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Anorexia nervosa is a serious problem that affects over one million males yearly. It is often misdiagnosed and overlooked completely in clinical, medical and school settings because of the misperception that it is a disorder exclusively present in females. The DSM-IV largely contributes to this misnomer due to the gender-biased criteria. The purpose of this exploratory study was to identify the etiology and clinical characteristics of male anorexia and devise a more comprehensive definition of anorexia nervosa that encompasses both males and females. An additional purpose was to develop an instrument that identifies risk factors associated with anorexia nervosa in males and aid mental health and medical practitioners in making this diagnosis. A review of literature illuminated unique features of the male anorexic as well as characteristics shared with females. The Assessment of Anorexia Nervosa in Males Questionnaire (AANMQ) was developed for this study to assess an expert panel's clinical observations regarding potential misdiagnosis and treatment gaps among males with anorexia nervosa. This panel included one male anorexic, one parent of an anorexic male, and eight mental health and medical practitioners who were selected based on personal and clinical experiences working with male anorexics. Data were collected via face-to-face and telephone interviews. A compilation of literature and the expert panel's responses to the AANMQ resulted in the content suggested for the Assessment of Male Anorexia Nervosa (AMAN), a diagnostic inventory that provides a comprehensive profile specific to male anorexics. This instrument is to be used by mental health and medical practitioners for the diagnosis of this disorder. Even when anorexia nervosa is correctly diagnosed, services for males are selective and inadequate due to treatment models being geared toward a female population. The AMAN compensates for the missing elements and gender-biased nature of DSM-IV and permits accurate assessment and diagnosis of male anorexia. / Ph. D.

Att leva med barn som insjuknat i anorexia nervosa - En litteraturstudie om familjens upplevelser Abstrakt (Sv) Bakgrund: I Sverige är de ca 1 % av alla kvinnor som fått diagnosen anorexia nervosa. När ett barn insjuknat i anorexia nervosa påverkas hela familjen av denna livssituationsförändring. Familjens inflytande är en viktig del i behandlingen av anorexia nervosa, genom att sjukdomen har en okänd orsak upplever familjen sig som den bidragande faktorn till insjuknandet. Syfte: Belysa familjemedlemmars upplevelse av att leva med ett barn som insjuknat i anorexia nervosa. Metod: En litteraturstudie baserad på elva artiklar med en kvalitativ ansats. Resultatet från varje artikel har granskat, analyserat och sammanställts. Resultat: Resultatet redovisades i två kategorier och sju underkategorier. Huvudkategorierna är att leva i vanmakt och att leva under förändrade livsförhållanden. Konklusion: Att leva med ett barn som insjuknat i anorexia nervosa upplevs av familjen som påfrestande på grund av att sjukdomen bidrog till stora livsförändringar. Utifrån denna studies resultat kan sjuksköterskan anpassa sitt bemötande och ge god omvårdnad till alla familjemedlemmar. Nyckelord: Familj, barn, upplevelse, anorexia nervosa / Living with a child diagnosed with anorexia nervosa - A literature review of the family's experiences Abstract (En) Background: Approximately 1 % of all women in Sweden is diagnosed with anorexia nervosa. When a child is diagnosed with anorexia nervosa the whole family is affected by the life change the dieses brings. The family's influence is an important part of the treatment of anorexia nervosa. Since the disease has an unknown cause, the family often blame themselves as the contributing factor to the onset. Aim: The aim of the study is to highlight the family members' experience of living with a child suffering from anorexia nervosa. Method: A literature study was conducted based on eleven articles using a qualitative approach. The results from each article has been reviewed, analysed and compiled. Results: The results were presented in two categories and seven subcategories. The main categories are to live in powerlessness and to live under lifechanging conditions. Conclusion: Living with a child suffering from anorexia is experienced by the family as stressful because the disease contributed to major life changes. Based on the result of this study, the nurse can adjust attitude and provide good care for all family members. Keywords: Family, child, experience, anorexia nervosa

Background: Anorexia Nervosa is a mental illness of which the result is a will-controlled weight loss. It is an illness that affects the entire body and can become life-threatening. The illness is most common in young women and is often developed because of a stressful life event, stressful family relationships or sexual abuse. The disease also has a heredity of 50-90% in all cases. Aim: The aim of this study is to describe how nurses can involve the family in the care of a patient with Anorexia Nervosa. Method: The method used in this study was a literary survey based on ten articles of both qualitative and quantitative type. The articles were analysed using the method of Friberg (2012b). Result: Three main themes were created: Building relationships, providing education and preparing for home. Conclusion: The result of this study shows that the involvement of the family in the care of a patient with Anorexia Nervosa has improved conditions of recovery. Nurses have a crucial role in this process by creating relationships, having an educational role and preparing both patient and family for the return home.

