Bakgrund: Anorexia nervosa (AN) innebär en viljestyrd viktnedgång där en låg sjukdomsinsikt ofta förekommer. Bland de psykiska sjukdomarna har AN den högsta mortaliteten och antalet som vårdas för sjukdomen har sedan 1990-talet tredubblats. För att kunna förstå och på ett djupare plan kunna hjälpa unga kvinnor som lever med sjukdomen behövs kunskap och erfarenhet av deras upplevelser. Syfte: Att beskriva unga svenska kvinnors erfarenheter av att leva med Anorexia nervosa. Metod: Induktiv ansats där datamaterialet bestående av självbiografier analyseras med kvalitativ innehållsanalys.Resultat: Ur analysen framkom tre kategorier; påverkan på självkänslan, svårigheter i relationen med familj och vänner och sjukdomen reglerar vardagen med sex underkategorier. Konklusion: Unga kvinnor med AN har ett kontrollbehov som orsakar en social hämning och ångest. Dessa kvinnor behöver bekräftelse från sin omgivning och hälso- och sjukvården på att de är sjuka och har rätt till att må bättre. / Background: Anorexia nervosa (AN) means a will-controlled weight loss and there is often a low disease insight. AN has the highest mortality rate among mental illnesses, and the number of people who are cared for because of the disease have tripled since the 1990s. Knowledge of young womens expirence of AN are needed to be able to in a deeper level understand and help young women living with the disease. Purpose: To describe young Swedish women's experiences of living with Anorexia nervosa. Method: The data were analysed using qualitative content analysis. The data material consists of five autobiographies. Results: The analysis revealed three categories; the influence on self- esteem, difficulties in the relationship with family and friends and the disease regulates everyday life with six subcategories. Conclusion: Young women with AN have a need of control that causes a social inhibition and anxiety. These women need confirmation from both their environment and health care that they have a disease.

Os transtornos alimentares são doenças graves que podem cursar com comorbidades importantes se não tratadas com abordagens múltiplas do ponto de vista clínico, nutricional, psicológico e psiquiátrico. Sendo assim, o objetivo deste estudo foi investigar aspectos nutricionais e psicossociais dos indivíduos que foram portadores de anorexia e bulimia nervosas do Grupo de Assistência em Transtornos Alimentares - (GRATA) - do Hospital das Clínicas da Faculdade de Medicina de Ribeirão Preto da Universidade de São Paulo-USP , se trataram e obtiveram alta hospitalar. Para tanto, elaborou-se uma entrevista semi - estruturada com dados demográficos de saúde atual, além as principais mudanças após o tratamento. Avaliou-se também o estado nutricional, por aferição de peso, altura, pregas cutâneas e circunferência do braço. O hábito alimentar foi questionado por meio de recordatório alimentar de 24 horas e questionário de freqüência alimentar. Para avaliação do ajustamento psicossocial do indivíduo, utilizou-se os seguintes instrumentos auto-aplicáveis: Questionário de Saúde Geral de Goldberg (QSG), Inventário de Depressão de Beck, Escala Hospitalar de Ansiedade e Depressão (HAD), Teste de Atitudes Alimentares (EAT-26).Foram encontrados 10 sujeitos, 9 mulheres e 1 homem, com idade entre 21 e 34 anos.Por meio da entrevista semi-estruturada, observou-se mudanças significativas após a alta hospitalar como: 5 sujeitos já concluíram o ensino superior e contribuem com a renda da família, 3 sujeitos estão concluindo esses cursos, 5 sujeitos casaram-se e já presenciaram o nascimento do primeiro filho.Apenas 1 sujeito faz acompanhamento psiquiátrico,e nenhum deles tem acompanhamento nutricional. A presença de ciclos menstruais regulares constando em todos sujeitos do sexo feminino.Atualmente 1 sujeito usa medicação fitoterápica e chás diuréticos para manter o peso. A ingestão calórica se aproximou das Recomendações Diárias (RDA) em 9 sujeitos e excedeu a recomendação diária de