Prevalence and risk factors of excess weight in school children in West Greece

The present study estimated the prevalence of childhood obesity and identified risk factors in 10–13 year old children. A cross‐sectional study was conducted, including 200 children and their parents, in seven randomly‐selected primary schools across Patras, Greece. Height, weight, and waist circumference were measured, and self‐reported information was collected via face‐to‐face interviews. Body mass index was calculated for the children and their parents. The effect of risk factors on overweight and obesity was analyzed using regression analysis. The prevalence of overweight and obesity was 32% and 10.5%, respectively. The odds of being overweight/obese increased in children whose parents had a lower educational level and/or higher body mass index. Fewer daily meals and more time spent in front of the television and/or on the computer were significantly associated with obesity in 10–13 year old children. The prevalence of excess weight in primary school children in Patras is of concern, especially for boys. Children's nutritional habits, leisure activities, and parental characteristics influence their somatometric characteristics. These findings highlight the need for future weight loss interventions targeted at this population.     

A preliminary study describing body position in daily life in children with severe cerebral palsy using a wearable device

Purpose.?The effects of gravity and immobilisation are regarded as factors in the development of spinal deformity in cerebral palsy (CP). This study was to assess the body positions in daily life of children with CP using a wearable device.

Method.?Four institutionalised children with severe quadriplegic CP participated in this study. Four age-matched children without disability also participated as healthy controls. The participants wore a body position recorder throughout their normal daily activities for a period of 24?h. After the body position data were recorded, the amount of time spent by each subject in upright, supine, prone, and left and right lateral lying positions and the frequency of positional change were computed.

Results.?The pattern of body position change in daily life was clearly different among children with CP and between children with CP and healthy controls. Children with CP spent less time in the upright position and remained in one position for longer periods of time than the control children.

Conclusions.?Twenty-four-hour monitoring could provide quantitative information about body position, the frequency of body position changes and the period of time spent in a preferred body position, with possible implications for preventing spinal deformity.     

Raising issues about children’s overweight – maternal and child health nurses’ experiences

Title. Raising issues about children’s overweight – maternal and child health nurses’ experiences. Aim. This paper is a report of a study carried out to describe maternal and child health nurses’ experiences of communicating and raising issues with parents about children’s overweight. Background. Children's overweight and obesity are rapidly increasing in many countries around the world. Maternal and child health nurses are in a unique position to influence parents, but studies of their experiences in communicating with parents about overweight are lacking. Method. Ten maternal and child health nurses in culturally diverse rural and urban areas in Melbourne, Australia, were interviewed in 2007. Data were analysed using qualitative content analysis to identify key categories. Findings. During the analysis, eight categories were identified. In summary, nurses described it as difficult to raise weight issues, especially if parents were overweight themselves. The growth chart was felt to be an essential tool in discussions about weight and nurses often described themselves as holding ‘expert’ roles in conversations. Denial, defensiveness and excuses about children being overweight were common reactions among parents and were described as difficult to deal with. However, a strong nurse–parent relationship was experienced as facilitating conversations about weight. Conclusion. Raising issues about weight can be difficult, especially if parents are overweight themselves. Further research in communications is needed to understand and approach parents better – especially overweight parents – about their children’s weight. Interventions involving patient‐centred approaches in this context have potential, but the area is still relatively unexplored. Maternal and child health centres could be important contributors in such future interventions.     

Experience of loneliness in Iranian abused elders

HERAVI‐KARIMOOI M., REJEH N., FOROUGHAN M. & VAISMORADI M. (2011) Experience of loneliness in Iranian abused elders. International Nursing Review 59 , 139–145 Aim: This study aimed to explore the experience of loneliness in Iranian abused elderly people. Methods: A qualitative design was employed to collect and analyse data regarding the experience of loneliness in abused elderly people living in an urban area of Iran. A purposeful sampling strategy was applied. Semi‐structured in‐depth interviews were held with 14 participants (five men and nine women) until the data richness was fulfilled. The data were analysed using the Colaizzi method. Findings: Three main themes emerged as follows: ‘feeling of pain and suffering’, ‘feeling of being an outsider’ and ‘feeling of deprivation’. A discrepancy existed between how the participants had imagined their lives in later life and how they actually lived them. Conclusion: The combination of abuse, old age and deprivation increased suffering and pain, which accompanied the loneliness experience in older people. The findings suggest that nurses need to address factors such as abuse, neglect and deprivation influencing the experience of loneliness during the assessment of their elder patients. This may help them to devise strategies for preventing abuse or alleviating the sense of loneliness in elderly people.     

