Department of Health Sciences, Faculty of Science, Vrije Universiteit Amsterdam, Amsterdam Public Health Research Institute, Amsterdam, The Netherlands.
Erasmus MC, University Medical Center Rotterdam, Obesity Center CGG, Rotterdam, The Netherlands.
BMC Health Serv Res. 2021 Jun 28;21(1):611. doi: 10.1186/s12913-021-06635-6.
The causes and consequences of childhood obesity are complex and multifaceted. Therefore, an integrated care approach is required to address weight-related issues and improve children's health, societal participation and quality of life. Conducting a psychosocial and lifestyle assessment is an essential part of an integrated care approach. The aim of this study was to explore the experiences, needs and wishes of healthcare professionals with respect to carrying out a psychosocial and lifestyle assessment of childhood obesity.
Fourteen semi-structured interviews were conducted with Dutch healthcare professionals, who are responsible for coordinating the support and care for children with obesity (coordinating professionals, 'CPs'). The following topics were addressed in our interviews with these professionals: CPs' experiences of both using childhood obesity assessment tools and their content, and CPs' needs and wishes related to content, circumstances and required competences. The interviews comprised open-ended questions and were recorded and transcribed verbatim. The data was analysed using template analyses and complemented with open coding in MAXQDA.
Most CPs experienced both developing a trusting relationship with the children and their parents, as well as establishing the right tone when engaging in weight-related conversations as important. CPs indicated that visual materials were helpful in such conversations. All CPs used a supporting assessment tool to conduct the psychosocial and lifestyle assessment but they also indicated that a more optimal tool was desirable. They recognized the need for specific attributes that helped them to carry out these assessments, namely: sufficient knowledge about the complexity of obesity; having an affinity with obesity-related issues; their experience as a CP; using conversational techniques, such as solution-focused counselling and motivational interviewing; peer-to-peer coaching; and finally, maintaining an open-minded, non-stigmatizing stance and harmonizing their attitude with that of the child and their parents.
Alongside the need for a suitable tool for conducting a psychosocial and lifestyle assessment, CPs expressed the need for requisite knowledge, skills and attitudes. Further developing a supporting assessment tool is necessary in order to facilitate CPs and thereby improve the support and care for children with obesity and their families.
儿童肥胖的原因和后果复杂且多方面。因此，需要采取综合护理方法来解决与体重相关的问题，改善儿童的健康、社会参与度和生活质量。进行社会心理和生活方式评估是综合护理方法的重要组成部分。本研究旨在探讨医疗保健专业人员在进行儿童肥胖社会心理和生活方式评估方面的经验、需求和愿望。
对 14 名负责协调肥胖儿童支持和护理的荷兰医疗保健专业人员（协调专业人员，“CP”）进行了半结构化访谈。在我们对这些专业人员的访谈中，探讨了以下主题：CP 使用儿童肥胖评估工具及其内容的经验，以及 CP 与内容、环境和所需能力相关的需求和愿望。访谈采用开放式问题，并进行了录音和逐字记录。使用模板分析对数据进行分析，并在 MAXQDA 中进行开放式编码补充。
大多数 CP 都经历了与儿童及其父母建立信任关系以及在进行与体重相关的对话时确立正确基调的重要性。CP 表示，视觉材料在这些对话中很有帮助。所有 CP 都使用支持性评估工具进行社会心理和生活方式评估，但他们也表示希望有更理想的工具。他们认识到需要具备帮助他们进行这些评估的特定属性，即：对肥胖复杂性的足够了解；对肥胖相关问题的亲和力；CP 的经验；使用对话技巧，如以解决方案为导向的咨询和动机性访谈；同行辅导；最后，保持开放、非污名化的立场，并协调他们的态度与儿童及其父母的态度。
除了需要适合进行社会心理和生活方式评估的工具外，CP 还表达了对必要知识、技能和态度的需求。进一步开发支持性评估工具对于促进 CP 并改善对肥胖儿童及其家庭的支持和护理是必要的。
