Magnusson Maria B, Hulthén Lena, Kjellgren Karin I
Institute of Medicine, Sahlgrenska Academy, University of Gothenburg, Sweden.
Commun Med. 2009;6(2):153-64. doi: 10.1558/cam.v6i2.153.
School nurses' counselling is pivotal in stemming the obesity epidemic. Barriers for good counselling such as nurses' misunderstandings and ambiguities when relating to overweight and obesity need to be addressed. In this study, we explored misunderstandings in school nurses' counselling of overweight pupils in multilingual settings, together with how school nurses talk about the condition. Counselling sessions involving eight nurses and 20 pupils (aged 8-16 years) were audio-recorded and analysed using theme-oriented discourse analysis. Statistical methods were used as a complement. The focal themes were misunderstandings and nurses' talk about overweight and obesity. Analytical themes were framing, footing and facework. Data analyses revealed three main origins of misunderstandings occurring in school nurses' counselling of obese and overweight pupils: (1) nurses' illusion that they know what advice the pupils need; (2) nurses' insensitivity to the pupils' and parents' concerns; and (3) lack of lingual understanding. School nurses' apparent difficulties to talk about overweight and obesity suggest a need to reflect on how to name these issues during counselling. School nurses' dominance and pupils'passivity were obvious. We suggest that counselling should be regarded as learning contexts and be subjected to possible quality assurance in the future.
学校护士的咨询对于遏制肥胖流行至关重要。诸如护士在处理超重和肥胖问题时的误解及含糊不清等良好咨询的障碍需要得到解决。在本研究中，我们探讨了多语言环境下学校护士对超重学生咨询中的误解，以及学校护士如何谈论这种情况。对涉及八名护士和20名学生（8至16岁）的咨询 session 进行了录音，并使用主题导向话语分析进行分析。统计方法用作补充。重点主题是误解以及护士对超重和肥胖的谈论。分析主题是框架、立足点和面子工作。数据分析揭示了学校护士对肥胖和超重学生咨询中出现误解的三个主要根源：（1）护士误以为自己知道学生需要什么建议；（2）护士对学生和家长的担忧不敏感；（3）缺乏语言理解。学校护士在谈论超重和肥胖方面明显存在困难，这表明需要思考在咨询期间如何称呼这些问题。学校护士的主导地位和学生的被动性很明显。我们建议咨询应被视为学习环境，并在未来接受可能的质量保证。
