Nurse evaluation of hyperactivity in anorexia nervosa: a comparative study

Up to 80% of patients with anorexia nervosa (AN) manifest elevated levels of physical activity or hyperactivity. A variety of methods have been used to evaluate activity levels, mostly questionnaires but also expensive and invasive methods such as actometry or other measurements of energy expenditure. Nurse observations have heretofore not been tested for validity and reliability. In this study, 18 patients with AN under treatment in a specialized eating disorder centre simultaneously rated their own physical activity levels, used an actometer, and were observed for physical activity by trained nurses. We found that nurse ratings of activity correlated significantly with the average actometer activity score (r = 0.61, p < 0.01). Patients could not rate their own activity levels accurately. Nurse observation of activity levels of AN patients during treatment is a reliable and useful monitoring tool.