No description available.

Bakgrund: Anorexia nervosa är en ätstörning där personerna har en förvrängd kroppsuppfattning och en intensiv rädsla för att gå upp i vikt. Detta leder till att personen använder olika metoder för att få en så låg kroppsvikt som möjligt. Sjukdomen debuterar ofta i tonåren och påverkar främst kvinnor. Syfte: Att beskriva unga kvinnors (12-25år) erfarenheter av omvårdnaden med Anorexia nervosa samt granska de inkluderade artiklarnas datainsamlingsmetod. Metod: Designen för litteraturstudien var deskriptiv och tio kvalitativa vetenskapliga artiklar inkluderades i resultatet. För att hitta dessa användes databaserna Cinahl, Medline och Scopus. Huvudresultat: I föreliggande studie har det visat sig att en god vårdrelation bidrar till trygghet och motivation till att tillfriskna. Det finns både negativa och positiva aspekter med att vårdas i grupp. Patienterna kunde hitta stöd hos varandra men samtidigt uppstod det ofta konkurrens mellan dem. Att ha strikta restriktioner i behandlingen upplevdes som något positivt hos vissa medan det skapade frustration hos andra. Många patienter ansåg att för mycket fokus låg på den fysiska återhämtningen medans det psykologiska stödet saknades. Slutsats: Tillit, respekt och förtroende behövs för att upprätthålla en god vårdrelation. En individualisering av vården behövs för att öka förutsättningarna för en optimal omvårdnad. Då Anorexia nervosa i grunden är ett psykiskt problem bör hela personen behandlas annars är risken för återfall stor. Det är även viktigt med information och adekvata motiveringar till de strikta metoderna i behandlingen.

The eating disorders, encompassing both bulimia and anorexia nervosa, have become a matter of increasing concern for mental health professionals. The presence of bulimic symptoms within the syndrome of anorexia nervosa has been associated with greater individual and family psychopathology as well as with poorer prognosis when compared to restricter type anorectics. This study hypothesizes that when compared with a normal control group, non-anorectic bulimics would show higher levels of individual psychopathology and family dysfunction, and more disordered eating attitudes and behaviors. This study further hypothesizes that an anorectic group would exhibit a similar pattern on these variables due to the presence of bulimic symptoms in many anorectics. These hypotheses were confirmed and support was generated for the proposition that bulimia even in normal weight persons is associated with significant pathology comparable to that documented in the bulimic subtype of anorexia nervosa.

Bakgrund: Anorexia Nervosa är en psykiatrisk sjukdom som främst drabbar unga kvinnor mellan 15 och 23 år med hög mortalitet. Sjukdomen orsakar ätstörning vilket medför kraftig viktnedgång. Syftet: Syftet är att beskriva kvinnors upplevelser av att leva med Anorexia Nervosa. Metod: Denna studie är genomförd av kvalitativ metod med analys av narratives. Datainsamlingen är baserad på fyra självbiografier skrivna av kvinnor som drabbats av Anorexia Nervosa. Resultat: Resultatet visade att samtliga kvinnor har haft olika upplevelser av Anorexia Nervosa. Kvinnornas upplevelser delas in i tre olika teman vilket förtydligades med citat. Teman som beskrivs avspelar kvinnors olika upplevelser. De teman som uppkom var Det svåruppnåeliga kvinnoidealet, Den ångestfyllda tillvaron, Betydelsen av att ha kontroll. Slutsats: Anorexia är en komplex psykiatrisk sjukdom som kräver en optimal omvårdnad med beredskap och förståelse från vårdpersonal. Sjuksköterskor strävar efter att förhindra ett lidande och främja hälsa i vårdandet av patienter. Studiens resultat bidrog med en bredare kunskap och förståelse kring sjukdomen Anorexia Nervosa för en optimal återhämtning hos patient. / Background: Anorexia nervosa is a psychiatric disorder that primarily affects young women between 15 and 23 years with high mortality. The disease causes eating disorder resulting in significant weight loss. Purpose: Purpose of the study was to describe women's experiences of living with anorexia nervosa. Method: This study was conducted by qualitative method of analysis of narratives. Data collection was based on four autobiographies written by women who have lived with Anorexia Nervosa. Results: The results showed that all women have had different experiences of Anorexia Nervosa. This experiences were divided into three different themes which are clarified with quote. Themes described reflects women's different experiences with anorexia nervosa, which is the elusive ideal of women, the anguished existence and the importance of being in control. Conclusion: Anorexia is a complex psychiatric illness that requires an optimum care of preparedness and understanding of health professionals. Nurses strive to prevent suffering and promote health in the care of patients. The study's results contributed to a wider knowledge and understanding of the disease anorexia nervosa for optimal recovery of the patient.

