Mental Health Nursing: Eating Disorder Case Study

This case study explores the biopsychosocial factors influencing the development of eating disorder and depression in Charlie. It discusses nursing management interventions and ethical considerations for patients with eating disorders.

Running head: MENTAL HEALTH NURSING
MENTAL HEALTH NURSING (EATING DISORDER)
Name of the student
Name of the University
Author note

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Introduction
In recent world, being in a good shape and physically attractive determines the holistic
fitness level to attain which millions of younger individuals are suffering from several disorders
or illness, which is known as eating disorder (Colton et al., 2013). This is characterized by
persisting irregular diet, unscientific eating habits and concerning stress and distress due to such
strange lifestyle habits. As per Brooks et al. (2012) eating disorder can be the reason of excess
and irregular inadequate eating habit which can affect the wellbeing of individuals affected with
it. Ferguson et al. (2014) determines that eating disorders are of three types such as Anorexia
Nervosa, Binge Eating Disorder and the Bulimia Nervosa, of which the ability to harm ranges
for both males and females. Lock and Le Grange (2015) also mentions that such disorder
emerges during the teenage of life and it requires appropriate nursing interventions. As per the
data of World Health Organization present in the research of Stice, Marti & Rohde, (2013), more
than 30% of people around the world are currently suffering from such disorder. In this case
study discussion, the case of Charlie (19) and her eating disorder related condition will be
discussed and her concerns such as eating disorder, stress, depression, low self-esteem and the
pressure of responsibilities will be discussed. As a daughter of successful parents and her ever so
high self-esteemed in studies., she feels stressed as well as she also thinks that her weight makes
her unattractive. Hence she isolated herself from her flat mates and spends hours at washroom
after eating minimal food and laxatives, resulted in loss of 10kgsin last three months. Hence, the
primary goal of this assignment is to provide the details about biopsychosocial factors
influencing the development of eating disorder, and depression and it will be discussed with
appropriate use of nursing management and interventions. Finally, the ethical inferencerequired
for the patient condition will also be discussed in this assignment.

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Analysis- biopsychosocial
As the ‘world mentality’ is shifting sharply from ‘being alright with the body to being fit
is the only motif of the body’, scientists and healthcare physicians are unable to detect the
primary reason for emergence of eating disorder throughout the world. However, Dakanalis et al.
(2015) mentions that eating disorder can properly be described by the relation between two
factors psychosomatic and psychiatric and due to this a relationship between body mind and
brain created which creates all the confusion in the brain of the patient regarding the weight and
appearance compared to others. Hence the biopsychosocial factor should be used to understand
the effect of the condition on patient, determine the best intervention regardless of it being
biological social or psychological and manage the condition. in the case study, Charlie’s friend
Jo mentioned that from last four months, Charlie has separated herself from her friends and do
not go out to have dinner with them (Udo et al., 2013). It was also mentioned that she thinks she
is too much overweight and need to lose much more weight so that she can become attractive
and smart. This event determined her mental stress, hopelessness and less confidence and self-
esteem that make her feel inferior to others. Further, in the case study, it was also mentioned that
she has lots of pressure for studies and performed really well in her educational career. However
she now feels that she need to become much more focused and successful like her parents
(Rodgers, Paxton & McLean, 2014). This also determines the pressure which she feels on her
shoulder prior to make any action. This is one of the primary reason for her depression and
eating disorder related condition as Winkler et al. (2014) has mentioned that people who suffer
from mental stress or pressure generally end up losing their appetite level and hence, they need
to take support of laxatives and other components. It was evident from the case study as Charlie

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used to eat less food and after that smaller amount of food she used to go to the washroom and
spend hours as well as used to take laxatives daily (Udo et al., 2013).
Besides this, the bio-psychosocial context of disease should be inclusive of the social
effect as society has a major impact on the human activities. Specifically, in teen age, it is
evident from the research by Gearhardt et al. (2012) that teenagers are much more prone to social
and communicable comments and due to this they develop negative thinking and perceptions
about their action and develop suicidal ideations. In his case of Charlie, she had several negative
thoughts about herself in her mind, she felt she is worthless as she was not smart like her brother,
she was unable to make her parents proud or she was not at all attractive so that society can
praise her smartness and beauty (Sarafino & Smith, 2014). These above mentioned events and
thinking made her negative perception in her own mind and she lost all her confidence and self-
esteem which is important to live a determined life. Further, she eventually developed her
depression level due to which as per Winkler et al. (2014), she lost her appetite and was forced to
take laxatives for her heath conditions. Further, her biological analysis should involve the after
effects of her eating disorder due to which she lost her 10 kg of weight in last 4 months, her
menstrual cycle was badly affected and she started developing pale skin and dry brittle hair. This
analysis was important as due to such appearance she started believing on her thinking and her
physical appearance made her confident that she is not appropriate and worthless to her smart
and successful family due to such health condition (Stice, Marti & Rohde, 2013).
Analysis- nursing management
Role of nursing interventions and nursing professionals are primary in the care process of
patients affected with eating disorder and associated health conditions as this disorder affects the
human health in every aspect of physical and mental health (Klainin-Yobas, Cho & Creedy,

