Case study of Charlie with anorexia nervosa
Discuss about the Biopsychosocial Assessment in Eating Disorder for Psychology.
The biopsychosocial approach deliberately thinks about natural, mental and social variables and their internal cooperation in understanding the wellbeing and disease of the body. The point of the essay is to identify the significance of a detailed biopsychosocial evaluation to classify the factors that lead to the analysis of an eating disorder and the implication of the nursing care management. The occurrence of the psychological disorders, which are characterized by the abnormal eating habits, is known as the eating disorder. Risk factors for the eating disorder involve a change in the biological and psychological behaviour within the body. However, because of the idea of the ailment and the patient’s craving to keep the disease, a large number of the cases stay undiscovered. Nurses ought to be cautious when administering to patients in every single caring sector. Nurses play a crucial role in eating-disorder recovery through person-centred care and therapeutic relationship. Nurses are essential in building up the establishments of improvement, particularly to the patients who may not comprehend that they have a illness within them. However, there has been impressive development in the principles on the eating disorder, with significant suggestion for the moral and theoretical issues that enclose the decision-making capacity and the way of examining the disease (Van Ommen et al., 2009)
Researches indicate that there is an increasing number of young women are suffering from eating disorder, and now they are seeking help through medical or nursing management. This case study discusses Charlie who is a 19-year-old girl. Charlie went out for dinner with her friends, but slowly she separated herself from them and started to stay alone. She eats very little and takes laxative throughout the day. Charlie was taken to the Eating Disorder Unit in Brisbane. She felt hesitated to disclose about her food habits to the nurses and eventually Charlie was admitted to the unit and was prescribed with multivitamin and antidepressant. According to the case study, the patient have anorexia nervosa because the symptoms which are expressed in the case study matches with anorexia nervosa. Anorexia nervosa has to types. They are purging type and restricting type. Restricting type is those type of anorexia nervosa in which the person has not sometimes engaged in the splurge eating and exclusion behaviour which is, self-prompted vomiting, high exercise or the mishandling of the laxatives. 90% of people with anorexia are females. 15-19 years olds make up to 40% anorexics. Extensive fear of weight gain and becoming fat are the two major problems with the patients. The biopsychosocial factors comprise genetic changes, developmental changes, neurobiological factors and social pressure on the patient. Hereditary components contribute half of the change for the advancement of the dietary issue (Johnson, 2008). Imbalance of serotonin causes the rise of the neurobiological factors. Social pressure from the families or parent causes the increase of an eating disorder. The biopsychosocial model explains the relationship between socio-cultural appearance pressures and adverse effect (socio-cultural and psychological components) and eating concerns in the adolescent girl. Rapid hormonal changes are associated with the increased risk of eating disorder. The characteristic varieties in eating and hunger might aggravate to women who are battled with food. There is a widespread endocrine disorder which involves hypothalamic pituitary gonadal axis. All the stressful development phases of life place young women at increased risk of eating issues. In addition to the physical transformations, these changes guide in clearly different common roles and everyday schedules. At the point when the life is evolving quickly, dithering and self- vulnerability, the human instinct to look something that exhibits a feeling of soundness and control. An eating disorder can turn into the appropriate response, promising a young lady that changing her body can change her life, comprehending ever one of the problems she faces as she advances through the grown up improvement. Eating disorder includes anorexia nervosa which naturally starts in the mid-adolescence with the beginning of nutritional constraint that quickly gets out of manage in the later stages of life (Watson & Bulik, 2013). The young women eating disorder come in the different, sizes, severities and shapes leads towards significant nutritional depletion with physical problems. The adult eating disorder often falls into the partial syndrome categories (Birmingham & Treasure, 2010). This circumstance makes it more challenging for the young women to self-analyse and seek medical cure. The symptoms of many young females develop through time is primarily restricting to anorexic behaviour. They have or may have begun to reduce eating and reach to a standard or abnormal weight of the body. The patient ma acknowledge that she ate something, while at the same time eating far not as much as her metabolic needs require, or may trust she is no longer purging when she has submitted the misuse of laxative for vomiting (Hildebrandt et al, 2012).
