Custom essay on Anorexia Nervosa
Findings and Discussion
Findings
The articles used in the review of literature in the research work had unique themes that
were identified and that contributed towards the entire research work. Some of the common
themes in the articles include therapeutic relationship, effective nursing care, recovery and
maternalism as seen from Zugai, Stein‐Parbury and Roche, (2018), Van Ommen et al. (2009),
Bakker et al. (2011), and Wright, (2015) respectively. The individual themes are sometimes
appearing in more than one article but at one point they are dominant in one article than the rest.
Thus the discussion of the findings of the themes is based on the articles that they are dominant.
The following is an elaboration of the themes with regard to the articles the individual themes are
appearing the most:
Therapeutic Relationship
Therapeutic relationship theme comes out clearly in the objective of the article by Zugai,
Stein‐Parbury and Roche, (2018, pg. 419) and it also contributes to the topic of the influence of
therapeutic alliance between mental health nurses adolescents with anorexia nervosa (AN). The
authors show that therapeutic alliance depends on the capacity of nurses to maintain their power
position as they show their trustworthiness to consumers who in this case are individuals
diagnosed with AN. As seen from the literature review a good relationship between nurses and
patients is of the essence in addressing mental health like AN. Thus, through the study there is a
belief by the nurses that addressing the issue of AN has no dependent on the use of the coercive
or authoritative style of interaction. The best approach as proposed was to rely on
supportiveness, collaboration and patient all of which are revolving around the therapeutic
relationship between the mental health nurses and patients diagnosed with AN. It is also worth
noting that the internal process of separation by the nurses in the study presented by Zugai,
Stein‐Parbury and Roche, (2018, pg. 422) demonstrated dependency on understanding and
judgmental orientation which is also reflective of the therapeutic relationship.
The aspect of a therapeutic relationship is also demonstrated through the collaborative
approach and the interaction and interpersonal skill. This relationship was found to lead to a
harmonized effort towards addressing challenges associated with AN while its disregard as
demonstrated by Zugai, Stein‐Parbury and Roche, (2018, pg. 423) invoked resistance and non-
adherence. Thus for better results, the nurses in the study depended on individualizing care to
enhance therapeutic alliance and from this, the nurses maintained a consistent set of
expectations. Last but not least, the aspect of dependency in the research was demonstrated on
the effort by the nurses to assist AN patients as also indicated in the literature review in their
recovery process and the success of their effort was dependent on their ability to maintain firm
professional boundaries.
Recovery
The theme of recovery cut across the articles used but it was more prominent in the
article by Bakker et al. (2011) as it addressed the recovery of normal body weight in adolescents
with AN. The article generally shows the importance of nurses in the inpatient treatment of AN
as they contribute towards the recovery process in their routine involvement with patients. this
can as well be found in the literature review which points out about the struggle to complete
recovery of patients with AN. However, through the implementation of the recovery process, the
nurses also have to put into consideration certain factors as attentiveness, acceptance, empathy,
respect, and honesty, a show of interest and recognition of the patient as well as their complaints
that need to be addressed. The recovery theme as demonstrated by Bakker et al. (2011, pg. 16) is
best met when it fully manifests through physical, psychological, and emotional recovery on the
patients.
The article through addressing the theme of recovery poses a question that to identify the
aspect of care that is believed by nurses to contribute towards the recovery of normal body
weight in AN patients. Thus, it sorts to develop a model that explained the significance of
inpatient nursing care. In the physical perspective, the theme of recovery is manifested through
the patients with AN recover their appropriate weight through the involvement of nurse’s
intervention. Thus they assist patients in overcoming their worst fear involved with taking of
meals. Bakker et al. (2011, pg. 17) in the article indicate that the patients who got recovered from
AN were used as role models to entice other patients to seek medical intervention through the
guidance of nurses.
The article further, in a bid to explore the theme of recovery the authors indicated that it
was of significance to ensure that patients were in touch with the outside world in the process of
their treatment (Bakker et al. 2011, pg 19). This was a great contributing factor in enhancing the
social activities of the patients to make them feel that the society also needs them. The
association further shows therapeutic alliance between the mental health nurses and those with
AN to further enable social recovery.
Maternalism
The theme of maternalism is highly addressed in the article by Wright, (2015) in a bid to
demonstrate mental health nursing to assist patients with AN. In this regard, the author has
delved into discussion the concept of maternalism which is a concept occurring within the
therapeutic relationship found in eating disorder. The theme also features in the literature review
where it is indicated that the consumers in various researches trusted maternalistic nurses.
Examining the influence of Therapeutic Alliance between Mental Health Nurses and
Adolescents diagnosed with Anorexia Nervosa in an Inpatient Setting, it comes out that the
eating disorder through the study in the United Kingdom mainly affects women. For this reason,
the article through the research undertaken tries to answer the question of “why women and not
men becoming associated with eating disorder leading to AN.” For this reason, this research
work by Wright, (2015, pg. 431) takes the maternalistic approach responsible for providing a
sense of security and nurturing as a compassionate way of facilitating a way out and hope of
getting rid of AN. This is further likened to good parenting and the way it can facilitate
independence and maturation.
