SREC ETHICS APPROVAL FORM

Introduction
UCC academic staff and postgraduate research students who are seeking ethical approval should complete
this approval form. Ethical review by the Social Research Ethics Committee (SREC) is required where the
methodology is not clinical or therapeutic in nature and proposes to involve:
• direct interaction with human participants for the purpose of data collection using research methods
such as questionnaires, interviews, observations, focus groups etc.;
• indirect observation with human participants for example using observation, web surveys etc.;
• access to, or utilisation of, anonymised datasets;
• access to, or utilisation of, data or case files/records concerning identifiable individuals;
• conducting Internet Research or research online.
SREC considers itself an enabling committee, promoting strong research ethics amongst UCC’s community of
staff and student researchers. We are open to all types of research in the social research domain. If your
research approach does not readily fit into this application form, do not be discouraged: please add additional
relevant notes to convey what you think is pertinent about the ethical aspects of your study.
Contact us: srec@ucc.ie
Further information about research ethics is available on the UCC Research Ethics website.
Further information on training videos, and sample informed consent/information sheet/assent forms are on
the SREC website.
Notes
1.
2.
3.
Digital inclusivity notice: text set to left-aligned, alternative text added to images, no italics, and plain English web links are used.
SREC is a committee of the University Ethics Committee. If you are unsure which University ethics committee you should apply to, please
consult this resource. Acknowledgement: An early version of this form was adapted from pp. 13-14 of the Guidelines for Minimum
Standards of Ethical Approval in Psychological Research (British Psychological Society, 2004).
Please submit a signed copy of this form and all relevant attachments as one PDF file to srec@ucc.ie. No hard copies of this application
are required.
4.
5.
6.
7.
8.
SREC is not primarily concerned with methodological issues, but we may comment on such issues in so far as they have ethical
implications.
Your SREC application form should be concise: please do not copy and paste a research proposal. Applications typically range between
10-20 pages (including appendices) with some longer applications at 25-30 pages. Overly long applications will be returned without a
review.
Your SREC application form should be written so that researchers outside of your profession / discipline can understand how you plan to
undertake your study.
If your study requires a Data Protection Impact Assessment (DPIA), you do not need to include a copy of the DPIA with your SREC
application form.
To access training on research ethics, please visit the SREC video training series here.
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SECTION 1: APPLICATION CHECKLIST
This checklist includes all of the items that are required for an application to be deemed complete. In the event
that any of these are not present, the application will be returned to the applicant without having been sent for
review. Please ensure that your application includes all of these items prior to submission. Thank you and best of
luck with your research!

Please complete prior to submission Yes/No
(not x or ü)
N/A
(ok to use x or
ü)
a. All relevant files are combined into one PDF file (SREC application form, consent/assent forms,
information sheets, data collection instruments, permission letters, etc.)
Yes

b. Completed SREC Application Form. Yes

c. Information Sheet(s) / Information Statement (i.e. at the beginning of an electronic survey)
included.
Yes

d. Consent / Assent Form(s) / Consent Statement (i.e. at the beginning of an electronic survey)
included.
Yes

e. Data Collection Instrument: Psychometric Instruments / Interview Guide / Focus Group Schedule
/ Survey Questionnaire / etc. included.

Yes

f. If this is a participatory / Public & Patient Involvement (PPI) project, it is possible that your data
collection instrument will be co-constructed during the research and there is nothing to submit at
this point to SREC. By ticking confirm here, you agree to submit the instrument to SREC, once
finalised.

Yes
g. To help researchers to ascertain whether a Data Protection Impact Assessment (DPIA) is required,
every SREC applicant is required to complete the DPIA Screening Tool for Social Research. A copy
of the completed Screening Tool should be retained by you (the researcher). You may be asked
to produce it for audit purposes by the University’s Data Protection Officer (OCLA). Note: Where
a DPIA is required for your project, you can submit your ethics application to SREC whilst a review
of the DPIA is pending. You do not need to submit your DPIA to SREC or include a copy of the
DPIA with your ethics application.
Please confirm that you have retained a copy of the results for your own records and for
UCC audit purposes.
Yes

h. Copy of permission letters / external ethical approvals to undertake research from relevant
agencies/services included (if available).
N/A

i. Have you applied for ethical approval for this project from another UCC ethics committee? No

j. If you are under academic supervision, your supervisor(s) have approved the wording of and co
signed this application prior to submission.
Yes

k. If this is a resubmission, all the revised and new text is highlighted in yellow. No

l. Please confirm that you have read and understood the following statement:
My research must not commence until I submit (following review and recommended
changes), my FINAL SREC form with highlighted changes to srec@ucc.ie.
Yes

Resources and services

UCC Code of Research Conduct and Research Policies RRI Tools Website
UCC Child Safeguarding Statement Irish Qualitative Data Archive (IQDA)
Guidance Document for Conducting Internet Research Irish Social Science Data Archive (quantitative datasets)
Garda Vetting of UCC Staff Health Service Executive National Consent Policy
UCC Student Garda Vetting Policy UCC IT Service Catalogue
UCC Data Protection Policy and Procedures UCC GDPR website

