Nurses and the ‘therapeutic relationship’: caring for adolescents with anorexia nervosa

Ramjan, Lucie M.

doi:10.1046/j.1365-2648.2003.02932.x

Cited by 89 publications

(145 citation statements)

References 29 publications

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“…Des entrevues menées auprès de 10 infirmières ayant au moins deux ans d'expérience de travail avec des adolescentes souffrant d'AM ont permis de constater que ces infirmières ressentaient de la frustration et étaient pessimistes par rapport à la rémission 13 . Elles avaient l'impression d'échouer car elles ne croyaient pas être en contrôle du processus de guérison.…”

Section: Fleming Et Szmuklerunclassified

“…De plus, le fait que plusieurs thérapeutes voient les TA comme étant « auto-induits » et « non nécessaires » est un autre facteur qui peut soulever de telles émotions. Ces perceptions seraient particulièrement saillantes lorsque les patients sont hospitalisés dans une unité non psychiatrique, aux côtés de patients ayant des maladies qui ne sont pas « volontaires » 5,12,13,19,32 . À l'extrême, ces sentiments peuvent mener à l'utilisation de formes punitives de traitement, tel que le tube naso-gastrique et l'isolement 20,21,28,45 .…”

Section: Fleming Et Szmuklerunclassified

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Le contre-transfert dans le traitement des troubles alimentaires: Recension systématique des écrits

2011

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Objectif : Identifier les manifestations du contre-transfert et leurs causes chez les thérapeutes qui traitent des patients souffrant de troubles alimentaires, et faire état des solutions qui ont été proposées pour surmonter les aspects négatifs du contre-transfert dans le but d'améliorer la qualité du traitement.Méthode : À l'aide des principales banques de données en sciences de la santé et psychologie, nous avons repéré les études traitant du contre-transfert dans le traitement des troubles alimentaires.Résultats : Une diversité de manifestations du contre-transfert sont recensées. Il appert notamment que les thérapeutes ressentent souvent des affects négatifs au cours du traitement des patients souffrant de troubles alimentaires. Le contre-transfert semble influencé par des facteurs en lien tant avec la maladie qu'avec le patient et le thérapeute. De plus, un contre-transfert négatif peut entraîner des conséquences qui entravent le bon déroulement du traitement. Les principales solutions recensées pour y faire face sont la supervision, la consultation auprès de collègues et le travail en équipe. Implications cliniques• Le travail auprès des patients souffrant de troubles alimentaires engendre souvent un contre-transfert négatif.• Les thérapeutes doivent être vigilants face au fait qu'un contre-transfert négatif peut entraîner des conséquences néfastes pour le traitement.• La supervision, la consultation auprès de collègues et le travail en équipe permettraient de mieux gérer les manifestations négatives du contre-transfert. Limites• Les textes recensés portent quasi exclusivement sur les manifestations négatives du contre-transfert; les manifestations positives possibles n'ont donc pu être discutées.• Les textes recensés ne tiennent pas compte de la présence possible de troubles comorbides; le contre-transfert évoqué pouvait donc ne pas être spécifique aux troubles alimentaires.• Le petit nombre d'études empiriques sur la question ne permet pas de conclusions fermes sur les questions traitées; en particulier aucune étude empirique n'a évalué l'efficacité des solutions proposées pour faire face au contre-transfert négatif.

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Section: Fleming Et Szmuklerunclassified

Le contre-transfert dans le traitement des troubles alimentaires: Recension systématique des écrits

2011

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“…This is further evidence that our ability to recover from a disease or medical condition can be influenced by the data flow from our environment e.g. (i) whether the attitude of the carer projects a positive or negative message to their patient, (ii) if the doctor gives a positive or negative message to the patient [165], (iii) if the nurse(s) have a caring demeanour [166][167][168][169][170][171], and (iv) if the environment in which the patient is being treated is able to stimulate their recovery [172][173][174][175][176][177][178][179][180][181][182] e.g. by light/colour, sound/noise, nutrition, smell, etc.…”

Section: Does One Person's Health Influence the Health And Function Omentioning

confidence: 99%

The Framework of a Mathematical Model of the Autonomic Nervous System and Physiological Systems: Using the Neuroregulation of Blood Glucose as an Example

