Okul Çağındaki Fazla Kilolu/Obez Çocukların ve Ebeveynlerinin “Sağlıklı Beslenme Sürecine Yönelik” Bakış Açıları: Nitel Bir Çalışma

Abstract

Amaç: Okul çağındaki fazla kilolu/obez çocuklara ve ebeveynlerine verilen sağlıklı beslenme danışmanlığı sürecinde katılımcıların deneyimlerinin aydınlatılması amaçlanmıştır. Gereç ve Yöntemler: Bandırma’da (Türkiye) yapılan çalışmada, sağlıklı beslenme danışmanlığı alan 8 çocuk (ve ebeveynleri) ile görüşmeler yapılmıştır. Temalar çalışma katılımcıları tarafından doğrulanmıştır. Süreçle ilgili deneyimler tematik analiz kullanılarak analiz edilmiştir. Bulgular: Çocuklar sağlıklı beslenme dönemindeki deneyimlerini farklı duygularla ifade etmiştir. Çalışmamızın ana temaları (a) eksiklikler, (b) çıktılar, (c) zorluklar, (d) başa çıkma stratejileri, (e) öneriler olarak belirlenmiştir. Temalar ve alt temalar sentezlendiğinde kolaylaştırıcıların, göstergelerin ve engellerin iç içe geçtiği, iletişim, motivasyon, somut adımların atılmasının ve iş birliğinin sağlıklı beslenme döneminin ihtiyaçları olduğu belirlenmiştir.Sonuç: Çalışmamız, sağlıklı beslenme döneminde aile-çocuk iş birliği konusuna dikkat çekmekte ve engellerin kaldırılmasına yönelik ihtiyaçları ortaya koymaktadır. Başa çıkma stratejilerinin geliştirilmesi, motivasyonun artırılması ve somut adımlar atılmasının desteklenmesi, daha sağlıklı bir gelecek için uygun ortamı sağlayabilir.

Keywords

• Çocuk
• Çocuk Beslenmesi Bilimleri
• Ebeveynler
• Pediatrik obezite

Perspectives of School-Aged Overweight/Obese Children and Their Parents on "Healthy Nutrition Period": A Qualitative Study

Abstract

Objective: It is aimed to illuminate the experiences of healthy nutrition counseling given to school aged overweight/obese children and their parents. Material and Methods: Interviews were conducted with 8 children (and their parents) who received healthy nutrition counseling from Bandırma, Turkey. Themes were validated by study participants. Experiences with the process were analyzed using thematic analysis. Results: Children expressed their experiences during the healthy nutrition period with different emotions. The main themes of our study were determined as (a) shortcomings, (b) outputs, (c) challenges, (d) coping strategies, (e) suggestions. By synthesizing the themes and sub-themes, it has been determined that facilitators, indicators and obstacles are intertwined, and communication, motivation, taking concrete steps and cooperation are the needs of the healthy nutrition period. Conclusion: Our study highlights the issue of family-child collaboration in the healthy nutrition period and presents needs to alleviate barriers. Developing coping strategies, increasing motivation, and supporting the taking of concrete steps could provide a suitable environment for a healthier future.

Keywords

• Child
• Child Nutrition Sciences
• Parents
• Pediatric obesity

References

1. 1. Nittari G, Scuri S, Petrelli F, Pirillo I, Di Luca NM, Grappasonni I. Fighting obesity in children from European world health organization member states. Epidemiological data, medicalsocial aspects, and prevention programs. La Clinica Terapeutica 2019; 170: 223-30.
2. 2. Skinner AC, Ravanbakht SN, Skelton JA, Perrin EM, Armstrong SC. Prevalence of obesity and severe obesity in US children, 1999–2016. Pediatrics 2018; 141: e20173459
3. 3. Ministry of Health. Monitoring the Growth of School Age Children (6-10 Age Group) in Turkey (TOÇBİ) Project Research Report. 2011; Ankara.
4. 4. Ministry of Health. Turkey Childhood (Primary School 2nd Grade Students) Obesity Survey COSI-TUR 2016. 2017; Ankara.
5. 5. Jensen MD, Ryan DH, Apovian CM, Ard JD, Comuzzie AG, Donato KA, et al. Obesity Society. 2013 AHA/ACC/TOS guideline for the management of overweight and obesity in adults: a report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines and The Obesity Society. Circulation 2014; 129(25 Suppl 2): 102–38.
6. 6. Bass R, Eneli I. Severe childhood obesity: an under-recognised and growing health problem. Postgrad Med J 2015; 91: 639–45.
7. 7. Dokuzcan DA, Aydoğdu NG, Gürkan KP. Parents of Primary School Students’ Perception-Anxiety Levels Related to Childhood Obesity and Their Practices Regarding Child FeedingSakarya Med J 2021; 11: 857-64.
8. 8. Vio F, Fretes G, Montenegro E, González CG, Salinas J. Prevention of children obesity: A nutrition education intervention model on dietary habits in basic schools in Childe. Food and Nutrition Sciences 2015; 6: 1220-8.

