Introductie: De behandeling van Anorexia Nervosa is multidisciplinair. Ondanks de uitvoerige behandeling blijkt dat herstelpercentages laag zijn en terugvalpercentages hoog. Er wordt vaak gezien dat (ex)eetstoornispatiënten een paar jaar na de behandeling nog restrictief eetgedrag vertonen. ‘Intuitief Eten’ is een wetenschappelijk onderbouwde methode die kan helpen met het herstellen van de relatie met eten en leren om weer te vertrouwen op het lichaam. Deze studie is opgezet om uit te zoeken hoe Intuïtief Eten het best geïmplementeerd kan worden in de behandeling van Anorexia Nervosa in de diëtistische praktijk. Methode: Om het (eet)gedrag tijdens en na de eetstoornis en de effecten van Intuïtief Eten bij Anorexia Nervosa in kaart te brengen is literatuuronderzoek uitgevoerd. De literatuur is gezocht in de volgende databases: CataloguePlus, Google Scholar, ScienceDirect en Pubmed. Vervolgens is kwalitatief onderzoek gedaan bij 17 vrouwen, in de leeftijd van 15-35 jaar die in behandeling waren voor Anorexia Nervosa of deze behandeling korter dan 5 jaar geleden hadden afgerond. Ze zijn naar hun meningen en voorkeuren bij de behandeling van Anorexia Nervosa gevraagd, door middel van semigestructureerde diepte-interviews. Resultaten: Uit de resultaten van het literatuuronderzoek is gebleken, dat Intuïtief Eten wordt geassocieerd met positieve behandeluitkomsten bij het herstel van Anorexia Nervosa, maar dat toepassing pas mogelijk is, nadat er een periode van hervoeden door middel van een gestructureerd eetschema heeft plaatsgevonden. Uit de diepte-interviews kwam naar voren dat de volgorde van de principes van belang lijkt voor een succesvolle toepassing van Intuïtief Eten. Het lijkt erop, dat er aan het begin van de behandeling mogelijk een grotere kans is dat er misbruik gemaakt wordt van bepaalde principes van Intuïtief Eten, doordat sommige principes als excuus gebruikt kunnen worden om minder te eten of extra te sporten en daarmee het eetstoornis gedrag voortzetten. Principes gericht op het herkennen van de eetstoornis, het lichaamsbeeld en omgaan met emoties, kunnen mogelijk al in een eerder stadium van de behandeling worden toegepast. De principes gericht op het luisteren naar honger- en verzadigingssignalen, bewegen en gezonde voeding worden door respondenten gezien als valkuilen en kunnen daardoor wellicht pas later toegepast worden. Conclusie: Om de toepassing van Intuïtief Eten bij Anorexia Nervosa succesvol te laten verlopen lijkt het van belang om rekening te houden met de volgorde waarin de principes worden geïntroduceerd. Rekening houden met de fase waarin bepaalde principes toegepast kunnen worden, kan mogelijk het verschil maken voor een succesvolle behandeling en zou de kans kunnen verkleinen dat de patiënt misbruik maakt van de principes. Het stroomschema: “Implementatie van Intuïtief Eten bij het herstel van Anorexia Nervosa” kan worden ingezet als hulpmiddel bij het toepassen van Intuïtief Eten bij patiënten met Anorexia Nervosa. Introduction: Anorexia Nervosa treatment is multidisciplinary. Despite comprehensive treatment, recovery rates are found to be low and relapse rates high. It is often seen that (former) eating disorder patients still exhibit restrictive eating behaviour a few years after treatment. 'Intuitive Eating' Wetenschap | Origineel artikel26 Voeding & Visie jaargang 36, nummer 1 2023 is a science-based method that can help restore the relationship with food and learn to trust the body again. This study was designed to find out how Intuitive Eating can best be implemented in the treatment of Anorexia Nervosa in dietetic practice. Method: To identify the (eating) behavior during and after the eating disorder and the effects of Intuitive Eating in Anorexia Nervosa, a literature search was conducted. The literature was searched in the following databases: CataloguePlus, Google Scholar, ScienceDirect and Pubmed. Next, qualitative research was conducted among 17 women, aged 15-35 years who were being treated for Anorexia Nervosa or who have completed this treatment less than 5 years ago. They were asked about their opinions and preferences in the treatment of Anorexia Nervosa, through semi-structured in-depth interviews. Results: The results of the literature review revealed that Intuitive Eating is associated with positive treatment outcomes in the recovery from Anorexia Nervosa, but that application is only possible after a period of refeeding through a structured eating schedule has taken place. The in-depth interviews revealed that the order of the principles appears to be important for the successful application of Intuitive Eating. There seems to be a greater chance of misusing certain principles of Intuitive Eating at the beginning of treatment, as some principles might be used as an excuse to eat less or exercise extra, thus continuing the eating disorder behavior. Principles focused on recognizing the eating disorder, body image and dealing with emotions can possibly be applied early in treatment. Principles focused on listening to hunger and satiety signals, exercise and healthy eating are seen as pitfalls and can possibly only be applied later. Conclusion: In order for the application of Intuitive Eating in Anorexia Nervosa to be successful, it seems important to take into account the order in which the principles are introduced. Considering the phase in which certain principles can be applied might make the difference to successful treatment and possibly reduces the likelihood of the patient misusing the principles. The flowchart: "Implementing Intuitive Eating in Recovery from Anorexia Nervosa" can be used as an aid in applying Intuitive Eating to patients with Anorexia Nervosa.
