Objectives: This study aimed to systematically identify and categorize nursing practices for children and adolescents with anorexia nervosa (AN) through a comprehensive literature review.

Subjects and Methods: A literature search was conducted using the Ichushi-Web with keywords such as “anorexia nervosa,” “eating disorders,” and “nursing.” The extracted literature was analyzed using Krippendorff’s content analysis method for systematically coding and categorizing qualitative data.

Results: A total of 26 relevant articles were selected. From 368 codes, 42 subcategories and 10 main categories were identified. The main categories were (1) encouraging emotional expression, (2) creating a safe and accepting environment, (3) fostering self-affirmation, (4) engaging with the illness while externalizing it, (5) providing physical care based on the patient’s condition, (6) coordinating a unified response with other professionals, (7) supporting the patient in actively facing treatment, (8) assuming a maternal role and facilitating re-nurturing, (9) involving parents in the treatment process, and (10) promoting the rebuilding of the parent-child relationship. These categories were grouped into three major perspectives: psychological support, environmental adjustment and physical care, and restructuring of family relationships with attention to developmental challenges.

Discussion: These results provide constructive insights into nursing practices that address both the psychological needs and family dynamics of patients with AN.

Conclusion: This study offers a comprehensive synthesis of nursing practices for patients with AN, addressing gaps in previous fragmented reports. The findings provide practical guidance for enhancing clinical nursing care.

Objectives (Background): Eating Disorders (EDs) can cause severe physical and psychological impairment. While standard treatments are established, the role of Occupational Therapy (OT) in restoring life functions and enhancing self-efficacy remains less defined, particularly in Japan. The rising global incidence of EDs, particularly among adolescents post-COVID-19, underscores the need to clarify the contribution of OTs. This study aimed to elucidate the clinical significance of OT in adolescent inpatients in the ED.

Subjects and Methods: This retrospective study analyzed 388 occupational therapists’ clinical records from 12 adolescent female inpatients (mean age 15.3±2.1 years, BMI 12.7±1.4) treated for EDs at K University Hospital (July 2020-May 2023). Language analysis of the assessment section involved morphological analysis, word2vec for distributed representation, PCA, and k-means clustering to identify the semantic clusters. After generating noun clusters, the frequency of noun occurrences within each cluster across the different phases of treatment were compared: “Early Stage” (individual OT), “Middle Stage” (group OT), and “Late Stage” (group OT + physical exercise), defined by BMI-based behavioral protocols.

Results: Eleven distinct therapeutic clusters were identified in this study. Early Stage records emphasized “psychological characteristics,” “ability evaluation,” and “ward life/program.” The Middle Stage continued these focuses while significantly shifting towards “interpersonal interaction/function.” The Late Stage maintained “interpersonal interaction/function” and introduced “discharge preparation.” “Behavioral characteristics” and “interpersonal interaction/function” clusters peaked in the Middle Stage, indicating strong emphasis on observing and providing feedback on behavioral patterns.

Discussion: OT interventions systematically evolve across the treatment phases. Early Stage OT establishes psychological safety, trust, and prepares for help-seeking through individual therapy, addressing unique adolescent challenges. The middle-stage group OT promotes autonomy and develops interpersonal, decision-making, and problem-solving skills via interactive experiences. The late Stage focuses on discharge preparation, strengthening problem-solving, and real-life reintegration. OT’s ability to observe non-verbal behaviors and promote help-seeking is crucial, given adolescent developmental traits.

Conclusion: This study revealed the evolving content of OT support across early, middle, and late inpatient treatment stages for adolescent ED patients. Occupational therapy, through staged and structured support, has been suggested to contribute to patient recovery by fostering psychological safety and trust (early), promoting autonomy and interpersonal skills (middle), and supporting real-life adaptation and problem-solving (late). OT’s role in facilitating help-seeking and understanding nonverbal characteristics is paramount for adolescent-tailored strategies. Future work should standardize OT, enhance multidisciplinary collaboration, and conduct multi-institutional studies to clarify OT’s role and translate the findings into practice.

With the publication of DSM-5(-TR) and ICD-11, the disease classification and Japanese nomenclature for eating disorders underwent significant revisions. The major changes included the establishment of a new category “Feeding and Eating Disorders” in DSM-5. Regarding Japanese disease names, anorexia nervosa has been renamed from terms associated with appetite to “神経性やせ症,” while bulimia nervosa has been changed to “神経性過食症.” Additionally, the newly adopted binge-eating disorder has been designated as “むちゃ食い症.” These nomenclature changes are expected to improve understanding of the true nature of these diseases and promote appropriate diagnosis and treatment.

Anorexia nervosa (AN) is characterized by a state of profound starvation, and nutritional rehabilitation forms the cornerstone of early treatment. However, the reintroduction of nutrition after prolonged energy deprivation carries the risk of refeeding syndrome (RFS). The primary aim of nutritional rehabilitation is to achieve medical stabilization and weight restoration while minimizing the risk of RFS. In recent years, driven by an expanding evidence base, international societies have published new diagnostic criteria for RFS and updated guidelines for the nutritional rehabilitation of AN. This review summarizes the current understanding of RFS in the context of AN, outlines the principles of nutritional rehabilitation, and discusses the latest evidence and emerging guideline recommendations.