Influence of body mass index,gender, and Hispanic ethnicity on physical activity in urban children

Purpose. This community‐based participatory research study examined the association between overweight status and activity among Hispanic urban, school‐age children. Design and Methods. In a sample of 140 children, activities were assessed using the Youth Risk Behavior Survey's questions about physical activity (PA) and team sports. Results. Thirty‐nine percent were overweight (body mass index [BMI] >85%). Normal‐weight children had higher levels of PA and team sports. Females had lower levels of PA and team sports. Significant associations included BMI and sports team participation, and BMI and Hispanic ethnicity. Practice Implications. Nurses should be aware that Hispanic urban children are at risk for lower activity.     

Older women nurses: health, ageing concerns and self-care strategies

Title. Older women nurses: health, ageing concerns and self‐care strategies Aim. This paper is a report of a study of the health and ageing concerns and self‐care strategies of older female Registered Nurses currently working in direct care‐giving roles in acute public hospitals and community facilities. Background. Nursing is a rapidly ageing, and female‐dominated workforce. However, despite the ageing of the nursing workforce, little is known about the needs and health concerns of older nurses. Method. A feminist perspective was used and 12 female Registered Nurses aged 40–60 years, employed in various acute hospital and community health settings in Australia took part in qualitative interviews in late 2004. Narratives were audio taped, transcribed and analysed thematically. Findings. Two major themes were identified. The first theme –Aches and pains of ageing– had four subthemes: Neglecting self: ‘You don't think of yourself first’; Physical changes: ‘The body is wearing out’; Living with pain: ‘You just work around it’; and Tiredness: ‘I’m just tired all the time’. The second theme –Evolving lifestyles: works in progress – had three subthemes: The power of exercise: ‘I feel great…and I’m enjoying life’; Healthy eating: ‘Low fat, lots of fruit and veg, little processed food’; and Adapting to ageing: ‘I think it’s quite a good time of life’. Conclusion. Further research is needed to explore the need for protective work practices and promoting healthy lifestyle practices for ageing nurses. Managers need to recognize the changing health needs of older clinical nurses and offer, for example, flexible rostering and tailored exercise programmes to promote their health.     

Factors associated with the feeling of stability in the daily life among colostomy patients

Aim: Colostomy patients must lead a stable life after discharge. However, little is known about the feeling of stability in the daily life of these patients. The purpose of the present study was to identify the associated factors. Methods: The subjects were outpatients who met all of the following criteria: (i) a permanent colostomy for the treatment of colonic, rectal, or anal cancer; (ii) under 80 years of age; (iii) a colostomy history of less than 10 years; and (iv) no significant prior physical or psychiatric disorders. Data were collected by conducting interviews using a questionnaire, examining medical records, and asking the nurses responsible for patients’ care. The following measures were evaluated: patients’ feeling of stability in the daily life, patients’ characteristics, physical condition, support resources, self‐evaluation of their current life, and hospital characteristics. Statistical analysis was performed using t‐tests, Spearman's rank correlation coefficients, and structural equation model. Results: Data from 133 patients were available for analysis. The final model fitted the data well. All estimated parameters were significant. The opportunity to attend periodic stoma clinics and support from nurses contributed to the feeling of stability in the daily life and had a positive effect on patients’ self‐evaluation of their current life. Conclusions: The results of this study corroborated the necessity for an outpatient support system to enhance the feeling of stability in the daily life after hospital discharge. This finding supports the need to improve stoma care systems and to make such systems more available.     

