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La presente tesis explora las representaciones y prácticas corporales que se diseminan en el imaginario de las usuarias de las comunidades virtuales “pro ana”; a través del análisis del discurso presentado en sus blogs; ya que éstos encierran una serie de manifestaciones respecto a la cultura de la belleza femenina hegemónica basada en el ideal de la delgadez que une e identifica a este grupo de usuarias; cuya posición frente al peso se ha convertido en una obsesión que conlleva a una extrema racionalización del cuerpo; y, la exploración de dicho proceso es el propósito de este estudio. El estudio desarrollado se basa en una metodología cualitativa y se enmarca en los estudios de sociología del cuerpo que rescata las teorías del interaccionismo simbólico y el constructivismo social; de tal forma que se pueda explorar y entender el problema recogiendo la mayor riqueza de los datos. PALABRAS CLAVES: Comunidades virtuales, anorexia, ideal de belleza. / --- This thesis explores the representations and bodily practices that spread in the imagination of users of virtual communities "pro ana"; by analyzing the speech delivered on their blogs; because they contain a series of events regarding the hegemonic culture of female beauty based on the ideal of thinness that unites and identifies this group of users; whose position on the weight has become an obsession that leads to extreme rationalization of the body; and exploration of this process is the purpose of this study. The study was developed based on a qualitative methodology and is part of the studies of sociology of the body that rescues the theory of symbolic interaction and social constructivism; so that you can explore and understand the problem collecting richer data. KEYWORDS: Virtual communities, anorexia, beauty ideal.

Literature on recovery from anorexia nervosa indicates that research studies often exclude the experience of recovery from a subjective point of view. As a result there seems to be a lack of understanding as to what the process of recovery entails. The aim of this study is to explore the process of recovery from the participants’ perspective. The focus of this study is on the narratives of young women who consider themselves recovered from anorexia nervosa with or without formal treatment. Semi-structured interviews were conducted with nine young women who reported recovery from adolescent-onset anorexia nervosa. The resulting interview transcripts were subsequently analysed qualitatively using a narrative analytic perspective in order to explore the ways in which participants narrated their recovery experiences. Particular attention was paid to the subjective perspective of the perceived causes of anorexia nervosa, how participants narrated what it was like to be anorexic, how treatment was experienced and various aspects of the recovery process. The narratives of recovery suggest that recovery has diverse meanings, creates different expectations and has different manifestations for different individuals. The narratives suggest that, rather than a dichotomy within recovery, there are shades of recovery through which traces of anorexia emerge. Experiences of treatment too are not clear cut with a tension existing between resistance to treatment and dissatisfaction with treatment. By presenting these narratives, this study aims to explore the contradictions and difficulties within recovery experiences in order to extend that which is already known about recovery from anorexia nervosa.

