Barriers and facilitators to health care professionals discussing child weight with parents: A meta-synthesis of qualitative studies
Barriers and facilitators to health care professionals discussing child weight with parents: A meta-synthesis of qualitative studies
复制标题
DOI：
10.1111/bjhp.12312
复制
发表时间：
2018-09-01
影响因子：
7.9
通讯作者：
Birtwistle, Sarah
中科院分区：
文献类型：
--
作者：
Bradbury, Daisy;Chisholm, Anna;Birtwistle, Sarah
前言儿童肥胖是全球公共卫生面临的最严峻挑战之一。然而，肥胖及其后果在很大程度上是可以预防的。由于父母在孩子与体重相关的行为中扮演着重要的角色，父母与卫生保健专业人员之间的良好沟通至关重要。这篇系统的综述提供了一个定性研究的总合，探讨了在与父母讨论儿童体重时，HCP所经历的障碍和促进者。方法使用以下数据库进行搜索：Medline(OVID)，心理信息(OVID)，EMBASE(OVID)，Web of Knowledge和CINAHL。纳入了自1985年以来在英语语言期刊上发表的13篇全文定性研究。研究包括从初级保健医生(例如护士、医生、营养师、心理学家和临床管理人员)收集的关于他们与父母讨论与儿童体重有关的问题的经验的数据。研究采用归纳式主题分析方法对研究结果进行综合分析，并利用社会生态框架将新出现的主题分为内部/人际因素、组织因素和社会因素。感知到的障碍和促进者通常与内部/人际层面的因素有关，即与员工因素、父母因素或职业-父母互动有关。在组织和社会层面上，HCP也归因于一些障碍，但不是促进者。结论本综述的结果可能有助于为未来体重相关沟通干预的发展提供参考。虽然内部/人际干预可能会在一定程度上改善卫生保健实践，但至关重要的是，所有利益攸关方都应考虑发生这些互动的更广泛的组织和社会背景。
IntroductionChildhood obesity is one of the most serious global public health challenges. However, obesity and its consequences are largely preventable. As parents play an important role in their children's weight-related behaviours, good communication between parents and health care professionals (HCPs) is essential. This systematic review provides a meta-synthesis of qualitative studies exploring the barriers and facilitators experienced by HCPs when discussing child weight with parents.MethodsSearches were conducted using the following databases: MEDLINE (OVID), Psych INFO (OVID), EMBASE (OVID), Web of Knowledge and CINAHL. Thirteen full-text qualitative studies published in English language journals since 1985 were included. Included studies collected data from HCPs (e.g., nurses, doctors, dieticians, psychologists, and clinical managers) concerning their experiences of discussing child weight-related issues with parents. An inductive thematic analysis was employed to synthesize findings.FindingsEmerging subthemes were categorized using a socio-ecological framework into intra/interpersonal factors, organizational factors, and societal factors. Perceived barriers and facilitators most commonly related to intra/interpersonal level factors, that is, relating to staff factors, parental factors, or professional-parent interactions. HCPs also attributed a number of barriers, but not facilitators, at the organizational and societal levels.ConclusionThe findings of this review may help to inform the development of future weight-related communication interventions. Whilst intra/interpersonal interventions may go some way to improving health care practice, it is crucial that all stakeholders consider the wider organizational and societal context in which these interactions take place.