ABSTRACT
The relationship between an individual's social, psychological, and cultural environment and his or her nutritional status is one of both cause and effect. Cultural patterns, economic stability, and attitudes toward health and disease all affect an individual's eating behavior. Similarly, illness or treatments that interfere with usual nutritional behaviors can affect an individual's emotional well-being and social relationships. We have discussed some of the symbolic and social meanings of food and have described how these are challenged by the necessity for "artificial feedings." We have suggested that an understanding of the interaction among the cultural and social factors involved in eating is important in helping to provide comprehensive care to patients requiring nutritional intervention as part of treatment for a medical or surgical disease. In addition, we have presented a description of anorexia nervosa as an example of an illness in which the primary symptoms involve the use of deviant eating behaviors as a way to meet psychological needs. The psychosocial context of food and of obtaining nutrition seem in many ways to be quite obvious, but we must make a conscious effort not to take for granted or to overlook the impact the psychological, social, and cultural environment has upon our patients receiving nutritional therapies.
Subject(s)
Nutritional Physiological Phenomena , Sick Role , Social Environment , Adolescent , Adult , Anorexia Nervosa/psychology , Culture , Enteral Nutrition/psychology , Feeding Behavior , Female , Humans , Male , Parenteral Nutrition/psychologyABSTRACT
Prediction of health at middle age was studied in two longitudinal investigations of urban children: the Berkeley Guidance Study from birth to 42 years of age and the Oakland Growth Study from 11 through 50 years of age. Overall health ratings, weight status, blood pressure, and personality measures were analyzed. Weight/height ratios were highly stable from childhood to adolescence and moderately stable from adolescence to middle age. Systolic and diastolic blood pressures in adolescence were moderately predictive of adult status. Health ratings in adolescence were predictive of health ratings in middle age for female only. Teenage personality traits appear to have significance for adult health in that a calm, controlled personality in adolescence tends to be a significant forecaster of health in midlife. Male and female patterns differ in that female health appears to be influenced more by personality and experiential factors.
Subject(s)
Adolescent , Health Status , Health , Personality , Adult , Blood Pressure , Body Height , Body Weight , Child , Female , Humans , Longitudinal Studies , Male , Middle Aged , Personality InventoryABSTRACT
A comprehensive, interdisciplinary program for patients requiring home parenteral nutrition (HPN) is described. This program begins with an initial patient assessment, which includes medical prerequisites and evaluation of patient motivation and learning abilities, family supports, emotional status, and individual life-styles. The teaching phase involves instructing the patient in the tasks necessary to self-administer parenteral nutrition at home. Problems that can arise are presented, and patient self-monitoring for adverse reactions and problem solving is emphasized. Outpatient follow-up is provided by the interdisciplinary Nutrition Support Service in a clinic setting. Specific components of these visits in relation to physical and emotional adjustment to HPN are discussed. The Nutrition Support Service recognizes a long-term commitment to patients receiving HPN, and members of the team are available to assist patients when problems occur.
