Orientador: Heloisa Pontes / Dissertação (mestrado) - Universidade Estadual de Campinas, Instituto de Filosofia e Ciencias Humanas / Made available in DSpace on 2018-08-04T01:47:41Z (GMT). No. of bitstreams: 1 Silva_DanielaFerreiraAraujo_M.pdf: 7828652 bytes, checksum: ee363c51663b72cdf441fd2cf26177fc (MD5) Previous issue date: 2004 / Resumo: Esta dissertação tem como objetivo investigar as perturbações físico-morais denominadas "transtornos alimentares", dentre as quais se destacam a "anorexia nervosa" e a "bulimia nervosa", no contexto brasileiro, por meio de uma etnografia realizada através da internet, a partir do material produzido por pessoas que se auto-identificam como portadoras de um transtorno alimentar. Partindo de uma perspectiva antropológica, a abordagem aqui desenvolvida privilegia a relação entre tais perturbações e as concepções culturalmente específicas de pessoa, corpo, corporalidade e gênero / Abstract: The aim of this text is to investigate the phisico-moral disturbances named "eating disorders", among which "anorexia nervosa" and "bulimia nervosa" stand out, within the brazilian context, through an etnography carried out in the internet, based on the material produced by people who auto-identify themselves as eating-disordered persons. Starting ITom an anthropological perspective, the approach developed here privileges the relationship between these disorders and the cultura1lyspecific conceptions of personhood, body, embodiment and gender / Mestrado / Antropologia / Mestre em Antropologia Social