Made available in DSpace on 2019-03-29T23:54:15Z (GMT). No. of bitstreams: 0 Previous issue date: 2014-09-19 / This study had as an objective to analyze the approximations and distances between the biomedical and psychoanalytic perspectives about the body in anorexia and bulimia and its consequences, especially in an interdisciplinary clinical institutional program, the interdisciplinary program of nutrition in eating disorders and obesity (PRONUTRA). To achieve those results, we have based on the psychoanalytic theory, especially the Freudian contributions to make considerations about the biomedical and psychoanalytic rationalities, the eating disorders, institutional clinical and the construction of clinical cases. As these cases presents a complexity and accentuated gravity, PRONUTRA proposes an interdisciplinary intervention, where professionals, psychiatrists, nutritionists and psychologists, attempt to act in an integrated form in the care of the attended patients. However, in this scenario, biomedical knowledge is emphasized, and the subjective approach, referring to the psychic constitution of the subject, privileged in psychoanalytic listening, we deem necessary to discuss the possibilities of dialogue between these knowledges. In the construction of the clinical case, the singularity of the subject becomes relevant and this device offers important contributions to public health , especially to interventions and institutional clinical research, enabling strategies for case-by-case interventions. Accordingly, here we built a case of anorexia and other of bulimia, considering the constitution of the subject, the notion of orality, emphasizing the importance of life story that interweaves individual and the collective, and appear especially (in) controllable bodies. We emphasize the risk of reductionist visions that only consider the subject of the biomedicine, or only the subject of psychoanalysis, considering that even with epistemological and methodological differences, the subject and its modes of existence should be the main in researches and interventions in this area. Keywords: Psychoanalysis, biomedicine, body, anorexia, bulimia / Este trabalho teve como objetivo analisar as aproximações e distanciamentos entre as perspectivas biomédica e psicanalítica acerca do corpo na anorexia e na bulimia e seus desdobramentos, sobretudo, em um programa clínico-institucional interdisciplinar, o programa interdisciplinar de nutrição em transtornos alimentares e obesidade (PRONUTRA). Para trilhar este percurso, pautamo-nos no referencial psicanalítico, especialmente a partir das contribuições freudianas, para tecer considerações sobre as racionalidades biomédica e psicanalítica, os transtornos alimentares, a clínica-institucional e a construção de casos clínicos. Visto que tais quadros apresentam uma complexidade e gravidade acentuada, o PRONUTRA apresenta uma proposta de intervenção interdisciplinar, onde os profissionais envolvidos, psiquiatras, nutricionistas e psicólogos, procuram atuar de forma integrada no cuidado às pacientes atendidas. Porém, neste cenário, o saber biomédico ganha destaque e, ao abordar questões subjetivas, referentes à constituição psíquica do sujeito, privilegiadas na escuta psicanalítica, julgamos necessário discutir as possibilidades de interlocução entre esses saberes. A partir da construção do caso clínico, a singularidade do sujeito ganha relevância e esse dispositivo traz importantes contribuições para o campo da saúde coletiva, sobretudo no que diz respeito às intervenções e pesquisas clínico-institucionais, possibilitando a construção de estratégias de intervenção no caso a caso. Nesse sentido, aqui construímos um caso de anorexia e outro de bulimia, considerando questões pertinentes à constituição do sujeito, à noção de oralidade, destacando a importância da história de vida que entrelaça o singular e o coletivo e, sobretudo, aparecem em corpos (in)controláveis. Ressaltamos os riscos de visões reducionistas que ora vislumbram o sujeito da biomedicina, ora da psicanálise, apostando que, mesmo com diferenças epistemológicas e metodológicas, o sujeito e seus modos de existir devem ser o balizador de pesquisas e intervenções. Palavras-chave: Psicanálise, biomedicina, corpo, anorexia, bulimia.

