from phase one informed phase two interviews. Phase two data were analysed through thematic analysis. Methods A convenience sample of nurses and consumers were recruited from six wards, in five hospitals. Phase one involved the completion of a survey ( N  =   128) that measured the strength of the therapeutic alliance, as well as other elements of ward context. Phase two interviews (N =   54) were focused on the therapeutic alliance between nurses and consumers and the implications of the inpatient setting. Data collection occurred between May 2014 ‐ February 2015. Results Anorexia nervosa as an illness carries destructive implications for the quality of the therapeutic alliance. Nurses’ intimate position in the inpatient setting and interpersonal capacity is influential in overcoming the obstacles that impede the therapeutic alliance. Conclusion Nurses’ capacity for developing therapeutic alliances is in part dependent on a supportive ward organization and the adequacy of resources to permit meaningful interactions with consumers with anorexia nervosa. Understanding the contextual factors specific to the inpatient setting enhances nurses’ ability to develop therapeutic alliances.

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