Helpful Attitude, Associated Behavior, and Communication of Healthcare Professionals Caring for Patients With an...

Eating disorders (EDs) are life-threatening disorders, in which treatment relationships may largely influence treatment outcomes. This review aimed to identify helpful as well as unhelpful aspects in establishing a beneficial treatment relationship based on patient and healthcare professional perspectives across diverse ED samples, including male patients.

A literature search yielded 63 relevant original qualitative studies. Thematic analysis and conceptual synthesis, following Evans' method, were employed to analyze these studies.

Four overarching themes captured the (un)helpful aspects of healthcare professionals' attitude, behaviors and communication: (1) "Attitude, characteristics and behavior"; (2) "Communication"; (3) "Alliance"; and (4) "Focus of the treatment." Helpful factors included respect, empathy, attunement, trust, collaboration, connection, and individualized care, emphasizing patient autonomy and the whole person rather than focusing solely on the disorder. Unhelpful were punishing, criticizing and blaming patients, and excessive focus on weight gain. Helpful and unhelpful aspects appeared to be similar between male and female patients.

The findings confirm that a respectful attitude, collaborative behavior and supportive communication of healthcare professionals facilitated a treatment relationship, whereas a dismissive attitude undermined this. Further research is needed to establish consensus on involvement of professionals with a personal ED history and on optimal mealtime management to support patients and maintain a strong therapeutic alliance.