Case Study and Analysis (Eating Disorder) - Anorexia nervosa

The report discusses the case study and analysis of Anorexia nervosa, a mental health issue. It highlights the importance of ethical and legal principles in providing effective care and treatment to the patient.

Running head: Case Study and Analysis (Eating Disorder)
0
Case Study and Analysis (Anorexia nervosa)
STUDENTS NAME:
2/1/2019

Case Study and Analysis (Eating Disorder) 1
Contents
Introduction...........................................................................................................................................2
Part 1: The Case Study (Anorexia nervosa)...........................................................................................2
Description of the situation along with background..........................................................................2
People involved.................................................................................................................................6
Part 2: The Case Study Analysis............................................................................................................7
Problems............................................................................................................................................7
Solutions............................................................................................................................................8
What I must do as a nurse..................................................................................................................8
Communication and therapeutic nurse-client relationship.................................................................9
Principles of legality and ethics related to mental health...................................................................9
Ethical Principles...........................................................................................................................9
Legal Principals.............................................................................................................................9
Cultural competency related to mental health nursing.....................................................................10
Principles and health promotion towards enhancing the mental health and wellbeing of client and
family..............................................................................................................................................10
The process of Nursing and nursing Metaparadigm.........................................................................10
Conclusion...........................................................................................................................................11
References...........................................................................................................................................12

Case Study and Analysis (Eating Disorder) 2
Introduction
The report brings about the discussion on the aspects of mental health and the various
issues or illness affecting the health of an individual. Mental health defines about the
psychological well-being or the absence of the mental health issues, or illness. A satisfactory
level of emotional wellbeing and behavioural adjustment has been the elements which
determine the mental health of an individual. The report will therefore discuss about one of
the mental health issues, i.e. eating disorder with the help of application of case study. The
rationale behind choosing the eating disorder, as the topic in mental health illness, is that it is
widespread and prevalent in almost at every stage of the life of an individual. The case study
of anorexia nervosa has been taken in this report, as it has been found as most common eating
disorder amongst young people. Thus, the readers will gain an understanding of the various
aspects of eating disorder through certain case studies.
Part 1: The Case Study (Anorexia nervosa)
Description of the situation along with background
The case study is based upon the fictional people and situations, and the person
‘Rose’ has been represented in the case. This is used for this case study to ensure the
maintenance of privacy and protection of the patient’s personal information in accordance
with the Privacy Act. The patient is 19 years old who is currently suffering from Anorexia
nervosa. She was very healthy as a child and possessed very normal bodyweight with respect
to her age. When she grew up and became a teenager, she started to get fascinated by the idea
of attaining a thin model like physical figure and continuously criticised all the natural flaws
that she possessed. When she grew up to be 17 years old she began to put on a scarce amount
of fat around her belly tummy but still was significantly healthy and had an appropriate body

Case Study and Analysis (Eating Disorder) 3
weight as well as BMI. Because of the extreme wanting to achieve a thin perfect appearance
she reduced her food intake drastically. At the beginning her parents did not consider the
condition of the situation to be very critical and thought that she will get over this obsession
with time and the fluctuating and sensitive emotions evident to happen to the girls of her age
are the reason behind this scenario. However, eventually the situations began to get worse
and she became extremely weak physically. Her body weight drastically declined in the
following year that made her seem like she was devoid of any fat in her body. Other
symptoms started to come into being which consists of insomnia, anxiety, and becoming
conscious for own looks, and checking self in the mirror, avoid food intake, weighing herself
every now and then etc. Even after she started to suffer from malnutrition and became under-
weight she constantly complained about looking fat and that was a point of awakening for her
parents and made them realise how serious critical her condition has become. She was
immediately taken to the hospital after she felt unconscious on the floor as a result of not
consuming any food or water for 5 days. This event took place 6 months ago.
After this incident intra-vinous injections and oral medicines were given to her in the
form of direct nutrition in order to avoid any further worsening of her current condition. She
was constantly given high dosage of medicines, and motivates for adopting healthy eating
habits through a proper diet. The medications led to a negative impact on her body an due to
which the natural food and diet has become more significant to attain recovery in her health
condition. Despite all these aspects, she constantly refused to eat food even after advised by
her parents and health professionals.
Within 2 months of regular treatment the recovery was not significant and beneficial.
After which I was assigned with the responsibility to take care of her and do my best to help
with her recovery. I laid out plan to follow to make sure that I have a solid and determined set