Homeless children: the lives of a group of Brazilian street children

Homeless children: the lives of a group of Brazilian street children Aim. To evaluate the life trajectories of a group of school‐age street children frequenting two São Paulo city public shelters. Background. A large proportion of the Brazilian child population suffers extreme disadvantage, although the Brazilian government gave the issue ‘absolute priority’ in 1990. Maternal and Under 5 mortality rates remain unacceptably high. In the metropolitan region of São Paulo an estimated 200 000 minors do not live with their mothers. Brazilian street children live lives of extreme personal and social risk. Study method. The data were collected through individual, semi‐structured interviews, with 14 school age (7–12 years) participants frequenting two city public refuges, with their legal guardians’ consent. Data analysis was based on Social Representation Theory and used content analysis. Findings. The children’s most meaningful experiences were grouped into the thematic categories of family, the street, friends, drugs, the police, the shelters and the future. Synthesis of these categories showed the lives of these children to be permeated by violence, resulting in experiences restricting their full development. Conclusion. The solution to their problems depends on pressure being put on the State by the civilian community in order to establish social and health policies that conform to the Child and Adolescent Statute (ECA). We consider that assisting street children involves attitudes that go beyond professional performance and demands acts of citizenship. Recommendations. The development of an ethical‐political attitude by professionals to the problems of homeless street children is essential, and educational curricula should be appropriately constituted. Political projects to develop health and welfare policies and education should be directed to these children and their relatives, and include participation by health professionals to provide the necessary preventive and curative services.     

Women's stories of their experiences as overweight patients

Title. Women’s stories of their experiences as overweight patients. Aim. This paper is a report of a study to illuminate the meaning of women’s experiences as overweight patients in their encounters with healthcare services and healthcare providers. Background. Overweight and obesity are increasingly important issues for women’s health internationally. Overweight or obese women may delay or avoid health care if care providers have previously reacted negatively to them based on weight. However, studies focusing on the meaning of women’s experiences as overweight patients and as recipients of healthcare services are lacking. Method. A hermeneutic phenomenological approach was used. Face‐to‐face interviews were conducted in the United States of America in 2007 with eight women volunteers who self‐identified as being overweight patients. The framework of van Manen’s lifeworld existentials of lived space, lived body, lived time and lived relation‐guided reflection for data analysis. Findings. The essence of women’s experiences was a battle to fit into the world of healthcare services. Four major themes were identified. ‘ Struggling to fit in ’ consisted of trying to fit into limited physical space (examination rooms, equipment), limited time, and limited satisfaction and support in relationships with healthcare providers. ‘ Being dismissed ’ consisted of demeaning and embarrassing interactions with providers. ‘ Feeling not quite human ’ involved the stigma of being different because of body size. ‘ Refusing to give up ’ consisted of persistence in seeking support and advice from professionals despite negative past experiences. Conclusion. Awareness of these findings could reform understanding of women’s experiences as overweight patients and raise the consciousness of nurses worldwide to develop sensitive communication strategies and healthcare environments that support holistic care.     

Frontline healthcare providers’ views of depression and its prevention in older adults

Aims and objectives.  To describe healthcare providers’ views on depression and its prevention in older people. Background.  There is an urgent need to develop public health approaches to depression prevention in older adults because of the growing older population and the high rate of depression among community‐dwelling older adults in Taiwan. Prior studies have focused on the prevalence of and risk factors for depression in Taiwanese community‐dwelling older adults. Research from the viewpoints of prevention and healthcare providers is needed to guide these approaches. Design.  A qualitative study involving semi‐structured interviews. Methods.  A purposive sample of 25 healthcare providers was recruited from a city in northern Taiwan. Data were collected through in‐depth individual interviews and analysed using thematic analysis. Results.  Results were embedded within four major themes: lack of children’s support, maladaptation to distressing life circumstances in late life, innate vulnerability in the individuals and being unaware of or reluctant to accept an illness. Conclusions.  Participants’ accounts of depression and its prevention were conceptualised within the family and socio‐cultural contexts older adults lived in. Lack of children’s support was reported as a main contributor to depression in older adults. Society was reported as the main context in which depression prevention intervention should take place. Communal activities were described as important for mental wellness and depression prevention. Relevance to clinical practice.  Study findings show how family, Chinese culture and socio‐economic circumstances influence accounts of depression and its prevention in older adults. Attention to the cultural construction of meanings may help extend our vision beyond a focus on the biomedical discourse and promote innovative ways of tackling depression that match the policy goals with the needs of older adults and community.     