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UCC Library Research Data Service UCC Guidance for Researchers Conducting Research with Vulnerable
People
UCC Supplied Survey Platforms SREC FAQs and Amendment Process
UCC Device Encryption Service SREC Video Training Series
Qualtrics SharePoint Site
Qualtrics – UCC login UCC student population survey approval process

SECTION 2: APPLICANT(S) DETAILS

Name of UCC applicant(s)
1.Dr Jelena Vojnic Barisic
2.Dr Ivona Kusen
3.Dr Keerti Karunakaran
4.Dr Eimear O’Neill
5.Dr Rakesh Rampal
Date 02/12/24

Name of Department /
School / College / Research
Institute / Centre / Unit
1. Cork North Lee Old Age Mental
Health Services
2.NLE CAMHS Cork
3.Cork North Lee Adult MHS
4. Eist Linn CAMHS Unit
5.CAMHS Liaison Cork
Contact Number Dr Keerti Karunakaran

087 032 4657

Correspondence Address
Dr Keerti Karunakaran
Mercy University Hospital
St Michaels Unit
Greenville Pl, Centre,
Cork
T12WE28
UCC Email
Address
118104511@umail.ucc.ie

Course Code/Name and
year of course (students only) N/A
Name of
supervisor(s)
(students only)
Start date to end date of
Project 24-36 months
Name of PI or
Mentor (PostDoc
researcher only)
Dr. Sara McDevitt
Is this a resubmission? No SREC Log No.
(if a resubmission): N/A
Is this research funded? No
If Yes, please
provide name/s of
Funding Agencies
N/A

Obtaining ethical approval from SREC does not free you from securing permissions and approvals
from other institutional decision-makers and agency ethical review bodies. These bodies may accept the SREC approval,
but researchers are responsible for ensuring they are compliant in advance of collecting data.

Project working title Exploration of the Working Knowledge of NCHD’s working in HSE South West Mental
Health Services in Ireland about diagnosis and management of the eating disorders

If this is a collaborative project / community-based participatory / PPI research project / joint application with
another agency, please complete this additional section:
Names of research partners
/ civil society organisations
collaborating on this project
N/A
Agency contact person and
position N/A
Agency address N/A

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Details of the partnership
(Please clearly identify the roles
and responsibilities held by each
party in the partnership in
relation to the different aspects
of the research).
N/A

SECTION 3: ETHICAL APPROVAL SELF-EVALUATION

If your answer falls into any of the shaded boxes below, please address each point separately in Q29 signposting
which checklist question the response relates to.
YES NO
Use X or NA
1 Do you consider that this project has significant ethical implications? X
2 Will you describe the main research procedures to participants in advance, so that they are informed about what to expect? X
3 Will participation in this project be voluntary?
X
4 Will you obtain informed consent in writing from participants? X
5 Will you tell participants that they may withdraw from the research at any time during the data collection period, and for any reason, and (where relevant) omit questionnaire items / questions to which they do not wish to respond? X
6 Will data be treated with full confidentiality / anonymity (as appropriate)? X
7 Will data be securely held for a minimum period of ten years after the completion of a research project, in line with the University’s Code of Research Conduct (2021)? X
8 If results are published, will anonymity be maintained, and participants not identified? (see Q. 30 below regarding open data considerations, if relevant) x
9 Will you debrief participants at the end of their participation (i.e. give them a brief explanation of the study)?
The findings will be shared with NCHDs working in South West HSE Mental Health Services

10 Will your project involve deliberately misleading participants in any way? X
11 Will your participants include children / young persons (under 18 years of age)? X
12 If yes to question 11, is your research in compliance with the UCC Child Safeguarding Statement which sets out the legal requirements under the Children First Act 2015? N/A
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Will your project require you to carry out “relevant work” as defined in the National Vetting Bureau (Children and Vulnerable Persons) Acts 2012 to 2016? (Relevant work constitutes any work or activity which is carried out by a
person, a necessary and regular part of which consists mainly of the person having access to, or contact with, children or
vulnerable adults.)
X
14 Do you require official Garda Vetting through UCC before collecting data from children or vulnerable adults? (Please note that having a Garda Vetting through another body is not sufficient; a separate UCC Garda Vetting is always required for UCC researchers) X
15 Will project participants include people with learning or communication difficulties? X
16 Will project participants include patients / service users / clients? A service user or client is a person who is served by or uses the services under consideration as part of this research. X
17 Will project participants include people in custody? X
18 Will project participants include people engaged in illegal activities (e.g. drug taking, illegal Internet behaviour, crime, etc.)? X
19a Is there a realistic risk of participants experiencing either physical or psychological distress? x
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19b Is there a realistic risk of the researcher experiencing either physical or psychological distress?
20
If yes to question 19a, has a proposed procedure for linking the participants to an appropriate support,
including the name of a contact person, been given? (see Q. 33)
x
N/A
21
If yes to question 19b, has a proposed procedure/support structure been identified?
N/A
22
Are the research participants students with whom you have some current/previous connection (module
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coordinator, research supervisor, professional tutor, etc.)?
Will the research participants receive payment / gifts / voucher / or other incentives for participating in this
X
study?
If your research is conducted on the internet, does it involve human participants? (e.g. through web surveys,
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social media, accessing or utilising data (information) generated by or about the participant/s; or involve
X
observing human participants in their online interactions/behaviour). If yes, please review and utilise the UCC
policy for conducting Internet Research.
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SECTION 4: DESCRIPTION OF THE PROJECT

