Julia Snethen

Addressing childhood overweight: strategies learned from one Latino community.

The purpose of this study is to understand one Latino communitys perspectives about childhood overweight within this high-risk ethnic group. Three focus groups, consisting of 12 mothers, 12 fathers, and 8 boys and 4 girls ages 10-12, participated. Transcripts of interviews were coded using N-VIVO and analyzed thematically. Several themes emerge: parents demanding work schedules, lack of time, transportation issues, opportunities for physical activities, and lack of meal preparation. Participants knew good nutrition and exercise help prevent obesity. Nursing interventions must address multiple challenges with childhood obesity at the family and community levels.

Weight, exercise, and health: children's perceptions.

Childhood overweight is increasing, yet limited information is available on childrens perspectives of overweight. The purpose of this investigation was to identify childrens perspective of their weight, exercise, and health status. Participants were 17 children, 8 to 12 years of age, with body mass indexes ≥ 95% for age and gender. A qualitative investigation using a phenomenological approach was conducted with a thematic analysis. Themes that emerged included intellectual disconnect, body image incongruence, social importance, and exercise perspectives . Children correctly identified healthy and unhealthy behaviors: dietary intake and physical activity. Childrens knowledge about healthy dietary intake and physical activities disconnected from actual health practices. Children demonstrated confusion about physical activity requirements: frequency, intensity, and duration. Nurses need to develop strategies to bridge disconnect between what children know and actual dietary intake and physical activities. Nurses are fundamental to increasing childrens knowledge of physical activity requirements for health promotion and disease prevention.

Obese women's perceptions and experiences of healthcare and primary care providers: a phenomenological study.

Background:Nearly two thirds of the adult population in the United States is overweight or obese. Adults who are overweight or obese require the same high-quality healthcare from their providers as any other adult. Unfortunately, stigma is a reality experienced by individuals who are overweight or obese, and healthcare professionals’ views have sometimes been reported to be biased against individuals who are overweight or obese. However, there are gaps and inconsistencies in the literature regarding the types of experiences and perceptions of obese women receiving healthcare and whether stigma is present. Objective:The aim of this study was to describe the experiences and perceptions of obese women with regard to stigma in healthcare and from their healthcare provider. Methods:A phenomenological research approach using the Colaizzi method was utilized to examine and describe the lived experience of overweight and obese women with healthcare. Semistructured interviews were conducted with a diverse, purposive sample of 26 English-speaking women with a body mass index of over 30 kg/m2. Participants were asked to describe their perceptions and experiences with regard to healthcare and their relationship with their healthcare providers. Results:Four themes emerged from the analysis of the data: (a) perceptions of health and healthcare, (b) respect me as a person, (c) establishing a healthcare connection, and (d) assertiveness is necessary. Although stigma was not named by women in this study, all acknowledged some negative treatment by healthcare providers. Discussion:Discussion relating to the current professional literature is presented. Implications for nursing education and research are discussed.

Children in Research: The Experiences of Siblings in Research Is a Family Affair

The specific aims of this study were to (a) ascertain siblings’ ethical concerns, process, and meaning of their brother’s or sister’s involvement in clinical research; (b) describe siblings’ understanding of the research in which their brother/sister was involved; (c) explore siblings’ perception of sociocultural influences on their brother’s/sister’s willingness to participate in research; and (d) describe how siblings are affected by their brother’s/sister’s research trial. Nineteen siblings (ages 9 to 21) whose brother or sister had been enrolled in a clinical research trial within the past 6 months were interviewed, and the data were analyzed qualitatively. A sibling’s understanding of the clinical research trial was distinctly different depending on his or her developmental age and the illness of the brother/sister. These differences included the invasiveness of procedures, seriousness of condition, and the need for siblings to actually participate in the clinical research treatment.

Dietary and Physical Activity Patterns: Examining Fathers’ Perspectives

PURPOSEnObesity adversely affects children, yet limited information is available on the familial environmental influence of fathers. The purpose of this study was to examine fathers influences on their childrens eating and activity patterns.nnnDESIGN AND METHODSnParticipants for this mixed methods study was a convenience sample of 51 multi-ethnic fathers of children 8-12 years of age, who completed surveys addressing dietary and physical activity behaviors.nnnRESULTSnAn association was found between fathers and childrens weight status. Half the children snacked without parental guidance.nnnPRACTICE IMPLICATIONSnNurses need to assist children and their families to develop effective weight management strategies.

Effective Weight Loss for Children: A Meta‐analysis of Intervention Studies 2002–2015

BACKGROUNDnInvestigators have implemented a variety of strategies for managing and treating childhood overweight and obesity over the past decade, yet the high prevalence of childhood overweight or obesity remains. The aim of this meta-analysis was to examine the effectiveness of childhood overweight or obesity interventions addressing weight loss from 2002-September 2015.nnnMETHODSnThe population focused on in this review were children who were overweight. The treatment group interventions focused on weight loss for overweight children, and included dietary, physical activity, life style changes, or a combination of treatments. Control groups received no treatment other than what they would usually receive in their normal daily lives including standard healthcare assessments. Outcomes for the studies were focused on whether the overweight children in the treatment groups lost weight.nnnRESULTSnThe criteria for the meta-analysis were met by 16 intervention studies, with a total of 19 outcomes reported within those studies. Two thousand, three hundred and seventeen participants ranged from 6 to 15 years of age with a mean age of 12 years or less. The majority of the 16 studies were conducted outside the United States (n = 13), with half reporting data on the cost of running the programming (n = 8) and were overwhelmingly conducted by interdisciplinary teams without nurses as members of the team (n = 13). The M effect was g = .732, p < .001 with a 95% confidence interval of 0.351 to 1.113, with quality scores ranging from 20 to 29 out of a possible 41. The heterogeneity analyses overall Q score was 378, an I-squared of 95, with a fail-safe N of 415.nnnLINKING EVIDENCE TO ACTIONnDiverse interventions included in this meta-analysis had a significant positive effect on weight loss in overweight children. Future research needs to focus on the role of the nurse in ensuring development and translation of the effective interventions in real world settings, at a scale that would move beyond small segments of the affected populations of overweight children.

