Når maden som medicin ikke er medicin nok
Oversat titel
When nutrition as medicine is not medicine enough
Forfattere
Schrøder, Nina ; Knudsen, Celina Kassow ; Lindstrøm, Trine Balser
Semester
4. semester
Uddannelse
Udgivelsesår
2017
Abstract
Afhandlingen undersøger, hvilken form for behandling der kommer til udtryk gennem forskellige deltageres perspektiver i det sociale arbejde med piger, der tidligere har haft en spiseforstyrrelse i Nordjylland. Projektet bygger på en hermeneutisk (fortolkende) tilgang, hvor viden skabes gennem tolkning af oplevelser og udsagn. Analysen er tematisk og tager afsæt i interviews. Vi interviewede tre piger med tidligere spiseforstyrrelse, overlægen for Enhed for Spiseforstyrrelser, to socialarbejdere fra et socialt botilbud i Nordjylland samt tre kommunale medarbejdere via telefon. Med afsæt i David M. Garner viser afhandlingen, at der er flere veje ind i en spiseforstyrrelse. Fælles for de tre piger er dog, at de forsøgte at skjule deres sygdomsidentitet og leve op til forventninger fra samfund, dem selv og deres omgivelser. I den psykiatriske behandling beskrives ofte mottoet "ernæring er medicinen". Med Erving Goffmans begreb kan Enhed for Spiseforstyrrelser forstås som en "total institution" – en institution, der styrer mange aspekter af hverdagen. Pigerne beskriver, at de føler sig overset og krænket i denne ramme, og at fokus på ernæring overskygger andre behov. Når de når en bestemt vægt, bliver de udskrevet og oplever at stå uden støtte: for raske til hospitalet, men for syge til at klare hverdagen. Interviews med kommunale medarbejdere peger på, at der ikke findes særlige indsatser for tilbagevenden til hverdagen for piger udskrevet fra Enhed for Spiseforstyrrelser, selv om der er et tydeligt behov. Afhandlingen konkluderer, at ernæring er nødvendig, men ikke tilstrækkelig. Der er behov for kvalificering og forbedring af det sociale arbejde og for en mere helhedsorienteret indsats, især i overgangen fra hospitalsbehandling til kommunal og social støtte.
This thesis explores what kind of treatment is expressed through different participants’ perspectives in social work with girls who have previously had an eating disorder in Northern Jutland. The study uses a hermeneutic (interpretive) approach, building knowledge by interpreting experiences and accounts. The analysis is thematic and grounded in interviews. We interviewed three girls with prior eating disorders, the chief physician of the Unit for Eating Disorders, two social workers from a social residence in Northern Jutland, and three municipal employees by telephone. Drawing on David M. Garner, the thesis recognizes multiple pathways into eating disorders. Common to the three girls were efforts to hide their illness identity and to meet expectations from society, themselves, and those around them. In psychiatric treatment, the guiding motto is often “nutrition is the medicine.” Using Erving Goffman’s concept, the Unit for Eating Disorders can be understood as a “total institution” – one that governs many aspects of everyday life. The girls report feeling neglected and violated within this setting, and that the focus on nutrition eclipses other needs. Once they reach a target weight, they are discharged and feel left without support: too well for hospital care, yet too unwell to manage daily life. Interviews with municipal staff indicate that there are no specific initiatives to support reintegration after discharge from the Unit, despite a clear need. The thesis concludes that nutrition is essential but not sufficient. There is a need to strengthen and improve social work and provide more holistic support, especially during the transition from hospital treatment to community and social services.
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