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The interviews lasted approximately 60 minutes and were performed with each caregiver, after a medical examination of the child, in the same facilities. They were recorded by means of an audio recording and fully transcribed.
Data analysis was based on the strategy proposed by the Grounded Theory 29 , a methodology used to develop a theory based on data that is systematically captured and analyzed. The analysis was performed using open coding , a process in which the information collected to classify the material into concepts and categories is examined and classified Density , depth and applicability were also considered, which make reference to a detailed description of the information, generating the effect of triangulation on the results and their complexity.
In addition, the triangulation of analysts is added to facilitate the discussion and consensus of all findings Before starting the process, parents signed an Informed Consent, in which they accepted the use of voice recorder.
The requirements of the Helsinki declaration of the World Medical Association on ethics in medical research in human beings and on the Chilean Law of Rights and Duties of patients were recognized and respected. We present the recommendations that this group of parents would make to the health team. This information was organized in the following five categories figure 1.
Summarized categories of recommendations from parents of obese children to the health-care team regarding their treatment. Relationship between Caregiver-Health Team. Parents who were interviewed think that a closer and established health team-caregiver relationship is appreciated, in which the professional is smiling and always willing to solve doubts. This would require a kind treatment that creates confidence.
Parents highlighted the importance of the health team to not to scold them. Some parents emphasize the importance of communication between the health team and the caregiver, being fundamental to explain and to guide in a polite way, with good manners and an understandable vocabulary. When we ask something to a health professional, many doctors just write down, they do not answer much, they only write.
This involves also to include the other members of the family, explaining the risks and enhancing their commitment. The doctor understood that very well, so I felt really supported that she could understand that it is not all because of my responsibility. To me, she [the health professional]was very clear and so graphic when she said And that was like a trigger, it moved me to continue. Would you say that those words motivated you to continue with the treatment? It is important for the participating parents that the health team promote healthy eating in a flexible way, requesting that the consumption of certain foods could be reduced without prohibiting them.
They also emphasize that recognizing the progress achieved favors a good relationship; This would add more confidence and more motivation to continue with the treatment. Relationship between Health Team-Child. Likewise, a close relationship with the caregiver is necessary, which creates more confidence. According to this, they recommend that they could be more cheerful and always willing to clarify concerns and doubts when talking with children. These caregivers suggest a kind treatment for children, to not scold them, and to get their attention in a playful way, being an emotional helper, especially if they express their possible fears about failures.
They do not come here happy, because they know they are going to measure their weigh and they could have gained some, or maybe they did not lose weight at all, so they are really scared, with fear. In order to establish a friendly treatment, they suggest that the health team ensure that the child is comfortable, talking about obesity with caution, avoiding the possibility of the child feeling hurt. I have taken my daughter to other doctors, for many reason, sometimes because her tummy hurts or whatever reason, and of course, they tell me: Most of the participants emphasize that it is important for the health team to establish a communication directed towards the child.
This would strengthen the bond between they both, producing a feeling of satisfaction in the child, helping them to develop a greater awareness of this illness, assuming with responsibility their role and being motivated to adhere to treatment. Because the doctor talked to X, and he was more aware after that. He already knew that he had an obesity problem before, but when she [the health professional] talked to him, she made X to think about what the doctor was saying, not what his parents told him.
On the other hand, certain caregivers recommend that health professionals who work with children may have sufficient skills in order to handle tantrums during controls. To enhance the family participation. The caregivers who participated in the study recommend that the health team promote the participation of the family during the therapeutic process, as well as their support, motivating to change rutines to obtain healthy habits.
To do this, it would be necessary for the team to explain to the family the importance of the participation of every member and also to include other caregivers in the medical examinations, this they could understand the problem and also the risks. They point out the need to promote family coexistence at the time of meals.
In addition, it is recommended that health professionals make separate interviews with different caregivers, in order to address the issue of obesity, as well as the therapeutic process. To motivate the child to the therapeutic adherence. To encourage the therapeutic adherence in children, it would be important to motivate them to healthy habits and to encourage the patient to assume the treatment responsibility.
It is emphasized in all participating caregivers the importance they give to how health workers congratulates the child for the progress made. Some say that, together with recognizing the effort and to highlight the favorable results, they should explain what remains to be achieved, giving enough motivation to persist. Environmental factors that contribute to behavior change include support from others in the form of encouragement, modeling behavior, and access to resources. A survey of American health professionals identified lack of parental involvement, lack of patient motivation, and lack of support services as key barriers to the management of childhood obesity [ 9 ].
Because parents are responsible for the physical and social environment of their children, they are indisputably the first line of prevention for youth obesity. Recommendations for what parents can do to promote healthful eating and physical activity are suggested by Ritchie et al. Provide children with ample access to nutrient-dense foods and beverages, and high-fiber foods, both at meals and snack time; 2.
The purpose of health education is to modify actions and behaviour. UK research papers also indicate that health professionals are not fully aware of the UK growth chart, which sets breastfeeding as the norm rather than formula feeding. Support Center Support Center. Summarized categories of recommendations from parents of obese children to the health-care team regarding their treatment. The data analysis was based on the Grounded Theory Approach through open coding.
When nutrient-poor foods are available, avoid excessive restriction and use of food as a reward; 4. Encourage children to eat breakfast; 5. Work to find ways to increase fun and achievable physical activity in children; 6. Model healthful eating and physical activity practices for children.
Parents play a pivotal role in maintaining motivation by providing an environment, which promotes healthy eating and exercise habits [ 8 ]. It should be noted that none of these recommendations address child weight because weight is not a behavior, but rather a reflection of the interface between genetics and behavior. Building on the first chapter of the childhood obesity plan, the new measures included within chapter 2 childhood obesity plan focus on:.
In addition to the actions highlighted for frontline professional, team leaders or managers can support this work by:. The Baby Friendly Standard is a UNICEF initiative which aims to create breastfeeding friendly spaces to encourage and support breastfeeding, often supported by peer education and peer support networks. As a health professional there are a range of reasons why it makes sense to measure your impact and demonstrate the value of your contribution. This could be about sharing what has worked well, in order to benefit your colleagues and local people or to help you with your professional development.
The Everyday Interactions Measuring Impact Toolkit provides a quick, straightforward and easy way for health care professionals HCPs to record and measure their public health impact in a uniform and comparable way. The childhood obesity impact pathway is recommended for healthcare professionals and the wider public health workforce to record and measure actions undertaken as part of routine care which impact on childhood obesity.
At a population level, the following outcome measures can help build a picture of the obesity-related risk factors in the population:. The Obesity Intelligence Knowledge hub website provides wide-ranging authoritative information on data, evaluation, and evidence related to weight status and its determinants. These resources for promoting healthier weight are intended to support health and care professionals to be consistent and provide a core set of evidence-based healthier weight, nutrition and physical activity messages throughout the life course.
They consist of a set of infographics for use in practice, a set of slides to be used as a training tool and a child obesity animation.
The Our Healthy Year resources help school nursing teams to explain NCMP , and engage parents using classroom activities, practical tips and educational tools. Guidance on healthier and more sustainable catering. UK physical activity guidelines - advice from the Chief Medical Officer on how much physical activity people should be doing.
Health Education England e-learning programme for practitioners in the NHS, and local authorities working in weight management. Healthcare professionals and the wider workforce can strengthen their knowledge by accessing a range of e-learning modules for free.