Health Needs Assessment on Anorexia Nervosa in the United Kingdom - Dissertation Example

?HEALTH AND SCIENCES TOPIC: HEALTH NEEDS ASSESSMENT ON ANOREXIA NERVOSA IN UNITED KINGDOM I. BACKGROUND Eating disorder is a serious psychological problem that can result to severe physical setback. It consist of anorexia nervosa, bulimia, and binge – eating that co – exist frequently with psychiatric conditions such as depression, substance abuse, obsessive – compulsive disorder, and anxiety disorder (National Institute of Mental Health, 2011). According to the National Institute of Mental Health (2011) and Edwards (2011), eating disorders initially start with consumption of small or large quantity of food that spirals out of control. Later on, this practice will turn out to be a cycle of obsession; however, majority of patients recovers fully with proper help and management. I.1 What is Anorexia Nervosa? Anorexia, a Greek word which means “loss of appetite,” is termed as anorexia nervosa, and is translated further as “loss of appetite due to anxiety” (NHS, 2010). It is the most popular eating disorder for several decades now, and is defined by the National Institute for Clinical Excellence (2004) and Edwards (2011) as a serious illness in which people turn out to be anxious of their weight because of the fear of becoming fat. In effect, they are motivated to go on extreme diet and exercise to the point of inducing vomiting after eating and making use of dietary pills and laxatives to reduce their weight. Kaplan and Sadock’s (1994) characterised anorexia nervosa as a profound body image disturbance as a result of persistent pursuit of being slender to the point of starving oneself. Arcelus, et al., (2011) in their study revealed that among other eating disorders, anorexia nervosa is the most fatal and is associated with highest rate of mortality and suicide risk. I.2 Statistics of Anorexia Nervosa Morris (2007) reported that anorexia nervosa is the third most common chronic diseases among women in their teenage years affecting 3% of affluent women in developed countries. According to NICE (2004), the incidence of anorexia nervosa among women in UK is around 19 per 100,000 population per year with the highest rates of 51 per 100,000 cases reported among teenage female ages between 13 and 19. On the other hand, only 2 cases per 100,000 of anorexia nervosa in males are reported annually (NICE, 2004). Among them, 40% completely recovers, 30% continue to suffer the long term illness and its physical effects, and around 5% of cases will turn out to be fatal (Kirby, 2011). According to the Priory Group, the Eating Disorders Association in UK reported that more than 1.6 of population in the UK is estimated to have suffered from diagnosed or undiagnosed eating disorders. A report from NHS hospitals, England for diagnosed and admitted cases of anorexia from year 1996 to 2006 revealed that in 1996 to 1997, there are 419 reported cases on anorexia with the latest report in 2005 to 2006 where new reported cases jumped to 620 (Kirby, 2011). I.3 Health Need Assessment, Purpose, and Implementation From the aforementioned statistics, 50% increment of newly diagnosed cases of anorexia nervosa in just a span of 8 years is noted. For this reason, it is apparent that health needs assessment is imperative so that the required information concerning anorexia nervosa will be collected to provide beneficial changes to the health of these patients. The subjects will be the patients in England who are identified to have suffered from anorexia nervosa as well as the unreported population believed to have suffered from anorexia nervosa. The purpose for Health Need Assessment (HNA) in anorexia nervosa is to promote emotional, mental, social, and physical development of individuals suffering from this particular eating disorder with the help of the Medical Health Officers and community officers who are trained to help, facilitate, and offer their support to patients (NICE, 2004). The objective of this study is to obtain health needs assessment and to identify the health needs of young women in the UK in order to ensure appropriate professional help and services. HNA incorporates the local population and patients’ needs and priorities and provide a clear goal towards meeting the needs of the patients (Heffernan, undated). II. RESOURCES To undertake the health needs assessment of anorexia nervosa, the following resources will be needed: (a) General practitioners, (2) Hospital doctors, (3) Nurses and allied medicine, (4) Public health doctors, (5) Commissioning managers, (6) Voluntary organisations, (7) General public, and (8) Patients. Volunteer workforce willing to give their extra hours to those who are suffering from anorexia nervosa will be requested from the health care system in England. A space for consultation, to educate patients, and gather collected data will be requested from the local community. Health Centres can be used as an alternative space for the study. Health centres can also be used to access data on anorexia nervosa and the population as well (NICE, 2004). Funding for this project will be