Ethical review requires that you reflect and seek to anticipate ethical issues that may arise,
rather than reproduce copious text from existing research proposals into these boxes.
Entries should be concise and relevant to the point/question.

25. Very brief description of your study (15-25 words max.)
[e.g. This is a qualitative study of primary school teachers’ attitudes towards religious teaching using focus groups to collect original
data]
This is a vignette-based survey/ cross sectional study that aims to explore the Working Knowledge of NCHD’s working in
HSE Mental Health Services in Ireland about diagnosis and management of the eating disorders

26. What is your study about? (100-200 words max.)
• An understanding of the current knowledge base regarding eating disorders among Psychiatry Basic
Specialty Trainees (BST) and Psychiatry Doctors in non-training posts in Cork and Kerry Mental Health
services
• Identification of areas for improvement in eating disorder education, management and training for
healthcare professionals.
• Understanding various strengths and limitations eating disorder management within community and
hospital settings.

27. What are your research questions? / If your study approach is participatory / PPI, which does not normally involve
research questions that are set in advance, please include a broad outline of your research focus / key themes.
[Do not include your interview/survey questions in Q27].
1. Knowledge in diagnosis of eating disorders
2. Knowledge in management of eating disorders
3. Knowledge in utilising MEED (medical emergencies in eating disorders)

28. Who are the participants in your study? Recruitment methods including details of how you will engage with
participants, number, age, gender, exclusion/inclusion criteria, detail permissions to be sought / secured already, and
how will you recruit participants? / If your study approach is participatory/PPI, please indicate a proposed cohort which
will be refined once the study progresses.
Exploration of the Working Knowledge of NCHD’s working in HSE South West Mental Health Services in Ireland about
diagnosis and management of the eating disorders

29. Concise statement of anticipated ethical issues raised by your project. How do you intend to deal with them?
Please refer to any item you checked in the Self-Evaluation form completed above, where your answers fell into a
shaded box. (350 words max.)
Distributing the questionnaires/ vignette electronically to NCHD’s working in HSE South West Mental Health Services in
Ireland.
Participants’ confidentiality will be assured.
No patients’ details or involvement in study.