proteína em 9 sujeitos. Algumas vitaminas e minerais se mostraram deficientes como ferro, cálcio e retinol em 6 indivíduos. O questionário de freqüência alimentar quando comparado com a pirâmide alimentar adaptada para a população brasileira, se mostrou adequado nos itens: grupo do leite, verduras e carboidratos. Alimentos hipocalóricos e dietéticos são consumidos com freqüência por 7 sujeitos.O QSG mostrou valores indicativos de normalidade em todos os fatores. O HAD classificou com ansiedade leve 4 sujeitos da amostra. O Inventário de Beck detectou depressão leve 1 sujeito da amostra. O EAT-26 não apresentou pontuação indicativa de comportamento alimentar anormal. Conclui-se que esses indivíduos após a doença, desenvolveram-se de maneira positiva para a vida familiar, profissionale emocional, com progresos significativos. / Eating disorders are serious diseases that can go along important comorbidities if not treated from a clinical, nutritional, psychological and psychiatric point of view. Thus, the aim of the study was to investigate nutritional and psychosocial aspects of individuals that carried anorexia nervosa and bulimia nervosa from the group of assistants in alimentary disorders – GRATA – of the clinic hospital of the University of Medicine of Ribeirão Preto, University of São Paulo – USP, which received treatment and were discharged from the hospital.For that, a semi-structured interview was elaborated, and the individuals studied were asked about their occupation, marital status, number of children and main changes that occurred after their treatment. Their nutritional state was also evaluated, by checking their weight, height, cutaneous fold and the arm circumference. We analyzed their eating habits through alimentary 24-hour records and questionnaire of alimentary frequency. In order to evaluate the psychosocial adjustment of the individual, the following auto-applicable instruments were utilized: The general health questionnaire of Goldberg, Beck’s Depression Inventory, the Hospital scale of Anxiety and Depression (HAD) and the Alimentary Attitude Test (EAT-26)We found 10 subjects, of which 9 were females and 1 was male with ages between 21 and 34 that felt euphoric. There was only 1 subject that was overweight. In the semi-structured interview, significant changes were observed after the discharge from the hospital, as follows: 5 subjects have already graduated from college and contribute to their family income, 3 subjects are still in college, 5 subjects have gotten married and have already had their first child, 1 subject has been getting a psychiatric follow-up, and none of them has been getting a nutritional follow-up. We noticed the presence of regular menstrual cycles in all of the female subjects. Currently, one subject uses phytotherapic medication and diuretic teas to maintain her weight. The caloric ingestion has become closer to the daily recommendations (RDA) for 9 subjects and was exceeded to the daily protein recommendations in 9 subjects. Some vitamins and minerals were deficient in 6 subjects, such as iron, calcium and retinol. The questionnaire of alimentary frequency, when compared to the alimentary pyramid adapted to the Brazilian populations was considered adequate in the following items: dairy group, vegetables and carbohydrates. Hypo caloric and diet aliments are frequently ingested by 7 subjects. The QSG shows values that indicate normality in all factors, HAD detected a slight anxiety in 4 subjects. Beck’s inventory detected a slight depression in 1 subject from the group. The EAT-26 didn’t present a negative score as to the indication of abnormal alimentary behavior. In conclusion, the group studied was within the adequate nutritional state as well as a psychosocial adjustment of what are considered normal boundaries. Therefore, further investigations are necessary with respect of the prognostics of the carriers of these disorders, in order to aid in more specific therapeutical approaches.

