Maternal-child nutrition practices and pediatric overweight/obesity in the United States and Chile: a comparative study.

Childhood overweight/obesity is now epidemic in both developed countries and those undergoing economic transition. This study compared maternal and school-age child nutrition practices and body mass index in the United States and in Chile. Children (125 in the United States, 121 in Chile) and their mothers (116 in the United States, 101 in Chile) participated. Findings indicated that child nutrition practices were comparable, but mothers in the U.S. group demonstrated fewer healthy nutrition practices on behalf of their children. Significant associations were found between maternal and child nutrition practices. Substantially more children in the U.S. sample were overweight/obese. Implications for practice are presented.

Relación entre prácticas alimentarias reportadas por niños chilenos y preferencias de los padres para su consumo / Relationship between reported dietary practices of Chilean children and their parents preferences for their consumption

The objective of this study was to examine agreement between parental preferences and self-reported food intake in Chilean children. In 2008,152 pairs, of 8 to 13 year old schoolchildren and their parents in Santiago were surveyed. Children self-reported their frequency of consumption of foods from various food groups. Parents reported how often they preferred their children to consume foods from these same food groups. Children reported consuming more sweets, high-calorie snacks, and fruit, and fewer grains than their parents reported preferring them to consume. Girls, 10 and 11 year olds, and children who watched television and used the computer for less than 2 hours per day had dietary patterns most closely aligned with their parents' reported preferences. Children 's dietary reports generally follow parental preferences. Intervention programs should include programs that facilitate parental guidance and encourage children to make healthy food choices at home and in school.

Se estudia concordancia entre preferencias de padres y auto-reporte de niños chilenos en consumo de alimentos. En 2008, se encuestaron 152 escolares ente 8 y 13 años de edad y sus padres, en Santiago, Chile. Los niños reportaron frecuencia de consumo de diferentes grupos de alimentos y los padres, frecuencia con que prefieren que sus hijos los consuman. Los niños informaron mayor consumo de dulces, colaciones altas en calorías y frutas y menor consumo de cereales, que lo declarado por sus padres. Los patrones alimentarios más estrechamente alineados con lo reportado por los padres se observan en: niñas; edades entre 10 y 11 años; ver televisión y utilizar computador menos de 2 horas diarias. En general, lo reportado por niños sigue los patrones de los padres. Programas de intervención debieran incluir guía a padres y estimulo a niños para elegir opciones alimentarias saludables en el hogar y en la escuela.

Spanish version of the Child and Adolescent Self-Care Performance Questionnaire: psychometric testing.

This methodological study sought to determine the psychometric properties of the Spanish version of the Child and Adolescent Self-Care Performance Questionnaire originally developed by Moore (1995). In this study, the questionnaire, written originally in English, was translated into Spanish, and some items were adapted for the Latin American culture. The instrument was administered to 536 children of moderate socioeconomic status, ages 10 to 15 years, living in Chile. Evidence for reliability and validity involved examining Coefficient Alpha for the total scale and each of the subscales, item analysis, and factor analysis with varimax rotation. Coefficient alpha for the total scale (35 items) was 0.82, similar to the reliability reported by Moore (1995) for the original instrument. Factor analysis supported eight factors. Use of the instrument in Central and South America may assist in determining self-care practices of Latin American children and the effect of interventions to improve such practices.

Childhood obesity study: a pilot study of the effect of the nutrition education program Color My Pyramid.

The need for successful nutrition interventions is critical as the prevalence of childhood obesity increases. Thus, this pilot project examines the effect of a nutrition education program, Color My Pyramid, on children's nutrition knowledge, self-care practices, activity levels, and nutrition status. Using a pretest-posttest, quasiexperimental design, 126 fourth- and fifth-grade students from experimental and control schools are compared. The intervention program incorporates an online component www.MyPyramid.gov, Orem's Self-Care Deficit Nursing Theory, and consists of six classes taught over a 3-month period. Results indicated that the program increased nutrition knowledge in the control group. Furthermore, it increased activity time from pretest to posttest and decreased systolic blood pressure for children in both groups; however, there were no significant differences in BMI percentiles. The findings indicate that Color My Pyramid can be successfully employed in school settings and thus support school nursing practice.

The effect of a nutrition education program on the nutritional knowledge, hemoglobin levels, and nutritional status of Nicaraguan adolescent girls.

OBJECTIVES: The purpose of this study was to examine the effect of a community-based nutrition education program on the nutritional knowledge, hemoglobin levels, and nutritional status of Nicaraguan adolescent girls and the nutritional knowledge of their mothers. THEORY: Self-care deficit nursing theory was used in this study. DESIGN: This longitudinal study used a mixed quantitative/qualitative design to study the effect of the nutrition education program. SAMPLE: The nonprobability sample consisted of 182 adolescent girls and 67 of their mothers. The setting for the study was a community (barrio) in Managua, Nicaragua. INTERVENTION/MEASUREMENT: A team of nurse and nutrition researchers created the nutrition education program designed to improve girls' and mother's nutrition-related self-care operations. Data collection was carried out for 4 years for girls and 2 years for mothers in Managua, Nicaragua, using questionnaires, a HemoCue, and anthropometric measures. RESULTS AND CONCLUSION: The findings of this study were that girls' and mothers' nutritional knowledge scores significantly improved in most cases after participation in the nutrition intervention program. Girls' hemoglobin levels did not significantly improve and their nutritional status findings were mixed. Girls and mothers described what dietary changes girls made and why.