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What apps and platforms can I use to collect, securely store, transcribe,
and share research data? Please read before completing Q. 30
As researchers, it is imperative that we can assure participants in our study that their data will be collected, transported, stored, and
archived securely; this is particularly important where sensitive personal details are involved. Exact details are required as to the
use (and location) of locked cabinets, management of audio files, encryption of laptops, electronic data collection/storage/sharing,
and so on.  We have prepared this 1-page summary guidance to support you in articulating your plan; however, in the case of
conflicting advice, official UCC policies will take precedence over this guidance.
I/we would like to undertake an online survey/interviews/focus groups
All data, both anonymised and non-anonymised, including sensitive personal data, can be collected, and stored on UCC-Supplied
Microsoft Products (OneDrive, Teams, SharePoint, Microsoft Forms, etc.) subject to logging in with your UCC credentials. See also
information on ResearchBox , cloud storage which may be applied for by UCC Staff and Postgraduate Students for the storage of active
research data.
Personal versions of Microsoft apps should not be used to collect and/or store research data. UCC also has a site licence for Qualtrics
for online survey data collection for academic research and research adjacent projects; however, data should not be stored on this
app. REDCap electronic data capture supports are available to patient-focused research projects. Data hosting and operational costs
will need to be covered through research project codes. Please contact REDCap UCC Admin for further information.
Only apps/platforms that have been approved through the central UCC procurement system (Agresso) should be used for data
collection, data sharing and data storage. If you would like to use an app/platform that is not covered here, please seek approval prior
to applying to SREC. The first step to getting an app approved for use in research is to complete the “IT System Request Form”. Please
note that SREC has no role in approving apps/platforms for collecting, storing, transcribing, or sharing research data.
I/we have audio to be transcribed by a person/software
If transcription is being outsourced, the transcription service used needs to be trustworthy, reliable, and confidential. It is essential
that data transferred outside of UCC is done securely (see HEAnet FileSender). Please note that the only software and cloud-based
transcription services approved by UCC for use in research for transcribing audio data are the tools embedded in Microsoft’s products:
use the dictate tool in newer versions of Microsoft Word, and the dictate and transcribe audio file upload tool through the online
Office 365 Microsoft Word when using your UCC credentials, and Microsoft Stream/Microsoft Teams when using your UCC credentials.
We are a team and would like to collaborate online (UCC colleagues only and/or UCC and external team members)
UCC-supplied collaboration and storage services like Microsoft Teams and OneDrive, can facilitate you to safely collaborate and
communicate on research studies with UCC staff and students, and to collaborate with partners outside of the university. Data saved
in Microsoft Teams apps when you login with your UCC credentials are stored on the UCC’s tenancies on Microsoft’s servers. Data is
encrypted in transit and at rest. Features such as version control, external sharing and audit logging are available. Microsoft Teams
sites can also be archived after the research is completed. If you have questions about these services, please contact the UCC IT
Helpdesk. For collaborative projects, research data should only be stored on approved storage and collaboration services such as
Microsoft Teams and OneDrive apps using your UCC credentials). If applying for ethical approval through SREC for collaborative, multi
agency projects and the data will not be stored in UCC / EU, please include comprehensive details on how these external services meet
the relevant standards.
Although UCC students currently have access to institutional cloud storage, access to Microsoft Office 365 does not extend beyond
their period of being a UCC student. Relying on one person’s access to online data storage is not best practice. To ensure that the
minimum data storage period of 10 years is adhered to, please discuss a long-term storage plan with your supervisor.
What I need to know about Research Data Storage
1. If data does not need to be identifiable, it should be converted to anonymous form as soon as is possible.
2.
Do not use free versions of services and platforms for data collection, sharing data, and/or data storage.
3. All laptops and PCs used to access data must be encrypted and password protected. Applicants should never store research data
on a USB and only use an encrypted portable hard drive or an encrypted and password protected laptop for short-term storage
until data has been anonymised.
4.
5.
Research data should only be stored on approved storage and collaboration services (see above). The personal versions of apps
and services like OneDrive and Microsoft Teams should not be used to store research data. Further information on research data
storage is available on this UCC library website.
Where possible, physical data such as survey and consent forms etc. should be converted to electronic format as soon as possible
and the originals shredded; however, if you need to retain physical data then it should be safely stored on premises at UCC in a
locked cabinet/office.
6. In the exceptional case where there is a requirement for on premise storage (e.g. a requirement of a data-sharing agreement with
a third party), Research Data Store can be accessed by researchers for storing research data. UCC Network File Store (NAS) can be
used for secure storage if the researcher has access to it (UCC staff).
7.
The HEAnet’s FileSender is a way to share large files with strong encryption to any email address in a safe manner, which is useful
for sending encrypted files to a transcriber or between team members outside of UCC if not using Microsoft Teams using your
UCC credentials.
8.
9.
Microsoft Azure Information Protection – AIP – enables you to protect documents on your computer before sharing them, and
also enables you to protect emails in Outlook before sending them (PCs only). Click here for the Azure how to guide. To download
the Azure software visit the Microsoft Azure website.
Further details on IT Services Storage Options are available on the UCC IT Service Storage Website.
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30. Data. (Please provide your answers to these questions in the white area below; see advice on data collection and data
storage on the previous page)
(a) How will you collect your data? Provide a brief description and justification of methods and data collection measures to
be used.
i. If conducting an online survey/questionnaire, what survey platform do you plan to use?
ii. If you plan to use a virtual meeting platform (Microsoft Teams using your UCC credentials to login, or another UCC
approved app/platform for research), please outline the steps you will take in the event of a security breach or an
interruption during a virtual call.
We are planning to electronically distribute anonymised Vignette based survey to NCHD’s working in HSE Mental Health
services, via HSE email.
Participants’ confidentiality will be assured. Information and Consent statement is attached.

(b) If you are creating audio/video recordings, provide a detailed account of how the transcription will be performed and
by whom. If transcription is being outsourced, it needs to be trustworthy, reliable, and confidential. Ensure that data
transfer is done securely. Recorded data must be deleted from a mobile recording device.

N/A

(c) When will the data recordings be deleted from the recording device and who will be assigned responsibility for this?

N/A

(d) What type of data will you be storing? (Briefly describe the type of data you plan to collect).

Vignette based survey response

(e) How and where will you store your data?1 (Please provide details about both physical and electronic documents and
any other relevant detail regarding data storage in the space provided below -e3. Refer to the guidance on data storage
provided on the previous page of this form).
e1 I confirm that I will use UCC-approved collaboration and storage services like Microsoft Teams and OneDrive to store data. Yes
e2 I confirm that I will store my research data on a UCC-approved system for the required period using my UCC login (see UCC Records Management Framework Guidance on Retention of Research Records and Data Conduct,
Appendix 1)
Yes
e3

(f) Who will you share the data with? Sample prompts: If you plan to make your raw research dataset available publicly as
part of the open data movement, or if you are required to do so as part of funding/journal requirements, please address
your protocol here (make explicit links to Q. 32 below and show that you have addressed this in your consent form and
information sheet). For collaborative/community-based participatory research/PPI, please address issues such as shared
ownership of data, will data be transferred (how?), publication of findings, etc. If your funder contractually requires you to
give them access to the ‘raw’ dataset, examine relevant implications, including appropriate anonymisation, protocols for
secure access to the dataset, etc.