Anorexia nervosa e transtorno alimentar não especificado (TANE) são os transtornos alimentares mais frequentes na adolescência. Cursam com alterações hormonais e amenorreia. Este projeto tem como objetivo a maior compreensão das alterações laboratoriais e hormonais que ocorrem concomitantemente com esses transtornos alimentares na adolescência, em especial a relação com o retorno dos ciclos menstruais, a recuperação nutricional e a secreção de leptina e IGF-1. Vinte e oito adolescentes do sexo feminino, portadoras de anorexia nervosa ou TANE foram submetidas a coletas de amostras de sangue para dosagem de leptina, LH, FSH, PRL, estradiol, GH, IGF-1, TSH, T4L, T4, T3, proteínas totais e frações, função renal, hemograma, ferro, ferritina e eletrólitos no início do estudo e a cada cinco semanas num total de cinco coletas. Densitometria óssea foi realizada no início do acompanhamento e após seis meses para avaliar comprometimento ósseo. As principais complicações clínicas observadas foram amenorreia (78%) e osteoporose (14,8%). No início do estudo, 12 pacientes encontravam-se desnutridas com z score de IMC -2. As alterações hormonais presentes foram: diminuição do T3, estradiol, leptina, LH e IGF-1. As pacientes evoluíram com boa recuperação nutricional (variação da média de IMC ao longo do estudo IMC p < 0,01) e melhora dos parâmetros clínicos e hormonais. O IGF-1 apresentou-se como o melhor marcador de recuperação nutricional (p = 0,0001) e teve boa correlação com o retorno menstrual. À época do retorno menstrual as pacientes apresentaram IGF-1 > 340ng/mL (p = 0,04) / Anorexia Nervosa (AN) and eating disorder not otherwise specified (EDNOS) are the most frequent eating disorders in adolescence. The patients show hormonal alterations as well as amenorrhea. The aim of this study was to improve the knowledge of hormonal disturbances that occur together with AN and EDNOS, especially with regard to menstrual cycles, nutritional recovery as well as leptin and IGF-1 secretion. Twenty eight female adolescents with AN or EDNOS had blood collected for the following dosages: leptin, LH, FSH, PRL, estradiol, GH, IGF-1, TSH, FT4, T4, T3, total proteins and fractions, renal function, CBC, iron , ferritin, electrolytes in the beginning of the study and at every 5 weeks totalizing 5 samples per patient. Bone densitometry was performed at the start and after 6 months. The main clinical complications were amenorrhea (78%) and osteoporosis (14.8%). Twelve patients were undernourished at the start of the study (BMI z score = -2). Hormonal alterations were low T3, estradiol, leptina, LH, and IGF-1. The patients had good nutritional recovery, evaluated as a variation of BMI (p < 0.001) and improved clinical and hormonal parameters. IGF-I was the best marker of nutritional recovery (p = 0.0001) and correlated very well with menstrual cycles recovery. At the time when the patients resumed menstrual cycles, IGF-1 was above 340ng/mL (p = 0.04)

Introdução: A Anorexia Nervosa é um transtorno alimentar grave que costuma se manifestar na adolescência. Historicamente, intervenções psicoterapeuticas destinados a essa população têm incluído a família como protagonista no tratamento. No entanto, o foco é psicoeducativo e no manejo comportamental dos pais com objetivo de normalização do peso do adolescente, sem abarcar características das famílias consideradas um fator de risco para a seleção e manutenção dos comportamentos verificados na Anorexia Nervosa, tais como os estilos e práticas parentais inadequados. Essas intervenções têm apresentado resultados modestos e, por isso, estudos recentes têm apontado para a necessidade de intervenções psicológicas que abarquem tanto o restabelecimento de peso dos filhos quanto o desenvolvimento de habilidades socioemocionais e educativas dos pais que respondam adequadamente às necessidades emocionais de seus filhos. O objetivo geral do presente estudo foi desenvolver e avaliar os efeitos de uma intervenção psicoterápica, de orientação Analítico-Comportamental, destinada a adolescentes com Anorexia Nervosa e a seus pais. Método: o delineamento do estudo foi de coletânea de casos. Participaram da pesquisa cinco tríades, compostas do adolescente com Anorexia Nervosa e de seus pais. Foram realizados, ao longo de seis meses, de 20 a 25 encontros com cada família, incluindo avaliação inicial, final e de seguimento. Na avaliação inicial os pais preencheram os seguintes instrumentos: Inventário de Autoavaliação para Adultos (ASR), Inventário de Percepção de Suporte