9. 9. Gray LA, Hernandez Alava M, Kelly MP, Campbell MJ. Family lifestyle dynamics and childhood obesity: evidence from the millennium cohort study. BMC Public Health 2018; 18: 1-15.
10. 10. Burchett HED, Sutcliffe K, Melendez-Torres GJ, Rees R, Thomas J. Lifestyle weight management programmes for children: A systematic review using qualitative comparative analysis to identify critical pathways to effectiveness. Preventive Medicine 2018; 106: 1–12.
11. 11. Wellard-Cole L, Davies A, Allman-Farinelli M. Contribution of foods prepared away from home to intakes of energy and nutrients of public health concern in adults: A systematic review. Crit Rev Food Sci Nutr 2022; 62: 5511-22.
12. 12. Kim HS, Park J, Ma Y, Im M. What Are the Barriers at Home and School to Healthy Eating? Overweight/Obese Child and Parent Perspectives. J Nurs Res 2019; 27:e48.
13. 13. Apperley LJ, Blackburn J, Erlandson-Parry K, Gait L, Laing P, Senniappan S. Childhood obesity: A review of current and future management options. Clin Endocrinol (Oxf) 2022; 96: 288-301.
14. 14. Kim J, Lim H. Nutritional Management in Childhood Obesity. J Obes Metab Syndr 2019; 28: 225-35.
15. 15. Appleton J, Fowler C, Brown N. Parents' views on childhood obesity: qualitative analysis of discussion board postings. Contemp Nurse 2017; 5: 410-20.
16. 16. Hodder RK, O'Brien KM, Lorien S, Wolfenden L, Moore TH, Hall A, et al. Interventions to prevent obesity in school-aged children 6-18 years: An update of a Cochrane systematic review and meta-analysis including studies from 2015–2021. EClinicalMedicine 2022:54: 101635.
17. 17. Kiess W, Galler A, Reich A, Müller G, Kapellen T, Raile K, et al. Clinic alaspects of obesity in childhood and adolescense. Obes Rev 2001;2:29-36.
18. 18. T.C. Sağlık Bakanlığı Halk Sağlığı Genel Müdürlüğü. (2013). Türkiye’de okul çağı çocuklarında (6-10 yaş grubu) büyümenin izlenmesi (TOÇBİ) projesi araştırma raporu. Ankara: Sağlık Bakanlığı Yayın No: 834.
19. 19. Ziser K, Decker S, Stuber F, Herschbach A, Giel KE, Zipfel S, Junne F. Barriers to behavior change in parents with overweight or obese children: a qualitative interview study. Frontiers in Psychology 2021:12;631678.
20. 20. Kansra AR, Lakkunarajah S, Jay MS. Childhood and adolescent obesity: A review. Front Pediatr 2021;8:581461.
21. 21. Martin A, Booth JN, Laird Y, Sproule J, Reilly JJ, Saunders DH. Physical activity, diet and other behavioural interventions for improving cognition and school achievement in children and adolescents with obesity or overweight. Cochrane Database Sys Rev 2018; ;1465-858.
22. 22. Bae JH, Lee H. The effect of diet, exercise, and lifestyle intervention on childhood obesity: A network meta-analysis. Clinical Nutrition 2021; 40: 3062-72.
23. 23. Rumaisa FS., Worsley A, Silva KRR, Nanayakkara J. Opportunities and challenges associated with food and nutrition education in Sri Lankan primary schools. International Journal of Health Promotion and Education 2021; 1-13.
24. 24. Cason-Wilkerson R, Goldberg S, Albright K, Allison M, Haemer M. Factors influencing healthy lifestyle changes: a qualitative look at low-income families engaged in treatment for overweight children. Child Obes 2015;11:170-6.
25. 25. Schalkwijk A, Bot S, de Vries L Westerman M, Nijpels G, Elders P. Perspectives of obese children and their parents on lifestyle behavior change: A qualitative study. Int J Behav Nutr Phys Act 2015;12:102.
