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在瑞典的儿童健康服务中,护士进行以儿童为中心的健康对话,使儿童及其家庭参与健康生活方式是一项具有挑战性的平衡行动——护士的经验。

A challenging balancing act to engage children and their families in a healthy lifestyle - Nurses' experiences of child-centred health dialogue in child health services in Sweden.

机构信息

Department of Health Sciences, Faculty of Medicine, Lund University, Lund, Sweden.

Healthcare Centre, Helsa Laurentii, Lund, Sweden.

出版信息

J Clin Nurs. 2021 Mar;30(5-6):819-829. doi: 10.1111/jocn.15622. Epub 2021 Jan 28.

Abstract

AIMS AND OBJECTIVES

To describe nurses' experiences of a child-centred family guided intervention of obesity tested within the child health services targeting children identified with overweight and their caregivers.

BACKGROUND

Interventions aiming to support families towards a healthier lifestyle can lead to decreased risk of overweight evolving into obesity in a child. At the same time, nurses have found dialogues on weight challenging and may therefore avoid them.

DESIGN

Qualitative descriptive inductive design following content analysis applying to the COREQ guidelines.

METHODS

Content analysis was used to analyse 13 individual semi-structured interviews with nurses in the child health service in Sweden after completed training in CCHD, including how to facilitate the dialogue with the use of illustrations.

RESULTS

The theme Health dialogue about weight is a challenging balancing act facilitated by a supportive intervention emerged through eight subcategories in three main categories. Nurses experienced that CCHD with children identified with overweight and their caregivers provoked an emotional response both for themselves and for the caregivers of the child. The training in child-centred health dialogues promoted the nurses' work with structure and professionalism, as the nurses carefully took tentative steps to engage the family for a healthy lifestyle.

CONCLUSIONS

Emotional and practical challenges in performing CCHD still remained among nurses after customised training, which might comprise the child's rights to be involved in his or her own care when the child was identified as overweight. However, training for nurses, including lectures and tutorials, was found to increase the quality and professionalism of performing CCHD by providing structure, tools and tutorial support.

RELEVANCE TO CLINICAL PRACTICE

Customised training and illustrations can support nurses when performing a structured intervention such as child-centred health dialogues.

摘要

目的和目标

描述护士在儿童健康服务中实施以儿童为中心的家庭指导干预肥胖的经验,该干预针对超重儿童及其照顾者。

背景

旨在支持家庭走向更健康生活方式的干预措施可以降低儿童超重演变为肥胖的风险。同时,护士发现关于体重的对话具有挑战性,因此可能会避免这些对话。

设计

在遵循 COREQ 指南的内容分析基础上,采用定性描述性归纳设计。

方法

使用内容分析法分析了瑞典儿童保健服务中 13 名接受过 CCHD 培训的护士的 13 次个人半结构化访谈,包括如何使用插图促进对话。

结果

主题“关于体重的健康对话是一项具有挑战性的平衡行为”通过三个主要类别的八个子类别出现。护士们体验到,CCHD 与超重儿童及其照顾者一起,不仅对自己,而且对孩子的照顾者都引起了情绪反应。儿童为中心的健康对话培训促进了护士的工作结构和专业性,因为护士小心翼翼地迈出试探性的步伐,让家庭为健康的生活方式做好准备。

结论

在接受了定制培训后,护士在进行 CCHD 方面仍然面临情感和实际挑战,这可能包括当孩子被确定为超重时,孩子参与自己护理的权利。然而,为护士提供的培训,包括讲座和辅导,被发现通过提供结构、工具和辅导支持,提高了进行 CCHD 的质量和专业性。

临床相关性

定制培训和插图可以在护士进行以儿童为中心的健康对话等结构化干预时为其提供支持。

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