Eating disorders, COVID-19 and reconfigurations of care
challenges for shared management of health professionals
Palabras clave:
COVID-19, Eating disorders, Mental health services, Multidisciplinary care team, Qualitative researchResumen
Objective
This study aimed to understand the meanings attributed by the team specialized in eating disorders to the reconfigurations implemented in the service during the first wave of the COVID-19 pandemic.
Method
This is a cross-sectional descriptive-exploratory investigation that adopted the clinical-qualitative method and the Psychoanalysis of Bonding Configurations as theoretical reference. Focus groups were conducted with 23 professionals, analyzed from the perspective of Reflective Thematic Analysis, which resulted in the elaboration of three themes.
Results
Professionals report that the outbreak of COVID-19 had an impact on the service, generating a feeling of helplessness, fear and paralysis. The need to provide care continuity led to team movement in order to reorganize, allowing the maintenance of assistance. The retrospective looks shared in the focus groups allowed the team to elaborate the facilitating and hindering factors of the experience.
Conclusion
The results offer support for managers and health professionals to improve health care in crisis situations.
Descargas
Citas
Barbour, R. (2009). Grupos focais. Artmed.
Berenstein, I., & Puget, J. (2008). Psychanalyse du lien: dans différents dispositifs thérapeutiques. Érès.
Birman, J. (2020). O trauma na pandemia do coronavírus: suas dimensões políticas, sociais, econômicas, ecológicas, culturais, éticas e científicas. José Olympio.
Borges, C. D., & Santos, M. A. (2005). Aplicações da técnica do grupo focal: fundamentos metodológicos, potencialidades e limites. Revista da SPAGESP, 6(1), 74-80. http://pepsic.bvsalud.org/scielo.php?pid=S1677-29702005000100010
Braun, V., & Clarke, V. (2013). Teaching thematic analysis: overcoming challenges and developing strategies for effective learning. The Psychologist, 26(2), 120-123. https://uwe-repository.worktribe.com/preview/937606/Teaching
Brolese, D. F., Lessa, G., Santos, J. L. G. D., Mendes, J. D. S., Cunha, K. S. D., & Rodrigues, J. (2017). Resilience of the health team in caring for people with mental disorders in a psychiatric hospital. Revista da Escola de Enfermagem da USP, 51, e03230. http://dx.doi.org/10.1590/S1980-220X2016026003230
Clark Bryan, D., MacDonald, P., Ambwani, S., Cardi, V., Rowlands, K., Willmott, D., & Treasure, J. (2020). Exploring the ways in which COVID-19 and lockdown has affected the lives of adult patients with anorexia nervosa and their carers. European Eating Disorders Review, 28(6), 826-835. https://doi.org/10.1002/erv.2762
Creswell, J. W., & Poth, C. N. (2013). Qualitative inquiry & research design: choosing among five approaches (3th ed.). Sage.
Datta, N., Derenne, J., Sanders, M., & Lock, J. D. (2020). Telehealth transition in a comprehensive care unit for eating disorders: Challenges and long-term benefits. International Journal of Eating Disorders, 53(11), 1774-1779. https://doi.org/10.1002/eat.23348
Davis, C., Ng, K. C., Oh, J. Y., Baeg, A., Rajasegaran, K., & Chew, C. S. E. (2020). Caring for children and adolescents with eating disorders in the current coronavirus 19 pandemic: a Singapore perspective. Journal of Adolescent Health, 67(1), 131-134. https://doi.org/10.1016/j.jadohealth.2020.03.037
Flick, U. (2019). An introduction of qualitative research (6th ed.). Sage.
