Broussard Brenda B
Department of Family and Child Nursing, University of Washington, Seattle, Washington 98195, USA.
J Adv Nurs. 2005 Jan;49(1):43-50. doi: 10.1111/j.1365-2648.2004.03262.x.
This paper reports a study to interpret and understand bulimia nervosa as women experience it.
Research into bulimia nervosa has focused on prevalence rates, health complications, comorbidity, neurochemical dysregulation, and cultural influences. Despite a multitude of investigations, little published research appraised bulimic women's personal experiences and understanding of this disorder. Such an understanding would assist health care professionals in providing sensitive, empathetic care.
The principles of Heideggerian phenomenology guided the study. Participants were 13 actively bulimic women, aged 18-36 years, with lengths of illness from 1 to 23 years. Data were obtained through interviews, personal diaries, and demographic questionnaires.
Participants' narratives revealed four themes that characterized the experience of living with bulimia: isolating self, living in fear, being at war with the mind, and pacifying the brain. The practices bulimic women engage in are carried out in secret, and hence participants experienced isolation. Binge eating and self-induced vomiting are considered abnormal behaviours; therefore, participants believed that they were subjected to negative public perceptions, which led to the experience of living in fear. The women feared being judged if others knew about the disorder. Several feared living without bulimia because it had become a significant part of their identity. In addition, these women were terrified of gaining weight or becoming fat. They experienced an internal struggle with the mind. In order to pacify the inner voice, many fed the compulsion to eat, and this resulted in guilt. The women subsequently balanced the experience by getting rid of fullness and erasing guilt, which was primarily achieved through self-induced vomiting.
Understanding the experience of bulimia for women who suffer from this disorder is important. Bulimia often presents as a chronic and potentially lifelong health issue. Awareness of bulimic women's perspectives could promote a comprehensive appreciation of bulimia, its aetiology, and directions for treatment alternatives.
本文报告一项研究，旨在解读和理解神经性贪食症患者（女性）的患病体验。
对神经性贪食症的研究主要集中在患病率、健康并发症、共病情况、神经化学调节异常以及文化影响等方面。尽管进行了大量调查，但鲜有已发表的研究评估过贪食症女性患者的个人经历以及她们对这种疾病的理解。这样的理解将有助于医护人员提供体贴、共情的护理。
本研究以海德格尔现象学原理为指导。研究对象为年龄在18至36岁之间、患病时长为1至23年的13名活跃期神经性贪食症女性患者。数据通过访谈、个人日记和人口统计学调查问卷收集。
参与者的叙述揭示了与神经性贪食症共存的经历所具有的四个主题：自我孤立、生活在恐惧中、与内心作斗争以及安抚大脑。贪食症女性患者的行为都是秘密进行的，因此参与者感到孤立。暴饮暴食和自我催吐被视为异常行为；因此，参与者认为自己会受到公众的负面看法，这导致她们生活在恐惧之中。这些女性担心如果别人知道她们的病情会受到评判。有几位担心没有神经性贪食症的生活，因为这已成为她们身份认同的重要组成部分。此外，这些女性害怕体重增加或变胖。她们内心与自己作斗争。为了平息内心的声音，许多人任由进食的冲动摆布，这导致了内疚感。随后，这些女性通过消除饱腹感和抹去内疚感来平衡这种体验，这主要通过自我催吐来实现。
了解患有这种疾病的女性的神经性贪食症经历很重要。神经性贪食症通常表现为一种慢性且可能伴随终身的健康问题。了解贪食症女性患者的观点有助于全面认识神经性贪食症、其病因以及治疗选择的方向。