Summary The aims of the current "Catamnestic examination of treatment satisfaction of patients with anorexia nervosa (AN) in childhood after inpatient treatment" were to extend the low data on AN in childhood in general and treatment satisfaction of this patient group in particular, and to use the knowledge gained to optimize future treatment concepts for patients with AN in childhood. To the best of our knowledge this is the first study retrospectively describing the treatment satisfaction of a patient population consisting exclusively of patients with a former AN in childhood. The central questions of the study were to find out whether and how many patients retrospectively found the treatment to be “satisfactory / unsatisfactory” or “helpful / harmful” and which elements of inpatient therapy produced “satisfaction / dissatisfaction” or subjective “help / harm” through the therapy. Further important aims of the study were to find out whether there is a correlation between the “treatment satisfaction / help / treatment amount” and various patient- and therapy-related parameters. The recent catamnestic study shows that former patients with AN in childhood, as well as other groups of AN patients (children, adolescents, adults) in previous studies, appear to be critical about the medical treatment compared to patients with other mental illnesses, with only 55.8 % of the total patients who were at least mediocrely satisfied showing rather moderate satisfaction rates in the context of closed questions. Most likely are also in patients with AN in childhood typical disease characteristics (e.g. ambivalence in recovery and treatment, fear of loss of control) and personality traits (e.g. rigidity) frequently observed in AN patients responsible for that. The majority of patients with AN in childhood (65.4 %) considered the therapy to be helpful retrospectively, in accordance with retrospective evaluations of patients with AN (children, adolescents, adults) on treatment as predominantly helpful. As part of the therapy, socio-emotional therapy components such as one-to-one therapeutic sessions, contact with fellow patients and caregivers were of the utmost importance for the patients with AN in childhood. These treatment elements generated the most satisfaction and were considered by many to be the most helpful. The results are hypothesis-generating that childlike patients with AN seem to have a special care / support need in the context of social relationships during therapy. However, the central role of socio-emotional components in therapy has also been highlighted in many other treatment satisfaction studies with childlike / adolescent and adult AN patients, patients with eating disorders in general, child and adolescent psychiatric and general psychiatric patients and in scientific work about the help of therapy for AN patients of different age groups as well as for other patient groups. As part of the therapeutic relationship, the desire for close contact with the therapist (more one-to-one interviews) was expressed. In addition, some patients wanted a more personalized therapy. The therapeutic relationship also played a key role in comparative studies with childlike and adolescent AN patients and other groups of patients, with sufficient time and individualism in therapy being required by the patients. A certain degree of self-determination, a fixed caregiver, inclusion of the family in the therapy, group therapy, adequate feedback and sufficient follow-up care were also important for the patients in the context of treatment. Treatment elements aimed at overcoming eating disordered behavior and recovering from the disease were partly rated to be satisfactory and helpful, but partly unsatisfactory and unhelpful. The critical evaluation of restrictive therapy elements to overcome the symptoms of eating disorders and ambivalence of patients with regard to their willingness to recover, their motivation to change and the initiation and implementation of a treatment, which has been cited in some studies, is also expressed in a group of patients with AN in childhood. With regard to these essential therapeutic ingredients for the treatment of AN, it is probably the right dosage in the context of the therapy concept. A comprehensible correlation was found in the fact that the former childlike AN patients, who judged the treatment to be satisfactory, also perceived it as more helpful and vice versa. The assumption that socio-cultural comparison variables (age and BMI) correlate with treatment satisfaction could not be proven in the own study for the former childlike study collective. Due to very different previous study results, further research on the relationship between socio-demographic variables and patient satisfaction