Freud, S. (2010). Além do princípio do prazer: Vol. 14. História de uma neurose infantil: (“O Homem dos Lobos”), Além do princípio do prazer e outros textos (1917-1920) (pp. 161-239). Companhia das Letras. (Trabalho originalmente publicado em 1920)
Freud, S. (2011). Psicologia das massas e análise do eu: Vol. 15. Psicologia das massas e análise do eu e outros textos (1920-1923) (pp. 13-113). Companhia das Letras. (Trabalho originalmente publicado em 1921)
Fundação Oswaldo Cruz. (2021). Comitê de ética em pesquisa. In Escola Nacional de Saúde Pública Sergio Arouca, Orientações sobre ética em pesquisa em ambientes virtuais. ENSP/Fiocruz. https://cep.ensp.fiocruz.br/sites/default/files/orientacoes_eticapesquisaambientevirtual.pdf
Graell, M., Morón-Nozaleda, M. G., Camarneiro, R., Villaseñor, Á., Yáñez, S., Muñoz, R., Martínez-Núñez, B., Miguélez-Fernández, C., Muñoz, M., & Faya, M. (2020). Children and adolescents with eating disorders during COVID-19 confinement: difficulties and future challenges. European Eating Disorders Review, 28(6), 864-870. https://doi.org/10.1002/erv.2763
Kang, L., Li, Y., Hu, S., Chen, M., Yang, C., Yang, B. X., & Liu, Z. (2020). The mental health of medical workers in Wuhan, China dealing with the 2019 novel coronavirus. The Lancet Psychiatry, 7(3), e14. https://doi.org/10.1016/S2215-0366(20)30047-X
Laplanche, J., & Pontalis, J. (1998). Vocabulário de psicanálise. Martins Fontes.
Leonidas, C., Nazar, B. P., Munguía, L., & Santos, M. A. (2019). How do we target the factors that maintain anorexia nervosa? A behaviour change taxonomical analysis. International Review of Psychiatry, 31(4), 403-410. https://doi.org/10.1080/09540261.2019.1624509
Moura, A. A. M., Bassoli, I. R., Silveira, B. V., Diehl, A., Santos, M. A., Santos, R. A., Wagstaff, C., & Pillon, S. C. (2022). Is social isolation during the COVID-19 pandemic a risk factor for depression? Revista Brasileira de Enfermagem, 75, e20210594. https://doi.org/10.1590/0034-7167-2021-0594
Nisticò, V., Bertelli, S., Tedesco, R., Anselmetti, S., Priori, A., Gambini, O., & Demartini, B. (2021). The psychological impact of COVID-19-related lockdown measures among a sample of Italian patients with eating disorders: a preliminary longitudinal study. Eating and Weight Disorders, 26(8), 2771-2777. https://doi.org/10.1007/s40519-021-01137-0
Nunes, M. A. F. (2021). Pertença. In R. Levisky, M. L. Dias, & D. L. Levisky (Orgs.), Dicionário de psicanálise de casal e família (pp. 404-409). Blucher.
Oliveira, W. A., Oliveira-Cardoso, E. A., Silva, J. L., & Santos, M. A. (2020). Impactos psicológicos e ocupacionais das sucessivas ondas recentes de pandemias em profissionais da saúde: revisão integrativa e lições aprendidas. Estudos de Psicologia (Campinas), 37, e200066. https://doi.org/10.1590/1982-0275202037e200066
Oliveira, J. C., Penido, C. M. F., Franco, A. C. R., Santos, T. L. A., & Silva, B. A. W. (2022). Especificidades do grupo focal on-line: uma revisão integrativa. Ciência e Saúde Coletiva, 27(5), 1813-1826. https://doi.org/10.1590/1413-81232022275.11682021
Oliveira-Cardoso, E. A., & Santos, M. A. (2019). Avaliação psicológica no contexto dos transtornos alimentares. In S. M. Barroso, F. Scorsolini-Comin, & E. Nascimento (Orgs.), Avaliação psicológica: contextos de atuação, teoria e modos de fazer (pp. 165-186). Sinopsys.