requested from the Government Health Agencies. III. ANTICIPATED PROBLEM Possible risks factor include uncooperative patients who refuse to recognise they are suffering from anorexia nervosa given that some patients still find it difficult to acknowledge they are encountering this problem (NICE, 2004). To stay away from this dilemma, patients must be educated about anorexia nervosa and the complications that would take place with undiagnosed and untreated cases. IV. METHODOLOGY 1. Identification of Population with Anorexia Nervosa in the UK About 1% of women in the UK ages 15 to 30 years old who were diagnosed with anorexia nervosa will be subjects for these study (Mental Health Foundation, 2000 and NICE, 2004). The incidence of anorexia nervosa among women is around 19 per 100,000 population and only 2 cases per 100,000 are reported annually in males (NICE, 2004). 2. Identification of Main Health Concern The symptoms of anorexia nervosa are much deeper and complicated than just food and weight – related issues (Smith, 2011). It basically affects the whole body and its function. Therefore, the totality of the patients will be assessed. 3. Identification of Health Priorities Symptoms of depression, loneliness, insecurity, pressure, and feeling out of control linked with the risk of committing suicide and death must be identified and addressed properly. Social, emotional, and biological factors that contribute to the complexity of anorexia nervosa must be acknowledged and deal with appropriately (Smith, 2011). 4. Assessment of Health Priorities for Proper Implementation Doctors must set guidelines to make sure that the best treatment can be made available to the patient. Yearly physical review of mental health must be offered by the general practitioners. V. IMPLEMENTATION AND IMPROVEMENT IN HEALTH 1. Increase Population Awareness Maheswaran (2010) noted that most individuals with eating disorders are reluctant to admit they are suffering from this problem and are hesitant to ask for treatment. To address this problem, attempt from the General Practitioners in identifying the problem and community workers to increase public understanding on anorexia nervosa is anticipated. The public must be aware that services are available in the locality to help them resolve this dilemma (Maheswaran, 2010). 2. Early Identification and Intervention Mild cases of anorexia nervosa must be identified and managed correctly by the proper health care authorities so that patients will not suffer from its long term serious effects. Management must focus on the dietary and food intake of the patient. This is primarily made possible by the collaborative effort of the doctors, nurses, and community workers within the primary care settings. Alternatively, patients with severe anorexia nervosa must be promptly referred to physicians who specialises in this area so that full medical and psychiatric assessment can be provided. 3. Quality Provision of Health Care Services Initial assessment of the patient by the General Practitioners in coordination with the public health nurses and community health workers must be made once the patient is diagnosed with anorexia nervosa. Target populations for the screening are women ages 15 – 30 years old who have low body mass index (BMI) and patients who comes in for consultation with complaints in their weight (NICE, 2005). Patients who do not improve with outpatient treatment are referred for inpatient management so that treatment can be closely monitored. Relatives are also advised to get involved in the inpatient care. The general community must be informed on the services offered in their locality to develop them to have a health seeking behaviour. Furthermore, level of awareness among General Practitioners and nurses on anorexia nervosa and its associated symptoms must be increased to facilitate early screening and intervention so that the effect and complications of anorexia nervosa will be minimised. Links to physicians who specialises on anorexia nervosa services must be made available in the locality so that support can be provided even to the milder forms of eating disorder. Hence, the risk of relapse after being discharged from their specialist is decreased. 4. Role of Community Health Community based health care staff specialising on early detection and management of anorexia nervosa must be offered to provide better quality service access in the community and patients. Patients who are at risk of acquiring this disorder can be easily identified so that mortality and morbidity secondary to anorexia nervosa will be reduced. Moreover, series of group activities and meetings with other patients suffering from the same condition can help the patient deal with anorexia nervosa (NICE, 2004). VI. CONCLUSION Health needs assessment is necessary for prompt identification and treatment of anorexia nervosa in the United Kingdom. Through health needs assessment, the unmet health and health care needs of the population is identified and necessary changes are made to cater the patient unmet needs (Heffernan, undated). VII. 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