Caring for Daughters with Anorexia Nervosa: A Qualitative Study on Parents’ Representation of the Problem and Management of the Disorder
Abstract
:1. Introduction
2. Theoretical Framework
3. Materials and Methods
3.1. Participants
3.2. Instrument
4. Data Analysis
5. Results
Dimensions of Meanings
“In my opinion, what starts immediately is the lack of self-esteem. It is also a question of character, perhaps, which then leads to being more affected by this pathology I think.”(Mother, 49 years old)
“I think it was the death of a wife, missing her, I think so. Or maybe in high school, some friends, unfortunately this also happens. First she was fine, then someone out of envy put in her brain that she had to lose weight, now she is eating again, maybe she has passed the step.”(Father, 64 years old)
In any case, the onset of the disease seems to be an interlock, generated by the family or by the patient’s innate pathology, from which it seems almost impossible to escape once the disease has manifested itself: “I repeat it can arise from a family context with its problems or it can be genetic and also accompanied by a personality disorder, in the sense I do not accept myself, I do not like myself and I have to change, to change I have to do this.”(Father, 49 years old)
“Because it is a monster that takes over, a very ugly feeling, of helplessness more than anything else.”(Mother, 48 years old)
“I don’t know how to prevent it because maybe I found myself inside, catapulted out of nowhere.”(Mother, 49 years old)
“[…] So more information, less perfect projected images. So more helpful information to prevent this should be the foundation of our society.”(Mother, 48 years old)
“[…] that is, after the nutritionist had pointed me to the hospital, before the polyclinic and the hospitalization, we did the day hospital with another nutritionist and then we went downstairs with the doctor. Just that, we didn’t go straight to the hospital I mean. At first once a week to do the day hospital with the nutritionist who weighed her and gave her a diet and then later the girl did not follow everything. Then the doctor sent us to the doctor and then the doctor said we have to hospitalize her, because the girl doesn’t want to participate. And so we found ourselves doing this hospitalization.”(Mother, 45 years old)
“When my husband and I understood that there was a problem… and… we immediately thought of going to a psychologist, so we moved immediately, almost immediately… The speech is that the psychologist is very good, available, for heaven’s sake… however, it was not her field… when she diagnosed me with eating disorder, she said that we must go elsewhere, but the doctor herself did not know where to send me, that it was a serious problem… so then I had to look… Let’s say that if there was… if there were structures, let’s say apart from the hospital, the polyclinic and then there is also the structure in Salerno, there are various structures in Italy, but let’s say that it’s not within everyone’s reach, in the sense that it is a problem enter it… you have to weigh 38/37 kg… you have to stand there and then almost risking your life… this I say because my experience of let’s say 3 months in the hospital made me understand exactly this… so it would take more structures, more information channels, so that a pers or how I felt on the high seas… she should feel less alone in that sense….”(Mother, 49 years old)
“However, society imposes on us characters, figures to imitate, which then everything emerged from the acquisition of the mobile phone, because before my daughter has never given problems so they are components that then emerge in this sense in my opinion. Then I am not a doctor, but from what I have been able to understand. I also lived in the hospital. Today’s world is based on images, on perfection, therefore giving the wrong tips and this certainly affects a lot.”(Mother, 49 years old)
“Because generally the parent, especially the father, especially in an era like today thinks of giving everything by giving what the children want rather than the dress, the trip, the mobile phone, the money to go out at night, but I mean. Then clearly you discover that perhaps one does not become a parent, one does not do this anymore, and that all this is not enough and then it comes back to what I said before. To a world, to a type of society that goes at two hundred kilometers per hour towards material goods, leaving out everything else and therefore these are all things that can be traced back, let’s say, to the bed of a family that is no longer there in fact and above all these guys they lose self-esteem because they are disoriented.”(Father, 55 years old)
“It is the refusal of food, in short, it is all a psychological factor. I’s like the brain refuses to eat, this is it. Heart and brain are in symbiosis and everything starts with the brain. […] Another thing could be television, which bombard the brains of models who do not know if they are human beings or walking ibex. So a weak girl can fall into this trap.”(Father, 64 years old)
“The fear of losing my daughter. This is little but sure. The fear of losing it, of not being able to do otherwise, because in the face of this situation I did not have the right tools, the right weapons to fight.”(Mother, 49 years old)
“The center, that is the private doctor that I met through a family member, because I had no idea who to contact… I informed Dr. Amato, the psychologist. Doctor Manna, don’t worry, don’t regret, let’s see something else, she introduced me to another doctor, I also did an interview with her and then through this doctor, who has a childhood at the polyclinic, I met the center.”(Mother, 55 years old)
“They call them Social but in fact they only create an a-Social, in the sense that everyone lives in a world that burns the moment and lives isolated from the context. I think they are all factors like a little, like drugs, like who comes there out of boredom.”(Father, 54 years old)
“The fact that, however, I realize that I am not prepared to face such a thing, and then obviously the desire to make my daughter feel good, both psychologically and physically.”(Mother, 42 years old)
“No doctor, I think, I would never have noticed. I have to thank my wife and the sensitivity and obviously the natural sensitivity that a mother has towards her children. I only saw that my daughter was losing weight but I certainly did not even have a relationship, let’s say that suddenly, even in terms of dialogue, it was closed. […] Because generally the parent, especially the father, especially in an age like today thinks of giving everything by giving what the children want rather than the dress, the trip, the cell phone, the money to go out at night, but I mean. Then clearly you discover that perhaps one does not act as a parent, one does not act like this anymore….”(Father, 54 years old)
6. Discussion
7. Conclusions
8. Strengths and Limitations
Author Contributions
Funding
Institutional Review Board Statement
Informed Consent Statement
Data Availability Statement
Conflicts of Interest
Appendix A
- What, in your opinion, is anorexia?