Case Study and Analysis (Eating Disorder) 4
of guidelines, which will act as guidance for me to be able to take care of my patient and
make sure she recovers fast and efficiently (Müller, 2016).
The guidelines were as follows:
 Informing her about her sickness and enabling her understand the importance of
ensuring and leading recovery of her health condition and the ways she must take care
of herself.
 To put a check on her physical health condition, on a regular basis every morning, and
then organising and managing the regular visits at clinic in order to ensure about her
health condition, also to avoid any risks that arise.
 To assist her in performing her day-to-day activities such as using the washroom,
eating, bathing, cleaning and others activities.
 Undertaking the responsibility of providing her regular medications and ensuring that
they are given in the correct manner and dosage as per the prescription of the doctors.
 To make her learn about the intake of food in her diet and educating her regarding the
intake of nutritious food and the role it plays in ensuring effective health.
 To provide a plan or a diet-chart inclusive of all the necessary food items or vitamins,
minerals, which will lead to building a physical health and ensure wellbeing? It also
includes feeding her 6 times each day and motivating her to eat sufficient amount of
the food required by her body. This can be done effectively by taking the support or
help from dieticians.
 It has been analysed from the discussion that her disease is related to her psychological
wellbeing, as I developed a healthy and friendly relation with her, and encouraged her
to love herself so that it would lead her towards self-improvement. In addition, it will
also encourage her to become committed towards adopting healthy eating habits and
embrace her weakness or flaws as they make her unique from others.

Case Study and Analysis (Eating Disorder) 5
 Ensuring best suggestions and care towards leading her mental wellness through
conducting visits to the psychologists, and promoting happiness and peace through
creating a healthy and friendly environment.
 To develop a sense of positive feeling towards the fact that healthy body and healthy
mind leads to beauty and the flaws or shortcomings of an individual are what which
makes the person unique and important.
 Involvement into efficacious activities and events like socialising and connecting with
people, watching movies or TV series, and adopting the habits of reading books etc.
 To indulge her into the daily walks or recreational activities in morning so that she can
attain her physical and mental fitness through exercising.
 Making her parents aware and informed regarding the improvements or pace of
recovery in health condition, and also guiding them about their efficient role in the
whole process.
 Keeping a regular check through use of checklist and records maintenance system for
effective monitoring or measurement of her recovery.
Therefore, I followed all these guidelines and principle and witnessed the recovery process.
Moreover, a gain in the body weight of Rose was observed within 6 months and recovered
significantly.
The plan led to some of the positive outcomes which are listed below:
The eating patterns of the patient also became uniform and better and now she has been not
dreading towards the idea of consuming food.
 It has been also observed that there was a control on her hunger level which
encouraged her to eat healthy food.

Case Study and Analysis (Eating Disorder) 6
 Furthermore, she became highly aware about the health condition and took
determination to consume nutritious food and do regular exercise to attain health and
fitness.
 Moreover, it was more surprising to the doctors to learn or witness the improvement
in her health and then, soon her medication was reduced.
 To develop a personal relationship with her which helped me to better understand her
case and take care of her in way that resulted in fast and effective recovery.
 Afterwards, she undergone a change and became positive towards herself, and life and
also learned to accept her body, and all other flaws.
 In the process of helping her, she was motivated enough to communicate about her
thoughts and feelings with me, which helped me to take care of her in order to provide
cure to her health issues.
 The development of the close or healthy bond also led to an encouragement leading
her to become positive or encouraged to take actions and listen to the health care
services for working towards the effective or better health outcomes.
People involved
People who were included in the process of the intervention were as follows:
 Parents
 Relatives
 Doctors
 Psychologist
 Nurse (me)
 Friends
 Dietician

Case Study and Analysis (Eating Disorder) 7
Part 2: The Case Study Analysis
What occurred and why?
My patient Rose was experiencing the issue of Anorexia nervosa which refers to an
eating disorder that result in the low body weight at extreme levels along-with the excessive
fear of weight gain (Treasure & Alexander, 2013). Patients of this disease put a lot of work in
order to control and lessen their body weight and shape, they make use of dangerous methods
that are life threatening. The case study mentions about the patient who is a teenager as like
many other girls who belong to similar age became fascinated towards the skinny perfect
appearance (Stice, Rohde, Gau, & Shaw, 2009). She was afraid of gaining any weight and
continuously criticised her flaws because of this she began to make her diet confined to an
extent which put risks to the life, causing extreme amount of weakness, weight-loss, as well
as malnutrition. Under this case, I was appointed as her nurse with the aim to assist her
recover and assisting her with regular nutrient rich diet, proper medication, and mental
support and I was capable and successful in doing so fast and effectively.
Problems
 One of the issues was that she refused sharing her emotions and feelings with anyone.
This further made the whole process of treatment quite complex.
 The medications were given to the patient, in order to ensure that it would prevent
risks but, because of her physic and under-nourished body, the medications were
highly prone leading to the negative effects on the health.
 Feeding her was not easy as she is a grown up and caretakers were not also not able to
force her to eat (Lock, et al., 2011).