School reentry for children with cancer: perceptions of nurses, school personnel, and parents.

The purpose of this interdisciplinary descriptive study was to examine the perceptions of nurses, school personnel, and parents about school reentry for children with cancer and to determine whether activities and services performed supported school reentry. The study also investigated parents' perception of the impact of cancer on their child's academic performance, cognitive ability, and school attendance. Results of the study showed that few activities and services were performed to facilitate children's school reentry by either nurses or school personnel. Parents reported no significant differences in their children's cognitive ability or academic performance. School attendance was significantly lower after diagnosis and therapy. Conclusions were that communication among nurses, school personnel, and parents was a major barrier to providing effective services to students and their parents. Nurses were unsure of how to help parents navigate the school bureaucracy, school personnel felt they needed more information, and parents felt that their children were not receiving all the school reentry services needed. Individuals in this study recommended that a liaison position be created to coordinate services.

Impact of a nutrition intervention program on the growth and nutritional status of Nicaraguan adolescent girls.

This research examines the impact of a nutrition education intervention program on the nutritional status and knowledge of Nicaraguan adolescent girls. Anthropometric measurements, hemoglobin values, and data concerning nutritional knowledge were collected from adolescent girls living in Managua, Nicaragua. Using a pre-test/post-test design, data are compared prior to and after the nutrition intervention program. When using Mexican American reference data, statistically significant differences in height-for-age z-scores and weight-for-age z-scores were found when comparing the entire sample of baseline data with data collected after three years of the nutrition intervention program (p < 0.05). Significant improvement was also found concerning the indicators of nutritional knowledge (p < 0.05). However, hemoglobin data revealed a significant decrease which may be due to specific environmental factors and pubertal changes. This research has implications concerning the development of successful adolescent focused nutrition intervention programs in Nicaragua, and examines the possibility that catch-up growth occurs during adolescence.

Self-care operations and nursing interventions for children with cancer and their parents.

As individuals assume more responsibility for their healthcare, nurses need to explore methods to support families' self-care practices. The purpose of this qualitative study was to: (a) determine what self-care and dependent-care operations children and parents perform to address self-care requisites, and (b) explore nursing interventions to promote operations. Orem's theory of self-care, theory of self-care deficit, and theory of nursing system were employed. Twenty-seven participants were interviewed about their cancer experiences. Results were that children and parents performed estimative, transitional, and productive operations to meet self-care requisites. Various nursing interventions that promoted these operations were identified. Recommendations were made for further interventions to support families.

Sources of conflict between families and health care professionals.

It is essential to examine conflict between patients and health care professionals from the patient's perspective. The purposes of this study were to 1) identify sources of conflict, 2) determine nursing interventions that alleviate conflict, and 3) test a conceptual framework of sources of conflict. This phenomenological study focused on children with cancer and their parents' perceptions of conflicts with health care professionals as well as what they thought helped with such conflicts. Their reports of conflict were compared to C. W. Moore's circle of conflict conceptual framework. A purposive sample of 27 participants (9 children, 14 mothers, and 4 fathers) participated in the study. Study findings showed that conflict occurred between health care professionals and families originating from differences in expectations and desires regarding data, interests, structure, relationships, and values, consistent with C. W. Moore's conceptual framework. Nursing interventions reported by children and parents to be helpful in preventing or alleviating conflict were identified. C. W. Moore's framework may provide a valuable structure for assessing conflict and designing nursing interventions to alleviate conflict.

Children with cancer and their parents: self-care and dependent-care practices.

In this qualitative study the self-care practices of children with cancer and the dependent-care practices of their parents were examined. These practices were organized according to self-care requisites presented in Orem's theory of self-care. The intent of this examination was to determine the competency of participants, identify where self-care deficits occurred, and decide what nursing interventions were needed. A purposive sample of 9 children and 18 parents were interviewed to determine their experiences with cancer. Content analysis was conducted using a deductive approach to code and analyze the data according to Orem's universal, developmental, and health-deviation self-care requisites. NVivo qualitative analysis software was employed for data analysis. The findings of this study revealed that participants were competent agents, performing many practices in the areas of universal and developmental self-care requisites. Participants performed far fewer practices regarding health-deviation self-care requisites and interferences with development, however, indicating a need for supportive-educative nursing interventions in these areas. Future research should examine participants' operations and specific nursing interventions to support those operations.

Parents' reactions to conflict with health care providers.

The purpose of this phenomenological study was to examine parents' reactions to conflict with health care providers and the outcomes of the conflicts. This study builds on previous research that confirmed the occurrence and sources of conflict among these informants. Seventeen parents whose children had a diagnosis of cancer were interviewed in this study. A priori coding was used to identify the specific strategies for dealing with conflict proposed by Rubin and associates. Ginsburg's approach to narrative analysis was used to examine parent's stories. Findings were that parents used the strategies of problem solving, yielding, withdrawing, inaction, and contending identified by Rubin and associates in reaction to conflict with health care providers. Following episodes of contending, many parents in the study reframed the conflict and experienced transformations or turning points, resolving to become more effective advocates for their children. A few of these advocates proceeded to become community activist.