- Could you tell me about your experience with anorexia?
- What factors do you think contributed to developing or maintaining this type of eating behavior?
- From your point of view, what could be done to prevent this problem?
- You turned to (facility)… about a problem with AN… What motivated you the most to ask for help?
- How would you describe the type of help/assistance received at the service?
- Had you looked for other forms of help before coming here? If YES, can you tell me about these previous experiences (why didn’t they go on? What difficulties did you encounter?)
- Is there anything you would like to add to your image of mental anorexia in general, or to this interview? Other aspects that you think are useful to investigate?
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Role | ||||||
---|---|---|---|---|---|---|
Variables | Mothers | Fathers | Total | Chisquare | p-Value | |
Marital status | Married | (12) 63.2% | 1 (5.3%) | 13 (68.4%) | 6.041 | 0.049 |
Divorced | (4) 21.1% | 1 (5.3%) | 5 (26.3%) | |||
Widowed | (0) | 1 (5.3%) | 1 (5.3%) | |||
Level of schooling | Lower primary school | 1 (5.3%) | (0) | 1 (5.3%) | 0.270 | 0.966 |
Lower secondary school | (4) 21.1% | 1 (5.3%) | 5 (26.3%) | |||
Secondary school | (6) 31.6% | 1 (5.3%) | 7 (36.8%) | |||
University degree | 5 (26.3%) | 1 (5.3%) | (6) 31.6% | |||
Employment | Employed | (6) 31.6% | (0) | (6) 31.6% | 8.972 | 0.072 |
Freelance professionals | (4) 21.1% | 2 (10.5) | (6) 31.6% | |||
Unemployed | 3 (15.8%) | (0) | 3 (15.8%) | |||
Housewives | 3 (15.8%) | (0) | 3 (15.8%) | |||
Retired | (0) | 1 (5.3%) | 1 (5.3%) |
No. | |
---|---|
Texts in the corpus | 106 |
Elementary contexts (EC) | 263 |
Types | 2253 |
Lemmas | 1845 |
Occurrences (Tokens) | 10,447 |
Threshold of lemma selection | 4 |
Lemmas in analysis | 180 (208) |
Models of Problem Explanation | |||
---|---|---|---|
Onset (−) | (no explanation) (+) | ||
Lemmas | Test value * | Lemmas | Test value * |
Lack | −18.7882 | - | - |
Familiar | −14.3825 | ||
Affection | −13.9494 | ||
Self-esteem | −8.9159 | ||
Problematic | −4.4027 | ||
To believe | −3.3084 | ||
Be born | −2.8362 | ||
Question | −2.7836 | ||
Pathology | −2.7501 | ||
To prevent | −2.5219 | ||
Need to | −2.5176 | ||
Greater | −2.2645 | ||
Family | −2.0764 |
Attribution of Responsibility | |||
---|---|---|---|
health care services (−) | Society (+) | ||
Lemmas | Test value * | Lemmas | Test value * |
Doctor | −6.4948 | Go out | 4.5532 |
Hospitalize | −5.4954 | Food | 4.5418 |
Polyclinic | −5.4435 | Love | 4.3694 |
Private | −5.328 | World | 3.9998 |
Salerno | −4.6301 | Today | 3.896 |
To accept | −4.5247 | Society | 3.4907 |
Send | −4.3906 | To remain | 3.4878 |
Asl | −4.3752 | Hunger | 3.4743 |
Antimo | −4.3186 | Psychological | 3.1393 |
Structure | −4.2642 | Fear | 3.1109 |
Call | −4.2613 | Figure | 3.0639 |
Psychologist | −4.2379 | Model | 3.0185 |
To address | −4.1458 | To be able to | 3.0036 |
Know | −3.952 | Image | 2.9712 |
Solve | −3.8744 | Brain | 2.814 |
I disturb | −3.8301 | Body | 2.7622 |
Center | −3.7027 | To think | 2.7202 |
Known | −3.6844 | Son | 2.6433 |