We are aiming to publish the research results in a relevant medical, preferably psychiatry journal.

(g) If you are planning to analyse an existing dataset, please outline how the original consent process allows for your
data analysis.

1 Data management should follow the FAIR guiding principles (Findability, Accessibility, Interoperability & Reusability). See, for example, Wilkinson, M.
D. et al. (2016) The FAIR Guiding Principles for Scientific Data Management and Stewardship. It is required that all staff and student researchers store
those data which are required to replicate research findings, and the information required to enable re-use of data. Details of the UCC policy on
research data storage can be found in section 8 of the UCC Code of Research Conduct. SREC advises against storing research data on non UCC approved
cloud-based storage services. Physical data must be stored in a locked cabinet, and you must specify who has permission to access this data.

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As the research questionnaire will be delivered electronically via Vignette based survey, participants participation will be
completely voluntary with no obligation to respond to the survey.

(h) If you are planning to request access to health/case files/personal records that were not created for research
purposes, please address Data Protection considerations, provide a strong rationale, and comprehensively address
associated ethical issues.
N/A

31. Arrangements for informing participants about the nature of the study and withdrawal from the study (e.g.
information sheets, letters of invitation, social media information, participant recruitment, focus group
welcome/schedule, withdrawal, etc.). Note: Please provide a copy of any materials to be given to participants in the
appendices, e.g. information sheets, letters of invitation, social media information.
Invitation email that will contain brief description and aim of the project, also as Vignette based survey link to participate
if opted. Initial page of vignette based survey will contain information about the project and participants, and the
consent statement.

32. How will you ensure that participants provide informed consent (or assent if relevant)? cf. Question 4 please
provide a copy of Consent form(s) in Appendices ensuring that special considerations for vulnerable persons are
addressed. If you plan to translate Participant Information Sheet(s) and Consent Form(s) to another language besides
English, you may be asked to provide certified translations to SREC prior to conducting your research.
If your study approach is participatory/PPI, indicative forms are fine, but if there are substantial changes made with
research partners, you will have to submit an SREC amendment request form)
Information leaflet and consent form is attached to this application.

33. Outline of debriefing process at the end of the data collection process (cf. Question 9). If you answered Yes to
Questions 19a or 19b, give details here. State what you will advise participants to do if they should experience
problems (e.g. who to contact for help – provide name and contact details where required.)
N/A