Implementation of the Bedside Paediatric Early Warning System (BedsidePEWS) for nurse identification of deteriorating patients

PURPOSEnThe purpose was to explore nurses and physicians recognition of signs of deterioration and management of symptoms.nnnDESIGN AND METHODSnThis descriptive, cross-sectional study used an electronic survey with 35 nurses and 17 physicians.nnnRESULTSnNurses using the Bedside Paediatric Early Warning System (BedsidePEWS) were significantly more likely to recognize risk for deterioration and respond with appropriate interventions. Physicians incorporating BedsidePEWS were more likely to choose reliable indicators of deterioration and reported significantly more effective communication from nurses to identify deterioration.nnnPRACTICE IMPLICATIONSnBedsidePEWS may improve nurses and physicians abilities to recognize early signs of patient deterioration, communicate findings to providers, and plan interventions.

Relationship between person's health beliefs and diabetes self-care management regimen

PURPOSEnTo examine the relationship between the health beliefs of Saudi adults with type 2 diabetes mellitus (T2DM) and their adherence to daily diabetes self-care management regimen. A secondary aim was to examine the health beliefs of adults with a diabetic foot ulcer (DFU) and participants without a DFU.nnnMETHODnDescriptive correlational design with a convenience sample of 30 participants. Participants were recruited for this pilot study from an outpatient clinic at King Abdulaziz Medical City in Riyadh. The participants completed self-reported questionnaires about their health beliefs, daily diabetes self-care management regimen, and demographic characteristics. Hierarchical multiple regression analysis was used to test the interaction effects.nnnFINDINGSnParticipants who reported having a high internal health locus of control (IHLoC) and a high level of self-efficacy (SE) adhered well to their foot care regimen (Pxa0=xa0.038). The more the participants believed that God controls their health, and the higher their SE, the greater the participants adherence to their medication regimen (Pxa0=xa0.035). The stronger the participants belief that following their diabetes treatment regimen will lead to good outcomes, the greater the participants adherence to their dietary regimen for those with a low IHLoC (Pxa0=xa0.015). Participants with a high SE and reported that their doctor is able to help them control their diabetes were more likely to follow their dietary regimen (Pxa0=xa0.048). Participants with a DFU reported having additional health conditions besides T2DM (Pxa0=xa0.018) and had less than a college education (Pxa0=xa0.015). Although participants with a DFU reported that they were responsible for their diabetes (Pxa0=xa0.21), they stated that God manages their diabetes (Pxa0=xa0.29), and the disease can be controlled based on luck (Pxa0=xa0.10).nnnCONCLUSIONSnParticipants beliefs were found to influence their daily self-care management regimen. Further studies are needed using a larger sample.

Life With HIV: Insights from HIV-infected Women in Cameroon, Central Africa

&NA; Women in Cameroon are disproportionately burdened by HIV illness. Understanding the impact HIV has on women is essential for developing interventions to enhance their quality of life. Our aim was to explore and provide an in‐depth understanding of the daily experiences of a sample of women living with HIV in Cameroon. Qualitative semi‐structured in‐depth interviews were conducted with women (N = 30) from the northwest region of Cameroon who self‐reported being infected with HIV. Participants shared that they had multiple challenges in their daily experiences living with HIV. The themes that emerged included: (a) receiving an HIV diagnosis is traumatic, (b) living with HIV is a constant struggle, (c) limited resources and support cause problems, and (d) stigma and powerlessness exacerbate the impact of HIV. We provide insight into the daily experiences of HIV‐infected women in Cameroon. Implications for improving health care and social services to women living with HIV in Cameroon are suggested.

School Nurses' Experiences and Perceptions of Healthy Eating School Environments

&NA; School nurses provide health promotion and health services within schools, as healthy children have a greater potential for optimal learning. One of the school nurses role is in encouraging healthy eating and increasing the availability of fruits and vegetables in the school. The purpose of this study was to explore and describe school nurses perceptions of their role in promoting increased fruit and vegetable consumption in the school setting. One avenue to increased availability of fruits and vegetables in schools is Farm to School programs mandated by the Federal government to improve the health of school children. School nurses are optimally positioned to work with Farm to School programs to promote healthy eating. A secondary aim was to explore school nurses knowledge, experiences and/or perceptions of the Farm to School program to promote fruit and vegetable consumption in the school setting. Three themes emerged from the focus groups: If There Were More of Me, I Could Do More; Food Environment in Schools; School Nurses Promote Health. School nurses reported that they addressed health issues more broadly in their roles as educator, collaborator, advocate and modeling healthy behaviors. Most of the participants knew of Farm to School programs, but only two school nurses worked in schools that participated in the program. Consequently, the participants reported having little or no experiences with the Farm to School programs. Highlights:School nurses have limited experiences with Farm to School Programs in WisconsinWisconsin School nurses define their role as educator, collaborator, advocate and model for healthy behaviors.Three themes emerged from the data regarding school nurses time, the schools food environment and health promotion.