Effective Nursing Care
The theme of nursing care is one that comes out in a good number of the articles as it
involves the efforts of nurses to help individuals with AN to recover from their ordeals. The
theme, however, is elaborated in the article by Van Ommen et al. (2009) and this can even be
seen in the objective which seeks to develop a theoretical model of the effectiveness of inpatient
nursing care of individuals with AN. Through a qualitative design and ground theory approaches
the article demonstrates how the contributions of nurses lead to the recovery of patients with AN.
This is also reflective of the literature review where effective nursing care had to be based on
reliability, compassion, and trust.
In a bid to explore the theme of nursing care, Van Ommen et al. (2009, pg. 2801)
approached the study through a question seeking to identify the nursing care aspects contribute to
the regaining of appropriate body weight. The findings by the authors as far as the aspects of
nursing care is concerned to demonstrate care included structure, normalization, and
responsibility. From this aspect, it can be said that nursing care as a theme in the article directly
relates to the identified categories. The aspect of nursing care according to the article has a
significant contribution to the recovery phase of patients with AN. During the recovery phase,
the article makes clear the role of nurses in nursing care which in clued: the nurses as substitute
decision makers, the nurses being role models, and the nurses as fall back. Based on these
findings regarding the theme of nursing care the article brings out the nursing care model and its
contribution towards influencing therapeutic alliance between mental health nurses and
individuals with AN in an inpatient setting.
Discussion
This section presents an in-depth critique of the research papers with a focus on the
findings section in examining the influence between mental health nurses and patients diagnosed
with anorexia nervosa. It thus looks into further elaborating the findings in terms of themes. The
above findings regarding themes by the articles addressing the influence of therapeutic alliance
between mental health nurses and adolescents diagnosed with anorexia nervosa in an Inpatient
Setting have a lot to contribute towards the general study. Together with the literature review
contributed by other articles the themes are impactful on the subject and they can be used in
enhancing knowledge in the nursing field as far as anorexia nervosa condition is concerned.
The theme of therapeutic relationship from its contribution towards dependency also
gives the picture of the importance of working together between patients and health practitioners.
The nurses despite their knowledge and experience depend on the cooperation of the patients for
them to understand the conditions through which the patients are passing and consequently come
up with appropriate treatment plan (Zugai, Stein‐Parbury and Roche, 2018). The dependency
when appropriately met contributes positively towards realizing the therapeutic alliance between
mental health nurses and adolescents with AN in an inpatient setting.
Further, the aspect of therapeutic relationship contributes towards achieving ethical
consideration which further helps in addressing moral and legal notions of research and nursing
practice. In this regard, it helps in putting into consideration the vulnerability of patients with AN
such as the acquisition of fully informed consent when treatment of the condition is involved.
When dealing with adolescents who are still considered to have a dependence on their parents or
guardians to make informed consents as far as treatment is concerned, a therapeutic alliance
formed through dependence between patients and nurses form centre stage.
In this regard, the theme of a therapeutic relationship has its significance through its
enhancement of understanding and judgmental orientation. This further ensures that appropriate
care for patients with AN as the exchange of the right information between the nurses and the
patients is productive and enables the nurses to come up with the right approach towards
addressing conditions associated with AN. Through the positive effect of the theme in
harmonizing efforts in addressing challenges with AN condition, it simplifies the efforts through
doing away with any form of misunderstanding that could have existed if the nurses and the
patients were not in agreement as a result of independence to one another. For this reason, the
theme has its great effect in influencing therapeutic alliance between mental health nurses and
adolescents with anorexia nervosa in an inpatient setting.
Recovery from bad health condition is essentially the aim of nursing intervention and it is
equally serving the same purpose in the need to address the condition of AN. As already
identified, recovery theme cuts across all the articles used in the research paper based on the fact
that it forms the primary goal of addressing the condition of anorexia nervosa as described y
Bakker et al. (2011). However, as identified in both the findings and literature review of this
research study involves best practices specific to conditions, in this case, AN, for it to be
effective. In addressing the influence of therapeutic alliance between nurses and adolescents
diagnosed with AN, the theme of recovery takes the centre stage and therefore its attainment will
determine the importance of therapeutic alliance considered in the treatment process.
The aspect of recovery also as identified does not only include medical and nursing
intervention, especially for the case of AN since the condition, needs to take various approaches
towards healing (Bakker et al. 2011). The importance of involving the outside world as identified
is meant to enhance the process of recovery which is solely associated with the social life of the
patients. This implies that the social relations between the nurses and the patients with AN are
not enough in addressing the condition successfully. Interaction with the outside world enhances
recovery as the patient gets to experience a diversified view of the world which closely
influences their social life. For this reason, the social intervention arrived at by nurses exposing
the patients to the outside world leads to healing the social life of the patients. Social recovery,
in this case, will enable the patient to be in a position to face the outside world which initially
was a threat to their self-esteem through their distorted perception of their body. Further, the
mental health nurses contributing to recovery from AN is indicative of a therapeutic alliance.
