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Abstract：
OBJECTIVE: The aim of this study was to understand the context of the inpatient setting for the treatment of anorexia nervosa and the implications for the therapeutic alliance between nurses and consumers.
BACKGROUND: The nature of the therapeutic alliance is dependent on the contextual factors that influence interactions. The inpatient setting for the treatment of anorexia nervosa is one such setting where the therapeutic alliance is operative, yet challenging and poorly understood.
METHODS: A two-phase explanatory sequential design was employed. Descriptive statistics from phase one informed phase two interviews. Phase two data were analysed through thematic analysis.
METHODS: A convenience sample of nurses and consumers were recruited from six wards, in five hospitals. Phase one involved the completion of a survey (N = 128) that measured the strength of the therapeutic alliance, as well as other elements of ward context. Phase two interviews (N = 54) were focused on the therapeutic alliance between nurses and consumers and the implications of the inpatient setting. Data collection occurred between May 2014 - February 2015.
RESULTS: Anorexia nervosa as an illness carries destructive implications for the quality of the therapeutic alliance. Nurses\' intimate position in the inpatient setting and interpersonal capacity is influential in overcoming the obstacles that impede the therapeutic alliance.
CONCLUSIONS: Nurses\' capacity for developing therapeutic alliances is in part dependent on a supportive ward organization and the adequacy of resources to permit meaningful interactions with consumers with anorexia nervosa. Understanding the contextual factors specific to the inpatient setting enhances nurses\' ability to develop therapeutic alliances.
BACKGROUND: The nature of the therapeutic alliance is dependent on the contextual factors that influence interactions. The inpatient setting for the treatment of anorexia nervosa is one such setting where the therapeutic alliance is operative, yet challenging and poorly understood.
METHODS: A two-phase explanatory sequential design was employed. Descriptive statistics from phase one informed phase two interviews. Phase two data were analysed through thematic analysis.
METHODS: A convenience sample of nurses and consumers were recruited from six wards, in five hospitals. Phase one involved the completion of a survey (N = 128) that measured the strength of the therapeutic alliance, as well as other elements of ward context. Phase two interviews (N = 54) were focused on the therapeutic alliance between nurses and consumers and the implications of the inpatient setting. Data collection occurred between May 2014 - February 2015.
RESULTS: Anorexia nervosa as an illness carries destructive implications for the quality of the therapeutic alliance. Nurses\' intimate position in the inpatient setting and interpersonal capacity is influential in overcoming the obstacles that impede the therapeutic alliance.
CONCLUSIONS: Nurses\' capacity for developing therapeutic alliances is in part dependent on a supportive ward organization and the adequacy of resources to permit meaningful interactions with consumers with anorexia nervosa. Understanding the contextual factors specific to the inpatient setting enhances nurses\' ability to develop therapeutic alliances.
摘要：
目的：这项研究的目的是了解治疗神经性厌食症的住院环境以及对护士和消费者之间的治疗联盟的影响。
背景：治疗联盟的性质取决于影响相互作用的环境因素。治疗神经性厌食症的住院设置是治疗联盟有效的设置，但具有挑战性和知之甚少。
方法：采用两阶段解释性序贯设计。第一阶段知情第二阶段访谈的描述性统计数据。通过专题分析对第二阶段数据进行了分析。
方法：从六个病房招募了护士和消费者的便利样本，在五家医院。第一阶段涉及完成一项调查（N=128），该调查测量了治疗联盟的实力，以及病房环境的其他元素。第二阶段访谈（N=54）的重点是护士和消费者之间的治疗联盟以及住院环境的影响。数据收集发生在2014年5月至2015年2月之间。
结果：神经性厌食症作为一种疾病对治疗联盟的质量具有破坏性意义。护士在住院环境中的亲密地位和人际交往能力对克服阻碍治疗联盟的障碍有影响。
结论：护士发展治疗联盟的能力部分取决于支持性病房组织和资源的充足性，以允许与患有神经性厌食症的消费者进行有意义的互动。了解住院患者特定的环境因素可增强护士发展治疗联盟的能力。
背景：治疗联盟的性质取决于影响相互作用的环境因素。治疗神经性厌食症的住院设置是治疗联盟有效的设置，但具有挑战性和知之甚少。
方法：采用两阶段解释性序贯设计。第一阶段知情第二阶段访谈的描述性统计数据。通过专题分析对第二阶段数据进行了分析。
方法：从六个病房招募了护士和消费者的便利样本，在五家医院。第一阶段涉及完成一项调查（N=128），该调查测量了治疗联盟的实力，以及病房环境的其他元素。第二阶段访谈（N=54）的重点是护士和消费者之间的治疗联盟以及住院环境的影响。数据收集发生在2014年5月至2015年2月之间。
结果：神经性厌食症作为一种疾病对治疗联盟的质量具有破坏性意义。护士在住院环境中的亲密地位和人际交往能力对克服阻碍治疗联盟的障碍有影响。
结论：护士发展治疗联盟的能力部分取决于支持性病房组织和资源的充足性，以允许与患有神经性厌食症的消费者进行有意义的互动。了解住院患者特定的环境因素可增强护士发展治疗联盟的能力。
