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In this essay, the contemporary issue of obesity in children will be discussed. It will explore the health implications and other challenges experienced by the child and family. Following this, it will discuss the impact of public health initiatives targeting obesity. A poster will be made to aid student nurses on the issue of obesity, the design will be discussed the effectiveness of its ability to teach different types of learners. Finally, this essay will identify and explore safeguarding issues along with ethico-legal issues.
Obesity is a term which describes someone with a high level of excess body fat. A person is classed as obese when their Body Mass Index (BMI) is 30 " 39.9 (World Health Organisation [WHO], 2019). BMI is not always an accurate determinant of obesity, as there is no way to distinguish between weight from fat and muscle. Yet for most people, BMI is a useful way to indicate whether their weight is healthy for their size and age.Childhood obesity is a global issue that mainly affects low and middle income countries and is becoming increasingly prevalent everywhere (WHO, 2019).
Children who are obese throughout their childhood are likely to remain obese into adulthood. Increasing the risk of developing serious health issues such as; diabetes, pulmonary disorders, impaired mobility, muscular skeletal discomfort, fatty liver disease, renal hyperfiltration, cardiovascular disease and psychological problems at a younger age. Therefore, premature mortality risk is increased and quality of life declines (WHO, 2019; Public Health England [PHE], 2015; Han et al, 2010).Obese children and their families face challenges every day, potentially putting a strain on relationships.
For example, interventions to combat obesity may not be welcomed by all members of the family and nurses may come across behavioural challenges and noncompliance. It is therefore important for the nurse to have an open conversation with the child and the family about any issues relating to the obesity. The nurse should also find out if the family recognise that the child is obese and then explore their knowledge and attitude surrounding the topic (PHE, 2015). To overcome any issues the nurse should educate the family and introduce them to support schemes. But overall negotiate on how to improve their lifestyle as a family, as it is the family who has the largest influence on the child (Nauert, 2018). An obese child will face emotional challenges because of obesity and their social interactions in and out of school. In 2011, Wang et al concluded that obese children are more likely to be verbally bullied at school than any other body type. The bullying they experience is more likely to be name calling and teasing in a hurtful manner, resulting in a negative impact on their mental health and causing low self-esteem. Due to bad experiences from bullying, the child may exclude themselves to avoid further bad experiences. Consequently, children who are obese are more likely to have school absences (Stevelos, 2018). The ethico-legal concerns associated with childhood obesity relate to a higher proportion of obese children coming from a deprived background. A child who comes from a deprived background is almost four times more likely to be overweight than their more affluent peers (Loring et al. 2014; NCMP, 2015-16). This is because healthier foods tend to be more expensive, and parents from poorer backgrounds tend to go for easy to store and cook foods that children like but tend to be less healthy. To combat this the UK government are trying to make healthy foods more accessible. Rates of obesity are higher in children of ethnic minority groups, which could be due to differences in cultural factors and eating habits (PHE, 2015). Another safety concern with children who are obese is bullying and how this affects their mental health. Clinical depression was identified as being highest in the more obese participants of a four-year observational study on adults with chronic medical and psychiatric conditions (Katz et al, 200). A nurse who is caring for an obese child should have an open conversation with the child about their weight and how it affects them. If the nurse has concerns about a child or young person's mental health then a CAMHS referral should be made (PHE, 2015). Public Health England is conducting multiple health initiatives to target childhood obesity, with the most recent ones targeting sugar consumption. In 2017 the UK government made proposals to reduce the overall amount of sugar consumed; the sugar tax, which aims to reduce consumption of sugary drinks by reducing their accessibility; a sugar levy on the soft drinks industry, encouraging producers to reduce the amount of sugar in their products; and the removal of 20% of sugar from products by 2020. Money earned from the levy will be invested into programmes aiming to reduce obesity and promote physical activity. Removal of 20% of sugar from products will be targeted on the foods children eat most, this will result in producers altering portion sizes or switching to a lower sugar alternative. The government also stated that the reduction in sugar should not result in an increase of saturated fat. The impact of these initiatives will make obesity programmes more accessible to children and young people through increased funding, promote portion control and healthy sugar alternatives. It will also be effective in improving the diets of families; in 2011 a similar tax levy introduced in Hungary resulted in reduced consumption of unhealthy foods high in sugars, salts and preservatives (Martos, 2015). Guidelines relating to childhood obesity state that advice and services information should be given to children and their families to help support and manage their weight. However, it is the families and young person's overall choice that decides the outcome. NICE guideline PH47 recommends that children's obesity should be monitored using BMI Z scores. This will show if the child is above or below average for their