26. 26. Watson L, Baker M, Chadwick P. Kids just wanna have fun: Children's experiences of a weight management programme. Br J Health Psychol 2016; 21: 407–20.
27. 27. Koneru G, Rao NSS, Sai TSR. A qualitative study on dietary habits and nutritional awareness among school children. J Community Health Manag 2019; 6: 105-12.
28. 28. von Hippel PT, Workman J. From Kindergarten Through Second Grade, U.S. Children's Obesity Prevalence Grows Only During Summer Vacations. Obesity (Silver Spring) 2016; 24: 2296–300.
29. 29. Graneheim UH, Lundman B. Qualitative content analysis in nursing research: concepts, procedures and measures to achieve trustworthiness. Nurse Education Today 2004; 24: 105-12.
30. 30. Kiger ME, Varpio L. Thematic analysis of qualitative data: AMEE Guide No. 131. Med teach 2020;42:846-54.
31. 31. Attride-Stirling J. Thematic networks: an analytic tool for qualitative research. Qualitative research 2001;1:385-405.
32. 32. Belgrave LL, Seide K. Coding for grounded theory. The SAGE handbook of current developments in grounded theory 2019: 167-85.
33. 33 Watson PM, Dugdill L, Pickering K, Hargreaves J, Staniford, LJ, Owen S, et al. Distinguishing factors that influence attendance and behaviour change in family‐based treatment of childhood obesity: A qualitative study. Br J Health Psychol 2021; 26: 67-89.
34. 34. Razi M, Nasiri A. Concerns of parents about children's overweight and obesity during the COVID-19 pandemic: A qualitative study. J Pediatr Nurs 2022 ;63: 111–6.
35. 35. Wagner E, Jamil O, Hodges B. Talking About Childhood Obesity. Clin Pediatr 2022; 61: 266-9.
36. 36. Nowicka P, Ek A, Grafström E, Johansson T, Nordin K, Neuman N, et al. How do interpersonal relationships affect children's weight management? A qualitative analysis of parents' long-term perceptions after obesity treatment. Child Obes 2022; 18: 274-80.
37. 37. Alexander R, Estabrooks P, Brock DJP, Hill JL, Whitt-Glover MC, Zoellner J. Capacity development and evaluation of a parent advisory team engaged in childhood obesity research. Health Promot Pract 2021;22:102-11.
38. 38. Li B, Adab P, Cheng KK. The role of grandparents in childhood obesity in China-evidence from a mixed methods study. Int J Behav Nutr Phys Act 2015; 12: 1-9.
39. 39. Murphy M, Boardman F, Robertson W, Johnson R. Children's perspectives and experiences of health, diet, physical activity and weight in an urban, multi‐ethnic UK population: A qualitative study. Child Care Health Dev 2021; 47: 597-607.
40. 40. San Giovanni CB, Dawley E, Pope C, Steffen M, Roberts J. The Doctor Will "Friend" You Now: A Qualitative Study on Adolescents' Preferences for Weight Management App Features. South Med J 2021; 114: 373–9.
41. 41. O'Donnell JE, Foskett-Tharby R, Gill PS. General practice views of managing childhood obesity in primary care: a qualitative analysis. JRSM Open 2017; 8: 2054270417693966.
42. 42. Sedibe HM, Kahn K, Edin K, Gitau T, Ivarsson A, Norris SA. Qualitative study exploring healthy eating practices and physical activity among adolescent girls in rural South Africa. BMC Pediatr 2014;14: 211.
43. 43. Rundle AG, Park Y, Herbstman JB, Kinsey EW, Wang YC. COVID-19-related school closings and risk of weight gain among children. Obesity (Silver Spring) 2020; 28;1008-9.