is necessary in order to be able to draw clearer conclusions in this regard. However, an assumed association between the perceived help of the therapy and patient- / therapy-related variables could be confirmed, as patients with higher discharge BMI found treatment to be more helpful retrospectively than those with lower values. From a retrospective patient's perspective, this confirms the currently valid therapeutic guideline for not discharging patients from inpatient treatment until they achieve a body weight appropriate for their age and height (DGPM 2011). In addition, the perceived help from treatment at the different university hospitals showed significant differences, presumably due to the different specialization of the facilities with regard to eating disorders, as previous study results suggest that the treatment in an eating disorder clinic is more helpful than in a non-specialized hospital. With regard to the assessment of the treatment amount, the present catamnestic study showed contradictory results in relation to the long-term (presence of an eating disorder at the time of the catamnestic examination) or short-term treatment result (BMI at discharge) of the former AN patients. On average, patients who rated the amount of treatment as too low reported a higher BMI at hospital discharge (better short-term treatment outcome) than those who judged the treatment amount to be too high. This means that patients with better treatment results in the short term would have wished to receive more treatment quantitatively in the retrospective, than those with worse results. However, in return, more frequently, patients who still had an eating disorder (worse long-term outcome) at the time of study wished to have more treatment quantitatively, than recovered subjects at the time of the study (better long-term outcome). On this basis, it can be hypothesized that the patient group with lower discharge BMI may have had less disease insight than the group with higher discharge BMI, thus less able to engage in therapy with less benefit from it as a result of a poorer treatment outcome. It can also be speculated that in the meantime patients with a still ongoing eating disorder at the time of catamnesis had sufficient insight into the disease and therefore would have wished for more treatment retrospectively. Another plausible result of the current study is that patients who rated the treatment as satisfactory / helpful would have wanted more treatment quantitatively and patients who rated the treatment as unsatisfactory / harmful also judging the treatment amount to be too high. In summary, it becomes clear from our own results that it is a particular challenge to provide a therapy for patients with AN that finds their acceptance and satisfaction (Gulliksen et al., 2012). Accordingly, it is important to refine existing therapies and provide treatments that are adapted to the needs of the patient population. This requires a systematic knowledge of what generates satisfaction and dissatisfaction in patients with AN (Gulliksen et al., 2012). To our knowledge, the present study is the first study on treatment satisfaction that examined exclusively patients with former AN in childhood as a patient collective. Therefore, the results could only be compared with study data from other groups of patients (general psychiatric, child and adolescent psychiatric, eating disorder, adult and adolescent or partly childlike AN patients). Further studies with patients with AN in childhood are useful and desirable to validate the results presented here and to draw practical conclusions for an individualized treatment that meets the needs of the young patients. / Zusammenfassung Ziel der aktuellen „Katamnestischen Untersuchung der Behandlungszufriedenheit kindlicher Patientinnen und Patienten mit AN nach stationärem Klinikaufenthalt“ war es, die geringe Datenlage zur AN im Kindesalter allgemein und zur Behandlungszufriedenheit dieser Patientengruppe im Speziellen zu erweitern und durch die gewonnen Erkenntnisse zukünftige Behandlungskonzepte für Patienten mit kindlicher AN zu optimieren. Erstmals wurde - unseres Wissens nach - ein ausschließlich aus Patienten mit ehemals kindlicher AN bestehendes Patientenkollektiv retrospektiv bezüglich der Behandlungszufriedenheit befragt. Die zentrale Fragestellung der Studie bestand darin herauszufinden, ob und wie viele Patienten die Behandlung retrospektiv als zufriedenstellend /unzufriedenstellend bzw. hilfreich/schädlich empfunden haben und welche