The Roy Adaptation Model: A Theoretical Framework for Nurses Providing Care to Individuals With Anorexia Nervosa.

Using a nursing theoretical framework to understand, elucidate, and propose nursing research is fundamental to knowledge development. This article presents the Roy Adaptation Model as a theoretical framework to better understand individuals with anorexia nervosa during acute treatment, and the role of nursing assessments and interventions in the promotion of weight restoration. Nursing assessments and interventions situated within the Roy Adaptation Model take into consideration how weight restoration does not occur in isolation but rather reflects an adaptive process within external and internal environments, and has the potential for more holistic care.

[Treating the somatic complications of anorexia]. / Traiter les complications somatiques de l'anorexie.

Anorexia can cause serious somatic complications, linked to undernutrition or associated pathological behaviours. The care pathway drawn up by a multi-discipline team is a real therapeutic challenge. Oral nutritional supplements, enteral nutrition and parenteral nutrition are three possible forms of nutritional assistance.

[Organising nutritional support for patients with anorexia]. / Organiser l'accompagnement alimentaire de l'anorexie.

Nutritional care in the Eating Disorder unit of Sainte-Anne general hospital in Paris, is organised around a care model based on cognitive behavioural therapy. Hospitalisation is generally prepared beforehand and aims to draw on patients' resources enabling them to clarify a request for help. A care contract can be drawn up to provide step-by-step support for the patient in terms of the goals to achieve.

[Therapeutic touch and anorexia nervosa]. / Toucher thérapeutique et anorexie mentale.

An innovative practice, therapeutic touch has been used for around ten years in the treatment of eating disorders. Delivered by nurse clinicians having received specific training, this approach is based on nursing diagnoses which identify the major symptoms of this pathology. The support is built around the body and its perceptions. Through the helping relationship, it mobilises the patient's resources to favour a relationship of trust, a letting-go, physical, psychological and emotional relaxation, and improves the therapeutic alliance.

[Art-therapy in anorexia: the mediative elements?]. / Art-thérapie et anorexie mentale: quels objets médiateurs?

Art does not have any inherent curative property; it is used as a therapeutic medium. Three mediative elements, depending on their specificities, have a role to play in the intrapsychic and interpersonal transformation of the patient: the creation the art-therapist and the group of participants. This article looks at the different components of art-therapy used in the treatment of anorexia.

Eating disorders and equine therapy: a nurse's perspective on connecting through the recovery process.

Patients with eating disorders may have the most complex interdisciplinary treatment plans of any mental illness. Nurses need innovative evidence-based treatment interventions to assist their patients with eating disorders on their road to recovery. Although much has been written about equine-assisted psychotherapy (EAP) and equine-facilitated psychotherapy, the literature has not described a detailed session that can help nurses understand how this experiential treatment works and the impact it can have on the patient. A review of the literature on eating disorders and on the use of equine therapy in its treatment is presented in this article. In addition, the role of the nurse during equine therapy will be highlighted, and an individual example will provide a detailed review of an EAP session.

A psychoneuroendocrino-immune approach in the nursing treatment of anorexia and bulimia nervosa.

Recent clinical reports have shown an increasing number of patients afflicted by eating disorders in the western world. There are numerous causes and mechanisms leading to eating disorders that affect the psychoneuroendocrinoimmune system. In this study, we define a novel psychoneuroendocrinoimmune nursing approach for anorexic and bulimic patients' treatment. According to the specific diagnostic items deriving from the Diagnostic and Statistical Manual of Mental Disorders and the International Classification of Diseases, and clinical guidelines in eating disorders formulated by the National Institute for Clinical Excellence, we carried out a qualitative study on the nursing treatment chosen by 210 international centers considered as a sample. This study was based on a no structured interview via e-mail to better understand the nursing approach in anorexia and bulimia nervosa. Thanks to the selected centers' answers, four different levels of nursing care were identified, that include: the nursing role analyzing the spectrum of patients' problems; the nursing intervention in inpatient care; the nursing intervention in outpatient care; the day hospital treatment. All four prove to be especially useful in the nursing practice.

Eating disorders and adolescents: an overview of a maladaptive behavior.

TOPIC: Eating disorders among the adolescent population are a serious health problem. The author provides an overview of anorexia nervosa and bulimia nervosa. PURPOSE: To present information on eating disorders that includes DSM-IV criteria and typical profiles of the client. Current hypotheses about the etiology of eating disorders, medical complications, treatment approaches, morbidity and mortality data research, and outcome research of treatment are reviewed. Research, treatment, and educational considerations for nursing care are discussed. SOURCES: Published literature, clinical experience. CONCLUSIONS: Advanced practice nurses are particularly suited for working with adolescents because of their holistic approach to client care. Inconsistencies and gaps in the knowledge base of eating disorders regarding incidence, etiology, treatment approaches, pharmacology, and outcome are areas for future nursing research.

Anorexia nervosa. Complex illness, complex adolescent nursing.

Adolescents requiring inpatient care for anorexia nervosa present an exciting challenge for nurses because of the complex biopsychosocial nature of the illness. Nurses currently play a major role in caring, not only for the physical health of these patients, but for many of their psychological, social and family needs as well. With the strong foundation in holistic care which underpins nursing, scientific research and innovative nursing interventions may well hold the key to improving the current less-than-ideal long-term outcome for young people with anorexia nervosa.