Ewing¹

2015

J Comput Sci Syst Biol

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IntroductionOur sense perception enables us to eat the correct amounts of food and, under normal circumstances, we cease eating when we have eaten sufficient food, and we drink sufficient to sati sfy the body 's need for liquid. We breathe at the normal expected rate, our heart pumps at the expected rate and maintain the normal level of blood pressure, our body maintains the normal levels of acidity and temperature, we sleep for 7-8 hours per night, etc. This suggests that the body is being regulated by a biological control mechanism of enormous sophistication and complexity, which has an enormous processing capacity; however as we age, and particularly as we age beyond 50 years, the mechanism which maintains our function become increasingly less able to sustain the levels of oxygen, blood glucose, blood cell content and a myriad of other biological components which the brain requires to function [1]. The i nnate g enetic c apacity o f key o rgans d eclines a nd r esults in shortages of proteins, hormones, etc. This h as a k nock-on e ffect affecting one biological sequence after another.The cumulative effect of our lifetime of experiences, due to environmental and biological factors, influences the function and/ or stability of the autonomic nervous system and ultimately the function of our DNA and genes [2]. The level of genetic expression of the proteins (genotype) which we require to sustain our function declines and the rate at which these expressed proteins subsequently react (phenotype) also declines i.e. the ability of the body to cope with extreme events declines.There are two fundamentally significant biological issues at play: (i) the genetic ability to express proteins (ii) the body's physiological demand i.e. the phenotype or influence of the environment. In the case of diabetes, in particular type 2 diabetes, this is the regulation of Blood Glucose. The greater the level of hyperglycaemia the greater is the associated demand for insulin. The development of a medical condition occurs when the environmental demand exceeds the body's innate capacity [3] i.e. the prevailing supply and/or level of insulin is insufficient to metabolise the excess of blood glucose. By contrast, the lower the level of hypoglycaemia, which occurs in type 1 diabetes, the lower is the demand/need for insulin. If there is insufficient blood glucose the excess of highly reactive insulin will seek an alternative substrate and ultimately results in damage to the peripheral blood vessels e.g. in particular to the brain, eyes, legs and feet.The evidence suggests that this regulatory process is performed by the brain via the process of neuroregulation [4][5][6]. This is a best-fit process which takes into account the prevailing state of development or physiological damage to a part of the brain, degeneration or damage to an organ (or limb), and the prevailing inter-cellular environment i.e. the feedback of biochemical signals from the viscera. AbstractDespite the immense advances of medical research there remains a fundamental theo...

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“…However, it has been found that some nurses feel that the patients have caused the illness and should therefore be able to deal with it themselves (Ramjan, 2004). King and Turner (2000) reported that nurses are suspicious of and find it difficult to understand patients exhibiting anorectic behavior.…”

Section: Introductionmentioning

confidence: 99%

“…Colton and Pistrang (2004) found that normalization, structure, and responsibility are aspects contributing to recovery. Aspects shown to have a negative influence on recovery are competing and comparing oneself with others in terms of slimness and learning new destructive behaviors from others (Ramjan, 2004).…”

Section: Introductionmentioning

confidence: 99%

Young Women With Anorexia Nervosa

et al. 2015

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The aim of this study was to describe how young women living with self-identified anorexia narrate about their lives by blogging. Thirteen Swedish blogs were chosen and analyzed by means of qualitative content analysis. The results described falling ill, the illness itself, and the path to recovery. Low self-esteem, depressed state of mind, and self-destructive behavior were typical signs at the start of the illness. The women's lives were characterized by a need for controlling their body by tormenting it and by the illness demanding all their concentration and energy. The women suffered from the feeling of being a disappointment to their family members. The illness was like an enemy that had to be defeated with the help of family members, health care professionals, and by means of therapy. A turning point occurred when the women felt at their worst or had tired of the illness and could concentrate on something other than their body and the eating disorder. Suffering from self-identified anorexia was described as experiencing low self-esteem. The illness took all of the women's time and energy. For a turning point to be reached, the women needed support from family, friends, and health care professionals, including the use of distractions.

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Nurses and the ‘therapeutic relationship’: caring for adolescents with anorexia nervosa

Abstract: Recommendations are made for improving the nursing component of hospital treatment programmes for adolescents with anorexia nervosa in the direction of more genuinely therapeutic relationships.

Cited by 89 publications

References 29 publications

Le contre-transfert dans le traitement des troubles alimentaires: Recension systématique des écrits

Le contre-transfert dans le traitement des troubles alimentaires: Recension systématique des écrits

The Framework of a Mathematical Model of the Autonomic Nervous System and Physiological Systems: Using the Neuroregulation of Blood Glucose as an Example

Young Women With Anorexia Nervosa

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