Submitted by Fabio Sobreira Campos da Costa (fabio.sobreira@ufpe.br) on 2017-07-25T12:42:31Z No. of bitstreams: 2 license_rdf: 811 bytes, checksum: e39d27027a6cc9cb039ad269a5db8e34 (MD5) tese_tatiana_bertulino.pdf: 10443220 bytes, checksum: 79c9bf743bf865c2a6d7ee7c679ecadb (MD5) / Made available in DSpace on 2017-07-25T12:42:32Z (GMT). No. of bitstreams: 2 license_rdf: 811 bytes, checksum: e39d27027a6cc9cb039ad269a5db8e34 (MD5) tese_tatiana_bertulino.pdf: 10443220 bytes, checksum: 79c9bf743bf865c2a6d7ee7c679ecadb (MD5) Previous issue date: 2016-06-17 / Os adolescentes aprendem em nossa sociedade que uma das características do sucesso é o corpo magro. Esta pressão social pela magreza está mais presente nas adolescentes, criando o aumento da insatisfação corporal nesta população. A insatisfação com a própria imagem corporal é o cerne dos transtornos alimentares. Entre os transtornos alimentares destaca-se a bulimia nervosa, caracterizada pelos comportamentos de compulsão alimentar associado à purgação. O tratamento clínico recomendável para a bulimia nervosa é a terapia cognitivo-comportamental, realizado por um especialista em transtornos alimentares. Outras formas de intervenção nos pacientes com transtornos alimentares também são utilizadas, entre elas a psicoeducação. O objetivo deste estudo foi de avaliar as possíveis diferenças entre a intervenção psicoterápica do tipo cognitivocomportamental e a intervenção psicoeducativa em adolescentes diagnosticadas com bulimia nervosa. Foi realizado um ensaio clínico, constituído de 11 adolescentes do sexo feminino entre 13 a 19 anos com diagnóstico de bulimia nervosa. Para o diagnóstico utilizou-se a entrevista clínica diagnóstica: Levantamento sobre o Desenvolvimento e Bem – Estar de Crianças e Adolescentes (DAWBA). As adolescentes foram divididas em dois grupos: controle e experimental. No grupo controle, constituído de cinco adolescentes, o tratamento utilizado foi a terapia cognitivo-comportamental em grupo durante 13 encontros em 12 semanas. No grupo experimental, constituído de seis adolescentes, o tratamento utilizado foi a psicoeducação em grupo, em 13 encontros semanais. As medidas primárias de eficácia no estudo foram: diminuição dos sintomas de bulimia nervosa, diminuição dos sintomas de compulsão alimentar e diminuição da insatisfação corporal. Houve diminuição de sintomas de bulimia nervosa nos dois grupos, porém não se comprovou diferença significativa entre os grupos. Em relação a compulsão alimentar não houve modificação nos sintomas em nenhum dos grupos. A insatisfação corporal foi a variável que demonstrou melhora significativa quando os grupos foram analisados em conjunto, porém não houve diferença significativa entre os grupos. Na terapia cognitivocomportamental é aceitável que após o tratamento da bulimia nervosa, os pacientes ainda apresentem sintomas de transtorno alimentar, como a compulsão alimentar, pois o principal objetivo é que o sistema de manutenção das crenças que mantem a bulimia nervosa seja interrompido. A psicoeducação possui como foco o aumento da satisfação com a imagem corporal, o que de fato ocorreu no estudo. A psicoeducação não foca especificamente na melhora da bulimia nervosa e de seus sintomas, como a compulsão alimentar. Apesar de estudos anteriores terem encontrado melhora na relação alimentar dos participantes de psicoeducação, além da melhora nos sintomas da insatisfação corporal. Os dois tratamentos realizados na pesquisa demonstraram diminuição de sintomas, porém essa diminuição não foi significativa em nenhum dos grupos quando avaliados individualmente. É necessária a continuação da pesquisa, com o aumento da amostra e se possível com a análise qualitativa dos dados. A pesquisa demonstrou a possibilidade da utilização da psicoeducação, em um primeiro momento, em populações não crônicas. / Teenagers learn in our society that one of the characteristics of success is a thin body. This social pressure for thinness is more prevalent among the girls, causing increased body dissatisfaction in their group. Dissatisfaction with their own body image is the core of eating disorders. Among the eating disorders, bulimia nervosa stands out, characterized by binge eating behaviors associated with purging. The recommended medical treatment for bulimia nervosa is cognitive-behavioral therapy with a specialist in eating disorders. Other forms of intervention in patients with eating disorders are also used, including psychoeducation. The goal of this study was to evaluate possible differences between the psychotherapeutic intervention of cognitive-behavioral type and the psychoeducational intervention in female teenagers diagnosed with bulimia nervosa. A clinical trial was performed, consisting of 11 female teenagers between 13 and 19 years old, all of whom were diagnosed with bulimia nervosa. The clinical interview Development and Well-Being Assessment (DAWBA) was used for the diagnosis. The teenagers were split into two groups: control and experimental. In the control group, consisting of five teenagers, the treatment used was cognitive-behavioral group therapy for 13 meetings in 12 weeks. In the experimental group, consisting of six teenagers, the treatment used was group psychoeducation, in 13 weekly meetings. The primary effectiveness measures in the study were: reduction of the symptoms of bulimia nervosa, decreased symptoms of binge eating, and decreased body dissatisfaction. There was a reduction of the symptoms of bulimia nervosa in both groups; however, no significant difference was proved between them. Regarding binge eating, there was no change in symptoms in either group. Body dissatisfaction was the variable that showed most significant improvement when the groups were analyzed together, but once again there was no significant difference between groups. In cognitive-behavioral therapy, it is acceptable that after the treatment of bulimia nervosa, patients still present symptoms of eating disorders such as binge eating, because the main goal is that the system of beliefs which sustains bulimia nervosa is interrupted. Psychoeducation, on the other hand, focuses on increasing body image satisfaction, which actually happened in the study; psychoeducation does not focus specifically on the improvement of bulimia nervosa and its symptoms, though previous studies have found an improvement in the participants' relationship with food, besides an improvement in the symptoms of body dissatisfaction. Both treatments carried out in the research showed decreased symptoms, but this decrease was not significant in either group when assessed individually. Continued research, with a larger sample and qualitative data analysis, if possible, is required. The study has shown the possibility of using psychoeducation, at first, in nonchronic populations.

The purpose of this study was to examine the relationship between anorexia nervosa and several personality traits. Past research in this area has been contradictory for several reasons. Sociocultural theories have described the media's role in promoting eating disorders by portraying a thin body-type as the ideal. However, they have neglected to describe the personality ideal which our society promotes in women. It is proposed here that anorexics incorporate and oppose this ideal. Therefore, the anorexic personality is one filled with conflict.