Bakgrund: Det finns olika sorters ätstörningar. Bland dessa är anorexia nervosa den allvarligaste. Sjukdomen drabbar mest unga kvinnor men även unga män kan insjukna. Anorexia nervosa påverkar patienternas kroppsuppfattning negativt vilket resulterar i att de svälter sig och/eller tränar frenetiskt. Syfte: Syftet var att beskriva patienter med anorexia nervosas upplevelser av omvårdnaden under slutenvård. Metod: En litteraturöversikt med kvalitativ ansats valdes som metod för att svara på studiens syfte. Resultat: Det framkom fem teman ur analysen, dessa är; ”Vikten av den goda relationen”, ”En objektifierad omvårdnad”, ”Vikten av stöd”, ”Känsla av att vara övervakad” samt ”Vikten av att uppleva delaktighet”. Dessa teman beskriver patienternas upplevelser av omvårdnaden inom slutenvård. Konklusion: Patienterna upplevde omvårdnaden som både positiv och negativ. Det hade stor betydelse för patienterna om de upplevde en god relation till sjuksköterskorna. För att kunna övervinna sjukdomen var det viktigt att patienterna kände sig delaktiga i omvårdnaden. Att patienterna fick känna sig som unika personer var också något som hjälpte dem att återhämta sig. / Background: There are different types of eating disorders. Among these are anorexia nervosa the most serious. It is mostly young women who develop the disease, but also young men can become ill. Anorexia nervosa affects patient´s body image negatively, which results in the patient starving him- or herself and/or exercising frenetically. Aim: The aim was to describe patients with anorexia nervosa experiences of care during hospitalization. Method: A literature review with qualitative approach was chosen as the method to answer the aim of the study. Results: It emerged five themes from the analysis. These are; “The importance of a good relationship”, “An objectified care”, “The importance of support”, “The feeling of being monitored” and “The importance of experiencing participation”. These themes describe patients' experiences of care in hospitalization. Conclusion: The patients experienced the care to be both positive and negative. It was of great importance to the patients if they experienced a good relationship with the nurses. In order to overcome the disease, it was important that patients felt involved in their own care. For the patients to recover from anorexia nervosa, the patients needed to be treated like individuals and not like the stereotype of the disease.