The theme of maternalism has a unique and obvious association with the condition of
anorexia nervosa especially when the condition is contributed by starvation despite the
shortcoming of the limited sample (Wright, 2015). The reason for this theme and the
contributions it makes towards looking into the influence through a therapeutic alliance between
AN patients and mental health nurses. as identified, the individuals affected are basically women
more than men. The reason behind this is based on the fact that most women are sensitive about
their physical appearance more than men and for this reason, they will do whatever possible to
attain the right shape and weight. In the process, they can develop an obsession with their
endeavour which leads to the development of anorexia nervosa.
The efforts that most women are victims of AN revolve around dieting which essentially
incorporates some bits of fasting and avoiding certain foods that are beneficial to the body. In the
process of undertaking this venture, the women develop the condition of AN. Involvement of
mental health nurses towards addressing the AN through therapeutic alliance is of the essence
since the nurses have the professional way of addressing the condition.
The alliance formed with the nurses will, therefore, help the AN patients to recover from
various side effects caused by the condition and further help them in attaining the best body
weight and not necessarily their desired body weight and shape. The therapeutic alliance in a bid
to address eating disorder thus will not only help in addressing the physical appearance of the
patients but will also address their social life by making them attain the ideal appearance in terms
of weight and body size. Some of the intervention methods that can be contributed to by the
mental health nurses include the right diet to have the patients attain the right weight and shape,
in addition to the right exercises that they can engage in for the same reason of attaining the right
appearance. The involvement of mental health nurses in addressing eating disorder will be of
significance in helping the patients to attain social recovery.
The four articles have all touched on the theme of nursing care which is essentially aimed
at helping in addressing the anorexia nervosa. The theme has an importance that cuts across
many interventions by nursing personnel. Van Ommen et al. (2009) in their study have thus
presented a context testing value of care within inpatient care. With regard to the formation of
the therapeutic alliance between mental health nurses and individuals with AN, it essentially
facilitates the healing process of the patients as they deal with the AN condition. The nursing
care in this regard is inclusive of other themes which are seen to be addressing the condition. For
instance, nursing care is reflected in the theme of eating disorder as nurses through the caring
process are involved in advising individuals with AN to have a good eating habit which is
beneficial to their bodies and health. The theme of recovery reflects nursing care in the sense that
it is the effort of the mental health nurses to provide treatment and pieces of advice to enable the
recovery process.
It is worth noting that for the nursing care to be fully effective the alliance between the
mental health nurses and the patients has to be strong which is reflective of the theme of
dependence. Thus the nursing care does not operate effectively in isolation but works with
various evidence-based practices to ensure that there is the attainment of healthy individuals. The
therapeutic alliance that enhances nursing care thus contributes towards the attainment of
empathy, acceptance, honesty, and respect in the association involving both AN patients and
mental health nurses. With strong nursing care, it is of essence that an equally strong therapeutic
alliance between the mental health nurses and individuals with anorexia nervosa in an inpatient
setting to be formed. Through the formation, it will be possible for the attainment of various
steps leading to the treatment of the AN condition.
The above studies contribute significantly to filling a gap regarding the alliance between
mental health nurses and individuals with AN condition since there are limited studies that have
been involved in scrutinizing the condition. The four articles, despite their few shortcomings,
have, therefore, contributed to shedding light on the condition of anorexia nervosa. Thus,
amongst adolescents diagnosed with AN, a productive therapeutic alliance has significance in the
creation of a context for successful treatment through the application of various approaches.
References
Bakker, R., van Meijel, B., Beukers, L., van Ommen, J., Meerwijk, E. and van Elburg, A., 2011.
Recovery of normal body weight in adolescents with anorexia nervosa: the nurses'
perspective on effective interventions. Journal of Child and Adolescent Psychiatric
Nursing, 24(1), pp.16-22.
Van Ommen, J., Meerwijk, E.L., Kars, M., Van Elburg, A. and Van Meijel, B., 2009. Effective
nursing care of adolescents diagnosed with anorexia nervosa: the patients’ perspective.
Journal of clinical nursing, 18(20), pp.2801-2808.
Wright, K.M., 2015. Maternalism: a healthy alliance for recovery and transition in eating
disorder services. Journal of psychiatric and mental health nursing, 22(6), pp.431-439.
Zugai, J.S., Stein‐Parbury, J. and Roche, M., 2018. The nature of the therapeutic alliance
between nurses and consumers with Anorexia Nervosa in the inpatient setting: A
mixed‐methods study. Journal of clinical nursing, 27(1-2), pp.416-426.