Risk factors for eating disorders
Nursing is the profession of science and caring together. It is a profession within a healthcare sector, and it focuses on the care of individual, families and communities. Nurses should provide high quality care, for that they need to practice within their professional standard and ensures that their case is based upon the quality evidence. Having the information and comprehension will empower attendants to screen the sustenance allow and watch the potential dietary problems. Nursing treatment will depend on the individual’s eating disorder symptoms (Tomey, (2009). Nurses will probably pass on a feeling of trust when they speak with their young patients. Nursing management involves various biopsychosocial assessment and interventions of the eating disorders. Refeeding is the most critical intervention during the initial stage of the treatment. The nurses will face resistance to the weight gain and many refusals to eat from the patients, and therefore they should monitor and record all the intake of the food carefully. The refeeding protocol to the patient starts at 1500 calories a day and slowly it will be increased to 3500 calories per day (Gentile et al., 2010). Two most common nursing diagnoses in anorexia nervosa are anxiety, and the other is the disturbed body image. For the awareness problems, the nurses can encourage the patients to keep a journal. Most patients use complaints that they are fat or they feel bloated to replace a negative emotion such as guilt or anger. The nurses should help their patients to identify the feelings and asked them to write about the nature of the fat perception and to list all the possible underlying emotions and troublesome situations next to this description. The nurses should conduct an eating aptitude test with their respective patient, and the eating aptitude test will contain all the necessary incidents that the patient faces on a day-to-day event. The nurses should not attempt to change the distorted body image by merely pointing out that the patient is too thin. However, these symptoms are severe to be abated, patients can continue to fear becoming fat but not be driven to act on the distortion by starving. The fear of fat will eventually diminish over time. Setting the realistic eating goals is one of the most helpful interventions for patients with eating disorders (Campbell & Hausenblas, 2009). The people with anorexia nervosa are often the perfectionist, and they usually set unrealistic goals. After the process of refeeding, treatment of eating disorder takes place on an outpatient basis, and it involves individual and family therapy to reinforce healthy eating patterns and attitudes in their daily habit.
Biopsychosocial factors that contribute to eating disorders
According to Zugai, Stein?Parbury, & Roche, (2018), the caring partnership engendered by a therapeutic association is considered a useful tool, appreciated by the customers who have gotten treatment for eating disorder (anorexia nervosa) in the inpatient setting, and also by the health takers who are specialised in their field. The growth of a therapeutic association between nurses and patients with anorexia nervosa is tough, in part, because anorexia nervosa is an ego-sytonic psychological turmoil. Consumers with anorexia nervosa often deny their illness. Nurses have trouble in setting up therapeutic relationships due to misunderstanding the anorexia nervosa, a struggle for control, and also the exhaustion, frustration and emotional challenge, from the needs of nursing patients with anorexia nervosa. In order to overcome these barriers, a successful blended technique approach was utilized with the introductory quantitative stage and eventually by a subsequent quantitative period. The examination enlisted consumers and nurses from six wards with a programme for the treatment of anorexia nervosa in five hospitals in New South Wales Australia. Taking and interest medical caretakers were required to work in a unit with particular application for the treatment of illness. Interviews conducted with the health caretakers and consumers that were acoustic recorded and examined. Nurses understood that customers wanted to feel the caring nature. The positive connection between nurse and patients drove the patients to investigate secure in confiding the helpful goal of the medical attendants who were endeavouring to encourage their weight gain. Nurses interacted with the patients in a proper way that conveyed optimistic values. The motherly nurses cordially assisted the consumers with difficult aspects of hospitalization and completed the meaningful and memorable contribution to the welling of the patients (Treasure, & Russell, 2011).