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2012). As Charlie was admitted to the healthcare facility in Brisbane and is unwilling to discuss
about her eating disorder related condition, a properly managed and controlled nursing
intervention should be applied on the care process for Charlie (Keltner, 2013). The primary thing
the nurses should apply on Charlie is creating a therapeutic relationship with him so that with the
emerging warmth, care, acceptance, positive regards and trust, Charlie’s trust on the healthcare
system can be enhanced. These will be included in the care process for Charlie as using this, a
therapeutic relationship can be created in the care process which will help Charlie to open up and
discuss her negative thoughts and grieves (Godsey, 2013). Further, including such therapeutic
relationship in care is necessary as Charlie thinks that she is not accepted by the society due to
her overweight or appearance (Vancampfort et al., 2013). The nurses are also the part of society,
and hence with their help the negative thoughts affecting the health of Charlie could be improved
so that with their support and communication, the confidence can be reinforced in Charlie’s
personality (MacNeil et al., 2012). Further, a properly managed intervention plan should be
implemented in the care process for Charlie which should include all the nursing diagnoses such
as body image, decreased cardiac output, constipation, coping with family issues and
ineffectively, deficit of fluid volume, nutritional imbalance, self-esteemed and confidence issue,
suicidal ideations and associated trauma related care (Keltner, 2013). All these nursing diagnosis
will be targeted for Charlie as anxiety, depression, suicidal ideation and lower self-esteem is
harmful for her health condition. Hence, using these interventions will help to decrease the
anxiety, and stress of Charlie by applying effective communication, involving her in activities
which are constructive and can be helpful in making her negative thoughts into positive
ideations. She will be encouraged to have food by making her favorite dishes so that she can be
prepared for a normal bowel movement and her laxative intake will be removed from her daily

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routine (Bauer et al., 2012). After this, she will be provided with multivitamin tablets and
medications, which are effective in increasing her appetite. Further, to provide her with
motivation, her perception about her body image, impact on functioning, family and social
influences will be assessed. For this perspective, she will be asked to draw herself with the help
of pen paper and then her drawing will be compared with her actual body image (Klainin-Yobas,
Cho & Creedy, 2012). After this, the healthcare facility will appoint a psychologist who will
make Charlie understand her body image through her own perspective and will also provide a
clear picture of the social perspective. This will help Charlie with clearing her mind about her
body image and she will be able to neglect the social aspect regarding her physical appearance
(Godart et al., 2015).
Analysis- ethical
Role of nursing professionals and nursing interventions are very critical and important for
patients affected by eating disorder with depression and stress as if the condition is not addressed
properly, the patient might take some serious step and develop suicidal ideations (Norman &
Ryrie, 2013). Majority of the healthcare organizations throughout the world applies medications
such as antidepressants, multivitamins and anxiolytic drugs for patients affected with eating
disorder and associated depression. However, it is evident from the research conducted by
(Vaismoradi, Turunen & Bondas, 2013) that in primary health care organizations, nursing
interventions applied by nursing staff is capable of increasing the effectiveness of these drugs.
However, when it comes to the ethical application of nursing interventions, majority of the
healthcare settings believe that it is not possible for patients affected with such vulnerable
condition. As patients affected with eating disorder, suffer from depression, low self esteemed
and are unable to think positively about themselves and people around them (Townsend &

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Morgan, 2017). Healthcare facilities and professionals do not provide them with ethical rights
such as autonomy, veracity, beneficence and non-maleficence, which are the four main aspect of
ethical healthcare process. Zugai, Stein‐Parbury and Roche (2013) mentions that ethical right is
the primary thing the healthcare facility should provide to the patient and within that autonomy
or right to decide the application of intervention on them is the biggest ethical right the
healthcare facility provide to the patient. Therefore, in case of Charlie, she will be provided with
all the ethical rights and besides this, healthcare professionals will keep an eye on her actions so
that she cannot attempt self-harm or similar actions (Zugai, Stein‐Parbury & Roche, 2013). This
is a crucial step because she might become violent due to the environmental stressors, which are
opposite to her calm and composed nature, and in such state, she can attempt anything negative
to herself and to other patients as well. Further, a multidisciplinary team of healthcare
professionals will be assigned for Charlie and her eating disorder related depressive condition so
that it can monitor the applied interventions on her as well as provide her with psychological and
educational sessions so that the usefulness of the drug could be assessed (Townsend & Morgan,
2017). Further, all the nursing staff will be trained with educational session of compliance to
ethical care process while caring for such patient and a monthly evaluation of those healthcare
professionals will be carried out. Further, if the patient is unable to provide consent to healthcare
interventions, her parents will be included in the care process so that while changing
medications, healthcare interventions, application of healthcare activities and so on, patient can
be provided with ethical care (Vaismoradi, Turunen & Bondas, 2013).
Conclusion
Eating disorder is one of the most common disorders nowadays as people are much more
concerned about their health and in these; they have affected their mental and physical health. In

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this assignment, discussion about Charlie and her eating disorder has been discussed which has
made her affected with stress and depression. She also suffers s\from low self-esteemed as she
believe\s she is not smart. Further, to discuss the case of Charlie, three perspective of care was
used such as the biopsychosocial analysis, in which three aspect of diagnosis biological, genetic
aspect, social effect and the psychological analyses was carried out, after this six nursing
intervention was provided so that a holistic approach could be taken for the care of Charlie.
Finally, discussion about the ethical consideration was also taken so that the care process can
achieve ethical compliance. In this, the right of autonomy was stressed as it will help Charlie to
accept or reject the nursing interventions.

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