Nutritional Care Planning in Children and Adolescents with Eating Disorders Admitted to Mental Health Units - A Qualitative Exploration Study

Nutritional care planning is a core part of treatment for eating disorders (EDs), yet practice varies and no studies to date have characterised nutritional care planning through exploration. This study looked at exploring nutritional care planning in terms of supporting a food first approach, use of oral nutrition support, use of nasogastric tube (NG) feeding, following current re-feeding guidelines and legal framework and characterise current practice.

A qualitative cross-sectional study was performed, analysing data thematically from semi-structured interviews. Ethics approved from the Local Ethics Coordinator at Leeds Beckett University on 10th May 2019. To explore current practices in child and adolescent mental health inpatient services in the UK, contact was made with dietitians working with ED patients.

The impact of differences in units was discussed, such as available NG intervention, threshold for commencing NG, collective behaviour, geographical locations, inclusion of young person and family in the treatment plans and pathways.

NG practice was affected by factors such as staffing, existing guidelines, legislation, prescribed meal plans, risk for re-feeding syndrome, vitamin- and mineral supplementation prescribed, and motivational techniques used. This study found there to be national variations in the practice of NG feeding such as different feed delivery methods used, threshold for commencing NG, and involvement of dietitians. Further, re-feeding starting rate were stated higher than the older guidelines, evidencing that dietitians has responded to updated evidence. Recommendations for research and practice have been developed based on these findings.

Angelica Skaar

Previous publication - Development of weight and height in Norwegian children: The Health Oriented Pedagogical Project (HOPP)

MSc Clinical Nutrition

Angelica is currently working as a senior dietitian in York