Fobia a tragar: plan de cuidados en la infancia y adolescencia / Choking phobia: Care plan in Children and Adolescents

Las alteraciones alimentarias son un problema frecuente en la edad pediátrica. La fobia a tragar se caracteriza por miedo a atragantarse al ingerir comida, líquidos o pastillas. Aunque es un trastorno considerado menor y de baja prevalencia, en estos últimos años se ha observado un aumento de su incidencia en la etapa infantil y juvenil. En el análisis de 4 casos atendidos en nuestro hospital de día por esta fobia específica, se establece la valoración y los cuidados necesarios para su tratamiento y solución, en colaboración con los demás profesionales implicados y la familia. Es de destacar el importante rol que posee enfermería en el tratamiento de este trastorno psicológico, en los dispositivos de hospitalización parcial, para la correcta aplicación del plan terapéutico, el establecimiento de vínculos robustos y de confianza con la familia y el propio usuario, así como en la motivación para el cambio terapéutico por parte de todo el núcleo familiar. Es indispensable la inclusión del trastorno en el diagnóstico diferencial de los trastornos de alimentación en la infancia y su conocimiento por parte de los profesionales comunitarios, con la finalidad de poder establecer un adecuado tratamiento precoz que mejore los resultados terapéuticos (AU)

Eating disorders are a common problem in childhood. Swallowing phobia is characterised by fear of choking on having consumed food, liquids or tablets. Although they are considered a minor disorder and have low prevalence, there has been an increase in its incidence in children and adolescents in the past few years. The analysis of four cases treated in our day hospital for this specific phobia provides an assessment and the care necessary for its treatment and solution, in collaboration with other professionals and the family The importance of the role that nurses have in the treatment of this psychological disorder is emphasised, as well admission to Day Units, the correct application of the treatment plan, the establishment of robust and reliable links with the family and the patient, and the motivation for therapeutic change by the whole family. It is essential to include the disorder in the differential diagnosis of eating disorders in children, as well as knowledge of this by community workers, in order to establish adequate early treatment to improve therapeutic outcomes (AU)

[Choking phobia: care plan in children and adolescents]. / Fobia a tragar: plan de cuidados en la infancia y adolescencia.

Eating disorders are a common problem in childhood. Swallowing phobia is characterised by fear of choking on having consumed food, liquids or tablets. Although they are considered a minor disorder and have low prevalence, there has been an increase in its incidence in children and adolescents in the past few years. The analysis of four cases treated in our day hospital for this specific phobia provides an assessment and the care necessary for its treatment and solution, in collaboration with other professionals and the family. The importance of the role that nurses have in the treatment of this psychological disorder is emphasised, as well admission to Day Units, the correct application of the treatment plan, the establishment of robust and reliable links with the family and the patient, and the motivation for therapeutic change by the whole family. It is essential to include the disorder in the differential diagnosis of eating disorders in children, as well as knowledge of this by community workers, in order to establish adequate early treatment to improve therapeutic outcomes.

Intervención enfermera en el plan terapéutico familiar de la anorexia nerviosa / Nursing intervention in the family treatment plan for anorexia nervosa

Una de las principales intervenciones que enfermería realiza en el tratamiento de los trastornos de conducta alimentaria se establece en la psicoeducación familiar, aspecto indispensable en la mayoría de tratamientos en Salud Mental. Este artículo describe y analiza las dificultades familiares expresadas en el cumplimiento del plan terapéutico establecido para los pacientes ingresados por anorexia nerviosa (AN) en el Hospital de Día de adolescentes de Salud Mental, de la Corporació Sanitària Parc Taulí, durante el año 2009. Así mismo, se recopilan datos sobre las intervenciones profesionales realizadas con la familia por parte de la enfermera asignada a esta unidad, con la finalidad de agruparlas y categorizarlas, para facilitar posteriormente la intervención enfermera en estos casos. Se incluyen en este plan de cuidados un total de 10 familias correspondientes a los 10 pacientes ingresados con diagnóstico de AN para el período estudiado. En todos los casos las pacientes son mujeres adolescentes que han recibido tratamiento previo, desde un dispositivo ambulatorio, con respuesta parcial o nula al tratamiento. Las dificultades familiares expresadas se han agrupado en cinco categorías a partir del análisis de su contenido: problemas para la elaboración de una dieta equilibrada, problemas para el manejo emocional/conductual de la paciente, problemas por inexistencia de hábitos alimentarios familiares previos, problemas por escaso control y supervisión familiar, y problemas por negativa/incumplimiento general de las pautas establecidas. Se proponen para estas categorías distintas intervenciones individuales específicas, desarrolladas e implementadas en el plan de cuidados de enfermería, y se evalúan los resultados de dichas intervenciones (AU)

