The Exploration of the Eating Experience in Adults with Celiac Disease: A Phenomenological Qualitative Study.

Abstract

The adjustment to a strict gluten-free diet for adults diagnosed with celiac disease (CD) may lead to changes in the eating experience affecting the physical, social, and emotional states. Through the application of the Social Cognitive Transition Model of Adjustment, the aim of the study was to explore the adjustment in the eating experience in adults recently diagnosed with CD and transitioning to a gluten-free diet. This was a qualitative phenomenological study conducted using semistructured interviews. Seventeen adults from the midwestern United States who were diagnosed with CD between 6 months and 5 years before the study were recruited using social media CD sites and snowball sampling. Participants completed a semistructured interview on Zoom and the Celiac Disease Adherence Test and CeliacQ-7 questionnaires from May to November2020. Two trained qualitative researchers engaged in four steps to reduce and contextualize the data: horizontilization, reduction and elimination, clustering and thematizing, and composition of textural description. During analysis, the Social Cognitive Transition Model of Adjustment was incorporated for organization of themes and text description. There was moderate to high dietary adherence in 14 of 17 participants and quality of life scores ranged from 19 to 43 (median= 33). Five themes emerged aligning with Social Cognitive Transition Model of Adjustment, describing the adjustment in pre- and postdiagnosis eating experience and the coping and behaviors enacted during adjustment to a gluten-free diet. In individuals with CD, moving beyond problem solving and identifying psychosocial and emotional attributes in the adoption of a gluten-free diet need to be considered to promote maintenance of quality of life and dietary adherence.