Refusal of Treatment for Anorexia Nervosa: Mental Health Professionals' Opinion on Willingness and Role Stress

Rev Colomb Psiquiatr (Engl Ed). 2021 Apr 19;S0034-7450(21)00046-9. doi: 10.1016/j.rcp.2021.01.005. Online ahead of print.
[Article in English, Spanish]

Abstract

Introduction: The hospitalisation of patients with anorexia nervosa poses an important bioethical quandary and can generate stress for the healthcare professionals. Our goal was to know and analyse the opinion of mental health professionals on some conditions for applying the involuntary hospitalisation of patients with anorexia nervosa.

Methods: Cross-sectional descriptive observational study on a sample of 270 mental health professionals, using an ad hoc questionnaire with scores ranging from 0 to 10.

Results: The professionals state that, in some cases, the patient accepts admission reluctantly: 7.74 (95% CI, 7.55-7.93). In the event of physical risk, it is difficult for them to combine respect for the patient's autonomy and the duty of care: 6.06 (95% CI, 5.70-6.41) and the relationship with the patient is largely oriented to convince them: 7.18 (95% CI, 6.91-7.46). They do not decide on the suitability of the participation of non-medical staff in the decision: 5.13 (95% CI, 4.75-5.52), or if the indication should correspond to someone other than the doctor in charge of their care: 4.79 (95% CI, 4.39-5.19). They reject the possibility of conscientious objection: 4.05 (95% CI, 3.68-4.41).

Conclusions: Mental health professionals are subject to ambiguous work demands, which affects their care dynamics.

Keywords: Actitud del personal de salud; Anorexia nerviosa; Anorexia nervosa; Attitude of health personnel; Compulsory admission of mentally ill patients; Encuestas y cuestionarios; Estrés laboral; Internamiento obligatorio del enfermo mental; Occupational stress; Surveys and questionnaires.