One of the main nursing interventions in the treatment of eating disorders is family psycho-education, an essential aspect of mental health treatment. This article describes and analyses the difficulties families expressed in the performance of a treatment plan for patients hospitalised for anorexia nervosa (AN) in the adolescent Day Hospital of Mental Health, of the Corporació Sanitària Parc Taulí, during 2009. Data was also collected data on professional interventions, performed by the nurse assigned to this unit, in order to group and categorise them, and as an aid to nursing intervention. A total of 10 families of the 10 patients admitted with a diagnosis of AN were included in the study period. In all cases, the patients were young women who had received treatment before in an Outpatient Unit, with partial or no response to the treatment. The difficulties expressed by the families were grouped into five categories from content analysis: problems in preparing a balanced diet, problems as they are unable to handle the behaviour and emotions of the patient, problems because as there are no previous family eating habits, problems because there is no family control or supervision, and problems with the established guidelines. Specific individualised interventions are proposed for developing and promoting a nursing care plan, and assessing the results (AU)

[Nursing intervention in the family treatment plan for anorexia nervosa]. / Intervención enfermera en el plan terapéutico familiar de la anorexia nerviosa.

One of the main nursing interventions in the treatment of eating disorders is family psycho-education, an essential aspect of mental health treatment. This article describes and analyses the difficulties families expressed in the performance of a treatment plan for patients hospitalised for anorexia nervosa (AN) in the adolescent Day Hospital of Mental Health, of the Corporació Sanitària Parc Taulí, during 2009. Data was also collected data on professional interventions, performed by the nurse assigned to this unit, in order to group and categorise them, and as an aid to nursing intervention. A total of 10 families of the 10 patients admitted with a diagnosis of AN were included in the study period. In all cases, the patients were young women who had received treatment before in an Outpatient Unit, with partial or no response to the treatment. The difficulties expressed by the families were grouped into five categories from content analysis: problems in preparing a balanced diet, problems as they are unable to handle the behaviour and emotions of the patient, problems because as there are no previous family eating habits, problems because there is no family control or supervision, and problems with the established guidelines. Specific individualised interventions are proposed for developing and promoting a nursing care plan, and assessing the results.

[Profile of adolescents with social withdrawal admitted to a partial hospitalization unit of Mental Health]. / Perfil de los adolescentes con retraimiento social ingresados en una Unidad de Hospitalización Parcial de Salud Mental.

OBJECTIVE: To analyse the general characteristics of teenagers admitted to the Day Care Unit who fulfilled the criteria of social withdrawal, in order to implement a specific action plan within the existing resources for adolescents. METHOD: In this retrospective descriptive observational study, data were collected from withdrawal adolescent teenagers admitted to the unit over the year 2008. The data analysed were personal variables, diagnostic assessment on discharge, IQ assessment and Scale for Assessment of Communication and Interaction Skills and truancy. RESULTS: Of the 76 adolescents admitted to the unit, a total of 33 teenagers with social isolation were included in this study (43%). They had an average age of 15 years, an equal distribution between sexes and with a stay in the Unit 33 days longer than the general population studied. The average intellectual quotient of the social isolation group did not exceed the lower zone of the Weschler Scale (<80), and they scored below 50 points in the Scale for Assessment of Communication and Interaction Skills. CONCLUSIONS: The present research has enabled us to quantify the withdrawal phenomenon and some of its characteristics in a sample of adolescents admitted to the unit, in order to develop an interdisciplinary treatment program that allows us to address social withdrawal using a more holistic and effective approach.