34. If further detail is required regarding Start or End dates of the study, please address here.
N/A

35. Additional information of relevance to your application
N/A

36. Declarations (clickable links to policies and codes quoted here are on the next page) Yes No
a) I/we agree that should there be unexpected ethical issues arising during the course of this study, that I/we will utilise
my/our professional/disciplinary code of ethics, and/or notify UCC SREC, where appropriate.
X
b) I/we have consulted the UCC Code of Research Conduct and believe my/our proposal is in line with its requirements. X
c) I/we have consulted the UCC Child Protection Policy and believe my/our proposal is in line with its requirements. N/A
d) I/we have consulted the UCC GDPR guidelines and declare that our project is GDPR compliant. X
e) I/we have consulted the UCC Garda Vetting Guidelines, and where appropriate, researchers on this project have valid
Garda vetting through UCC (having a valid Garda Vetting through another body is insufficient).
N/A
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f)
In the event that my research data collection extends beyond the notified period outlined in my original SREC approval
form, I agree to notify srec@ucc.ie via email.
37. Signatures
X
UCC Applicant(s)
A picture of signatures pasted here is acceptable once the
application is emailed to srec@ucc.ie from your UCC email
address. However, if you cannot paste a picture of your
signature, please type your name here and email this form to
SREC using your UCC email account.
Academic Supervisor(s) / Principal Investigator(s) / Tutor(s)
All academic supervisors (where applicable) must approve the
contents of this application and sign this form.
A picture of signatures pasted here is acceptable.
Date: 02/12/24
Date: 04/12/24
Supervisor’s UCC email address: sara.mcdevitt@hse.ie
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An exploration of working knowledge of NCHD’s in psychiatry working in HSE
South West about the diagnosis and treatment of eating disorders
1. Introduction
Eating disorders are a group of mental health disorders with significant medical, psychological,
and social consequences impacting both childhood and adult populations (1).
Eating disorders have the highest mortality rate of all mental illnesses (2). The incidence of
eating disorders has been increasing over time, and this accelerated during the Covid-19
pandemic (3).
A previous study has found insufficient knowledge about evidence-based psychotherapies,
general psychopathology, and the role of family members in the management of eating
disorders among all health professionals as well as a stigma among non-psychiatric doctors (4).
One of the studies emphasized the importance of raising awareness of stigma and lack of
knowledge in eating disorders through educational programmes and the impact of the same on
treatment effectiveness (5). Following the development of the HSE National Model of Care for
Eating Disorders Services (HSE, 2018) there has been an increase in training and exposure to
eating disorders within mental health services.
However, it is important to address that there are a considerable number of healthcare
professionals in the field of mental health who report not feeling fully confident in diagnosing
and managing these cases. With gaining enhanced knowledge and confidence in managing
eating disorders, there is a great potential in improving patient safety and outcomes by
minimising the risk of late detection of eating disorders, improving the identification of medical
risks, and early access to evidence-based treatment.
The purpose of this research project is to explore the current status of knowledge and
understanding of eating disorders among psychiatry trainees working in Ireland, initially in HSE
South West in order to inform future planning.
2. Objectives
• To explore the knowledge of NCDSs regarding a diagnosis of eating disorders
• To understand the knowledge of NCHDs in relation to the management of eating
disorders
• To gain an insight about the knowledge on the MEED Guidelines and their practical use in
emergency situations
• To identify the areas for improvement regarding education, management, and training for
healthcare professionals.
3. Methodology
a. Study Design: Quantitative research design (Vignette based survey)
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b. Participants: We will initially include all NCHDs working in Mental Health Services in South
West region of Ireland, including Senior Registrars with potential expansion to all NCHDs
working in Psychiatry in the Republic of Ireland who are willing to participate.
c. Data Management
• The study team will develop a questionnaire assessing the understanding of eating
disorders management and diagnosis via case vignettes.
• Questionnaires will be distributed electronically to all NCHDS working in Mental Health
Services in South West region of Ireland.
• Survey responses will be analysed using standard statistical software (SPSS). We are
planning to include qualitative descriptive statistics and explore any between-group
comparisons.
d. Ethical Considerations
Ethical approval will be obtained from the Social Research Ethics Committee (SREC). The
participant leaflet will be provided and potential participants will have an opportunity to contact
any of the involved researchers at any point, in case of concerns or if any additional information
is needed about the research participation. We will ensure that only participants who have
consented are offered to complete the survey. Participation is entirely voluntary and
participants are entitled to end their participation at any time. However, as the survey will be
anonymous, we will not be able to withdraw their response once they have submitted the
survey. We will highlight that there is no fee for participating in this study and that confidentiality
of information cannot be guaranteed by researchers and can only be protected within the
limitations of the law.
The legal basis under which we are processing the data is Article 6.1 (a) and Article 9.2 (a) GDPR
2016 as per UCC SREC requirements. Only members of the research team will have access to
the information. Data will be stored anonymously on password protected and encrypted
devices that only the research team has access to. Data will be destroyed following completion
of the study therefore it will not be possible to remove participants from the study if they change
their mind after completion of the survey. In case of any concerns, they can contact the Data
Protection Commissioner. Participants will not be able to request access to or obtain a copy of
the information due to anonymization from the outset.
4. Anticipated Outcomes
• To gain quantitative information about the knowledge of NCHD’s in Psychiatry about the
