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Enabling overweight children to improve their food and exercise habits - school nurses' counselling in multilingual settings.

Journal article
Authors Maria B Magnusson
Karin I Kjellgren
Anna Winkvist
Published in Journal of clinical nursing
Volume 21
Issue 17-18
Pages 2452-2460
ISSN 1365-2702
Publication year 2012
Published at University of Gothenburg Centre for person-centred care (GPCC)
Institute of Medicine, Department of Clinical Nutrition
Institute of Health and Care Sciences
Pages 2452-2460
Language en
Keywords child; counselling; cultural; enabling; health promotion; immigrants; obesity; overweight; person-centeredness; school nursing
Subject categories Health Sciences, Nutrition and Dietetics, Nursing


Aims and objectives.  The study aimed at analysing school nurses' counselling of overweight and obese children in settings with many immigrants, focusing on content concerning food and physical activity and how this was communicated. Background.  For people with a predisposition for overweight, the weight control process requires cognitive skills. School nurses' counselling of overweight children has the potential to support this process by enabling personal resources in the children and their families. However, there is uncertainty among nurses about how to conduct supportive counselling. Design.  An explorative design was used when collecting and analysing data. Method.  Twenty-two counselling sessions between eight school nurses and 20 overweight children were audio-recorded and analysed using qualitative content analysis. Most of the participating schools represented areas with low socioeconomic status and a high proportion of immigrants and refugees. Results.  Less adequate skills in enabling resources in the children and their parents were observed. Concurrently, school nurses provided inadequate explanations about food and physical activity. Topics related to general nutrition models were frequently communicated as general advice instead of individually tailored counselling. Counselling families with other languages and food cultures than the traditional Swedish created additional difficulties. Conclusions.  Improved nutritional knowledge for nurses may enhance their skills in enabling children's and families' resources. School nurses should be provided with opportunities to cooperate with other professions in counteracting overweight. Relevance to clinical practice.  Our findings demonstrate a relationship between content skills and person-centeredness in the counselling. This highlights the importance of inter-professional collaboration to ensure a high quality of lifestyle counselling. School health authorities should give high priority to facilitating school nurses' evidence-based continuing education.

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