Ethical dilemma frequently arises in the cure of the client with eating disorders and the doctors or the other clinicians encounter an array of ethical changes on a day to day basis. The clinicians who examine their patients with an eating disorder often face ethical implications such as counsellor capability and specific action knowledge in the rural areas. The problems of eating disorders, which include a possible death- the clinicians frequently, discover themselves, making treatment decisions that affect a clients’ mental physical and health. The ethical principles of aptitude have an assortment of suggestions for those treating dietary issues since the dietary issues enormously influence physical wellbeing and emotional wellbeing and they are problematic to treat. Obvious forms of self-disclosure such as exercise, thoughts on diet, and personal struggles with an eating disorder can also have a tremendous consequence, potentially waiting to the patients’ healing. Whether stating a thought of estimation on the newest diet chart or explaining any individual revival status, the clinicians must check and appraise their observations, on an ongoing basis. The nurses or the clinicians did not plan to cause hurt, if their patients experienced brought down certainty or confidence, self perception or any state of state of mind unsettling influences due to the associations, the clinicians’ approach must be analyzed. (Wong, Cummings & Ducharme, 2013). Treating of the eating disorders in the rural areas faces many ethical implications. Eating disorders involve both physical and mental health, it is essential for the clinicians to have some education in the treatment modalities and standards of practice. Few areas sometimes be short of professionals who have dedicated understanding and preparation. Thus, the clinicians without sufficient background in eating disorders may work with a patient who has an eating disorder. For a clinician or nurse it is essential for them to understand the deficits from the root level, proper consultation is required with more knowledgeable practitioners, and dedicated training can be achieved through some investigations. (Snell, Crowe & Jordan, 2010).
Nursing interventions for patients with eating disorders
It can be concluded from the analysis is that Charlie had an eating disorder and the symptoms which are related to that type of eating disorder is anorexia nervosa. She felt that she is fat and psychologically she became an imbalance as the day passes. Therefore, proper guidance is required for her. Researchers indicate that young women suffering from an eating disorder are increasing in numbers and they seek medical attention. The increase in eating disorder can be analyzed from a biopsychosocial viewpoint. Young ladies with eating disorders frequently encounter on the beginning of side effects during the developmental changes including entry to universities college and their coming years. Nurses and clinicians who regularly check patients through these moment of change must recognize and understand the problems which the patient’s face. The helpful relationship among medical attendants and the patient’s with anorexia nervosa is not created through arrangements between equal partners. The healing association is dependent on health takers’ capacity to maintain their position of control, while signifying their honesty to the patients. In trusting medical caretakers, the patients felt more secure in contributing another idea of solace. Nurses and clinicians face ethical implications, and it is another factor which associates with the eating disorder.
References
Birmingham, C. L., & Treasure, J. (2010). Medical management of eating disorders. Cambridge University Press.
Campbell, A., & Hausenblas, H. A. (2009). Effects of exercise interventions on body image: A meta-analysis. Journal of health psychology, 14(6), 780-793.
Gentile, M. G., Pastorelli, P., Ciceri, R., Manna, G. M., & Collimedaglia, S. (2010). Specialized refeeding treatment for anorexia nervosa patients suffering from extreme undernutrition. Clinical nutrition, 29(5), 627-632.
Hildebrandt, T., Bacow, T., Markella, M., & Loeb, K. L. (2012). Anxiety in anorexia nervosa and its management using family?based treatment. European Eating Disorders Review, 20(1), e1-e16.
Johnson, S. K. (2008). Medically unexplained illness: Gender and biopsychosocial implications. Psychological Medicine, 38(4), 607.
Tomey, A. M. (2009). Nursing management and leadership. USA: Mosby Elsevier.
Treasure, J., & Russell, G. (2011). The case for early intervention in anorexia nervosa: theoretical exploration of maintaining factors. The British Journal of Psychiatry, 199(1), 5-7.
Watson, H. J., & Bulik, C. M. (2013). Update on the treatment of anorexia nervosa: review of clinical trials, practice guidelines and emerging interventions. Psychological medicine, 43(12), 2477-2500.
Wong, C. A., Cummings, G. G., & Ducharme, L. (2013). The relationship between nursing leadership and patient outcomes: a systematic review update. Journal of nursing management, 21(5), 709-724.
Zugai, J. S., Stein?Parbury, J., & Roche, M. (2018). The nature of the therapeutic alliance between nurses and consumers with Anorexia Nervosa in the inpatient setting: A mixed?methods study. Journal of clinical nursing, 27(1-2), 416-426.
Snell, L., Crowe, M., & Jordan, J. (2010). Maintaining a therapeutic connection: nursing in an inpatient eating disorder unit. Journal of Clinical Nursing, 19(3?4), 351-358.
Van Ommen, J., Meerwijk, E. L., Kars, M., Van Elburg, A., & Van Meijel, B. (2009). Effective nursing care of adolescents diagnosed with anorexia nervosa: the patients’ perspective. Journal of Clinical Nursing, 18(20), 2801-2808.
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