Familiar (IPSF) e Questionário Sociodemográfico. Os filhos foram submetidos ao exame antropométrico, realizado por uma nutricionista especialista em transtornos alimentares, e preencheram os seguintes instrumentos: Questionário sobre Alimentação (EDE-q), Escala de Responsividade e Exigência (ERE), Inventário de Autoavaliação para Adolescentes (YSR) e o IPSF. A intervenção psicoterápica envolveu: (a) psicoeducação sobre Anorexia Nervosa para adolescente e pais; (b) manejo comportamental dos pais para recuperação do peso de seus filhos e (c) treinamento de habilidades socioemocionais e educativas. Todas as fases do tratamento tiveram como guia o livro Anorexia Nervosa na adolescência: como a família pode ajudar?, elaborado pelo autor desta tese. A avaliação final envolveu os mesmos instrumentos da etapa inicial, acrescidos do Inventário de Satisfação com a Intervenção, também elaborado pelo autor, destinado aos pais. A avaliação de seguimento, agendada três meses após a avaliação final, envolveu nova aplicação dos mesmos instrumentos e entrevista devolutiva aos pais e ao adolescente. Paralelamente à etapa de tratamento foram realizados acompanhamentos nutricional e psiquiátrico. Os dados provenientes da aplicação dos instrumentos de avaliação psicológica foram analisados por meio de suas padronizações específicas. Foram conduzidas análises descritivas de frequência simples dos comportamentos dos pais, mães e adolescentes, adotando-se os participantes como seus próprios controles. Resultados: quatro famílias finalizaram o tratamento. A aderência foi de 100%, sem faltas ou interrupções embora o nível de engajamento tenha variado entre as famílias e dentro da própria família. Ao final do tratamento e em seguimento todas as adolescentes estavam com o peso adequado e com menstruação regular. O tratamento produziu melhora expressiva dos indicadores de gravidade do transtorno alimentar de todas as adolescentes participantes. Houve melhoras no funcionamento adaptativo e nos problemas de comportamento referidos pelas adolescentes. Indicadores de funcionamento adaptativo e de problemas de comportamento referidos pelos pais, estilos parentais e suporte familiar percebido mudaram de maneira menos consistente, com tendência de piora após a intervenção e melhora em seguimento. Conclusão: a modalidade de psicoterapia testada se mostrou viável e produziu efeitos positivos. Novos estudos são necessários para solidificar as evidências produzidas nesta pesquisa, sobretudo quanto aos achados sobre suporte familiar e estilos parentais / Introduction: Anorexia Nervosa is a severe eating disorder that usually manifests during adolescence. Historically, research protocols directed to this population include the family as the protagonist of the treatment. These protocols, however, focus on the psycho-educational and behavioral management on the part of parents to normalize adolescents bodyweight, without addressing the characteristics of families that are considered risk factors for the selection and maintenance of Anorexia Nervosa behaviors, such as inappropriate parenting practices and styles. These interventions achieve modest results. For this reason, recent studies highlight the need for psychological interventions to focus on the reestablishment of patients bodyweight and the development of socio-emotional and parenting skills for them to respond properly to their childrens emotional needs. This studys general objective was to develop and assess the effects of a psychotherapeutic intervention with an Analytical-Behavioral approach, directed to adolescents with Anorexia Nervosa and their parents. Method: the studys design was a collection of cases. Five families, each composed of an adolescent with Anorexia Nervosa and her parents, participated in the study. Twenty to twenty-five meetings were conducted over a period of six months with each family, including initial and final assessment and follow-up. The parents completed the following instruments: Adult Self-Report (ASR), Inventário de Percepção de Suporte (IPSF) and a Sociodemographic Questionnaire. The adolescents were given an anthropometric assessment conducted by a nutritionist who was an expert on eating disorders, and completed the following instruments: Eating Disorder Examination Questionnaire (EDE-q); Escala de Responsividade e Exigência (ERE); Youth Self-Report (YSR), and the IPSF. The intervention included: (a) psycho-education addressing Anorexia Nervosa directed to adolescents and parents; (b) behavioral management directed