Healthcare Professionals’ Capacity for Compassion and Interactions with People Diagnosed with Eating Disorders

Retkiewicz, Emily and Fletcher, Ian (2021) Healthcare Professionals’ Capacity for Compassion and Interactions with People Diagnosed with Eating Disorders. PhD thesis, Lancaster University.

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Abstract

This thesis explored vital aspects of care offered to people diagnosed with eating disorders (EDs). Firstly, a systematic literature review was carried out to explore experiences of people diagnosed with EDs on their therapeutic relationships with healthcare professionals (HCPs) during an inpatient admission. Findings from 13 studies were synthesised using a meta-ethnography approach. Three themes emerged: treated as an ‘anorexic’; us versus them; a good therapeutic relationship with inpatient staff is vital. These themes highlighted the benefits of a positive therapeutic relationship and the challenges of negative relationships with HCPs. Furthermore, an overarching theme of “a delicate balance” highlighted the challenges emerging from polarised expectations patients had regarding how HCPs should interact with them, along with dilemmas associated with distinct aspects of HCPs’ roles in inpatient settings. Recommendations for improving HCPs’ self-awareness and relationships with patients are identified. Secondly, a cross-sectional study was carried out to explore the role of workplace stress factors and emotion regulation strategies in predicting levels of compassion fatigue and compassion satisfaction in HCPs working with people diagnosed with EDs in various settings. “High” levels of compassion fatigue were experienced by approximately 22% of HCPs in the sample, while “low” levels of compassion satisfaction were experienced by approximately 17% of HCPs. Workload demands and job insecurity were identified as the most influential variables in predicting compassion fatigue. Recommendations for addressing these factors at an organisational level are discussed. The expressive suppression strategy for emotion regulation was identified as the most influential variable in predicting compassion satisfaction. Recommendations for tackling workplace stress factors and expressive suppression at an individual and team level are offered. Finally, a critical appraisal of the project discusses the author’s reflections on the challenges associated with it. Recommendations for future research and clinical implications of the project are also identified.