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Case report: Autism spectrum disorder as the basis of a feeding problem. A view from nursing care
Sara Martínez-de Castro1, Ana Bermúdez-Saiz1, José Luis Cobo-Sánchez2
1Servicio de Psiquiatría, Hospital Universitario Marqués de Valdecilla, Santander, Spain.
This case report presents the nursing approach to a 38-year-old woman diagnosed with restrictive-type anorexia nervosa (AN) since the age of 15 and autism spectrum disorder (ASD) at 35. The patient was admitted due to structured suicidal ideation with a high risk of acting on it, triggered by the experience of significant personal losses. A comprehensive assessment was conducted using Gordon's functional health patterns, identifying the following nursing diagnoses: ineffective health self-management, impaired social interaction, imbalanced nutrition: less than body requirements, and constipation. Additionally, collaborative problems such as insomnia, chronic pain, and suicidal behaviour risk were identified. The care plan was designed following the Nursing Outcomes Classification (NOC) and the Nursing Interventions Classification (NIC), incorporating individualised interventions that included adapting the environment to the sensory and communicative needs associated with ASD, as well as implementing a personalized educational strategy to promote health self-management. After three months of hospitalization, notable improvements were observed in emotional regulation, coping mechanisms, and the resolution of suicidal ideation. Furthermore, a weight gain of 7 kg was achieved, placing the patient within the normal BMI range. This case highlights the importance of specialised mental health nursing care and the need to tailor interventions to comprehensively address the needs resulting from the coexistence of ASD and AN.
This case report presents the nursing approach to a 38-year-old woman diagnosed with restrictive-type anorexia nervosa (AN) since the age of 15 and autism spectrum disorder (ASD) at 35. The patient was admitted due to structured suicidal ideation with a high risk of acting on it, triggered by the experience of significant personal losses. A comprehensive assessment was conducted using Gordon's functional health patterns, identifying the following nursing diagnoses: ineffective health self-management, impaired social interaction, imbalanced nutrition: less than body requirements, and constipation. Additionally, collaborative problems such as insomnia, chronic pain, and suicidal behaviour risk were identified. The care plan was designed following the Nursing Outcomes Classification (NOC) and the Nursing Interventions Classification (NIC), incorporating individualised interventions that included adapting the environment to the sensory and communicative needs associated with ASD, as well as implementing a personalized educational strategy to promote health self-management. After three months of hospitalization, notable improvements were observed in emotional regulation, coping mechanisms, and the resolution of suicidal ideation. Furthermore, a weight gain of 7 kg was achieved, placing the patient within the normal BMI range. This case highlights the importance of specialised mental health nursing care and the need to tailor interventions to comprehensively address the needs resulting from the coexistence of ASD and AN.
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