Elemente der stationären Therapie Zufriedenheit/Unzufriedenheit erzeugt haben bzw. zur Einschätzung subjektiver/-n Hilfestellung/Schadens durch die Therapie geführt haben. Weitere wichtige Fragestellungen der Studie lagen darin herauszufinden, ob ein Zusammenhang zwischen der Behandlungszufriedenheit/Hilfe/Behandlungs-menge und verschiedenen patienten- und therapiebezogenen Parametern besteht. Die aktuelle Katamnesestudie verdeutlicht, dass ehemalige Patienten mit kindlicher AN ebenso wie kindliche, jugendliche und erwachsene AN-Patienten in vorhergehenden Studien im Vergleich zu Patienten mit anderen psychischen Erkrankungen durchaus kritisch bezüglich der medizinischen Behandlung zu sein scheinen, da sich mit 55,8 % der Patienten/-innen, die zumindest mittelmäßig zufrieden waren, eher mäßige Zufriedenheitsraten im Rahmen geschlossener Fragen ergaben (s. Punkt 5.1.1). Am wahrscheinlichsten sind hierfür die auch bei kindlichen AN-Patienten typischen Krankheitscharakteristika (z. B. Ambivalenz bezüglich der Genesung und Behandlung, Angst vor Kontrollverlust) und häufig bei AN-Patienten beobachteten Persönlichkeitszüge (z. B. Rigidität) verantwortlich (s. Punkt 5.1.1). Der Großteil der hier untersuchten Patienten/-innen mit AN im Kindesalter (65,4 %) empfand die Therapie retrospektiv als hilfreich, wobei auch hier Parallelen zu retrospektiven Bewertungen kindlicher, jugendlicher und erwachsener AN-Patienten der Behandlung als überwiegend hilfreich bestehen (s. Punkt 5.2.1). Im Rahmen der Therapie waren für die kindlichen AN-Patienten sozioemotionale Therapiebestandteile wie therapeutische Einzelgespräche, Kontakt zu Mitpatienten und Betreuern von größter Bedeutung. Diese Behandlungselemente generierten am meisten Zufriedenheit und wurden von vielen Patienten/-innen als am hilfreichsten eingestuft. Die Ergebnisse sind hypothesengenerierend dafür, dass kindliche Patienten mit AN einen besonderen Fürsorge-/Unterstützungsbedarf im Rahmen sozialer Beziehungen während der Therapie zu haben scheinen. Allerdings wurde die zentrale Rolle sozioemotionaler Komponenten in der Therapie auch in vielen anderen Behandlungszufriedenheitsstudien mit kindlichen/jugendlichen und erwachsenen AN-Patienten, Patienten mit Essstörungen allgemein, kinder- und jugendpsychiatrischen und allgemeinpsychiatrischen Patienten (s. Punkt 5.1.2) und wissenschaftlichen Arbeiten zur Hilfe durch die Therapie für AN-Patienten unterschiedlicher Altersklassen sowie für weitere Patientengruppen unterstrichen (s. Punkt 5.2.2). Im Rahmen der therapeutischen Beziehung kam der Wunsch nach engmaschigem Kontakt zum Behandler (mehr Einzelgespräche) zum Ausdruck. Zudem wünschten sich einige Patienten eine individuellere Therapiegestaltung (s. Veränderungswünsche der Patienten, Tabelle 23). Auch in Vergleichsstudien mit kindlichen, jugendlichen AN-Patienten und weiteren Patientengruppen nahm die therapeutische Beziehung eine Schlüsselrolle ein, wobei ebenfalls ausreichend Zeit und Individualismus in der Therapie von den Patienten gefordert wurden (s. Punkt 5.3). Ein gewisses Maß an Selbstbestimmung, eine feste Bezugsperson, Miteinbeziehung des familiären Umfelds in die Therapie, Gruppentherapie, ausreichend Rückmeldung und eine suffiziente Nachbetreuung waren den kindlichen AN-Patienten ebenfalls wichtig im Rahmen der Behandlung (s. qualitative Aussagen, Tabelle 23). Behandlungselemente, die eine Überwindung des essstörungsspezifischen Verhaltens und die Genesung von der Erkrankung zum Ziel hatten, wurden teilweise als zufriedenstellend und hilfreich (s. Punkt 5.1.2, 5.2.2), zum Teil jedoch als unzufriedenstellend und nicht hilfreich (s. Punkt 5.1.3, 5.2.3) beurteilt. Die in einigen Studien angeführte kritische Bewertung restriktiver Therapieelemente zur Überwindung der Essstörungssymptomatik und Ambivalenz von AN-Patienten bezüglich ihres Genesungswillens, ihrer Veränderungsmotivation und der Aufnahme und Durchführung einer Behandlung kommt hierdurch auch bei einem Patientenkollektiv von kindlichen AN-Patienten zum Ausdruck (s. Punkt 5.1.1). In Hinblick auf diese essentiellen Therapiebestandteile zur Behandlung einer AN kommt es wahrscheinlich auf die richtige Dosierung im Rahmen des Therapiekonzeptes an. Ein nachvollziehbarer Zusammenhang ergab sich, indem die kindlichen AN-Patienten, welche die Behandlung als zufriedenstellend beurteilten, diese auch als hilfreicher wahrnahmen und umgekehrt (s. Punkt 5.1.4). Die Annahme, dass soziokulturelle Vergleichsvariablen (Alter und BMI) mit der Behandlungszufriedenheit korrelieren, konnte