The Anorexic Adolescent: Challenges to Nursing Care

Topics: Anorexia nervosa, Nursing, Eating disorders Pages: 15 (4375 words) Published: January 28, 2013
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 result, it is evident that nurse education is pertinent in order to overcome the challenges presented by the anorexic patient and successfully provide appropriate care.

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Introduction Anorexia nervosa, hereafter referred to as “AN”, can be defined as a psychological illness, characterized by an obsessive desire to lose weight by refusing to eat (Soanes & Stevenson, 2008). There is an annual incidence of 10 cases of AN per 100,000 of the population in females and 0.5 for males (DoHC, 2006). The typical onset of AN occurs between the ages of 14-18 (WHO, 2004). AN is a serious condition with a 20% mortality rate in chronic patients (DoHC, 2006). It is suggested that this is as a result of a strong sense of denial within the anorexic population, leading to late presentation. The anorexic patient often does not accept diagnosis, minimizes the implications of the illness and refuses treatment (Couterier & Lock, 2006). Therefore, providing treatment is difficult (DoHC, 2006). Furthermore, for patients suffering from AN, a sense of self worth can be dependant on thinness (Paterson et al., 2007). As a result, patients can view treatment as a fight for control and become resistant to care (Halvorsen & Heyerdohl). Consequently, providing care for the AN patient can be challenging for nursing staff.

Currently, there is a growing weight loss culture and AN is becoming an increasingly salient issue in nursing care (King & Turner, 2000). While AN 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. Consequently, the purpose of this literature review is to explore the challenges presented to nursing staff when caring for an adolescent suffering from AN.

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Search Method A literature review was undertaken by searching the databases CINAHL, PsycArticles, PsycInfo and PubMed. The search terms “anorexia”, “anorexia nervosa”, “nursing care”, “weight restoration”,...

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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.
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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.
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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.
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