diagnosis and management of eating disorders
• To identify the areas for improvement regarding education, management, and training for
healthcare professionals.
5. Significance and Implications
V.9 Sep. 2024| Social Research Ethics Committee (SREC) |University College Cork, Ireland | https://www.ucc.ie/en/research/support/ethics/
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• The research has the potential to raise awareness about eating disorders among
NCHDs in psychiatry and to contribute to the improvement in patient care and
outcomes
• The findings will provide guidance for targeted educational interventions and training
programs about eating disorders for both trainees and non-trainee Psychiatry Doctors
working in Irish mental health services
6. Timeline
• Literature search: 1 month
• Preparation and Approval: 1 month
• Survey Development and Pilot Testing: 2 months
• Survey Distribution and Data Collection within the UCC Deanery: 2 months
• Data Analysis and interpretation of results: 2 months
• Drawing conclusions and writing up discussion: 2 months
• Report Writing and Dissemination: 2 months
• Survey Distribution and Data Collection on the national level: 4 months
• Data Analysis and interpretation of results: 4 months
• Drawing conclusions and writing up discussion: 2 months
• Report Writing and Dissemination: 2 months
7. Budget
• No expenses are required for participant recruitment and data analysis.
8. Conclusion
This research project has the potential to provide further insight into clinician understanding
and knowledge about eating disorder treatment which will in turn enable service leads and
educators to identify areas for quality improvement and improve patient care and safety.
Reference list
1.
2.
3.
4.
5.
World Health Organization (2022) ICD-11, International Classification of Diseases 11th Revision. Available at: https://icd.who.int/en.
Arcelus, J. et al. (2011) ‘Mortality rates in patients with anorexia nervosa and other eating disorders. A meta-analysis of 36 studies’,
Archives of general psychiatry, 68(7), pp. 724–31. Available at: https://doi.org/10.1001/archgenpsychiatry.2011.74.
Raventós, B. et al. (2022) ‘Impact of the COVID -19 pandemic on eating disorders diagnoses among adolescents and young adults in
Catalonia: A population-based cohort study’, International Journal of Eating Disorders, 56(1). Available at:
https://doi.org/10.1002/eat.23848.
Alessio Maria Monteleone et al. (2024) ‘Attitudes and gaps in knowledge of the diagnosis, treatment, and psychopathology of eating
disorders among different health professionals’, Journal of Eating Disorders, 12(1). Available at: https://doi.org/10.1186/s40337-024
01053-5.
McNicholas, F. et al. (2015) ‘Stigma and treatment of eating disorders in Ireland: healthcare professionals’ knowledge and attitudes’,
Irish Journal of Psychological Medicine, 33(1), pp. 21–31. Available at: https://doi.org/10.1017/ipm.2015.24.
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Exploration of the Working Knowledge of NCHD’s working in Psychiatry South West
HSE Mental Health Services in Ireland about diagnosis and management of the eating
disorders
We are interested in getting the views and knowledge about the diagnosis and care of eating disorders
in children, adolescents and adults presenting to mental health professionals in South West region
Ireland. This will help inform the training and professional development of doctors working in
psychiatry in this clinical area.
This survey is completely anonymous and should take no more than five minutes of your time to
complete. If you are interested, a participant information leaflet can be accessed below:
Participant Information Leaflet contains:
Ø Introductory Statement:
Exploration of the Working Knowledge of NCHD’s working in HSE South West Mental Health
Services in Ireland about diagnosis and management of the eating disorders
Site
Principal Investigator(s) and Co
Investigators
South West MHS – online vignette survey
1.Dr Sara McDevitt – Supervisor
2.Dr Jelena Vojnic Barisic – Senior Registrar
3.Dr Ivona Kusen – Senior Registrar
4. Dr Keerti Karunakaran
5.Dr Eimear O’Neill – Senior Registrar
6.Dr Rakesh Rampal – Registrar
Data Controller
DPO UCC
UCC
gdpr@ucc.ie
You are being invited to take part in a research study that is being carried out by a group of Senior
Registrars/ Registrars working in CAMHS and Adult South West Mental Health Services. This
research is being supervised by Dr Sara McDevitt Child and Adolescent Psychiatrist at CAREDS, the
Child and Adolescent Regional Eating Disorder Service for Cork and Kerry.
Before you decide whether or not you wish to take part, please read this information leaflet carefully
and contact any of the involved researchers (contact details below) if you have any queries.
Participation is entirely voluntary and you are not obliged to answer this survey but your participation
would be appreciated and will enhance our findings. This study has been approved by the UCC SREC
ethics committee. There is no fee for participating in this study.
What is this research about?
The purpose of this study is to explore the knowledge of psychiatry NCHDs about the assessment and
care of people with eating disorders.
Why am I doing this research?
You have been invited to take part in this study because you are an NCHD working in HSE mental
health services in Ireland.
What will happen if I decide to take part in this research study?
The research is a short vignette based survey which should take no longer than 5 minutes to complete.
How will your data be used?
V.9 Sep. 2024| Social Research Ethics Committee (SREC) |University College Cork, Ireland | https://www.ucc.ie/en/research/support/ethics/
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The data collected will be anonymised from the outset. The Data gathered will be analysed and the
anonymised group results may be published. Results may be disseminated in medical journals or at
conferences.
How will we protect your privacy?
The legal basis under which we are processing your data is Article 6.1 (a) and Article 9.2 (a) GDPR
2016 as per UCC SREC requirements. Only members of the research team will have access to the
information. Data will be stored anonymously on password protected and encrypted devices that only
the research team have access to. Data will be destroyed following completion of the study therefore it
will not be possible for you to be removed from the study if you change your mind after completion of
the survey. Any concerns you can contact the Data Protection Commissioner. Participants will not be
able to request access to or obtain a copy of the information due to anonymization from the outset.
What are the benefits of taking part in this research study?
This research may inform and benefit future psychiatric training with the ultimate aim of benefiting
