Larsen L, Mandleco B, Williams M, Tiedeman M
McKinney Pediatrics, McKinney, TX 75069, USA.
J Am Acad Nurse Pract. 2006 Feb;18(2):70-9. doi: 10.1111/j.1745-7599.2006.00105.x.
The purposes or this study were to (a) describe the prevention practices of nurse practitioners (NPs) regarding childhood obesity, (b) compare the practices of NPs by specialty, practice setting, and awareness of childhood obesity prevention guidelines, (c) identify relationships between prevention practices and demographic variables of NPs, and (d) examine the resources for and barriers to implementing prevention practices.
A convenience sample of 99 family NPs (FNPs) and pediatric NPs (PNPs) from the Intermountain area was used. Participants completed a questionnaire based on documented risk factors for childhood obesity as well as prevention guidelines developed by the American Academy of Pediatrics (AAP).
NPs working in family practice or general pediatric practice settings were not consistently using the BMI-for-age index to screen for childhood obesity, as recommended by the AAP. However, they were teaching parents to promote healthy food choices and physical activity in their families. PNPs and FNPs working in a pediatric practice setting and NPs who were aware of prevention guidelines were more likely to perform several prevention strategies than FNPs working in a family practice setting and those who were unaware of guidelines. Major barriers to implementing childhood obesity prevention strategies included parental attitudes, the American lifestyle, and lack of resources for both the NP and the family. The main resources NPs used in preventing childhood obesity were a dietician, journal articles, and Web sites.
Although the majority of the NPs in this study reported being aware of childhood obesity prevention guidelines (73.7%), most were not consistently using BMI for age or monitoring children at increased risk for obesity. Because childhood obesity is escalating at such a rapid rate, it is critical that NPs working in family practice and pediatric practice settings take the necessary steps to help curtail obesity in childhood, including calculating BMI for age, targeting children at risk, and helping families develop healthy nutrition and physical activity habits. In addition to proper health supervision of children, NPs also need to be advocates in their communities to overcome barriers to childhood obesity prevention.
本研究的目的是：(a) 描述执业护士（NP）针对儿童肥胖的预防措施；(b) 按专业、执业环境以及对儿童肥胖预防指南的知晓情况比较执业护士的措施；(c) 确定预防措施与执业护士人口统计学变量之间的关系；(d) 研究实施预防措施的资源和障碍。
采用便利抽样法，选取了来自山间地区的99名家庭执业护士（FNP）和儿科执业护士（PNP）。参与者根据记录的儿童肥胖风险因素以及美国儿科学会（AAP）制定的预防指南完成了一份问卷。
在家庭医疗或普通儿科医疗环境中工作的执业护士并未按照美国儿科学会的建议，始终如一地使用年龄别体重指数来筛查儿童肥胖。然而，他们在教导家长在家庭中促进健康的食物选择和体育活动。在儿科医疗环境中工作的儿科执业护士和家庭执业护士以及知晓预防指南的执业护士比在家庭医疗环境中工作且不知晓指南的家庭执业护士更有可能实施多种预防策略。实施儿童肥胖预防策略的主要障碍包括家长态度、美国生活方式以及执业护士和家庭缺乏资源。执业护士用于预防儿童肥胖的主要资源是营养师、期刊文章和网站。
尽管本研究中的大多数执业护士报告知晓儿童肥胖预防指南（73.7%），但大多数人并未始终如一地使用年龄别体重指数或监测肥胖风险增加的儿童。由于儿童肥胖正以如此快的速度不断攀升，在家庭医疗和儿科医疗环境中工作的执业护士必须采取必要措施帮助减少儿童肥胖，包括计算年龄别体重指数、针对有风险的儿童以及帮助家庭养成健康的营养和体育活动习惯，这一点至关重要。除了对儿童进行适当的健康监督外，执业护士还需要在其社区中成为倡导者，以克服儿童肥胖预防的障碍。
