Fatores que influenciam a adesão ao tratamento da anorexia nervosa sob perspectiva de pacientes e familiares

Abstract

An integrative review was conducted to understand, from the perspective of patients with anorexia nervosa (AN) and their families, which factors hinder or favor adherence to treatment. The protocol followed the six stages of Mendes, Silveira and Galvão (2008). The search was conducted in PubMed, ScienceDirect, SciELO and the Virtual Health Library (BVS), using MeSH/DeCS descriptors and exclusion and inclusion criteria. Fourteen studies met the criteria, totaling approximately 375 participants, including patients, parents, siblings and other caregivers. The thematic synthesis revealed five central barriers to adherence: invisibility of emotional suffering, parental burden in the initial phase of Family-Based Therapy, protocol rigidity, fragmented communication between services and abrupt transition to adult care. The facilitators included empathic therapeutic alliance, family strengthening through practical workshops, multi-family support networks, guilt-reducing neurobiological psychoeducation, and intensive daytime programs that alleviate the domestic burden. It is concluded that staying in treatment requires integration between evidence-based techniques and psychosocial support, with active listening to family singularities.