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This study was motivated by a desire to help working-age individuals gain a better understanding of their daily nutritional intakes with a new self-reported dietary assessment method because an unhealthy eating behavior increases the risks of developing chronic diseases. In this study, we present the design and evaluation of NutriColoring, a food diary that leverages doodling on sketches to report and reflect on everyday diet in the working context. Through a 2-week field study involving 18 participants, the usefulness of NutriColoring in facilitating dietary assessment was tested by making comparisons with the typical bullet diary method. Our quantitative results showed that NutriColoring provided users with improved dietary assessment experience and intrinsic motivations, with significantly low task frustration and high enjoyment. Because of the freedom and playfulness in reporting intakes at work, the interview findings showed a high acceptance of employing NutriColoring at work. This article is concluded with a set of implications for the design and development of a Doodling toolkit to support healthy eating behaviors among office workers.
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Food from home can increase feelings of belonging and act as a source of comfortfor people who move to another country and their children. Nevertheless, people whomove elsewhere often start taking over dietary elements of the host culture, a dynamicprocess referred to as food acculturation. This paper argues that this process is not only related to identity negotiations and emotional connections, but that food choices are also shaped by everyday practical realities. Using a social practice theory-inspired approach, focusing on the elements of material, competence, and meaning, this study investigates the food provisioning practices of eighteen people with a migration background through semistructured interviews.Keywords: migration; acculturation; food environment; procuring; cooking; eating; social practice theory
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Background: A paradigm shift in health care from illness to wellbeing requires new assessment technologies and intervention strategies. Self-monitoring tools based on the Experience Sampling Method (ESM) might provide a solution. They enable patients to monitor both vulnerability and resilience in daily life. Although ESM solutions are extensively used in research, a translation from science into daily clinical practice is needed. Objective: To investigate the redesign process of an existing platform for ESM data collection for detailed functional analysis and disease management used by psychological assistants to the general practitioner (PAGPs) in family medicine. Methods: The experience-sampling platform was reconceptualized according to the design thinking framework in three phases. PAGPs were closely involved in co-creation sessions. In the ‘understand’ phase, knowledge about end-users’ characteristics and current eHealth use was collected (nominal group technique – 2 sessions with N = 15). In the ‘explore’ phase, the key needs concerning the platform content and functionalities were evaluated and prioritized (empathy mapping – 1 session with N = 5, moderated user testing – 1 session with N = 4). In the ‘materialize’ phase, the adjusted version of the platform was tested in daily clinical practice (4 months with N = 4). The whole process was extensively logged, analyzed using content analysis, and discussed with an interprofessional project group. Results: In the ‘understand’ phase, PAGPs emphasized the variability in symptoms reported by patients. Therefore, moment-to-moment assessment of mood and behavior in a daily life context could be valuable. In the ‘explore’ phase, (motivational) functionalities, technological performance and instructions turned out to be important user requirements and could be improved. In the ‘materialize’ phase, PAGPs encountered barriers to implement the experience-sampling platform. They were insufficiently facilitated by the regional primary care group and general practitioners. Conclusion: The redesign process in co-creation yielded meaningful insights into the needs, desires and daily routines in family medicine. Severe barriers were encountered related to the use and uptake of the experience-sampling platform in settings where health care professionals lack the time, knowledge and skills. Future research should focus on the applicability of this platform in family medicine and incorporate patient experiences.
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Despite increased interest in applying psychological theory to the practice of designing behavioral change interventions, design professionals often lack adequate knowledge and resources to do so. In this paper, we present a tool to help professionals in the creative industries design evidence-based health interventions, the Persuasive by Design model. This paper describes the contents and application of the model as well as plans for further development and testing.
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Objective: This article explores the use of experiential knowledge by traditional mental health professionals and the possible contribution to the recovery of service users. Design and Methods: The review identified scientific publications from a range of sources and disciplines. Initial searches were undertaken in databases PsycINFO, PubMed, and Cochrane using specific near operator search strategies and inclusion and exclusion criteria. Results: Fifteen articles were selected. These were published in a broad range of mental health and psychology journals reporting research in western countries. In the selected articles, a varying conceptualization of experiential knowledge was found, differing from therapeutic self-disclosure embedded in psychotherapeutic contexts to a relational and destigmatizing use in recovery-oriented practices. Nurses and social workers especially are speaking out about their own experiences with mental health distress. Experiential knowledge stemming from lived experience affects the professional’s identity and the system. Only a few studies explored the outcomes for service users’ recovery. Conclusion: A small body of literature reports about the use of experiential knowledge by mental health professionals. The mental health system is still in transformation to meaningfully incorporate the lived experience perspective from traditional professionals. There is little data available on the value for the recovery of service users. This data indicates positive outcomes, such as new understandings of recovery, feeling recognized and heard, and increased hope, trust, and motivation. More research about the meaning of experiential knowledge for the recovery of service users is desirable.