in der eigenen Studie für das kindliche Studienkollektiv nicht belegt werden. Aufgrund von sehr unterschiedlichen bisherigen Studienergebnissen, ist weitere Forschung bezüglich der Beziehung zwischen soziodemographischen Variablen und der Patientenzufriedenheit notwendig, um diesbezüglich klarere Schlüsse ziehen zu können (s. Punkt 5.1.4). Ein angenommener Zusammenhang zwischen der Hilfe der Therapie und patienten-/therapiebezogenen Variablen konnte allerdings bestätigt werden, da Patienten mit höherem Entlass-BMI die Behandlung retrospektiv als hilfreicher im Vergleich zu solchen mit niedrigeren Werten empfanden (s. Punkt 5.2.4). Damit wird auch aus retrospektiver Patientensicht die heute geltende Therapieleitlinie bestätigt, die Patienten erst mit Erreichen eines für Alter und Größe angemessenen Körpergewichts aus der stationären Behandlung zu entlassen (DGPM 2011). Zudem ergab die Einstufung der Hilfe durch die Behandlung an den verschiedenen Universitätskliniken signifikante Unterschiede, was vermutlich auf die unterschiedliche Spezialisierung der Einrichtungen bezüglich Essstörungen zurückzuführen ist, da bisherige Studienergebnisse darauf hindeuten, dass die Behandlung in einer auf Essstörungen spezialisierten Klinik von den Patienten als hilfreicher eingeschätzt wurde, als in einer nicht spezialisierten Einrichtung (s. Punkt 5.2.4). Bezüglich der Beurteilung der Behandlungsmenge zeigten sich in der vorliegenden Katamnesestudie gegensätzliche Ergebnisse in Relation zum langfristigen (Vorliegen einer Essstörung zum Katamnesezeitpunkt) bzw. kurzfristigen Behandlungsergebnis (BMI bei Entlassung) der kindlichen AN-Patienten. So wiesen Patienten/-innen, die die Behandlungsmenge als zu gering einstuften im Durchschnitt einen höheren BMI bei Klinikentlassung (besseres kurzfristiges Behandlungsergebnis) auf, als solche, welche die Behandlungsmenge als zu viel beurteilten. Das bedeutet, dass Patienten/-innen mit kurzfristig besserem Behandlungsergebnis sich in der Retrospektive quantitativ mehr Behandlung gewünscht hätten, als solche mit schlechterem. Jedoch wünschten sich im Gegenzug häufiger Patienten, die zum Studienzeitpunkt noch an einer Essstörung (schlechteres Langzeit-Outcome) litten retrospektiv quantitativ mehr Behandlung, als zum Studienzeitpunkt genesene Probanden/-innen (besseres Langzeit-Outcome) (s. Punkt 5.4). Auf dieser Grundlage lässt sich die Hypothese aufstellen, dass die Patientengruppe mit niedrigerem Entlass-BMI möglicherweise weniger krankheitseinsichtig als die Gruppe mit höherem Entlass-BMI war, wodurch sie sich weniger auf die Therapie einlassen und resultierend in einem schlechteren Behandlungsergebnis auch weniger von ihr profitieren konnte. Es kann außerdem gemutmaßt werden, dass Patienten mit einer noch andauernden Essstörung zum Katamnesezeitpunkt im Gegenzug mittlerweile ausreichend Krankheitseinsicht aufwiesen und sich deshalb retrospektiv mehr Behandlung gewünscht hätten. Ein weiteres plausibles Ergebnis der aktuellen Studie ist, dass sich Patienten, die die Behandlung als zufriedenstellend/hilfreich bewerteten, quantitativ mehr Behandlung gewünscht hätten, wobei vorwiegend Patienten, die die Behandlung als unzufriedenstellend/schädlich einstuften, auch die Behandlungsmenge als zu viel beurteilten. Zusammenfassend wird anhand der eigenen Ergebnisse deutlich, dass es eine besondere Herausforderung darstellt, für Patienten mit AN, eine Therapie zur Verfügung zu stellen, welche deren Akzeptanz und Zufriedenheit findet (Gulliksen et al. 2012). Dementsprechend ist es wichtig, bestehende Therapien weiterzuentwickeln und Behandlungsformen bereitzustellen, die an die Bedürfnisse der Patientengruppe angepasst sind. Hierfür ist ein systematisches Wissen darüber, was Zufriedenheit und Unzufriedenheit bei AN-Patienten generiert, von Nöten (Gulliksen et al. 2012). Die vorliegende Arbeit ist unseres Wissens nach die erste Studie zur Behandlungszufriedenheit an ausschließlich kindlichen AN-Patienten/-innen als Patientenkollektiv. Daher konnten die Ergebnisse nur mit Studiendaten aus anderen Patientenkollektiven (allgemeinpsychiatrische, kinder- und jugendpsychiatrische, Essstörungs-, erwachsene und jugendliche oder z. T. kindliche AN-Patienten) verglichen werden. Weitere Studien mit kindlichen AN-Patienten/innen sind sinnvoll und wünschenswert, um die hier dargestellten Ergebnisse zu validieren und praktische Schlüsse für eine individualisierte Behandlung, welche die Bedürfnisse der jungen Patienten bestmöglich berücksichtigt, ziehen zu können.