Week | −3.6781 | Husband | 2.5407 |
Food | −3.2595 | Become | 2.4018 |
SPEC (+) | SPEC (−) | |||||||||
---|---|---|---|---|---|---|---|---|---|---|
Categorial Variable | LEMMA * | SUB | TOT | CHI2 | (p) | LEMMA | SUB | TOT | CHI2 | (p) |
Mother | Doctor | 29 | 30 | 6.54 | 0.01 | To live | 12 | 31 | −19.04 | 0.00 |
- | - | - | - | - | Brain | 0 | 5 | −16.99 | 0.00 | |
- | - | - | - | - | Disease | 4 | 12 | −13.21 | 0.00 | |
- | - | - | - | - | Sensation | 1 | 5 | −9.33 | 0.00 | |
- | - | - | - | - | Good | 1 | 5 | −9.33 | 0.00 | |
- | - | - | - | - | Social | 1 | 5 | −9.33 | 0.00 | |
- | - | - | - | - | Greater | 1 | 5 | −9.33 | 0.00 | |
- | - | - | - | - | Experience | 12 | 23 | −8.29 | 0.00 | |
- | - | - | - | - | Family | 7 | 15 | −8.02 | 0.00 | |
- | - | - | - | - | Hold | 3 | 8 | −7.20 | 0.00 | |
Father | To live | 16 | 31 | 19.04 | 0.00 | Doctor | 1 | 30 | −6.54 | 0.01 |
Disease | 8 | 12 | 13.21 | 0.00 | To follow | 0 | 18 | −5.35 | 0.02 | |
Sensation | 4 | 5 | 9.33 | 0.00 | To be able to | 0 | 17 | −5.05 | 0.02 | |
Good | 4 | 5 | 9.33 | 0.00 | Nutritionist | 0 | 13 | −3.86 | 0.05 | |
Greater | 4 | 5 | 9.33 | 0.00 | - | - | - | - | - | |
Social | 4 | 5 | 9.33 | 0.00 | - | - | - | - | - | |
Experience | 11 | 23 | 8.30 | 0.00 | - | - | - | - | - | |
Family | 8 | 15 | 8.02 | 0.00 | - | - | - | - | - | |
Hold | 5 | 8 | 7.20 | 0.00 | - | - | - | - | - | |
Sense | 4 | 6 | 6.59 | 0.01 | - | - | - | - | - |
Mather | Father | ||
---|---|---|---|
Lemma | Occurrence | Lemma | Occurrence |
Own | 29 | Brain | 5 |
To follow | 18 | Isolated | 4 |
To be able to | 17 | Take advantage | 3 |
Nutritionist | 13 | Depression | 3 |
Ugly | 12 | Wife | 3 |
To start | 12 | Forty | 3 |
To accept | 10 | Put back | 3 |
Face up to | 10 | You | 3 |
Hard | 10 | Insiders | 2 |
Physicist | 9 | Analyses | 2 |
Lose | 9 | To surround | 2 |
Polyclinic | 9 | Contribute | 2 |
Personal | 8 | Domestic partnership | 2 |
Need | 7 | Depressive | 2 |
Character | 7 | Disorientation | 2 |
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Carpinelli, L.; Marinaci, T.; Savarese, G. Caring for Daughters with Anorexia Nervosa: A Qualitative Study on Parents’ Representation of the Problem and Management of the Disorder. Healthcare 2022, 10, 1353. https://doi.org/10.3390/healthcare10071353
Carpinelli L, Marinaci T, Savarese G. Caring for Daughters with Anorexia Nervosa: A Qualitative Study on Parents’ Representation of the Problem and Management of the Disorder. Healthcare. 2022; 10(7):1353. https://doi.org/10.3390/healthcare10071353
Chicago/Turabian StyleCarpinelli, Luna, Tiziana Marinaci, and Giulia Savarese. 2022. "Caring for Daughters with Anorexia Nervosa: A Qualitative Study on Parents’ Representation of the Problem and Management of the Disorder" Healthcare 10, no. 7: 1353. https://doi.org/10.3390/healthcare10071353
APA StyleCarpinelli, L., Marinaci, T., & Savarese, G. (2022). Caring for Daughters with Anorexia Nervosa: A Qualitative Study on Parents’ Representation of the Problem and Management of the Disorder. Healthcare, 10(7), 1353. https://doi.org/10.3390/healthcare10071353