O objetivo geral deste trabalho foi compreender as práticas discursivas de pessoas diagnosticadas com Anorexia Nervosa (AN) ou Bulimia Nervosa (BN) com relação a produção de sentidos sobre as relações profissional-paciente no âmbito do tratamento desses transtornos alimentares (TA), aqui considerados não como quadros diagnósticos, mas como construções sociais. Esse objetivo foi traçado no diálogo com a literatura científica na área que identifica poucos espaços de escuta dessas pessoas sobre o que elas consideram importante em suas relações com os profissionais de saúde, e no diálogo com as narrativas das participantes deste estudo que apontaram a boa qualidade do relacionamento profissionalpaciente como importante na construção de um atendimento considerado satisfatório. De maneira específica, buscou-se compreender como o uso de diferentes repertórios interpretativos e discursos sociais participam da produção de sentidos sobre as relações profissional-paciente, além de investigar as implicações dos diferentes posicionamentos assumidos por ambos na coconstrução de descrições de si, direitos, deveres e lugares ocupados pelos pacientes na relação com os profissionais. Para tanto, foram entrevistadas 12 mulheres diagnosticadas com AN e BN atendidas por um serviço de assistência em TA. 5 dessas mulheres responderam de forma mais pessoal sobre o que é um relacionamento significativo com um profissional, oferecendo histórias de seus relacionamentos anteriores e atuais com os profissionais, narradas com riqueza de detalhes. Considerando-se a vasta quantidade de material a ser analisado, um recorte do material foi necessário e essa riqueza narrativa foi o critério utilizado para a seleção dessas 5 entrevistas para análise. O corpus de análise foi composto pelo recorte dos momentos das entrevistas nos quais o tema do relacionamento profissional-paciente estava presente. Assumindo-se uma perspectiva construcionista social sobre produção do conhecimento, utilizou-se, para a análise desse corpus, a Teoria relacional do sentido, a Teoria do posicionamento e a proposta teóricometodológica das Práticas discursivas e produção de sentidos. A partir da análise desse material foi possível abordar: as implicações do uso do discurso biomédico, que entende a AN e BN como psicopatologias, para as construções de si das participantes deste estudo e para a construção de possibilidades e limites da sua participação nas decisões sobre o tratamento; o pedido das participantes para uma maior proximidade afetiva com o profissional; o lugar ocupado pelo psicólogo e pelos demais profissionais da equipe multidisciplinar frente a esse pedido; os efeitos dos repertórios interpretativos disponibilizados pela literatura da área sobre a dificuldade no relacionamento profissional-paciente para as práticas discursivas das participantes ao falarem de seus desentendimentos com os profissionais; e as implicações da eleição do tratamento hospitalar como locus privilegiado de cuidado dessas pessoas. Alguns aportes teóricos construcionistas sociais, como a responsabilidade relacional, o ser relacional, o diálogo transformador e a postura colaborativa foram ofertados para pensar cenários relacionais entre profissionais e pacientes que pudessem incluir: a noção de identidade como movimento e não como estabilidade; o entendimento dos sucessos e insucessos nesses relacionamentos como ações conjuntas; a defesa do paciente como agente coconstrutor de seu cuidado e a possibilidade de convivência de diferentes verdades em saúde. / The general aim of this work was to understand the discursive practices of people diagnosed with Anorexia Nervosa (AN) and Bulimia Nervosa (BN) in the meaning production about professional-patient relationships in the treatment of eating disorders. Eating disorders are understood here as social constructions. This objective was delineated in dialogue with the scientific literature in the field that identifies a lack of spaces to listen to these people as well as in dialogue with this study participants\' narratives that associated meaningful assistance with the possibility of good quality in professional-patient relationship. Specifically, we aimed at understanding how the use of different interpretive repertoire and social discourses participate in the meaning production about the professional-patient relationship. We also tried to comprehend the implications of different positions assumed by both of them in the coconstruction of self descriptions, rights, duties and places occupied by patients in their relations with professionals. In order to do that, 12 women diagnosed with AN and BN assisted by an eating disorder service were interviewed. 5 interviews were selected to be analysed considering its richness of narratives about professional-patient relationship. Interview excerpts in which the theme of professional-patient relationship was discussed were selected to compose the analysis corpus Assuming a social constructionist perspective about knowledge construction, the following theoretical and methodological resources were used: Relational Theory of Meaning, Positioning Theory and Discursive practices and production of meanings. The analysis highlighted: the implications of biomedical discourse use, in which AN and BN is understood as psychopathologies, to the self constructions of the participants of this study and to the construction of possibilities and limitations of their participation in the decisions about the treatment; the participants\' request for closer and emotional relationship with professionals; the role of the psychologist and the rest of the multidisciplinary team to address this request; the effects of the use of the literature in the field that constructs the professional-patient relationships in terms of its difficulties in the discursive practice of the participants when they talked about their conflicts with professionals; and the implication of electing treatment as the privileged scenario of health care. Some social constructionist resources such as Relational Responsibility, Relational Being, Transformative Dialogue and Collaborative Partnership, were implemented to think about relational scenarios between professionals and patients that could include: the idea of identity as movement instead of stability; the understanding of the success and failure in these relationships as conjoint actions; the defense of the patient\'s protagonism in the construction of health; and the possibility of the coexistence of diverse realities.