Obstacles to the prevention of overweight and obesity in the context of child health care in Sweden

Abstract

BackgroundOverweight and obesity in younger children could better be brought in focus through a deeper understanding of how Child Health Care nurses (CHC-nurses) perceive their work with the problems of overweight at the CHC Centers. The aim of this study was to elucidate the CHC-nurses conceptions of their preventive work with childhood overweight and obesity in Child Health Care.MethodA qualitative study, based on open-ended interviews, involving 18 CHC-nurses strategically selected from 17 CHC Centres in the southern part of Sweden using a phenomenographic approach.ResultsTwo categories of description emerged from the data: (i) Internal obstacles to the CHC- nurses’ work with overweight in children and (ii) External obstacles to the management of overweight in children. The CHC-nurses conceived their work with overweight in Child Health Care to be complicated and constrained by several obstacles depending on the nurses’ personal priorities, knowledge, responsibility and the absence of resources and cooperation, as well as the lack of uniform guidelines for preventing and managing childhood overweight and further a deficient management organisation.ConclusionNurses’ attention to monitoring overweight in children, and their initiative for prevention, is based on their conceptions of the obstacles that hinder them in their efforts. An increased awareness of the CHC-nurses conceptions of the priorities, their sense of responsibility and prevention practices is warranted. If measures in this direction are not taken there is a growing risk that overweight children will pass through the CHC without any formal recognition of their situation. There is an indication that the present level of the CHC-nurses’ preventive work with childhood overweight has room for improvement in several areas. It is suggested that the specialist education of these health care professionals should be supplemented and that organisation of the management of childhood overweight should be also revised at the primary health care level.

A Review of Primary Care-Based Childhood Obesity Prevention and Treatment Interventions

“…While recent studies suggest increased provider comfort in screening and counseling for obesity [27, 28], rates of obesity prevention and treatment activities in primary care remain low in many countries, including the USA Israel, Australia, and several European countries [25, 29, 30•, 31–34]. Furthermore, primary care providers have expressed reservations about the effectiveness of provider-delivered obesity prevention and treatment strategies, citing concerns regarding the obesogenic environment, lack of parent motivation to make weight-related behavioral changes for themselves and their family, and low parent concern about child weight [16, 20, 22, 24, 27, 32, 34–36]. …”

Nursing interventions with people with obesity in Primary Health Care: an integrative review

“…Among the barriers, the nurses highlighted lack of uniformity in obesity prevention and control guidelines, as well as inadequate management of the services. They also noted the need for knowledge about this chronic disease, responsibility, and cooperation among health team members (15) .…”

“…Some of the studies reviewed mentioned that health team professionals had limited knowledge about obesity (15,17,(21)(22)37) . Research in Australia found that nurses were interested in participating in training aimed at child obesity prevention (17) .…”

Atuação dos enfermeiros na prevenção e no controle da obesidade na atenção primária à saúde

“…Possuir conhecimentos limitados sobre obesidade foi um tema destacado pelos enfermeiros nas pesquisas encontradas sobre a percepção desse profissional acerca de sua atuação frente à obesidade na APS (Isma et al, 2013;Blackburn et al, 2015). Ressalta-se que a falta de capacitação da equipe pode ser um dificultador no acolhimento às pessoas com obesidade, uma vez que é imprescindível que os profissionais de saúde da UBS estejam aptos e sensibilizados para captação e acolhimento eficientes dessa demanda (Brasil, 2014b (Minayo, 2015).…”

“…Em um município da região sudeste do Brasil, uma investigação que utilizou a antropometria na APS para o diagnóstico e acompanhamento do crescimento de crianças e adolescentes em parceria com o Nasf apontou que a ação realizada com 200 participantes, proporcionou a sensibilização dos pais ou responsáveis quanto à prevenção de agravos à saúde, levando-os a refletir sobre seus hábitos alimentares (Rosa, Sales, Andrade, 2017 (Matos et al, 2015). Também estudo realizado com 18 enfermeiros de APS na Suécia apontou que a deficiência de recursos físicos e a desorganização do serviço de saúde limitavam os participantes em sua atuação na prevenção do sobrepeso e obesidade infantil, resultando na concepção de que esta é uma tarefa difícil de ser desenvolvida pelos profissionais nesse nível de atenção à saúde (Isma et al, 2013).…”