Illuminating multiple perspectives : meanings of nasogastric feeding in anorexia nervosa

This qualitative study examined the range of meanings that female adolescent patients with anorexia nervosa attach to nasogastric feeding (NGF). In-depth interviews were conducted with 23 patients. Qualitative analysis revealed that patients attached four broad meanings to NGF: an unpleasant physical experience; a necessary or helpful intervention; a physical and/or psychological signifier of anorexia; and a focus in a broader struggle for control. Importantly, individual patients sometimes attached multiple and seemingly contradictory meanings to NGF, and the meanings patients attached to NGF shaped their responses to treatment. The findings illustrate the difficulties of a 'one-size-fits-all' approach to NGF and the importance of accommodating patients' perspectives into clinical practice. The implications for the institution of NGF are discussed and a framework for developing clinical protocols that accommodate patients' constructions of NGF is proposed.