School of Nursing, Duke University, Durham, North Carolina, USA.
School of Nursing, University of North Carolina at Chapel Hill, North Carolina, USA.
J Adv Nurs. 2017 Jan;73(1):56-70. doi: 10.1111/jan.13140. Epub 2016 Sep 23.
The aim of this study was to report an analysis of the concept of pediatric feeding problems.
Reviews of the literature on pediatric feeding problems and disorders repeatedly reference the lack of a shared conceptualization of feeding problems. It is difficult to track aetiology, prevalence and incidence of a phenomenon when available definitions and diagnoses lack practical utility.
An evolutionary concept analysis.
A search was conducted in October 2014 of Google Scholar, CINAHL, PubMed and Web of Science databases, with MeSH terms and key words including: failure to thrive, feeding disorder/difficulty/problems, infantile anorexia, oral aversion, mealtime behaviour and dysphagia. Inclusion criteria were: subject of feeding problems, index children 0-10 years of age, English language and full text.
The articles (n = 266) were sorted into disciplines of authorship, including Psychology, Medicine, Nursing, Nutrition, Occupational Therapy, Speech Language Pathology or Other. The sample was divided into a historical sample (n = 42) for pre-2000 articles and current for those published post-2000. The current sample was later reduced to 100 and coded for surrogate terms, related concepts, attributes, antecedents and consequences.
The historical view of pediatric feeding problems shows a tradition of mother blame or parental culpability, both direct and indirect. Currently, there exist many different definitions and typologies, but none have sound validity or generalizability. Areas of attribute consensus across disciplines are problematic feeding behaviours and selective or restrictive intake.
A spectrum conceptualization of feeding problems is suggested for further development, with attributes that would be critical to have a feeding problem.
本研究旨在报告对儿科喂养问题概念的分析。
对儿科喂养问题和障碍的文献综述反复提到缺乏对喂养问题的共识概念。当现有的定义和诊断缺乏实际效用时，很难追踪病因、患病率和发病率。
进化概念分析。
2014 年 10 月，在 Google Scholar、CINAHL、PubMed 和 Web of Science 数据库中，使用包括“发育不良”、“喂养障碍/困难/问题”、“婴儿厌食症”、“口腔厌恶”、“进餐行为”和“吞咽困难”等主题词和关键词进行了搜索。纳入标准为：喂养问题的主题，索引儿童 0-10 岁，英语语言，全文。
将文章（n=266）按照作者的学科进行分类，包括心理学、医学、护理、营养、职业治疗、言语语言病理学或其他。样本分为历史样本（n=42）和现代样本（n=224），前者为 2000 年前的文章，后者为 2000 年后的文章。现代样本进一步减少到 100 篇，并对替代术语、相关概念、属性、前提和后果进行编码。
儿科喂养问题的历史观点显示出一种传统的母亲责任或父母责任，直接的和间接的都有。目前，存在许多不同的定义和分类，但没有一个具有良好的有效性或可推广性。跨学科的属性共识领域是有问题的喂养行为和选择性或限制性摄入。
建议进一步发展喂养问题的谱概念化，具有成为喂养问题的关键属性。