Case Study and Analysis (Eating Disorder) 8
Solutions
 To provide her psychological treatment this ensures about professional level
emotional help with the aim to motivate her to become more expressive of her
emotions.
 Planning a diet-chart which will lead to the fulfilment of the nutrition requirements of
her body.
 Educating her about the importance of eating and taking a healthy diet.
Implementation of Solutions
 Fixing up a visit to the psychologist for the purpose of emotional counselling
 To take help or consult a dietician for making a suitable diet chart (Ozier & Henry,
2011)
 A talk session can be undertaken through the way of taking a lesson which represents
the aspect of importance of eating.
What I must do as a nurse
 Being with Rose during her visits to the psychologist for encouraging her towards
speaking about her thoughts, and ideas in her mind and also giving information
related to her mental being to the psychologist about all other relevant facts.
 Informing the dietician about the preference of Rose in eating and all the other aspects
or issues of her physical health condition, to help follow a effective diet-chart and
then actively feeding Rose.
 To note down the essential points about the relevance and importance of eating and
also highlights the harmful effects of reduced calories or avoiding food. This is
required to stating to the patient in a manner that it motivates her to take proper diet.

Case Study and Analysis (Eating Disorder) 9
Communication and therapeutic nurse-client relationship
Nurses must make use of many types of communication strategies along with
interpersonal skills in order to appropriately maintain, develop, re-establish and terminate the
relationship between the nurse and the client (Mathias & Pullen, 2010). The bond motivates
the patients to become effectively able to share their thoughts and feelings, which is
important for the nurses to become aware of. It is due to the reason that they need to establish
suitable criteria for providing care and treatment for the particular patient (Ontario, 2019).
For this purpose, in this discussion, it was necessary to develop healthy relation with Rose
in order to promote her to love herself, body and also ensure healthy eating (Schmidt et al.,
2015).
Principles of legality and ethics related to mental health
Ethical Principles
 Autonomy: giving respect to the other’s right to take their own decisions ( NGUI,
KHASAKHALA, NDETEI, & ROBERTS, 2010)
 Beneficence: benefit others
 Veracity: communicate truthfully (Sriram, 2006)
 Justice: Ensuring equal distribution of resources
 Fidelity: commitment and being loyal towards patients
Legal Principals
 Patients’ rights- A patient’s Right to treatment, and refusing the treatment and it must
oblige to the right of informed consent (WHO, 2019).
 Privacy of the patient should be maintained.
 Voluntary involuntary, emergency or temporary Admission to the Hospital.
 The rights must be obeyed in relation to the admission.

Case Study and Analysis (Eating Disorder) 10
 Civil rights and Due Process
Cultural competency related to mental health nursing
It has been found that nurses in healthcare are obliged to treat every patient in an
equal manner without taking into consideration their cultural background and ensure effective
care and support to them in order to make sure that efficient and fast recovery is achieved
( Monteiro & Fernandes, 2016). During the time of providing treatment to the patient the only
factor that must be considered is the extent of their sickness for formulating treatment plans
for them to make sure it is effective or appropriate and lead to benefits ( Nardi, Waite, &
Killian, 2012).
Principles and health promotion towards enhancing the mental health and wellbeing of
client and family
A nurse is considered to perform the responsibility of educating and informing the
patient and their family properly as about their sickness in depth to make sure that they all are
well informed and aware of the patient’s health situation and condition to provide them
adequate knowledge of treatment that will be carried on. This will help them to stick to their
responsibilities in the process of the treatment to ensure fast and efficient recovery. The
patients family at times becomes disheartened and sad when they see the person that they
love so much in a terrible health state, as a nurse I must provide them emotional support and
encourage them to stay strong.
The process of Nursing and nursing Metaparadigm
Nursing metaparadigms comprises of:

Case Study and Analysis (Eating Disorder) 11
 Environment: the factor of environment includes both internal and external, as they
are equally associated with the patient. This may include the interaction of the patient
with visitors or support members (Thompson, 2019).
 Person: It refers to the patient who is provided with the health care services, and
includes the components, like the culture, spirituality, friends, family, and the socio-
economic status (BRANCH, DEAK, HINER, & HOLZWART , 2019).
 Nursing: It states about the role of nurses, and their capability to his/her ability to
utilise their skills and knowledge representing their attributes (Francis, 2017).
 Health: The aspect of health depicts about the wellness and quality of patient’s health
condition, and also states about the admission of the client/patient to the hospital or
healthcare ( Nikfarid, Hekmat, Vedad, & Rajabi, 2018).
It is essential for every nurse to oblige to all the metaparadigms in their process of nursing
during the process of care and treatment they provide to the patient (Dupree, 2019).
Conclusion
To conclude the above discussion it has been analysed that the mental health illness is
one of the serious health issue at different stages of life. The report has described well about
the issue of eating disorders, impacts, relevance, and importance of communication and other
aspects. Eating disorder has been illustrated well with the case study, i.e. in context to the
anorexia nervosa. The findings of the case about the patient has led to the positive impacts or
implications on her health, and represented improvement in her health condition, and
maintenance of weight. Hence, the overall discussion and study of the eating disorders has
been described in the report leading to the health promotion and wellbeing of the patient in
the case.

