Book Description

Background: It is well documented that adolescents who have Cystic Fibrosis (CF) can improve their respiratory prognosis and achieve normal growth patterns by optimizing nutrition (Corey, McLaughlan, Williams & Levison, 1988). This is accomplished by a high calorie diet, pancreatic enzyme replacement and vitamin supplementation. Adolescents with CF may often have distorted views on normal eating, and thus choose to follow the path of a low-calorie diet and misuse pancreatic enzymes (Gilchrist & Lenney, 2008). This concept often triggers the known developmental continuum between eating disturbance and eating disorders in the general population (Thompson & Smolak, 2001). The nature of CF brings into focus the very risk factors for eating disturbances: preoccupations with food, weight, exercise and caloric intake. The existence of eating disturbances in this population possesses a serious concern for life considering the potentially fatal consequences related to low weight. According to Shearer and Byron (2004), the development of a screening measure for frequent use in clinics by health professionals is warranted. A resource to identify those adolescents at risk for eating disturbances would help to avoid nutritional decline and therefore the potential for respiratory decline. Currently the lack of a screening tool exists to identify eating disturbances. The purpose of this study is to develop, implement, and evaluate a screening tool and educational session intended for nurses for the identification of eating disturbances in at-risk adolescent patients with cystic fibrosis at CHOP. Methods: This research was a pilot study. It included a pre -and post-test questionnaire developed by the researcher. The research was a quasi-experiment that utilized a convenience population. The pre-test and the post-test were identical questionnaires. The test included a case scenario. The case scenario included behaviors that place the adolescent at risk for developing eating disturbances. An educational session was provided to the participants. The session reviewed the assessment categories of the screening tool and details about each question related to adolescents who have cystic fibrosis. Results: Participants included six total, five females and one male. All participants were registered nurses working with the CF population. There are 16 possible answers on the pre- and post-test. There are 9 possible correct answers. The correct answers are those behaviors that place the adolescent with CF at risk for an eating disturbance. The incorrect behaviors are those behaviors that do not definitively place the adolescent with CF at risk for an eating disturbance. There was an improvement in knowledge in one participant. A participant scored in the satisfactory category in the pre-test and increased to the knowledgeable category in the post-test. Approximately 16.5% of the participants improved their score, 33% participants worsened their score, and approximately 49.5% had no change in score. Conclusions: Although, intense preoccupation with food and weight do exist in both the general and CF adolescent population, so does the potential to develop an eating disorder. As noted, eating disturbances can place the adolescent with CF at risk for nutritional decline and potential respiratory decline. Respiratory decline can impact the longevity of a person's life in CF. Given these facts, it is important for the health of the population and the awareness of healthcare professionals to develop a validated and reliable screening tool. Further research in the area of developing a screening tool as well as an effective intervention and possibly training for healthcare professionals in this area is warranted.