Discovering a "sense of community": patient experiences of connection in intentionally remote eating disorder care

J Eat Disord. 2024 Oct 30;12(1):171. doi: 10.1186/s40337-024-01127-4.

Abstract

Background: While some findings indicate high levels of patient satisfaction with remote eating disorder treatment, others reflect feelings of disconnection due to unique telehealth treatment challenges. The COVID-19 pandemic presented circumstances that likely impacted the findings established thus far. As such, the present study sought to understand patient experiences of connection in an intentionally remote eating disorder treatment program, specifically in a context outside of pandemic transition.

Methods: A secondary analysis of de-identified qualitative data previously obtained for quality improvement purposes via a client satisfaction survey was conducted. Adult patient responses (N = 38) were analyzed via reflexive thematic analysis within a critical realist framework.

Results: Four themes were generated from the data: (1) Embracing one's humanity paves the way for connection, (2) Discovering a "sense of community" in remote care, (3) "They made me feel I was worth recovering": connection as a vehicle for healing, and (4) Aligning expectations and reality: reconceptualizing the journey to connection in remote eating disorder care.

Conclusions: Overall, findings suggest that it is possible for patients to form strong, impactful connections in remote treatment. Importantly, patient perspectives indicated that there were shifts in how these connections were experienced as a result of the remote care environment (e.g., how support could be provided and by whom). Considerations unique to remote care (e.g., offering training to improve clients' comfort with technology) may be important to fostering connection, thereby contributing to improved patient experiences and treatment outcomes.

Keywords: Adult; Connection; Eating disorder; Technology; Telehealth.

Plain language summary

This study investigated patient experiences of connection in remote eating disorder treatment using satisfaction survey data. Patients reported forming strong interpersonal connections that were deeply impactful to their recovery, emphasizing the importance of feeling understood, accepted, and cared for in building these connections. However, they noted some differences in how these connections were experienced as compared to in-person settings (e.g., how support could be provided and by whom), indicating a need for adaptations in remote care (e.g., training on how to use technology). These lived experience perspectives can help to inform the ongoing implementation of remote eating disorder treatment to improve patient care.