Case Study and Analysis (Eating Disorder) 12
References
Monteiro, A. P., & Fernandes, A. B. (2016). Cultural competence in mental health nursing:
validity and internal consistency of the Portuguese version of the multicultural mental
health awareness scale—MMHAS. BMC Psychiatry, 16(149).
Nardi, D., Waite, R., & Killian, P. (2012). Journal of Psychosocial Nursing and Mental
Health Services. Establishing Standards for Culturally Competent Mental Health
Care, 50(7), 3-5.
NGUI, E. M., KHASAKHALA, L., NDETEI, D., & ROBERTS, L. W. (2010). Mental
disorders, health inequalities and ethics: A global perspective. Int Rev Psychiatry,
22(3), 235–244.
Nikfarid, L., Hekmat, N., Vedad, A., & Rajabi, A. (2018). The main nursing metaparadigm
concepts in human caring theory and Persian mysticism: a comparative study. Journal
of Medical ethics and History of medicine, 11(6).
BRANCH, C., DEAK, H., HINER, C., & HOLZWART , T. (2019). Four Nursing
Metaparadigms . Nursing, 124- 131.
Dupree, D. (2019). Four Basic Metaparadigm Concepts in Nursing. Retrieved February 1,
2018, from Career Trend: https://careertrend.com/13373959/four-basic-
metaparadigm-concepts-in-nursing
Francis, I. (2017). Nursing Informatics and the Metaparadigms of Nursing. Online Journal of
Nursing Informatics, 21(1).
Lock, J., Brandt , H., Woodside, B., Agras, S., Halmi , W. K., Johnson, C., et al. (2011).
Challenges in conducting a multi‐site randomized clinical trial comparing treatments
for adolescent anorexia nervosa. International Journal of Eating Disorder, 45(2),
202-213.
Mathias, T., & Pullen, R. L. (2010). Fostering therapeutic nurse-patient relationships.
Nursing Made Incredibly Easy!, 8(3), 4.

Case Study and Analysis (Eating Disorder) 13
Ontario, C. o. (2019). Therapeutic Nurse-Client Relationship, Revised 2006. Retrieved
February 1, 2019, from Practice Standard:
http://www.cno.org/globalassets/docs/prac/41033_therapeutic.pdf
Ozier, A. D., & Henry, B. W. (2011). Position of the American Dietetic Association:
Nutrition Intervention in the Treatment of Eating Disorders. Journal of the American
Dietetic Association, 111(8), 1236-1241.
Sriram, T. G. (2006). Ethical and Legal Issues for Mental Health Professionals: A
Comprehensive Handbook of Principles and Standards. Journal of the American
Academy of Psychiatry and the Law, 34(4), 566.
Stice, E., Rohde, P., Gau, J., & Shaw, H. (2009). An effectiveness trial of a dissonance-based
eating disorder prevention program for high-risk adolescent girls. Journal of
Consulting and Clinical Psychology, 77(5), 825-834.
Thompson, C. J. (2019). What is the Nursing Metaparadigm? Retrieved February 1, 2019,
from Nursing Education Expert: https://nursingeducationexpert.com/metaparadigm/
Treasure, J., & Alexander, J. (2013). Anorexia Nervosa A Recovery Guide for Sufferers,
Families and Friends. London: Routledge.
WHO. (2019). MENTAL HEALTH CARE LAW: TEN BASIC. Retrieved February 1, 2019,
from WHO: https://www.who.int/mental_health/media/en/75.pdf
Müller, H. L. (2016). Craniopharyngioma and hypothalamic injury: latest insights into
consequent eating disorders and obesity. Current opinion in endocrinology, diabetes,
and obesity, 23(1), 81.
Schmidt, U., Magill, N., Renwick, B., Keyes, A., Kenyon, M., Dejong, H. & Watson, C.
(2015). The Maudsley Outpatient Study of Treatments for Anorexia Nervosa and
Related Conditions (MOSAIC): Comparison of the Maudsley Model of Anorexia
Nervosa Treatment for Adults (MANTRA) with specialist supportive clinical

Case Study and Analysis (Eating Disorder) 14
management (SSCM) in outpatients with broadly defined anorexia nervosa: A
randomized controlled trial. Journal of consulting and clinical psychology, 83(4), 796.