to parents to support their childrens bodyweight recovery; and (c) training focused on parents socio-emotional and child-raising skills. All the treatment phases were based on the book Anorexia Nervosa na adolescência: como a família pode ajudar?, written by the author. The final assessment included the same instruments used in the initial phase, along with a questionnaire to assess the satisfaction of parents with the intervention, also developed by the author. The follow-up interview was scheduled with parents and adolescents three months after the final assessment and the same instruments were applied. Nutritional and psychiatric monitoring was performed concomitantly with psychotherapy. Data concerning the psychological assessment were analyzed using the instruments specific standards. Descriptive analysis included the simple frequency of the behaviors of fathers, mothers and adolescents, while the participants were their own controls. Results: Four families completed treatment. There was 100% adherence to the intervention, with no absences or interruptions, though the level of engagement between and within families varied. All the adolescents reached an appropriate bodyweight and had their periods regulated at the end of the treatment and in follow-up. The treatment produced expressive improvement of indicators concerning the severity of the eating disorder among all the adolescents. Adaptive functioning and behavior problems reported by the adolescents improved. Indicators of adaptive functioning and behavior problems reported by the parents, parenting styles and perceived family support presented a less consistent change, tending to worsen after the intervention and improve during follow-up. Conclusion: the psychotherapy modality tested was viable and produced positive effects. Further studies are needed to consolidate evidence found in this study, especially in regard to the findings concerning family support and parenting styles

<p>Bakgrund: Anorexia nervosa blir allt vanligare bland unga kvinnor. Med rätt behandling och stöd tillfrisknar ändå de flesta från sin ätstörning. Syfte: Syftet med litteraturstudien var att ur en ung kvinnas perspektiv som har haft anorexianervosa, beskriva faktorer som har betydelse för tillfrisknandet från ätstörningen, för att sjuksköterskan ska få en ökad förståelse för unga kvinnor med anorexia nervosa och därmed kunna hjälpa dem. Metod: Litteraturstudien baseras på tio vetenskapliga artiklar, både kvalitativa och kvantitativa, som analyserades och utformades till studiens resultat. Resultat: De faktorer som hade betydelse för tillfrisknandet var att den unga kvinnan själv kom till insikt om sin sjukdom och lärde sig begripa och hantera sina känslor, sin självbild och självkänsla. Tillfrisknandet påverkades även av den unga kvinnans egen motivation till att vilja tillfriskna och ändra sitt matbeteende. Resultatet visade att sjuksköterskan hade en viktig roll i att vägleda den unga kvinnan med anorexia nervosa genom tillfrisknandeprocessen. Andra personer som familj, vänner, partner, terapeuter och sjukvårdspersonal hade också en betydelsefull roll, men även aktiviteter för att sysselsätta sig var viktigt. Slutsats: För att en ung kvinna med anorexia nervosa ska kunna tillfriskna krävs rätt stöd från familj och vänner men även sjuksköterskor med rätt utbildning har en betydelsefull roll i att stödja kvinnan till ett liv utan anorexia nervosa.</p><p> </p><p> </p><p> </p> / <p>Background: Anorexia nervosa is increasing more and more among young women, although with accurate treatment and support most of them recover from their eating disorder. Aim: The aim of the literature study is to describe factors of importance concerning recovery from an eating disorder from a young woman’s perspective, in order for nurses to receive an increased understanding of young women with anorexia nervosa. Method: The literature study is based on ten scientific articles, qualitative as well as quantitative, which were analysed to obtain the result of the study. Result: Factors of importance for recovery were that the young woman herself obtains an awareness of her disease and learns to understand and handle her feelings, her selfimage, self-esteem and the young woman’s motivation and will to get well and to change her eating habits. In addition the result also shows that nurses have an important role in guiding the young woman in her process of recovery, as well as family, friends, partners, therapists and remaining medical staff. Finally occupational activitites are also vital for the recovery process. Conclusion: In order for a young woman suffering from anorexia nervosa to recover she needs support from family and friends but especially from nurses with suitable training and education. They have an important role in supporting the young woman on her way to recovery to a life without anorexia nervosa.</p><p> </p>