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Exploratory analyses are an important first step in psychological research, particularly in problem-based research where various variables are often included from multiple theoretical perspectives not studied together in combination before. Notably, exploratory analyses aim to give first insights into how items and variables included in a study relate to each other. Typically, exploratory analyses involve computing bivariate correlations between items and variables and presenting them in a table. While this is suitable for relatively small data sets, such tables can easily become overwhelming when datasets contain a broad set of variables from multiple theories. We propose the Gaussian graphical model as a novel exploratory analyses tool and present a systematic roadmap to apply this model to explore relationships between items and variables in environmental psychology research. We demonstrate the use and value of the Gaussian graphical model to study relationships between a broad set of items and variables that are expected to explain the effectiveness of community energy initiatives in promoting sustainable energy behaviors.
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In recent years there has been much emphasis on 'research waste' caused by poor question selection, insufficient attention to previous research results, and avoidable weakness in research design, conduct and analysis. Little attention has been paid to the effect of inadequate development of interventions before proceeding to a full clinical trial. We therefore propose to enrich the development phase of the MRC Framework by adding crucial elements to improve the likelihood of success and enhance the fit with clinical practice METHODS: Based on existing intervention development guidance and synthesis, a comprehensive iterative intervention development approach is proposed. Examples from published reports are presented to illustrate the methodology that can be applied within each element to enhance the intervention design.
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Background: Art therapy (AT) is frequently offered to children and adolescents with psychosocial problems. AT is an experiential form of treatment in which the use of art materials, the process of creation in the presence and guidance of an art therapist, and the resulting artwork are assumed to contribute to the reduction of psychosocial problems. Although previous research reports positive effects, there is a lack of knowledge on which (combination of) art therapeutic components contribute to the reduction of psychosocial problems in children and adolescents. Method: A systematic narrative review was conducted to give an overview of AT interventions for children and adolescents with psychosocial problems. Fourteen databases and four electronic journals up to January 2020 were systematically searched. The applied means and forms of expression, therapist behavior, supposed mechanisms of change, and effects were extracted and coded. Results: Thirty-seven studies out of 1,299 studies met the inclusion criteria. This concerned 16 randomized controlled trials, eight controlled trials, and 13 single-group pre–post design studies. AT interventions for children and adolescents are characterized by a variety of materials/techniques, forms of structure such as giving topics or assignments, and the use of language. Three forms of therapist behavior were seen: non-directive, directive, and eclectic. All three forms of therapist behavior, in combination with a variety of means and forms of expression, showed significant effects on psychosocial problems. Conclusions: The results showed that the use of means and forms of expression and therapist behavior is applied flexibly. This suggests the responsiveness of AT, in which means and forms of expression and therapist behavior are applied to respond to the client's needs and circumstances, thereby giving positive results for psychosocial outcomes. For future studies, presenting detailed information on the potential beneficial effects of used therapeutic perspectives, means, art techniques, and therapist behavior is recommended to get a better insight into (un)successful art therapeutic elements.
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There is increasing interest in the use of experiential knowledge and the development of experiential expertise in mental health. Yet, little is known about how best to use this expertise in the role of a psychiatrist. This study aims to gain insight into the concerns of psychiatrists using their lived experiences with mental health distress as a source of knowledge for patients, colleagues and themselves. Eighteen psychiatrists with lived experience as patients in mental health care were interviewed with a semi-structured questionnaire. The interviews were analyzed using qualitative narrative thematic analysis. The majority of the respondents use their lived experience implicitly in the contact with patients, which makes the contact more equal and strengthens the treatment relationship. When explicitly using experiential knowledge in the contact with patients, thought should be given at forehand to its purpose, timing and dosage. Recommendations are that the psychiatrist should be able to reflect on his/her lived experience from a sufficient distance and should take patient factors into account. When working in a team, it is advisable to discuss the use of experiential knowledge in advance with the team. An open organizational culture facilitates the use of experiential knowledge and safety and stability in the team are vital. Current professional codes do not always offer the space to be open. Organizational interests play a role, in the degree of self-disclosure as it can lead to conflict situations and job loss. Respondents unanimously indicated that the use of experiential knowledge in the role of a psychiatrist is a personal decision. Self-reflection and peer supervision with colleagues can be helpful to reflect on different considerations with regard to the use of experiential knowledge. Having personal lived experiences with a mental disorder affects the way psychiatrists think about and performs the profession. The perception of psychopathology becomes more nuanced and there seems to be an increased understanding of the suffering. Even though harnessing experiential knowledge makes the doctor-patient relationship more horizontal it remains unequal because of the difference in roles. However, if adequately used, experiential knowledge can enhance the treatment relationship.
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