Research Summary and Ethical Considerations
Grand Canyon University
Introduction to Nursing Research NRS 433V
November 30, 2012
Research Summary and Ethical Considerations
Obesity is a problem sweeping across our nation with incredible speed and the prevalence of pediatric obesity is a continually increasing problem. Never before in history have children risked outliving their parents and developing middle-aged adult illnesses while still young. School nurses hold enormous potential to affect change in the area of children’s health and pediatric obesity, however many are not taking advantage of the opportunities placed before them for a variety of reasons. This study addresses school nurse’s perceived barriers to weight-related issues. This paper will discuss the study, the method used in obtaining data and the results, and how it applies to nursing today. A large portion of waking hours for the majority of children are spent in the school environment. School nurses are in a unique position to greatly impact the health and well-being of their students; however this is not happening to its fullest extent on a regular basis so the question is what is standing in the way?
There are many obstacles that school nurses see as problems in discussing weight related health issues with children, youth, and their families. The purpose of this study was to identify those perceived barriers and allow for the development of interventions that would remove those barriers and increase the ability and frequency school nurses address this issue with children and families. Many of these perceived barriers have the potential of crossing over into other areas of nursing. The identification of barriers that prevent nurses from achieving their highest potential effectiveness will improve communication, public’s perception of nurses, and their overall ability to have a positive impact on people’s health. A qualitative approach with the use of focus groups and discussion is how data was collected for this study.
There were twenty two school nurses from three different school districts, ranging from suburban to rural areas for a total of seven focus groups. Each focus group session was led by a facilitator who introduced the topic questions, encouraged discussion, clarified responses and a second facilitator took detailed notes on the discussion. Additionally all focus groups were either videotaped or audio-taped for later review or transcription. Once all information had been reviewed and transcribed, identified themes were organized and evaluated. Researchers used NVivo8 to code and evaluate themes. The perceived barriers were then divided into the following five categories: Individual (nurse) Factors, Family Factors, Interactions between Nurses and Families, Institutional Factors, and Societal Factors. This study revealed many barriers to weight-related communication already identified and discussed in previous research. However family characteristics, lack of motivation for child and adolescent, fear of other’s reactions, nurse’s negative past experiences, difficulty building relationships with children and youth, and changing societal norms were all new key barriers to weight-related communication identified through this study. The majority of the nurses in this study indicated they felt inadequate or incompetent in providing information to children, youth, and families regarding obesity. Such data supports the necessity of continuing medical education (CME.)
When considering a workshop to attend or offer to staff it is important to know that the literature indicates more effective results if given in an interactive format as opposed to a static, non-interactive workshop. Assisting nurses in their approach and interview techniques may also help reduce communication barriers. Motivation Interviewing is a technique that focuses on the patient’s values and concerns rather than the goals of the interviewer. The implications on nursing from this study are the undeniable value of CME opportunities addressing the assessment and treatment of pediatric obesity as well as training on effective communication techniques. Nurses who are properly educated and given the tools need to do their job with confidence; excellence and skill will greatly impact their environment. Staff wellness initiatives are encouraged as the school nurse leads her/his peers in being healthy examples for children, youth, and families. This study was approved by the institutional review board (Human Subjects Committee) of the University of Kansas.
Privacy was maintained and all names were removed from the surveys. No specific ethical issues regarding treatment or lack of treatment were identified. However about half of the nurses felt they had an obligation to address and intervene in situations involving children who were either obese or at risk for becoming obese even though this may not be their current practice. As expected evidence supported several barriers to communication previously identified as well as identifying new areas of concern. There were suggested changes in specific settings in theory is expected to improve weight-related communication between nurses and families. Research in the area of barriers to weight-related communication is vital to monitor the progress of eliminating existing barriers and the development of new ones. When going to war it is essential to understand one’s opponent and any opposing issues that may be encountered. Our nation is at war with obesity.
Understanding what barriers are affecting school nurses from being able to appropriately and affectively approach weight-related issues and how it applies to nursing as a whole is a vital step toward reducing and eliminating barriers, and ultimately reigning victorious over the war against obesity.
Steele, R. G. (2011 March). School Nurses’ Perceived Barriers to Discussing Weight With Children and Their Families: A Qualitative Approach. Journal of School Health, 81(3): 128-37 (34 ref).