title: Self-admission to inpatient treatment for patients with anorexia nervosa: The patient's perspective.
abstract: The aim of the present study was to explore patients' experiences of participating in a self-admission program at a specialist eating disorders clinic. Sixteen adult program participants with a diagnosis of anorexia nervosa were interviewed at 6 months about their experiences in the self-admission program. A qualitative content analysis approach was applied to identify recurring themes. Four themes were identified: Agency and Flexibility, Functions, Barriers, and Applicability. Participants used self-admission to boost healthy behaviors, to prevent deterioration, to forestall the need for longer periods of hospitalizations, and to get a break from overwhelming demands. Quick access to brief admissions provides a safety net that can increase feelings of security in everyday life, even for patients who do not actually make use of the opportunity to self-admit. It also provided relief to participants' relatives. Furthermore, participants experienced that self-admission may foster agency and motivation. However, the model also requires a certain level of maturity and an encouraging environment to overcome barriers that could otherwise hinder optimal use, such as ambivalence in asking for help. Informants experienced that self-admission could allow them to gain greater insight into their disease process, take greater responsibility for their recovery, and transform their health care from crisis-driven to proactive. By offering a shift in perspective on help-seeking and participation, self-admission may potentially strengthen participants' internal responsibility for their treatment and promote partnership in treatment.
authors.affiliation: Stockholm Centre for Eating Disorders, Stockholm, Sweden.|Centre for Psychiatry Research, Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden.
authors.forename: Mattias
authors.initials: M
authors.lastname: Strand
authors.affiliation: Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden.|Department of Psychiatry, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina.|Department of Nutrition, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina.
authors.forename: Cynthia M
authors.initials: CM
authors.lastname: Bulik
authors.affiliation: Stockholm Centre for Eating Disorders, Stockholm, Sweden.|Centre for Psychiatry Research, Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden.
authors.forename: Yvonne
authors.initials: Y
authors.lastname: von Hausswolff-Juhlin
authors.affiliation: Faculty of Medicine and Health, Psychiatric Research Centre, Örebro University, Örebro, Sweden.
authors.forename: Sanna A
authors.initials: SA
authors.lastname: Gustafsson
mesh_terms: D000328:Adult; D000856:Anorexia Nervosa / Q000523:psychology / Q000628:therapy*; D005260:Female; D006760:Hospitalization; D006801:Humans; D007297:Inpatients / Q000523:psychology*; D008297:Male; D009042:Motivation
keywords: anorexia nervosa; eating disorders; inpatients; patient admissions; patient participation; patient-centered care; voluntary admissions