Public health nurses’ experiences following up children with overweight and obesity according to national guidelines. A qualitative study

ABSTRACT

Purpose

This study aimed to develop knowledge of how the follow-up regarding overweight and obesity among children in primary school is experienced by the PHN and how the guidelines may be used to improve health services in this follow-up.

Methods

We analysed semi-structured interviews of 9 PHNs using qualitative content analysis.

Results

Two themes emerged: Following up with children with overweight and obesity is an important but challenging duty; The PHNs call for clearer guidelines. Following five sub-themes: PHNs strive to adhere to the guidelines, show compassion in the follow-up, have difficulty handling parents’ feelings and reactions, feel alone with the responsibility, and have suggestions for clearer guidelines.

Conclusions

PHNs call for enough resources to communicate the results of the child’s weight in a sufficient form. PHNs and families should establish common goals. The PHN should avoid one-way communication but meet the parents’ concerns and needs. This requires the PHN to focus on building a secure relation to the child and the families, as described by Peplau. Guidelines must include instructions and tools on how to communicate and meet the family’s concerns. Political action and increased funding could strengthen the follow-up and thereby prevent more obesity among children, which can be a predictor of poorer health outcomes later in life.

KEYWORDS:

• Children
• overweight
• obesity
• guidelines
• public health nurse
• school nurse
• communication
• qualitative
• Hildegard Peplau

Acknowledgments

We are grateful to the participants who took part in this study for sharing valuable information and to the leaders of the school health service for facilitating the possibility of interviewing the participants in a busy work schedule.

Disclosure statement

No potential conflict of interest was reported by the author(s).

Additional information

Funding

The author(s) reported thereis no funding associated with the work featured in this article.

Notes on contributors

Hanna Skjelbred Nygaard

Hanna Skjelbred Nygaard, bachelor’s degree in nursing, and master’s degree in public health nursing. Work experience as Public Health Nurse in the school health service, both primary school and secondary school. Currently working as a registered Public Health Nurse in Stavanger kommune.

Kirsten Gudbjørg Øen

Kirsten Gudbjørg Øen, Professor at the University of Stavanger, Norway, with background as public health nurse, psychiatric - and paediatric nurse, counselling, with a master’s in health psychology. Research areas are health care services for children and families, interaction, and communication, with particular emphasis on mental health, children, adolescents, and families where obesity is a challenge. She has expertise in action research and various qualitative research methods, has led the action research project “Healthy Future”, and is the editor and author of two books on overweight and obesity in children in Norwegian. Her areas of expertise are also pedagogy, learning, and education in nursing and health - and psychosocial care, and motivational interviewing.