Bakgrund Anorexia Nervosa och Bulimia Nervosa är två ätstörningar som kan leda till allvarliga fysiska och psykiska konsekvenser. Individer med dessa sjukdomar döljer för det mesta symtomen i den mån som går, vilket skapar stora mörkertal i samhället och försvårar sjuksköterskans förmåga att identifiera tidiga tecken. Prevalensen av ätstörningar ses öka i dagens samhälle, och sjuksköterskan kan därmed möta dessa patientgrupper i olika former av vårdkontexter. För detta krävs kunskap hos sjuksköterskan kring det omvårdnadsarbete som bedrivs vid dessa sjukdomar. Syfte Syftet med denna litteraturöversikt var att belysa omvårdnadsåtgärder vid Anorexia Nervosa och Bulimia Nervosa. Metod I denna litteraturöversikt har datainsamling skett genom databaserna CINAHL och PubMed. Efter noggrann kvalitetsgranskning valdes 15 artiklar av både kvalitativ och kvantitativ karaktär ut för en integrerad dataanalys. Resultat Fyra huvudkategorier som i sin tur bestod av egna underkategorier identifierades. Kategorin samtalet med tillhörande underkategorier första mötet och samtalets viktiga komponenter, kategorin socialt stöd med den terapeutiska alliansen, en svårbehandlad patientgrupp och familjen, kategorin främja hälsosamma vanor med matvanor, fysisk aktivitet och sociala aktiviteter samt kategorin kunskap och utbildning utan tillhörande underkategori. Slutsats Krav ställdes på samtalets innehåll och bemötandet önskades vara öppet, empatiskt och kunnigt. Dåliga upplevelser kunde resultera i negativa konsekvenser på tillfrisknandeprocessen. Att skapa en terapeutisk allians med såväl patient som familj lyftes vara av vikt för vårdförloppet, men karaktären av dessa sjukdomar försvårade den terapeutiska alliansen till följd av ambivalens inför viktuppgång och bristande sjukdomsinsikt. Erfarenhet och utbildning identifierades som viktiga faktorer för att kunna upprätthålla auktoritet och samtidigt balansera detta med ett empatiskt bemötande. Sjuksköterskorna ansvarade för att utbilda patienterna i hälsosamma vanor och guida patienten ur dess sociala och emotionella isolering. Ett flertal problematiska områden identifierades, varav bristande kunskap och utbildning hos vårdpersonalen var ett. I syfte att komma åt identifierade problemområden ställs krav på vidare forskning.

This study investigated the extent biological, cultural, and psychological factors predispose individuals to eating disorders and compared the prevalence between (N = 103) male and female students (18-27 years of age) from Mississippi State University (MSU). Data was collected from the Eating Disorder Screen for Primary Care (ESP), a media consumption questionnaire, the Contour Drawing Rating Scale (CDRS), the Diet History Questionnaire III (DHQ III), the Eating Attitudes Test-26 (EAT-26), and the Rosenberg Self Esteem Scale. Age of onset was collected if participants identified as having an eating disorder. Data was analyzed using the Mann-Whitey U test and Pearson correlations to determine biological, cultural, and psychological susceptibility. This study determined that there are significant biological, cultural, and psychological predispositions that should be considered when diagnosing and treating individuals with eating disorders. Findings from MSU students were compared to current evidence and provides a basis for the development of future studies.

Diagnostic practices utilized in studies of participants with Anorexia Nervosa, Bulimia Nervosa, and Binge-Eating Disorder were investigated. A reliable coding system was used by two reviewers to analyze the diagnostic documentation practices in articles from the top-thirty most cited articles for each diagnostic category. Interrater agreements were all above .95. Results showed that many important diagnostic practices and criteria are either not being employed or not being documented. Uniform reporting procedures are necessary to help readers know how each article’s sampling procedure and subject pool differs from other samples used in the literature. Researchers reported the most details about sample characteristics with the recently proposed Binge-Eating Disorder category. Discussion focuses on identifying the specific diagnostic and sampling procedures deserving better documentation in the eating disorder literatures.

No description available.

Although factors associated with eating disorders (ED) have been studied, no comprehensive source of research findings was identified in this review. The purpose of this study was to identify and synthesize research findings of factors associated with ED in women published from 1992-2006. These findings may be useful to nurses, other professionals, families, and the public to facilitate the prevention, detection, treatment, and rehabilitation of women with EDs. The factors identified as most pertinent through this review were depression, sexual abuse, substance abuse, anxiety disorders, early pubertal onset and the personality traits of perfectionism and impulsivity. No factor was identified as causative for EDs, but sexual abuse and anxiety disorders often preceded the ED. Findings varied among ED subtypes, with sexual abuse and substance abuse more common with binge/purge behaviors and bulimic symptomology, while depression and anxiety disorders were more common with both anorexia nervosa and bulimia nervosa. Perfectionism was most common in anorexics; in one study it was identified independent of stress and persisted after recovery. Limitations noted in the research reviewed include using self-report questionnaires, some small samples, exclusion of some ED subtypes, and a predominant use of cross-sectional and clinical samples. Recommendations for further research included large epidemiological samples containing multiple ED subtypes and males, as well as longitudinal studies and methods to determine causal relationships among EDs and the associated factors identified. Implications for nursing education, practice, and policy development focus on screening for ED during physical examinations and interviews, posing questions to facilitate disclosure, addressing emotions elicited, and suggestions for routine monitoring of patients in clinical settings.