<p>Bakgrund: Anorexia Nervosa är en sjukdom som främst drabbar kvinnor mellan 15-24 år och det är cirka en % av världens befolkning som drabbas varje år. Syfte: Att belysa sjuksköterskans omvårdnadsåtgärder hos flickor med anorexia nervosa och att se vilka riskfaktorer som predisponerar för utveckling av denna sjukdom. Metod: Litteraturstudien genomfördes som en allmän litteraturstudie med systematisk analys. Resultat: Sjuksköterskan kan spela en nyckelroll i omvårdnaden av flickor som drabbats av anorexia nervosa genom empati och förståelse. Detta kan resultera i att flickorna känner förtroende och tillit för sjuksköterskorna och det kan hjälpa dem att tillfriskna. Riskfaktorerna är allt från sociokulturella, familjära, biologiska och genetiska faktorer. Slutsats: Sjuksköterskan kan genom att vara en sann medmänniska och genom att bidra med sin tid och sin kompetens vara en avgörande faktor för att dessa flickor tillfrisknar. Riskfaktorer som predisponerar för utveckling av anorexia nervosa är individuella och mångdimensionella.</p> / <p>Background: Anorexia Nervosa is a disease that mostly affects women that are 15-24 years old and approximately one percent of the world’s population are affected of it every year. Aim: To illustrate the nurses caring measures of girls with anorexia nervosa, and to see what kind of risk factors that are causing the disease to outburst. Method: The literature review was done as a common literature review with systematic analysis. Result: The nurse might have a key role in the care of girls affected with anorexia nervosa by providing empathy and understanding. The result of this could be that the nurses gain the girls trust and reliance which can help them while they fight to recover. The risk factors are many and vary from sociocultural factors to familiar, genetic and biological factors. Conclusion: The nurse might by being a true fellowman and by contributing with her time and knowledge facilitate to the girls recovery. The risk factors that are causing anorexia nervosa to outburst are individual and multidimensional.</p>

Bakgrund: Anorexia Nervosa är en sjukdom som främst drabbar kvinnor mellan 15-24 år och det är cirka en % av världens befolkning som drabbas varje år. Syfte: Att belysa sjuksköterskans omvårdnadsåtgärder hos flickor med anorexia nervosa och att se vilka riskfaktorer som predisponerar för utveckling av denna sjukdom. Metod: Litteraturstudien genomfördes som en allmän litteraturstudie med systematisk analys. Resultat: Sjuksköterskan kan spela en nyckelroll i omvårdnaden av flickor som drabbats av anorexia nervosa genom empati och förståelse. Detta kan resultera i att flickorna känner förtroende och tillit för sjuksköterskorna och det kan hjälpa dem att tillfriskna. Riskfaktorerna är allt från sociokulturella, familjära, biologiska och genetiska faktorer. Slutsats: Sjuksköterskan kan genom att vara en sann medmänniska och genom att bidra med sin tid och sin kompetens vara en avgörande faktor för att dessa flickor tillfrisknar. Riskfaktorer som predisponerar för utveckling av anorexia nervosa är individuella och mångdimensionella. / Background: Anorexia Nervosa is a disease that mostly affects women that are 15-24 years old and approximately one percent of the world’s population are affected of it every year. Aim: To illustrate the nurses caring measures of girls with anorexia nervosa, and to see what kind of risk factors that are causing the disease to outburst. Method: The literature review was done as a common literature review with systematic analysis. Result: The nurse might have a key role in the care of girls affected with anorexia nervosa by providing empathy and understanding. The result of this could be that the nurses gain the girls trust and reliance which can help them while they fight to recover. The risk factors are many and vary from sociocultural factors to familiar, genetic and biological factors. Conclusion: The nurse might by being a true fellowman and by contributing with her time and knowledge facilitate to the girls recovery. The risk factors that are causing anorexia nervosa to outburst are individual and multidimensional.

