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The Anorexic Adolescent: Challenges to Nursing Care

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The Anorexic Adolescent: Challenges to Nursing Care
The anorexic adolescent: Challenges to nursing care

Literature review

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Table of Contents Abstract……………………………………………………………………………………..3 Introduction…………………………………………………………………………………4 Search Method………………………………………………………………………………5 Therapeutic Relationship…………………………………………………………………6-7 Weight Restoration……………………………………………………………………….8-9 Family Centred Care…………………………………………………………………...10-11 Conclusion……………………………………………………………………………..12-13 Further Research Recommendations………………………………………………………14 References……………………………………………………………………………...15-17

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Abstract Background: Anorexia nervosa can be defined as a psychological illness, characterized by an obsessive desire to lose weight by refusing to eat. The typical onset of anorexia nervosa occurs between the ages of 14-18. Currently, there is a growing weight loss culture and anorexia nervosa is becoming an increasingly salient issue in nursing care. While anorexia nervosa is a widely researched topic, the writer found there to be limited research into difficulties nursing staff are faced with when caring for the anorexic adolescent. Aim: The purpose of this literature review is to explore the challenges presented to nursing staff when caring for an adolescent suffering from anorexia nervosa. Method: A literature review was undertaken by searching the databases CINAHL, PsycArticles, PsycInfo and PubMed. Articles gathered range in date from 1997-2009. 26 articles were selected to be included in the literature review; 11 qualitative, 13 quantitative and 2 literature reviews. Results: Three main challenges to nursing care emerged from the literature; a therapeutic relationship, weight restoration and family-centred-care. Conclusion: Overall, it is evident that the anorexic patient can be a challenge to nursing staff. Through difficulties in building a therapeutic relationship, resistance to weight restoration, incorporating the family into care and resolving family conflicts, providing treatment can be problematic. As a


References: Carlton, P. & Pyle, R. (2007) A program for parents of teens with anorexia nervosa and eating disorders not otherwise specified. International Journal of Psychiatry in Clinical Practice 11(1) 9-15. Colton, A. & Pistrong, N (2004) Adolescents’ experiences of inpatient treatment for anorexia nervosa. European Eating Disorders Review 12, 307-316. Couturier, J. & Lock, J. (2006) Denial and minimization in adolescents with anorexia nervosa. International Journal of Eating Disorders 39(3) 212-216. Dallos, R. & Denford, S. (2008) A qualitative exploration of relationship and attachment themes in families with an eating disorder. Clinical Child Psychology 13, 305-322. Department of Health & Children (2006) ‘A Vision for Change’ Report of the Expert Group on Mental Health Policy. Stationary Office, Sun Alliance House, Molesworth Street, Dublin 2. Fassino, S., Doga, G., Piero, A., Leombruni, P. & Rovera, G. (2001) Anger and personalities in eating disorders. Journal of Psychosomatic Research 51, 757-764. Fox, J. (2009) A qualitative exploration of the perception of emotions in anorexia nervosa: A basic emotion and developmental perspective. Clinical Psychology and Psychotherapy 16, 276-302. George, L. (1997) The psychological characteristics of patients suffering from anorexia nervosa and the nurse’s role in creating a therapeutic relationship. Journal of Advanced Nursing 26, 899-908. Golden. N., Jacobson, M., Sterling, W. & Hertz, S. (2008) Treatment goal weight in adolescents with anorexia nervosa: Use of BMI percentiles. International Journal of Eating Disorders 41(4) 301-306. Halvorsen, I. & Heyerdohl, S. (2007) Perception in adolescent onset of anorexia nervosa: Retrospective views of patients and parents. International Journal of eating Disorders 40(7) 629-639. Harrison, A., Sullivan, S., Tchanturio, K. & Treasure, J. (2009) Emotion recognition and regulation in anorexia nervosa. Clinical Psychology and Psychotherapy 16, 348356. Honey, A., Broughtwood,D. Clarke, S., Halse, C., Kohn, M. & Madden, S. (2008) Support for parents of children with anorexia: What parents want. Eating Disorders 16, 40-51. Honey, A., Clarke, S., Halse, C., Kohn, M. & Madden, S. (2006) The influence of siblings on the experience of anorexia nervosa for adolescent girls. European Eating Disorders Review 14, 315-322. Karpowicz, E., Skarsater, I. & Nevonen, L. (2009) self-esteem in patients treated for anorexia nervosa. International Journal of Mental Health Nursing 18, 318-325. King, S. & Turner, D. (2000) caring for adolescent females with anorexia nervosa: Registered nurses’ perspective. Journal of Advanced Nursing 32(1) 139-147. Kyriacou, O., Easter, A. & Tchanturia, K. (2009) Comparing views of patients, parents and clinicians on emotions in anorexia: A qualitative study. Journal of Health Psychology 14, 843-854. Ma, J. (2008) Patients’ perspective on family therapy for anorexia nervosa: A qualitative inquiry in a Chinese context. Australian & New Zealand Journal of Family Therapy 29(1) 10-16/ Nilsson, K., Abrahamsson, E., Torbiornsson, A Patel, D. Pratt, H. & Greydanus, D. (2003) Treatment of adolescents with anorexia nervosa. Journal of Adolescent Research 18(3) 244-260. Paterson, G., Power, K., Yellowlees, A., Park, K. & Taylor, L. (2007) The relationship between two-dimensional self-esteem and problem solving style in an anorexic inpatient sample. European Eating Disorders Review 15, 70-77. Roots, P. Howker, J. & Gowers, S. (2006) The use of target weights in the inpatient treatment of adolescent anorexia nervosa. European Eating Disorders Review 14, 323328. Turrell, S., Davis, R., Graham, H. & Weiss, I. (2005) Adolescents with anorexia nervosa: Multiple perspectives of discharge readiness. Journal of Child and Adolescent Psychiatric Nursing 18(3) 116-126.
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