Clinical Child Psychology Program, University of Kansas, 2011 Dole Human Development Center, 1000 Sunnyside Ave., Lawrence, KS 66045, USA.
J Sch Health. 2011 Mar;81(3):128-37. doi: 10.1111/j.1746-1561.2010.00571.x.
Previous studies have documented the presence of specific barriers to school nurses' communications with families about weight-related health. The purpose of the present study was to contribute to the literature by further analyzing, using focus group methodology, school nurses' perceived barriers to addressing weight-related health issues with children and their families.
Twenty-two school nurses from urban and rural school districts in the Midwestern United States participated in 7 focus groups during the spring semester of 2008. Sessions were recorded and transcribed in their entirety. Study authors reviewed the focus group content and identified themes of perceived barriers. NVivo 8 was used to code and evaluate themes.
Consistent with the extant literature, nurses identified a lack of knowledge and resources, personal weight challenges, lack of institutional support, and lack of time as barriers to weight-related communications with families. However, in addition to these previously identified barriers, nurses also identified family characteristics, child motivation, fear of reactions, and difficulty establishing relationships with children as barriers that impeded their communication with families about weight-related health.
As expected, the use of focus group methodology yielded evidence of barriers to communication that had not been previously identified in the literature, as well as those that had been well documented. Consistent with a socioecological view of pediatric healthcare, results suggest a number of systems that could be targeted to improve nurses' weight-related communications with families.
先前的研究记录了学校护士与家庭就体重相关健康问题进行沟通时存在的特定障碍。本研究的目的是通过使用焦点小组方法进一步分析，为文献做出贡献，以分析学校护士在与儿童及其家庭讨论体重相关健康问题时感知到的障碍。
2008 年春季学期，来自美国中西部城市和农村学区的 22 名学校护士参加了 7 个焦点小组。会议全程录音并记录。研究作者回顾了焦点小组的内容并确定了感知障碍的主题。使用 NVivo 8 对主题进行编码和评估。
与现有文献一致，护士们认为缺乏知识和资源、个人体重问题、缺乏机构支持以及缺乏时间是与家庭进行体重相关沟通的障碍。然而，除了这些先前确定的障碍外，护士们还确定了家庭特征、孩子的动机、对反应的恐惧以及与孩子建立关系的困难等障碍，这些障碍阻碍了他们与家庭就体重相关健康问题进行沟通。
正如预期的那样，使用焦点小组方法产生了一些证据，证明存在先前文献中未识别出的沟通障碍，以及那些已得到充分记录的障碍。与儿童医疗保健的社会生态学观点一致，研究结果表明有许多系统可以针对这些障碍进行改进，以提高护士与家庭进行体重相关的沟通。