Papandreou, C., Arija, V., Aretouli, E., Tsilidis, K., & Bulló, M. (2020). Comparing eating behaviours, and symptoms of depression and anxiety between Spain and Greece during the COVID-19 outbreak: cross-sectional analysis of two different confinement strategies. European Eating Disorders Review, 28(6), 836-846. https://doi.org/10.1002/erv.2772
Plumley, S., Kristensen, A., & Jenkins, P. E. (2021). Continuation of an eating disorders day programme during the COVID-19 pandemic. Journal of Eating Disorders, 9(1), 34-41. https://doi.org/10.1186/s40337-021-00390-z
Puget, J. (2005). El trauma, los traumas y las temporalidades. Psicoanálisis ApdeBA, 28(112), 293-310.
Puget, J. (2015). Subjetivación descontinua y psicoanálisis: incertidumbre y certezas. Lugar Editorial.
Roussillon, R. (2019). Manual da prática clínica em psicología e psicopatologia. Blucher.
Santos, M. A., Oliveira, W. A., & Oliveira-Cardoso, É. A. (2020). Inconfidências de abril: impacto do isolamento social na comunidade trans em tempos de pandemia de COVID-19. Psicologia & Sociedade, 32, e020018. http://doi.org/10.1590/1807-0310/2020v32240339
Santos, M. A., Valdanha-Ornelas, E. D., Leonidas, C., & Oliveira-Cardoso, E. A. (2020). Adolescentes intransigentes: revisitando as psicoterapias no contexto da anorexia e bulimia. In D. M. Amparo, R. A. O. Morais, K. T. Brasil, & E. R. Lazzarini (Orgs.), Adolescência: psicoterapias e mediações terapêuticas na clínica dos extremos (pp. 51-74). TechnoPolitik.
Schlegl, S., Maier, J., Meule, A., & Voderholzer, U. (2020). Eating disorders in times of the COVID-19 pandemic: results from an online survey of patients with anorexia nervosa. International Journal of Eating Disorders, 53(11), 1791-1800. https://doi.org/10.1002/eat.23374
Simonds, L. M., & Spokes, N. (2017). Therapist self-disclosure and the therapeutic alliance in the treatment of eating problems. Jounal of Eating Disorders, 25(2), 151-164. https://doi.org/10.1080/10640266.2016.1269557
Souza, K. Z., & Lopes, F. M. (2022). Perception of bonding and occupational stress in a multidisciplinary cancer patients health team. Estudos de Psicologia (Campinas), 39, e200002. https://doi.org/10.1590/1982-0275202239e200002
Termorshuizen, J. D., Watson, H. J., Thornton, L. M., Borg, S., Flatt, R. E., MacDermod, C. M., & Bulik, C. M. (2020). Early impact of COVID-19 on individuals with self-reported eating disorders: a survey of 1,000 individuals in the United States and the Netherlands. International Journal of Eating Disorders, 53(11), 1780-1790. https://doi.org/10.1002/eat.23353
Tong, A., Sainsbury, P., & Craig, J. (2007). Consolidated criteria for reporting qualitative research (COREQ): a 32-item checklist for interviews and focus groups. International Journal for Quality in Health Care, 19(6), 349-357. https://doi.org/10.1093/intqhc/mzm042
Turato, E. R. (2013). Tratado de metodologia da pesquisa clínico-qualitativa: construção teórico-epistemológica, discussão comparada e aplicação nas áreas da saúde e humanas (6th ed.). Vozes.
Weintraub, A. C. A. M., Noal, S D., & Damásio, F. (2020). Saúde mental e atenção psicossocial na pandemia COVID-19: orientações aos trabalhadores dos serviços de saúde. Fiocruz/CEPEDES.
Word Health Organization. (2021). Advice for the public: coronavirus disease (COVID-19). https://www.who.int/emergencies/diseases/novel-coronavirus2019/advice-for-public
Descargas
Publicado
Cómo citar
Número
Sección
Licencia
Derechos de autor 2025 Bruna Bortolozzi Maia, Érika Arantes Oliveira-Cardoso, Eduardo Name Risk, Sandra Cristina Pillon, Manoel Antônio Santos
Esta obra está bajo una licencia internacional Creative Commons Atribución 4.0.