BAKGRUND: Psykisk ohälsa bland unga kvinnor är ett folkhälsoproblem. Anorexia nervosa kategoriseras in som en psykisk sjukdom. Anorexia nervosa drabbar främst unga kvinnor, vilket exempelvis kan bero på tidigare händelser i livet som gett upphov till psykisk obalans i deras vardag. SYFTE: Syftet med studien var att undersöka vilka sociokulturella orsaker som bidrar till utvecklingen av Anorexia nervosa bland flickor och unga kvinnor i åldrarna 12-25 år. METOD: En literaturstudie utfördes, som baseras på 21 olika vetenskapliga artiklar. Databaserna som användes var pubmed och psycinfo. Temaanalys användes och artiklarna kategoriserades in i huvudteman och underteman. RESULTAT: Resultatet i studien delades in i två huvudkategorier, med två underkategorier vardera. Sociala orsaker till uppkomsten av Anorexia nervosa: skola och ungdomskultur, samt bristande familjerelationer. Mediala orsaker till uppkomsten av Anorexia nervosa: exponering av unga kvinnors idealkroppar och negativ inspiration på internet. Olika orsaker bidrar till utvecklingen av Anorexia nervosa. Sociokulturella orsaker, mediala orsaker, familjära orsaker och kulturella orsaker samspelar och bidrar tillsammans till en utveckling av sjukdomen. IMPLIKATION: Exempelvis kan man studera de olika orsakerna på en mer specifik nivå och studera varje enskild orsak för sig. Studien kan också användas som en form av inspiration som stärker betydelsen av att hälsofrämjande åtgärder för psykisk ohälsa sätts i fokus. / BACKGROUND: Mental illness among young woman is a public health problem. Anorexia nervosa is categorized as a mental illness. Young woman affected by Anorexia nervosa, wich for example may be due to earlier life events that gave rise to mental imbalance in their everyday lives. OBJECTIVE: The aim of this study was to describe the socio-cultural reasons that contribute to the development of Anorexia nervosa among girls and young women 12-25 years. METHOD: The study is a literature review, based on 21 differens aricles. The method has been to look up earlier research in the area through various databases on the internet. Databases that have been used is pubmed and psycinfo. The articles were divided into different themes, with main category and subcategory. RESULTS: The results of the study was divided into two main categories each with two subcategories. Social causes for the occurrence of Anorexia nervosa: School and youth culture and the second was lack of family relationship. Media reasons in the emergence of Anorexia nervosa: Media image of the feminine ideal and negative inspiration on the internet. Socio-cultural reasons, medial reasons, family reasons, and cultural reasons. IMPLICATION: For example, one can study the various reason in a more specific level, and studying each factors separately. The study can also be used as a form of inspiration that reinforces the importance of health promotion activities for mental illness is the focus.

Bakgrund: Anorexia nervosa blir allt vanligare bland unga kvinnor. Med rätt behandling och stöd tillfrisknar ändå de flesta från sin ätstörning. Syfte: Syftet med litteraturstudien var att ur en ung kvinnas perspektiv som har haft anorexianervosa, beskriva faktorer som har betydelse för tillfrisknandet från ätstörningen, för att sjuksköterskan ska få en ökad förståelse för unga kvinnor med anorexia nervosa och därmed kunna hjälpa dem. Metod: Litteraturstudien baseras på tio vetenskapliga artiklar, både kvalitativa och kvantitativa, som analyserades och utformades till studiens resultat. Resultat: De faktorer som hade betydelse för tillfrisknandet var att den unga kvinnan själv kom till insikt om sin sjukdom och lärde sig begripa och hantera sina känslor, sin självbild och självkänsla. Tillfrisknandet påverkades även av den unga kvinnans egen motivation till att vilja tillfriskna och ändra sitt matbeteende. Resultatet visade att sjuksköterskan hade en viktig roll i att vägleda den unga kvinnan med anorexia nervosa genom tillfrisknandeprocessen. Andra personer som familj, vänner, partner, terapeuter och sjukvårdspersonal hade också en betydelsefull roll, men även aktiviteter för att sysselsätta sig var viktigt. Slutsats: För att en ung kvinna med anorexia nervosa ska kunna tillfriskna krävs rätt stöd från familj och vänner men även sjuksköterskor med rätt utbildning har en betydelsefull roll i att stödja kvinnan till ett liv utan anorexia nervosa. / Background: Anorexia nervosa is increasing more and more among young women, although with accurate treatment and support most of them recover from their eating disorder. Aim: The aim of the literature study is to describe factors of importance concerning recovery from an eating disorder from a young woman’s perspective, in order for nurses to receive an increased understanding of young women with anorexia nervosa. Method: The literature study is based on ten scientific articles, qualitative as well as quantitative, which were analysed to obtain the result of the study. Result: Factors of importance for recovery were that the young woman herself obtains an awareness of her disease and learns to understand and handle her feelings, her selfimage, self-esteem and the young woman’s motivation and will to get well and to change her eating habits. In addition the result also shows that nurses have an important role in guiding the young woman in her process of recovery, as well as family, friends, partners, therapists and remaining medical staff. Finally occupational activitites are also vital for the recovery process. Conclusion: In order for a young woman suffering from anorexia nervosa to recover she needs support from family and friends but especially from nurses with suitable training and education. They have an important role in supporting the young woman on her way to recovery to a life without anorexia nervosa.