future patient care. We hope it will be helpful in advocating for further educational and training
support in eating disorders. This study will also raise the awareness of importance of early
recognition, risk management and treatment of eating disorders that is crucial for recovery, and
prevention of potential long-term impairment or disability.
For further information please contact:
Jelena.VojnicBarisic@hse.ie
118104511@umail.ucc.ie
(all above will be available on “Participant Information Leaflet” link)
If you are happy to participate in this anonymous survey, please answer the following questions.
V.9 Sep. 2024| Social Research Ethics Committee (SREC) |University College Cork, Ireland | https://www.ucc.ie/en/research/support/ethics/
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Electronic Survey
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Section 1 – About you
1.
2.
3.
4.
Are you currently on the training scheme
• I am on the training scheme in psychiatry
• I am on the GP training scheme
• I am in a non-training post
Which of the following best describes your current grade at work?
• Senior House Officer
• Registrar
• Senior Registrar
Where do you work currently?
• Child and Adolescent Mental Health Service(MHS)
• Adult MHS
• MHS for older persons
How many patients with Eating disorders did you review in the last year?
Section 2 – Vignettes
1.
A 15-year-old female is referred by her GP to A&E because of food restriction, over-exercise,
and weight loss. She reports an intense fear of weight gain and excessive feelings of guilt after every
dietary intake. She has lost 11 kg in the last 2 months. She complains of headaches, low energy, and
dizziness. She has been amenorrhoeic for 4 months. She counts calories and her goal is < 800
kcal/day. Her parents were not able to implement increased intake as advised by her GP. On
Examination, her height is 160 cm with a weight of 35 kg and the %m BMI is calculated below 1st
centile. Blood results show WCC (2.0x 109/ L) and neutrophil count (1.2 x 109/L). Biochemical
investigations suggested potassium level (3mmol/L), magnesium level (0.40 mmol/L), and phosphate
level (0.50 mmol/L). She is pale and cold and her skin is dry. Her BP is 80/45 mm Hg, and her body
temperature is 35.9 c.
1.1 You are the CAMHS NCHD on call and you’re seeing this girl in the emergency department.
What is your preliminary working diagnosis?
a) Anorexia nervosa
b) ARFID
c) OSFED
1.2 What is the correct way to measure weight in a child or adolescent population? (tick as many as
apply)
a) Median BMI
b) BMI
c) BMI centile charts
1.3. Which guidelines are currently used for the assessment of medical risks in eating disorders?
V.9 Sep. 2024| Social Research Ethics Committee (SREC) |University College Cork, Ireland | https://www.ucc.ie/en/research/support/ethics/
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a) MARSIPAN
b) CNMED
c) MEED
1.4 Based on the clinical scenario above, what is the best course of action?
a) Referral to outpatient psychiatric treatment
b) Referral to an emergency department
c) GP routine monitoring
1.6 Which of the following are NICE recommended interventions for this eating disorder?
(a) FBT
(b) DBT
(c) Psychodynamic therapy
d) MANTRA
e) EMDR
f) SSRI
1.7 What are the clinical features of refeeding syndrome? Tick as many as apply.
a) Abdominal pain
b) Weakness
c) Confusion
d) Difficulty breathing
e) Increased heart rate
f) Edema
g) Hair loss
h) High blood pressure
i) Osteoporosis
g) Rapid weight gain
2.
A 26-year-old female has presented to her GP because of binge eating episodes, occurring
three times per week over the last year. She also complains of self-induced vomiting after meals, at
least once a day. She has gastritis diagnosed by her GP and she was prescribed a PPI for the same. On
observation, she has front teeth erosions. Her vital signs are normal, and her BMI is 30. Her menstrual
periods are regular. She struggles with self-esteem, and she is preoccupied with body image and
weight.
2.1 According to the ICD 11 what is your provisional working diagnosis?
a) Binge eating disorder
b) Bulimia nervosa
c) OSFED
2.2 According to the ICD 11 criteria for this eating disorder, what is the minimal occurrence of binge
eating episodes over the week, and for how long?
a) Once a week or more over a period of at least a month
b) Once a week over a period of three months
c) Twice a week over a month
2.3 What ECG changes are most commonly seen with hypokalaemia?
a) U wave that occurs just after the T wave and is usually of smaller amplitude than the T wave
b) ST depression with flattened p wave, prolonged PR interval, and prolonged QRS duration
c) Prolonged QT interval
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2.4 Recommended outpatient treatments for bulimia nervosa (tick as many as apply):
a) CBT-ED
b) FBT
c) DBT
d) Bulimia nervosa focus guided self-help programme
e) Group CBT
f) Psychodynamic psychotherapy
g) MANTRA
h) Schema therapy
3. An 11-year-old boy has been referred to the community CAMHS team by his GP due to concerns
about his eating. He is very particular about the foods he eats, only eating food of a certain texture in a
particular order, and not allowing different food touching on the plate. He tends to avoid carrots as
they feel “mushy” or mushrooms as they have an intense smell. He eats plain food without spices and
has his meals scheduled at certain times of the day (e.g.13:13, 17:21, etc.) This has caused anaemia
and a weight loss of >5 kg in the last year. He reports feeling dizzy and lethargic and this is impacting
his academic performance. He is no longer able to play the video games he enjoyed due to poor
concentration and headaches. There is no body image distortion or desire to lose weight. He does not
have any other medical condition, or other mental disorder, or food allergies which explain his weight
loss. His mBMI is 92%.
3.1. What is your provisional working diagnosis in this case?
a) Avoidant Restrictive Food Intake Disorder (ARFID)
b) OSFED
c) Anorexia nervosa
d) Disordered picky eating
e Bulimia Nervosa
3.2. Which of the following are psychopathologies that commonly drive this eating or feeding
disorder (tick as many as relevant)?
a) Shape and/ or weight dissatisfaction
b) Lack of interest in food
c) Concern about food contaminants
d) Sensory sensitivity
e) Preoccupation with clean eating
3.3. The main recommended therapy options for this condition are: (tick as many as apply)
a) Nutritional rehabilitation
b) SLT
c) Psychodynamic psychotherapy
d) Family therapy
e) Specialised- CBT
f. art therapy
G. Occupational Therapy
We would be grateful for any additional comments:
_________________________________________________________________
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Thank you for your participation.
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