percentile. It is the Healthcare providers duty to educate parents and children about their weight and the benefits of maintaining a healthy weight, they must offer support and give advice on the next actions to take. The recommended actions to be advised for childhood obesity is as followed; healthy diet and eating habits, physical activity, reducing the sedimentary time and providing strategies to change behaviours of families and children. Referring an obese child to a weight management scheme increases the likelihood that they will achieve and maintain a healthy weight (Department of Health, 2009). These programmes also show improvements in the child's emotional health and self-esteem (Lowry et al. 2007).The Resource developed is a poster targeted at student nurses who's learning type is visual and/or reading and writing; however, other learning types can still benefit from the resource as the information has been displayed in a simple easy to read format with charts and graphics to supplement the information. The nurses who will be reading the poster are usually self-directed, internally motivated and use their personal life-experiences to learn (Knowles et al, 2011). The cognitive theory of multimedia learning suggests that visual learners find it easier to take on information through the use of both images and writing (Mayer, 2009; Hughes et al, 2013). Therefore, the resource contains colourful graphics and charts to enhance the writing for visual learners. The resource also benefits Visual learners using colour and layout. A visual learner's memory remembers colour and layout, each section of information has a different layout and colour so the patterns and colours will trigger subconscious memories to be created (Alfaro-LeFevre 2013). The kinaesthetic learner's needs are partially met as there is guidance on actions to be taken to achieve beneficial outcomes which they can put into practice. Reading and writing learners benefit from this resource through written aspects of the poster, along with information being referenced to allow for further reading. Knowles adult learning theory of andragogy suggests that adult learners want to learn and find out more information. Their learning is self-directive so further independent reading allows them to take on more information and understanding. The Resource has been made Dyslexia friendly as all the writing is written in a san serif font and the background behind is cream and blue (Dyslexia Association, 2019). The Writing itself avoids long paragraphs and the information is given in short concise bursts. Each learner using the information processes in a different way. To make the resource universal a range of different formats are used such as bullet points, paragraphs, charts and visuals.In conclusion, childhood obesity is a complex contemporary issue, which comes with many challenges and should be approached with sensitivity. Childhood obesity is extremely prevalent and needs to be addressed by healthcare providers for changes to occur. The government are addressing the issue of poor diet across the UK by creating schemes to prevent future obesity. The poster resource is available for student nurses to raise awareness of the issue and to inform about the steps to be taken when faced with childhood obesity.Word count: 1493Reference Alfaro-LeFevre, R. (2013). Critical thinking, clinical reasoning, and clinical judgment: A practical guide (5th ed.). St. Louis, MO: Elsevier Saunders.Currie C. NGSGE, International HBSC Network Coordinating Committee. The Health Behaviour in School-aged Children: WHO Collaborative Cross-National (HBSC) study: origins, concept, history and development 1982"2008. Int J Public Health. 2009;54:131"139. [PubMed] Department of Health (2009) Healthy child programme: from 5 to 19 years old. London: Department of HealthDyslexia association (2019) UK Guidance (2017) Childhood Obesity; a plan for action S & QuinF (2013) Principles and Practice of Nurse Education, 6th, London Cengage LearningJanssen I, Craig WM, Boyce WF, Pickett W. Associations between overweight and obesity with bullying behaviors in school-aged children. Pediatrics. 2004;113(5):1187-1194. Accessed: November 2010Joan C. Han, Debbie A. Lawlor, and Sue Y.S. Kimm (2010) Childhood obesity 2010 " progress and challenges Lancet. 2010 May 15; 375(9727): 1737"1748. Published online 2010 May 5. doi: 10.1016/S0140-6736(10)60171-7 D. A. et al. Impact of obesity on health-related quality of life in patients with chronic illness. Journal of General Internal Medicine, Vol. 15, November 2000, pp. 789-96.Knowles, MS; Holton, E & Swanson, R (2011) The Adult Learner Burlington, MA: ElsevierLowry KW, Sallinen, BJ, Janicke, DM (2007) The effects of weight management programs on self-esteem in pediatric overweight populations. Journal of Pediatric Psychology 32: 1179"95Martos E. (2015) The Hungarian policies to reduce population sugar intake R. E. (2009). Multimedia Learning. Cambridge University Press.National Children's Burau (2017) Child Measurement Program, (2015-16) statistics on obesity, (2017) R. PHD (August 2018) More family involvement lowers the risk of childhood obesity NICE (2009) Promoting physical activity and sport for children and young people in school and community settings. London: National Institute for Health and Care Excellence.NICE Guidelines (PH47) 2013 Health England, (2015) Public Health England (2015) Everybody active, everyday " an evidence-based approach to physical activity. London: PHE Stevelos J. (2018) BULLYING, Bullycide and Childhood Obesity C and Enoch, N (2016) Evaluation Report: Let's Get Physical Birmingham Case Study " Twickenham Primary School. VAGA Associates.Wang J. Ph.D, Ronald J. Iannotti Ph.D, Jeremy W. Luk (February 2010) Bullying Victimization among Underweight and Overweight U.S. Youth J Adolesc Health. 2010 Jul; 47(1): 99"101. Published online 2010 Feb 4. doi: 10.1016/j.jadohealth.2009.12.007 Health Organisation, 2019, childhood overweight and obesity Health Organisation, 2019, Obesity
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