General
Define 'eating disorder'
A range of complex illnesses related to abnormal eating behaviours that impact biopsychosocial health and functioning.
Who can diagnose EDs and name 1 screening tool that can be used to assess EDs
- Psychologist, Psychiatrist, GP, Paediatrician
- Diagnostic and Statistical Manual (DSM-5)
- Eating Disorder Examination-Questionnaire (EDE-Q)
- Eating Disorder Examination (EDE)
- Eating Disorder Diagnostic Scale (EDDS)
Name 2 psychotherapeutic treatment options for children/adolescents with ED.
- Family Based Therapy
- Cognitive Behavioural Therapy
Describe the role of nurses in caring for children/adolescents with an ED.
- Provide physical and emotional support
- assess clinical findings
- monitor weight, adherence to dietary plans and ensure adequate food intake
- identify eating patterns and body image concerns
List healthcare professions who may work with children/adolescents with an ED
- Paediatrician
- GP
- Dietician
- Therapist, Psychologist, Psychiatrist
What are the common types of eating disorders?
Anorexia nervosa, Bulimia Nervosa
During a physical examination of the patient, what are some signs/symptoms of EDs to look out for?
Physical appearance - nausea, fatigue, hair loss, reflux, constipation
Vital signs - hypotension/hypertension, bradycardia/tachycardia
Lab/blood tests - BMI, anemia, electrolyte imbalances
What pharmacological treatment can be used during the treatment of Anorexia Nervosa and Bulimia Nervosa?
Selective Serotonin Reuptake Inhibitors (SSRIs):
E.g. Fluoxetine - can help treat co-morbid conditions such as anxiety, depression, OCD
Give examples of phrases that nurses should avoid saying to ED patients.
"She/he is anorexic or bulimic"
"You have to eat more"
"You ate a lot of food"
"You lost/gained a lot of weight"
What is the role of a dietician in treating patients with an ED?
- Reviewing and prescribing personalised meal plans
- Assessing previous and current dietary habits
- Providing guidance on nutritional requirements
Describe 3 risk factors contributing to eating disorders
- More common in females than males.
- Family history
- Social media influences = increased interest in appearance and body image.
- Premorbid mental health conditions
- Poor treatment response
Describe why a mental health assessment is important for assessing EDs
- Reveals psychological/emotional factors that may be contributing to the ED e.g. stressors, self-critical thoughts, body image distortion, self harm, suicidal thoughts and low self-esteem or confidence levels.
- Help identify underlying comorbidities e.g. depression, anxiety
Explain how Cognitive Behavioural Therapy can be used to treat ED.
- Allows recognition of exacerbating behaviours, patterns of thinking and helps build healthy habits
AN - improves emotional regulation, reduces subjective feelings of incompetence, produces significant weight gain alongside nutritional treatment plans
BN - decreases binge/purge behaviours, positive impact on emotional regulation and self-esteem, reduction of depressive symptoms
List 3 therapeutic communication techniques nurses can apply in creating a safe and non-judgemental environment
- avoid stigma / negative stereotyping
- avoid comments on appearance
- avoid statements
- trauma informed care e.g. empathy
- use non-triggering words
- use shared language
How can nurses work within a interdisciplinary team to enhance patient health outcomes?
- Build therapeutic relationship with patient to facilitate trust and communication
- Coordinate and communicate the patient’s needs and concerns with the multidisciplinary team to address health concerns and create person-centred care plans.
- Ensure patient adheres to treatment