Experiences of childhood weight management among Norwegian fathers of children with overweight or obesity - a qualitative interview study.

OBJECTIVE: Paternal participation and experiences in childhood weight management is an understudied studied area. Given the important role fathers play in childhood obesity prevention and treatment, the aim of this study was to explore Norwegian fathers' experiences of helping to prevent further weight gain in their children with overweight or obesity. METHODS: Data were collected through semi-structured interviews with eight fathers of ten children with overweight or obesity and analysed by qualitative content analysis. RESULTS: The analysis resulted in one overall theme: Balancing between assuming and avoiding responsibility for weight management with a desire to preserve the child's dignity, comprising two themes: 1) Alternating between concern, helplessness and responsibility, 2) Needing acknowledgement, and flexible and tailored professional support, both of which have several sub-themes. CONCLUSION: Fathers need guidance on how to talk to their children to prevent further weight gain, while at the same time emphasizing safeguarding the child's dignity. Healthcare professionals should address parents' own emotional barriers and include fathers to a greater extent as a resource in family-centred counselling and tailor guidance and support to help with childhood weight management.

Struggling with overweight or obesity in children - fathers' perceptions and experiences of contributing factors, role and responsibility.

PURPOSE: The family environment is crucial in the prevention and treatment of childhood obesity; however, there is a lack of knowledge concerning paternal perceptions and experiences in childhood weight management. The aim of this study was to explore (i) perceptions of contributing factors to childhood overweight and obesity among fathers of children with overweight or obesity and (ii) the fathers' experiences of their parental role caring for a child with overweight or obesity. METHOD: A qualitative content analysis was conducted of data from semi-structured in-depth interviews with eight Norwegian fathers of ten children and adolescents with overweight or obesity. RESULTS: The analysis identified one overall theme; Feeling uncertain and struggling to understand their own responsibility for the child's overweight or obesity, which consists of two themes; 1)Trying hard to figure out the child's obesity as a complex interaction of factors and 2)Family functioning-negotiating roles and responsibility in parenthood. CONCLUSION: Fathers must be met with understanding about their uncertainty and their struggle to understand their individual responsibility for their child's weight excess. It can be necessary to address the significance of family functioning, collaboration, responsibility within the familiy in addition to structural responsibility in clinical dialogues and counselling in order to help with weight management.

Suicide prevention strategies for older persons-An integrative review of empirical and theoretical papers.

AIM: To synthesize suicide prevention strategies for older adults. The review question was Which suicide prevention strategies are useful for older adults? DESIGN: Integrative review. DATA SOURCES: Academic Search Premier, CINAHL, Ovid PsycINFO and PubMed were searched for articles published between January 2009 and December 2019. REVIEW METHODS: An integrative review of quantitative, qualitative and theoretical papers with a qualitative thematic analysis. RESULTS: Key aspects of the included studies contributed to the formulation of four themes: (1) Recognizing older adults' physical and/or mental health problems and referring them for help and treatment, (2) Designing an educational programme, (3) Communication and dialogue about warning signs and (4) Social support and awareness of causing significant others emotional pain. The findings indicate an urgent need to identify effective suicide prevention strategies for older adults.

Beneficial self-management support and user involvement in Healthy Life Centres-A qualitative interview study in persons afflicted by overweight or obesity.

BACKGROUND: Relapse is high in lifestyle interventions involving behavioural change and weight loss maintenance. The purpose of lifestyle self-management interventions offered at Healthy Life Centres (HLCs) is to empower the participants, leading to self-management and improved health. Exploring beneficial self-management support and user involvement in HLCs is critical for quality, improving effectiveness and guiding approaches to lifestyle change support in overweight and obesity. OBJECTIVE: The aim of this study was to explore how persons afflicted by overweight or obesity attending lifestyle interventions in Norwegian HLCs experience beneficial self-management support and user involvement. METHOD: Semi-structured in-depth interviews were conducted with 13 service users (5 men and 8 women). Data were analysed using qualitative content analysis. RESULTS: One main theme was identified: regaining self-esteem and dignity through active involvement and long-term self-worth support in partnership with others. This main theme comprised four themes: (a) self-efficacy through active involvement and better perceived health, (b) valued through health-care professionals (HPs) acknowledgement, equality and individualized support, (c) increased motivation and self-belief through fellowship and peer support; and (d) maintenance of lifestyle change through accessibility and long-term support. CONCLUSION: Service users' active involvement, acknowledgement and long-term self-worth support from HPs and peers seem to support self-management and user involvement and may be some of the successful ingredients to lifestyle change. However, prolonged follow-up support is needed. A collectivistic and long-term perspective can integrate the importance of significant others and shared responsibility.