'Finding home': a grounded theory on how older people 'find home' in long-term care settings

cooney a. (2011) ‘Finding home’: a grounded theory on how older people ‘find home’ in long‐term care settings. International Journal of Older People Nursing 7 , 188–199
doi: 10.1111/j.1748‐3743.2011.00278.x Background. A link between residents ‘feeling at home’ in long‐term care facilities and ‘quality of life’ is emerging in the literature. Few studies, however, have focused on what helps residents to find a home in long‐term care settings. This study aimed to fill this gap. Aim. This study aimed to understand older peoples’ perceptions of ‘being at home’ in long‐term care settings and the factors that influence these perceptions. Design. Grounded theory guided the study design. Residents (n = 61) living in public or private long‐term care settings were interviewed using unstructured interviews. Findings. Four categories were identified as critical to finding a home in long‐term care settings: ‘continuity’, ‘preserving personal identity’, ‘belonging’ and ‘being active and working’. ‘Finding Home’ was conceptualised as the core category. The potential to ‘find home’ was influenced by mediating and facilitating/constraining factors. Conclusions. The Theory of Finding Home was generated from the data. This theory describes the factors critical to ‘finding home’ in long‐term care settings. Implications for practice. The Theory of Finding Home gives insight into what matters to older people living in long‐term care settings. Strategies to help generate a feeling of home in long‐term care settings are shared.     

Women’s experiences of recovery from childbirth: Focus on pelvis problems that extend beyond the puerperium

Aims. This study aimed to build understandings of women’s recovery experiences in the presence of continued pelvic problems extending beyond the puerperium to provide nurses and other health care professionals with information to enhance current practice. Background. Trauma to the pelvic floor during childbirth is a relatively common occurrence and can include damage to structures and nerves. A significant number of women will experience ongoing physical pelvic problems resulting from childbirth that extend past the puerperium; however, little is known about the experiential aspects of recovery for these women. Design. A qualitative, phenomenological study. Method. Narrative data were collected during conversational interviews with 10 mothers who had sustained pelvic injury during the birth process that persisted past the puerperium. Recruitment was via media releases and brochures distributed through childcare facilities. The data was analysed using Van Manen’s thematic analysis. Results. The themes that arose from the analysis were: ‘fearing intimacy’, ‘managing an unpredictable body’, ‘being resigned’ and ‘feeling devalued and dismissed’. Conclusions. Pelvic injuries that extend beyond the postpartum period are distressing for women. They negatively affect women’s views of themselves and have an impact on various aspects of life including intimate relationships and social activities. Relevance to clinical practice. Currently, postpartum care may have a focus on baby rather than mother and this focus may impede women making full disclosures of ongoing health needs arising from their delivery. Findings of this study suggest that women may have specific needs that extend beyond the puerperium, indicating a need for continued holistic assessments and extending practice to identify and support women experiencing persistent pelvic postpartum complications.     

The meaning of fatigue for women with multiple sclerosis

AIM: This paper reports the findings of a study that aimed to elucidate the meaning of fatigue for women with multiple sclerosis (MS). BACKGROUND: Living with chronic illness can involve giving up usual activities. MS is a chronic autoimmune disease of the central nervous system. Fatigue is a common experience among people with MS; however, little is known about the meaning of fatigue experienced by women with this condition. METHOD: Ten women with MS were interviewed about their experience of fatigue. A phenomenological hermeneutic method influenced by Ricoeur was used to interpret the transcribed interviews. FINDINGS: The findings were presented in two major themes with five subthemes; experiencing the body as a barrier and experiencing a different absence. Fatigue seemed to give rise to an experience of being absent and divided into two parts. This also led to a feeling of not being able to participate in the surrounding world. The feeling of being an outsider and lacking the ability as a healthy person is interpreted as a form of suffering. Although the fatigue had a great impact on the women's daily life, the women still hoped for some relief. Fatigue seemed to imply that instead of working as an implement to manage in the world the body has become an enemy of survival. CONCLUSION: This study highlights the importance for nurses of understanding how women with MS experience fatigue, which is a prerequisite for communication based on a shared understanding. This awareness would enhance nurses' opportunities to alleviate suffering. More research is needed to investigate what kinds of interventions can help these women to manage their everyday lives and to maintain a sense of normality despite their fatigue and illness. Such interventions should be subject to empirical evaluation research.     

