Koivumäki Terhi, Kääriäinen Maria, Tuomikoski Anna-Maria, Kaunonen Marja
Health Sciences, Faculty of Social Sciences, Tampere University, Tampere, Finland.
Finnish Centre for Evidence-Based Health Care: A JBI Centre of Excellence, Nursing Research Foundation, Helsinki, Finland.
JBI Evid Synth. 2025 Apr 1;23(4):576-637. doi: 10.11124/JBIES-24-00056. Epub 2025 Apr 7.
The objective of this systematic review was to identify, critically appraise, and synthesize the best available qualitative evidence on parent and carer experiences of communications from health care professionals concerning their child's higher weight.
Public discourse on obesity has shifted in recent years and created pressure to change the way that weight is discussed in health care. A child's higher weight can be a sensitive issue to discuss in health care, but successful communication with parents can increase parental compliance with treatment and improve overall family welfare. It is, therefore, important to explore how parents and carers experience the communication about children's higher weight to ensure effective, up-to-date, and ethical counseling on childhood obesity.
This qualitative review included studies that focused on the experiences of parents or carers of children (birth to 12 years) with a higher weight who received verbal or written communication from health care professionals about their child's weight.
The following databases were systematically searched from 2010 onward: MEDLINE (EBSCOhost), CINAHL (EBSCOhost), PsycINFO (Ovid), Scopus, LILACS, and the Finnish health sciences database MEDIC. ProQuest Dissertations and Theses (ProQuest) was searched for unpublished articles. The search was conducted in July 2022 and updated in October 2023. No country or language limits were applied. A manual search was used to supplement the database searches. Study selection including title and abstract screening, full-text screening, critical appraisal, and data extraction were performed by 2 reviewers. The research findings were categorized and aggregated into synthesized findings. The synthesized findings were assigned confidence scores, and categories and finalized synthesized findings were agreed upon by all reviewers.
The 33 included studies varied in qualitative study design and methodological quality. There were over 900 eligible participants (parents and carers) and 147 unequivocal and credible research findings. The research findings yielded 8 categories and 3 synthesized findings with low confidence scores. The synthesized findings were as follows: i) Parents receiving communication on a child's higher weight experience strong feelings that can affect their parenting; ii) A health care professional's active and individual communication, with the sensitive use of words, creates a good communication experience for parents; and iii) Parents want to receive information about the child's higher weight that is useful to them and is based on an acceptable weight estimation.
Although confidence in the synthesized findings is low, this review indicates that communication from a health care professional on a child's higher weight should meet the parents' expectations and the family's situation and needs. Having the skills to deal with heightened emotions, using expertise and empathy as a professional, and providing appropriate information create a good communication experience for parents. In addition, parents' desire to protect their child and the strengthening of the parenting experience should be acknowledged to conduct safe communication.
A Finnish-language version of the abstract of this review is available at: http://links.lww.com/SRX/A92 .
本系统评价的目的是识别、严格评估并综合关于家长和照料者在医护人员就其孩子超重问题进行沟通方面的最佳现有定性证据。
近年来,关于肥胖的公众讨论发生了变化,给医疗保健中体重讨论方式的改变带来了压力。孩子超重是医疗保健中一个敏感的讨论话题,但与家长的成功沟通可以提高家长对治疗的依从性并改善家庭整体福祉。因此,探索家长和照料者如何体验关于孩子超重的沟通,对于确保提供关于儿童肥胖的有效、最新且符合伦理的咨询至关重要。
本定性综述纳入了关注体重较高的儿童(出生至12岁)的家长或照料者经历的研究,这些家长或照料者收到了医护人员关于其孩子体重的口头或书面沟通。
从2010年起对以下数据库进行系统检索:MEDLINE(EBSCOhost)、CINAHL(EBSCOhost)、PsycINFO(Ovid)、Scopus、LILACS以及芬兰健康科学数据库MEDIC。在ProQuest学位论文和论文数据库(ProQuest)中搜索未发表的文章。检索于2022年7月进行,并于2023年10月更新。未设国家或语言限制。采用手动检索来补充数据库检索。由两名评审员进行包括标题和摘要筛选、全文筛选、严格评估以及数据提取在内的研究选择。对研究结果进行分类并汇总为综合结果。为综合结果分配置信度得分,所有评审员就类别和最终的综合结果达成一致。
纳入的33项研究在定性研究设计和方法质量方面存在差异。有900多名符合条件的参与者(家长和照料者)以及147项明确且可信的研究结果。研究结果产生了8个类别和3个置信度得分较低的综合结果。综合结果如下:i)收到关于孩子超重沟通的家长会产生强烈情绪,这可能会影响他们的养育方式;ii)医护人员积极且个性化的沟通,以及用词谨慎,会为家长创造良好的沟通体验;iii)家长希望获得对他们有用且基于可接受体重估计的关于孩子超重的信息。
尽管对综合结果的置信度较低,但本综述表明,医护人员就孩子超重问题进行的沟通应符合家长的期望以及家庭的情况和需求。具备应对强烈情绪的技巧、以专业人员的专业知识和同理心进行沟通,并提供适当信息,会为家长创造良好的沟通体验。此外,在进行安全沟通时,应承认家长保护孩子的愿望以及强化养育体验的需求。
本综述的芬兰语摘要版本可在以下网址获取:http://links.lww.com/SRX/A92 。