Anorexia nervosa is recognised as a complex and chronic disorder that is often associated with poor prognosis and severe psychological and physiological consequences. Previous research has identified an array of factors associated with anorexia nervosa of which self-esteem, self-concept and body image are amongst the most commonly cited factors involved in the development and maintenance of the disorder. Capitalising on recent advances that have been made in other realms of psychology, the current study attempts to address current limitations regarding self-esteem, self-concept, body image and experiences of adolescent girls with anorexia nervosa. More specifically, a series of three studies were designed to address : a/ self-esteem and self-concept ; b/ body image and the association between body image and self-concept; and c/ the experiences and support needs of young people with eating disorders.The current findings have demonstrated that whilst quantitative methods can be effectively utilised to elucidate various relations between predictor and outcome variables, qualitative methods can offer important insight into the patient with the eating disorder On a more general level, the current results obtained from the current series of studies may be able to inform current conceptualisations of anorexia nervosa and the future development of aetiology and treatment programs. / Doctor of Philosophy (PhD)

<p>The object with the study of this literature was to describe differente programs of care and patients and relatives experience and opinion about the caring for patients with Anorexia Nervosa. The method the author used was a descriptive literature study based on imperial studies. The studies were based on 15 scientific articles within the chosen field. The results shows that these patients hade special needs to be seen and heard as individuals, involved in their own treatment, and have good contact with the caring staff. The study also shows which methods were mostly appreciated involving nurses, patients and relatives. Results show the patients appreciating the individual therapy and an empathetic caring staff. Parents though thought that family therapy was the best treatment. Here they felt they could show their feelings and at the same time get help and advice in handling different situations. The result also shows problem areas such as framing oneself from the world or patients starting a competition of weight loss among the group members. The study also shows the difference in the nurses views of the different situation. Most nurses found it difficult to treat Anorexia Nervosa or to understand the illness, didn’t feel they had enough knowledge of the psychological health. It also shows that more studies and knowledge is needed in regards to forms and ways of treatment and the different causes of the illness.</p>

No description available.

<p>Anorexia nervosa is a severe and multifaceted eating disorder generally found in the female population. Throughout anorectic starvation relationship related conflicts revolving round power and autonomy are bound to happen. For that reason the most crucial part of treatment should be to build a trusting relationship.The aim of this study was to describe relationship promoting strategies a nurse can use during care of anorexia nervosa patients. This literature study derives from a qualitative analysis of scientific articles. The findings indicate on five different strategies a nurse can use during care of anorexia nervosa patients. All five strategies are described in the following themes: see the person behind the disease, offer control and freedom of choice, offer support, inspire with confidence, and the significance of reflection. For good result they demand the nurses utmost interest in patients and work, or else a relationship is likely not to be established.</p>