DIFFERENCES IN NUTRITIONAL OUTCOME MEASURES BETWEEN PREADOLESCENTS AND ADOLECENTS WITH ANOREXIA NERVOSA WHO RECEIVED A NASOGASTRIC FEEDING TUBE VERSUS ORAL DIET UPON HOSPITAL ADMISSION by Paige E. Herring Background: Anorexia nervosa (AN) is a disease defined by an extreme weight loss due to an intense fear of gaining weight, and it is the third most chronic disease in adolescent females. Hospitalizations are common among patients with AN due to the major consequences that can arise from this disease. Most of the complications can be resolved with significant weight gain, so hospitals have an implemented feeding protocols to optimize weight gain. Studies have shown that nasogastric (NG) feedings have resulted in a greater weight gain and reduced length of stay without significant side effects. Objective: The purpose of this study is to examine the association between demographic and clinical characteristics and mode of nutrition therapy (oral feeding vs. NG tube feedings) in a population of pre-adolescents and adolescents with a hospital admission diagnosis of AN. The clinical outcome measures are length of stay (LOS), weight gain, and suspected refeeding syndrome. Participants/Setting: The study sample includes 64 patients between the ages 9 and 20 years who have been admitted to Children’s Healthcare of Atlanta between January 1, 2014 and December 31, 2015 for clinical treatment of AN. The demographic, anthropometric, mode of nutrition therapy and clinical characteristics of the patient population were obtained. Statistical Analysis: Frequency statistics were used to describe demographic, anthropometric, mode of nutrition therapy and clinical characteristics of the patient population. A Student’s t-test was used to examine differences in continuous variables by tube feeding status, while a Mann-Whitney U test was used for the non-normally distributed variables. A Chi-square test was used to examine differences in tube feeding status by categorical variables. Results: Data were collected and analyzed for 64 patients, with a mean age of 14.6 + 2.4 years, and the majority of the population being female (93.8%) and Caucasian (92.2%). Approximately half (n=30, 47%) of the population received an NG tube during the admission. Mean discharge BMI was significantly higher in those who received an oral diet vs. NG tube (16.67 vs. 17.08, respectively; p=0.042) while weight change was significantly lower (1.3 kg vs. 2.1 kg, respectively; p=0.012) and LOS shorter (8 days vs. 11 days, respectively; p=0.002) There were no significant differences in other characteristics by mode of nutrition therapy. Conclusion: NG tube feeding is an effective method for feeding hospitalize adolescent patients with AN to yield greater weight gain results. Future studies are necessary to determine the amount of time exclusively on the NG tube, reasons for choosing NG vs. oral feedings, and other variables associated with weight gain and length of stay.

Abstract: The present study was designed to answer the following questions: (a) What is the level of awareness patients with Bulimia Nervosa (BN) and the professionals who work with them regarding the vocal health risks associated with self-induced vomiting? (b) Is the bulimic population at risk for under-referral for assessment and treatment of vocal pathology? (c) How do patients and professionals perceive the role of the Speech-Language Pathologist (SLP) in the treatment of eating disorder-related vocal pathology? Three original surveys were developed to address the research questions. There was one survey for individuals with a history of BN, one for SLPs, and one for other health care professionals involved in the care of bulimic individuals. There were 89 total participants in the present study. Thirty were respondents to the Health Care Providers Survey, 28 were respondents to the SLP Survey, and 31 were respondents to the Patient Survey. Results indicate a general lack of awareness concerning these risks and treatment options to address them on the part of patients and health care professionals and a lack of specific knowledge of how to recognize and treat individuals with BN on the part of SLPs. Results from all three groups supported the notion that the bulimic population is at risk for under-referral for treatment for voice disorders. Finally, results suggest that SLPs do in fact provide services to persons with BN, but that at present, patients and other health care professionals do not seem to perceive the SLP as having a role in management of care of this population. / text