INSERM, U-669 PSIGIAM, Paris, France.
Obes Rev. 2013 May;14(5):351-68. doi: 10.1111/obr.12010. Epub 2012 Dec 5.
Childhood obesity is a complex condition involving medical, social, moral and cultural issues. Qualitative approaches are of great value in understanding this complexity. This meta-synthesis of 45 qualitative studies deals specifically with the issue of obesity in children and adolescents from different perspectives--those of obese children and adolescents, of parents, and of health professionals providing support to the family. Our aim was to obtain a coherent view of child and adolescent obesity, focused on clinical and personal experience. The themes derived from the synthesis process fall under three main axes: 'Seeing others, seeing oneself', 'Understanding others, understanding oneself', and 'Treating others, treating oneself'. It emerges that participants in all three groups had equal difficulty in perceiving and labelling obesity, mainly because of their lack of any real common ground. The insufficiency of shared representations destabilizes the therapeutic relationship and its construction: an important issue in the doctor-child-parent relationship in this context is the need to exchange their viewpoints of obesity. Health workers may also expand their understanding of obesity by incorporating the personal experiences of obese children and their parents in order to match treatment plans to their needs and expectations.
儿童肥胖是一个涉及医学、社会、道德和文化等多方面问题的复杂状况。定性方法对于理解这种复杂性具有重要价值。本研究对 45 项定性研究进行了元分析,这些研究从不同的角度专门探讨了儿童和青少年肥胖问题,包括肥胖儿童和青少年自身、其父母以及为家庭提供支持的卫生专业人员的观点。我们的目的是从临床和个人经验的角度全面了解儿童和青少年肥胖问题。综合分析得出的主题主要分为三个方面:“了解他人,认识自己”、“了解他人,了解自己”和“治疗他人,治疗自己”。结果表明,所有三个群体的参与者在感知和标记肥胖问题上都存在同样的困难,主要是因为他们缺乏真正的共同点。共同表象的不足破坏了治疗关系及其构建:在这种情况下,医生-儿童-家长关系中的一个重要问题是需要交流他们对肥胖的看法。卫生工作者还可以通过纳入肥胖儿童及其父母的个人经验来扩大对肥胖的理解,以使治疗计划符合他们的需求和期望。