The importance of a daily rhythm in a supportive environment – promoting ability in activities in everyday life among older women living alone with chronic pain

Abstract

Purpose: The aim of this study was to explore how older women living alone with chronic musculoskeletal pain, describe their ability in performing activities in everyday life and what could promote their ability in activities in everyday life as well as their perceived meaning of a changed ability to perform activities in everyday life. Method: Qualitative interviews were conducted with 12 women, and an inductive content analysis was used. Results: The results showed the importance of a daily rhythm of activities. Activities included in the daily rhythm were socializing with family and friends, physical activities, doing own activities as well as activities supported by relatives and the community. The activities described by the women also promoted their ability in activities in everyday life. Other findings were the women’s perceived meaning of being independent and maintaining that independency, along with the meaning of accepting and adapting to a changed life situation. Conclusion: This paper concludes that it is important to be sensitive of individual needs regarding the daily rhythm of activities when health-care professionals intervene in the activities in everyday life of older women living alone, promote the women’s independency, and enable them to participate in the community.

• Implications for Rehabilitation

• A daily rhythm of activities is important for older women who live alone with chronic musculoskeletal pain.

• The importance of health-care professionals being sensitive to individual needs to promote ability in activities in everyday life and to encourage the everyday activities into a daily rhythm.

• Facilitate the women’s desire and will of independency, despite their needs of help from their environment to manage their everyday life.

     

Maintenance haemodialysis: patients' experiences of their life situation

Aim. The aim of this study was to examine how patients suffering from CKD on maintenance haemodialysis experience their life situation. The focus was on how treatment encroaches on time and space and how patients experience care. The rationale was that this knowledge is necessary to provide professional support that takes into consideration a person's whole life situation. Background. The experiences of patients with chronic kidney disease (CKD) undergoing maintenance haemodialysis have been studied in many quantitative studies, which translate patients’ subjective experiences into objectively quantifiable data. However, there are few qualitative studies examining the experiences of these patients’ life situation and expressing their experiences within the context of a nursing and caregiver's perspective. Method. Data were collected by interviews with 41 patients between the ages of 29 and 86 years who participated in the study. A content analysis was used to identify common themes that describe the patients’ experiences of their life situation. Results. Three main themes were identified, ‘not finding space for living’, ‘feelings evoked in the care situation’ and, ‘attempting to manage restricted life’. The first theme ‘not finding space for living’ consisted of two sub‐themes: ‘struggling with time‐consuming care’ and ‘feeling that life is restricted’. The second theme ‘feelings evoked in the care situation’ consisted of two sub‐themes: ‘sense of emotional distance’ and ‘feeling vulnerable’. Conclusions. The patients in this study indirectly expressed an existential struggle, indicating that encroachment of time and space were important existential dimensions of CKD. The findings indicated that caregivers were not always aware of this inducing a sense of emotional distance and a sense of vulnerability in the patients. Relevance to clinical practice. Caregivers in dialysis units have to consider haemodialysis patients’ experience of a sense of emotional distance in their relationship to caregivers. Nurses and doctors need to create routines within nursing practice to overcome this.     

Functional outcomes and daily life activities of African-American elders after hospitalization.

OBJECTIVE: African-American elders were recruited from a transitional unit after hospitalization and tracked for 6 months in the community after discharge to (a) examine functional outcomes on the unit and in the community and (b) identify patterns of participation in daily life activities. The International Classification of Impairments, Disabilities, and Handicaps (ICIDH-2) framework provided the structure to examine the connections among body systems, functional outcomes, and social participation for this population that has been underrepresented in past research. METHOD: A mixed design combined qualitative and quantitative methods, including qualitative interviews to document personal adaptive experience, a standardized functional assessment to identify functional outcomes, and a structured format to record activity participation. RESULTS: Findings revealed that 11 of the 17 participants improved their functional outcomes after discharge. Three patterns of activity participation identified were self-care, self-care and household management, and mixed activities. Contextual influences were diverse family support arrangements. CONCLUSION: Complex relationships were identified among body systems, functional outcomes, and daily life activities that were influenced by individual values and support arrangements.