title: Anorexia nervosa treatment from the patient perspective: a metasynthesis of qualitative studies.
abstract: BACKGROUND
  Anorexia nervosa is a complex condition that brings great challenges at each stage of treatment. This study aims to organize the body of information available in qualitative studies about the treatment of anorexia nervosa through a systematic literature review and metasynthesis.
  
  
  METHODS
  Searches were carried out on the following databases for the years 1990 to 2005: PubMed, ISI, PsycINFO, EMBASE, LILACS, and SciELO from 1990 to 2005. A meta-ethnographic approach was used to synthesize the data through second-order and third-order interpretations.
  
  
  RESULTS
  The search revealed 3415 studies, of which 16 were selected. Two concepts for second-order interpretation emerged from the process: (1) the process of change (phases of recovery, factors favoring recovery, factors limiting recovery) and (2) perception of the treatment modalities. From the second-order categories, a third-order category was derived--reconciliation, in which personal and environmental acceptance have a central role.
  
  
  CONCLUSIONS
  Recovery from anorexia nervosa, as a very complex process, goes well beyond conventional treatment. Self-acceptance, determination, and spirituality are equally important elements.
authors.affiliation: Department of Psychiatry, Federal University of São Paulo/UNIFESP, São Paulo, Brazil.
authors.forename: Cybele Ribeiro
authors.initials: CR
authors.lastname: Espíndola
authors.forename: Sergio Luís
authors.initials: SL
authors.lastname: Blay
mesh_terms: D000856:Anorexia Nervosa / Q000523:psychology* / Q000628:therapy*; D004035:Diet Therapy; D005239:Fear; D006801:Humans; D008402:Mass Media; D009042:Motivation; D011613:Psychotherapy; D012649:Self Concept; D012944:Social Support; D029181:Spirituality