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“宁愿被告知也不愿蒙在鼓里”——一项质性研究,探讨父母对于在婴儿期识别儿童未来超重和肥胖风险的看法。

"I would rather be told than not know" - A qualitative study exploring parental views on identifying the future risk of childhood overweight and obesity during infancy.

作者信息

Bentley Faye, Swift Judy Anne, Cook Rachel, Redsell Sarah A

机构信息

Anglia Ruskin University, Cambridge, United Kingdom.

Behavioural Nutrition, University of Nottingham, Nottingham, United Kingdom.

出版信息

BMC Public Health. 2017 Aug 29;17(1):684. doi: 10.1186/s12889-017-4684-y.

Abstract

BACKGROUND

Risk assessment tools provide an opportunity to prevent childhood overweight and obesity through early identification and intervention to influence infant feeding practices. Engaging parents of infants is paramount for success however; the literature suggests there is uncertainty surrounding the use of such tools with concerns about stigmatisation, labelling and expressions of parental guilt. This study explores parents' views on identifying future risk of childhood overweight and obesity during infancy and communicating risk to parents.

METHODS

Semi-structured qualitative interviews were conducted with 23 parents and inductive, interpretive and thematic analysis performed.

RESULTS

Three main themes emerged from the data: 1) Identification of infant overweight and obesity risk. Parents were hesitant about health professionals identifying infant overweight as believed they would recognise this for themselves, in addition parents feared judgement from health professionals. Identification of future obesity risk during infancy was viewed positively however the use of a non-judgemental communication style was viewed as imperative. 2) Consequences of infant overweight. Parents expressed immediate anxieties about the impact of excess weight on infant ability to start walking. Parents were aware of the progressive nature of childhood obesity however, did not view overweight as a significant problem until the infant could walk as viewed this as a point when any excess weight would be lost due to increased energy expenditure. 3) Parental attributions of causality, responsibility, and control. Parents articulated a high level of personal responsibility for preventing and controlling overweight during infancy, which translated into self-blame. Parents attributed infant overweight to overfeeding however articulated a reluctance to modify infant feeding practices prior to weaning.

CONCLUSION

This is the first study to explore the use of obesity risk tools in clinical practice, the findings suggest that identification, and communication of future overweight and obesity risk is acceptable to parents of infants. Despite this positive response, findings suggest that parents' acceptance to identification of risk and implementation of behaviour change is time specific. The apparent level of parental responsibility, fear of judgement and self-blame also highlights the importance of health professionals approach to personalised risk communication so feelings of self-blame are negated and stigmatisation avoided.

摘要

背景

风险评估工具为通过早期识别和干预来影响婴儿喂养方式,从而预防儿童超重和肥胖提供了契机。然而,让婴儿的父母参与其中对于成功预防至关重要;文献表明,围绕此类工具的使用存在不确定性,人们担心会给父母带来污名化、贴标签以及引发父母的内疚感。本研究探讨了父母对于在婴儿期识别儿童未来超重和肥胖风险以及向父母传达风险的看法。

方法

对23位父母进行了半结构化定性访谈,并进行了归纳、解释性和主题分析。

结果

数据中出现了三个主要主题:1)婴儿超重和肥胖风险的识别。父母对于健康专业人员识别婴儿超重持犹豫态度,因为他们认为自己能够识别,此外,父母还担心会受到健康专业人员的评判。然而,对于在婴儿期识别未来肥胖风险持积极态度,但认为采用非评判性的沟通方式至关重要。2)婴儿超重的后果。父母对超重对婴儿开始走路能力的影响立即表示担忧。父母意识到儿童肥胖具有渐进性,然而,在婴儿能够走路之前,他们并不认为超重是一个重大问题,因为他们认为到那时由于能量消耗增加,任何多余的体重都会减掉。3)父母对因果关系、责任和控制的归因。父母明确表示在婴儿期预防和控制超重方面负有高度的个人责任,这转化为自责。父母将婴儿超重归因于过度喂养,但表示在断奶前不愿改变婴儿的喂养方式。

结论

这是第一项探讨在临床实践中使用肥胖风险工具的研究,研究结果表明,婴儿的父母能够接受对未来超重和肥胖风险的识别及沟通。尽管有这种积极的反应,但研究结果表明,父母对风险识别和行为改变实施的接受是有时间限制的。父母明显的责任感、对评判的恐惧和自责也凸显了健康专业人员采用个性化风险沟通方式的重要性,这样可以消除自责感并避免污名化。

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