Bakgrund: Anorexia nervosa innebär för en människa svår viktnedgång, som är en konsekvens av dennes rädsla att gå upp i vikt. Omvårdnaden består till stor del av kontrollerad behandling av de fysiska symtomen, vilket kan resultera i en maktkamp då människor med anorexia nervosa inte inser att de behöver hjälp och inte vill bli friska. Detta utmanar skapandet av en vårdrelation. En fungerande vårdrelation är avgörande för patienters tillfrisknande. Syfte: Att beskriva patienters och sjuksköterskors upplevelser av vårdrelationen i omvårdnaden av anorexia nervosa. Metod: Studien är baserad på en kvalitativ litteraturstudie. Informationssökning gjordes via databasen Cumulative Index to Nursing and Allied Health Literature, CINAHL. Materialet analyserades med hjälp av en innehållsanalys. Travelbees omvårdnadsteori används som teoretisk referensram. Resultat: Ur ett patient-och sjuksköterskeperspektiv framkom två huvudteman och åtta subteman gällande upplevelser av omvårdnad i behandling och relationsfrämjande faktorer i omvårdnaden. Det första huvudtemat som framkom var fråntagande av kontroll och ansvar, med dess subteman; upplevelser av: behandling, vårdrelationen, kommunikationens betydelse, tillgänglighetens betydelse och  individualiserad vård. Det andra huvudtemat blev att återskapa kontroll och ansvar, där subteman kom att bli; upplevelser av: självbestämmandets betydelse, kunskapens betydelse och stödets betydelse. Diskussion: Sjuksköterskan bör ta hänsyn till individuella skillnader i omvårdnaden av patienter med anorexia nervosa. De kontrollerande omvårdnadsåtgärderna, med fokus på fysiska symtom, bidrar till att individen glöms bort. Med hjälp av Travelbees omvårdnadsteori diskuterar författarna vikten av att skapa en vårdrelation för att främja patientens autonomi och integritet. / Background: Anorexia nervosa means severe weight loss, which is a consequence of fear of gaining weight. A large part of the nursing consists of controlled treatment of physically symptoms. That can lead to a struggle of power due to the fact that people with anorexia nervosa neither wants to be helped or get well. This challenges the creation of care relationship. A working health care relationship is crucial for the recovery. Objective: To describe patients and nurses experiences of the health care relationship in nursing of anorexia nervosa. Method: The study is based on a qualitative literature review. The information was retrieved from the Cumulative Index to Nursing and Allied Health Literature, CINAHL, database. The material was analyzed using a content analysis. Results: From a patient and nurse perspective two main and eight sub themes emerged regarding experiences of nursing in treatment and relationship promotional factors in nursing. The first main theme that emerged was removal of control and responsibility, which has the following sub themes; experiences of:  treatment, the health care relationship, the significance of communication, the significance of availability and individualized care. The second main theme was to restore control and responsibility, with the following sub themes; experiences of: the significance of self-determination, the significance of knowledge and the significance of support. Discussion: The nurse should take in consideration individual differences in nursing patients with anorexia nervosa.The controlled nursing measures, with focus on the physically symptoms, contributes to that the individual becomes neglected. With the help of Travelbees nursing theory the authors discuss the importance of creating a health care relationship to promote the patients autonomy and integrity.