To bend or not to bend? Rule adherence among staff at an eating disorder unit

On inpatient eating disorder units, resolving under-nutrition and reestablishing normal eating behavior are key treatment aims. Consequently, the provision of support at mealtimes is a core work task for patients with severe eating disorders. The purpose of this study was to explore staff deliberations and actions, as observed during staff-patient interactions at mealtimes on an inpatient eating disorder unit (EDU). We specifically aimed to characterize how and why staff members intervene during staff-patient interactions in which a refeeding script is activated. This exploratory qualitative study combined non-participant observation and in-depth interviews. Content analysis was used to categorize and abstract the data material. Through the described analysis, we identified two main types of patterns which were categorized as rule adherence and rule bending, describing how staff chose how to intervene in situations where refeeding scripts were activated. The current findings may contribute to enhanced insight and awareness regarding staff behavior and deliberations when providing meal support, and thus help staff members to better understand how meal time support is practiced on inpatient EDUs.