Perfil de los adolescentes con retraimiento social ingresados en una Unidad de Hospitalización Parcial de Salud Mental / Profile of adolescents with social withdrawal admitted to a partial hospitalization unit of Mental Health

Objetivo. Analizar las características generales de los adolescentes ingresados en la unidad de hospitalización parcial que cumplan los criterios de retraimiento social, con la finalidad de establecer un plan de trabajo específico hacia los adolescentes en el dispositivo con los recursos existentes. Método. En este estudio observacional descriptivo retrospectivo, se recopilaron los datos de los adolescentes con retraimiento social ingresados en la unidad durante todo el año 2008, analizándose las variables personales, orientación diagnóstica al alta, valoración del cociente intelectual y de la escala de evaluación de las habilidades de comunicación e interacción y absentismo escolar. Resultados. De los 76 adolescentes ingresados en la unidad, un total de 33 chicos con retraimiento social fueron incluidos en el presente estudio (43%), presentando una edad media de 15 años, distribución equitativa entre sexos y con estancia en el dispositivo 33 días superior que en la población general estudiada. Todos los casos estudiados no superaban los 50 puntos en la escala escala de evaluación de las habilidades de comunicación e interacción. Conclusiones. El presente estudio nos ha permitido cuantificar el fenómeno y algunas de sus características, en una muestra de adolescentes ingresados en la unidad, con la finalidad de elaborar un programa terapéutico interdisciplinar que nos permita abordar el retraimiento social con perspectiva integral y de forma más eficaz

Objective. To analyse the general characteristics of teenagers admitted to the Day Care Unit who fulfilled the criteria of social withdrawal, in order to implement a specific action plan within the existing resources for adolescents. Method. In this retrospective descriptive observational study, data were collected from withdrawal adolescent teenagers admitted to the unit over the year 2008. The data analysed were personal variables, diagnostic assessmnet on discharge, IQ assessment and Scale for Assessment of Communication and Interaction Skills and truancy. Results. Of the 76 adolescents admitted to the unit, a total of 33 teenagers with social isolation were included in this study (43%). They had an average age of 15 years, an equal distribution between sexes and with a stay in the Unit 33 days longer than the general population studied. The average intellectual quotient of the social isolation group did not exceed the lower zone of the Weschler Scale (<80), and they scored below 50 points in the Scale for Assessment of Communication and Interaction Skills. Conclusions. The present research has enabled us to quantify the with drawal phenomenon and some of its characteristics in a sample of adolescents admitted to the unit, in order to develop an interdisciplinary treatment program that allows us to address social withdrawal using a more holistic and effective approach(AU)

Intervención de enfermería en la rehabilitación psicosocial del paciente esquizofrénico / Nursing intervention in psychosocial rehabilitation of the schizophrenic patient

La repercusión bio-psico-social de la esquizofrenia hace de ella una enfermedad compleja. Existen estudios realizados en los últimos años que han demostrado que el tratamiento ideal es aquel que integra la terapéutica farmacológica y psicosocial.• En este trabajo pretendemos reflejar las diversas intervenciones rehabilitadoras que pueden desarrollar los profesionales de la Enfermería para contribuir a la recuperación del paciente esquizofrénico desde las unidades de hospitalización y a lo largo de todo el proceso asistencial. La magnitud y complejidad de esta enfermedad requiere que la enfermera incluya en el plan terapéutico individual estrategias de rehabilitación psicosocial que vayan dirigidas tanto al paciente como a sus familiares, con una bordaje individual y/o grupal

The repercussion of schizophrenia at a biopsycho-social level makes this condition a complex disease. In these past years some studies have been carried out demonstrating that the ideal treatment integrates drug therapy and psychosocial therapy.• With this paper we aim to illustrate the different rehabilitation interventions that the nursing professional can implement to contribute towards the recovery of the schizophrenic patient, from hospitalization units throughout the entire healthcare process. The magnitude and complexity of this disease requires Nursing to include in the strategic therapeutic plan psychosocial rehabilitation strategies aimed at both the patient as well as his or her family, not only through an individual but also through a group approach