Perez A J, Avis J L S, Holt N L, Gokiert R, Chanoine J-P, Legault L, Morrison K M, Sharma A M, Ball G D C
Department of Pediatrics, Faculty of Medicine and Dentistry, University of Alberta, Edmonton, AB, Canada.
Faculty of Physical Education and Recreation, University of Alberta, Edmonton, AB, Canada.
Child Care Health Dev. 2016 Mar;42(2):278-87. doi: 10.1111/cch.12311. Epub 2016 Jan 5.
Few children with obesity who are referred for weight management end up enroled in treatment. Factors enabling enrolment are poorly understood. Our purpose was to explore reasons for and facilitators of enrolment in paediatric weight management from the parental perspective.
Semi-structured interviews were conducted with parents of 10- to 17-year-olds who were referred to one of four Canadian weight management clinics and enroled in treatment. Interviews were audio-recorded and transcribed verbatim. Manifest/inductive content analysis was used to analyse the data, which included the frequency with which parents referred to reasons for and facilitators of enrolment.
In total, 65 parents were interviewed. Most had a child with a BMI ≥95th percentile (n = 59; 91%), were mothers (n = 55; 85%) and had completed some post-secondary education (n = 43; 66%). Reasons for enrolment were related to concerns about the child, recommended care and expected benefits. Most common reasons included weight concern, weight loss expectation, lifestyle improvement, health concern and need for external support. Facilitators concerned the referral initiator, treatment motivation and barrier control. Most common facilitators included the absence of major barriers, parental control over the decision to enrol, referring physicians stressing the need for specialized care and parents' ability to overcome enrolment challenges.
Healthcare providers might optimize enrolment in paediatric weight management by being proactive in referring families, discussing the advantages of the recommended care to meet treatment expectations and providing support to overcome enrolment barriers.
很少有被转介进行体重管理的肥胖儿童最终能够登记接受治疗。促使登记的因素尚不清楚。我们的目的是从家长的角度探讨儿童体重管理登记的原因和促进因素。
对10至17岁被转介到加拿大四家体重管理诊所之一并登记接受治疗的儿童的家长进行了半结构化访谈。访谈进行了录音并逐字转录。采用显性/归纳性内容分析法对数据进行分析,其中包括家长提及登记原因和促进因素的频率。
总共采访了65位家长。大多数家长的孩子BMI≥第95百分位数(n = 59;91%),母亲占多数(n = 55;85%),并且完成了一些高等教育(n = 43;66%)。登记的原因与对孩子的担忧、推荐的护理和预期的益处有关。最常见的原因包括对体重的担忧、减肥期望、生活方式改善、健康担忧以及对外部支持的需求。促进因素涉及转诊发起者、治疗动机和障碍控制。最常见的促进因素包括没有重大障碍、家长对登记决定的掌控、转诊医生强调需要专科护理以及家长克服登记挑战的能力。
医疗保健提供者可以通过积极主动地转诊家庭、讨论推荐护理的优势以满足治疗期望以及提供支持以克服登记障碍,来优化儿童体重管理的登记工作。