Understanding beneficial self-management support and the meaning of user involvement in lifestyle interventions: a qualitative study from the perspective of healthcare professionals.

BACKGROUND: In light of the high prevalence of overweight and obesity among adults and the subsequent stigmatization and health consequences, there is a need to develop effective interventions to support lifestyle change. The literature supports the key role of healthcare professionals (HPs) in facilitating self-management through lifestyle interventions for those with chronic conditions. However, there is a lack of knowledge about how HPs practice self-management support (SMS) and user involvement for persons afflicted by overweight or obesity in lifestyle interventions in primary care Healthy Life Centres (HLC). The aim of this study was to explore how HPs provide SMS and what user involvement implies for HPs in HLCs. METHODS: An interpretative exploratory design, using qualitative thematic analysis of data from two focus group interviews with ten HPs from eight different HLCs, was conducted. RESULTS: The analysis resulted in one overall theme; A partnership based on ethical awareness, non-judgemental attitude, dialogue and shared responsibility, comprising four interrelated themes: 1) Supporting self-efficacy, self-worth and dignity through an attitude of respect, acknowledgement and generosity, 2) Promoting self-belief and self-perceived health, 3) Collaborating and sharing responsibility, and 4) Being flexible, adjusting and sharing time. CONCLUSION: HPs in HLCs see service users as equal partners in a collaboration based on shared responsibility, acknowledgement and generosity. In order to help, their practice involves a heightened level of ethical awareness, including a non-judgemental attitude and dialogue. HPs in HLCs have something to teach us about ethical acting and helping persons who are struggling with overweight or obesity to change their lifestyle and regain dignity. They seem to see the service users' existential needs and have learned the art of meeting the other in her/his most vulnerable situation i.e., seeking help for a "wrong lifestyle". It may be time to highlight the need for SMS and user involvement to focus on shared responsibility in partnership rather than personal responsibility. More research is required to explore the conditions for such practice.

Healthy Life Centre participants' perceptions of living with overweight or obesity and seeking help for a perceived "wrong" lifestyle - a qualitative interview study.

BACKGROUND: Overweight and obesity are complex conditions, associated with a wide range of serious health issues. In contemporary society, body size is an important part of a person's self-representation. Lifestyle changes are difficult and long-term weight management is associated with a high risk of failure. In primary health care in Norway, lifestyle interventions are offered by Healthy Life Centres (HLCs) to those seeking help with weight management. The aim of this study was to explore HLC participants' experiences of living with overweight or obesity and perceptions of seeking help to change dietary and activity habits. METHOD: This exploratory study employed a qualitative design. Semi-structured in-depth interviews were conducted with 13 participants. Data were transcribed verbatim and analysed using qualitative content analysis. RESULTS: The analysis resulted in one main theme: Searching for dignity, based on two themes: 1) Needing to justify avoidance of personal responsibility and 2) A desire to change. CONCLUSION: Changing dietary and activity habits is difficult as the emotional alternation between shame, guilt and pride influences the ability to assume personal responsibility. A deeper understanding of each participant's perceptions and experiences is important for the ability to tailor and provide a high quality health service. Addressing participants' emotional distress and search for dignity is necessary for enabling dietary and activity change. This should be considered in the future development of HLCs and health promotion interventions in order to educate service users about emotions and the role they play in food consumption and inactivity. Weight stigma at individual and system level as well as responsibility related to dilemmas about "right" or "wrong" lifestyle should be addressed.