| 1. |
- Astermark, Cathrine, et al.
(författare)
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Health-related quality of life in children with Type 1 diabetes : an RCT of hospital-based care and hospital-based home care at diagnosis
- 2017
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Ingår i: International Diabetes Nursing. - : Taylor & Francis. - 2057-3316 .- 2057-3324. ; 14:2-3, s. 90-95
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Tidskriftsartikel (refereegranskat)abstract
- Introduktion: När ett barn får diagnosen typ 1 diabetes betyder det omfattande ändringar i livsstilen för hela familjen. Det finns begränsad kunskap avseende den påverkan som den initiala vården har för barn och föräldrar. Syftet var att jämföra barns diabetesspecifika hälsorelaterade livskvalitet (HRQOL) i sjukhusbaserad vård och sjukhusbaserad hemsjukvård (HBHC), 12 respektive 24 månader efter debuten av typ 1 diabetes. Syftet var också att jämföra barnens och föräldrarnas beskrivning av barnens diabetesspecifika HRQOL efter 12 och 24 månader oavsett vårdform. Metod: Undersökningen genomfördes vid ett universitetssjukhus i Sverige och hade en randomiserad kontrollerad design för att utvärdera sjukhusbaserad vård och HBHC, med hänvisning till specialist vård i en hemmiljö. Barn i åldern 5-16 år och deras föräldrar besvarade enkäten PedsQLTM 3.0 Diabetes Module, 12 månader och 24 månader efter debuten av sjukdomen. Resultat: Resultatet visade ingen skillnad avseende barnens diabetes-specifika HRQOL. Däremot, 12 månader efter diagnos, upplevde barnen och deras föräldrar som fått HBHC mer oro jämfört med de som hade fått sjukhusbaserad vård vid diagnosen (p=0,012). Oaktat vilken vårdform som erbjudits rapporterade barnen mer obehag av sjukdomen jämfört med vad deras föräldrar upplevde att barnen kände (p=0.017). Konklusion: Sammanfattningsvis så indikerar resultatet att både sjukhusbaserad vård och HBHC erbjuder jämförbara resultat gällande barnens diabetes-specifika HRQOL. Dock verkar en vårdmodell mer lik vård i hemmet innebära större påfrestning för vissa familjer. Dessa familjer behöver bli identifierade och rutinerna behöver vara mer flexibla för att kunna möta dessa familjers behov.
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| 2. |
- Castor, Charlotte, et al.
(författare)
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A challenging balancing act to engage children and their families in a healthy lifestyle – Nurses' experiences of child-centred health dialogue in child health services in Sweden
- 2021
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Ingår i: Journal of Clinical Nursing. - : Wiley. - 0962-1067 .- 1365-2702. ; 30:44322, s. 819-829
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Tidskriftsartikel (refereegranskat)abstract
- Aims and objectives: To describe nurses' experiences of a child-centred family guided intervention of obesity tested within the child health services targeting children identified with overweight and their caregivers. Background: Interventions aiming to support families towards a healthier lifestyle can lead to decreased risk of overweight evolving into obesity in a child. At the same time, nurses have found dialogues on weight challenging and may therefore avoid them. Design: Qualitative descriptive inductive design following content analysis applying to the COREQ guidelines. Methods: Content analysis was used to analyse 13 individual semi-structured interviews with nurses in the child health service in Sweden after completed training in CCHD, including how to facilitate the dialogue with the use of illustrations. Results: The theme Health dialogue about weight is a challenging balancing act facilitated by a supportive intervention emerged through eight subcategories in three main categories. Nurses experienced that CCHD with children identified with overweight and their caregivers provoked an emotional response both for themselves and for the caregivers of the child. The training in child-centred health dialogues promoted the nurses' work with structure and professionalism, as the nurses carefully took tentative steps to engage the family for a healthy lifestyle. Conclusions: Emotional and practical challenges in performing CCHD still remained among nurses after customised training, which might comprise the child's rights to be involved in his or her own care when the child was identified as overweight. However, training for nurses, including lectures and tutorials, was found to increase the quality and professionalism of performing CCHD by providing structure, tools and tutorial support. Relevance to clinical practice: Customised training and illustrations can support nurses when performing a structured intervention such as child-centred health dialogues.
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| 3. |
- Derwig, Mariette, et al.
(författare)
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A child‐centered health dialogue for the prevention of obesity in child health services in Sweden – A randomized controlled trial including an economic evaluation
- 2022
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Ingår i: Obesity Science Practice. - : Wiley. - 2055-2238. ; 8:1, s. 77-90
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Tidskriftsartikel (refereegranskat)abstract
- BackgroundPrevention of child obesity is an international public health priority and believed to be effective when started in early childhood. Caregivers often ask for an early and structured response from health professionals when their child is identified with overweight, yet cost-effective interventions for children aged 2–6 years and their caregivers in Child Health Services are lacking.ObjectivesTo evaluate the effects and cost-effectiveness of a child-centered health dialogue in the Child Health Services in Sweden on 4-year-old children with normal weight and overweight.MethodsThirty-seven Child Health Centers were randomly assigned to deliver intervention or usual care. The primary outcome was zBMI-change.ResultsA total of 4598 children with normal weight (zBMI: 0.1 [SD = 0.6] and 490 children with overweight (zBMI: 1.6 [SD = 0.3]) (mean age: 4.1 years [SD = 0.1]; 49% females) were included. At follow-up, at a mean age of 5.1 years [SD = 0.1], there was no intervention effect on zBMI-change for children with normal weight. Children with overweight in the control group increased zBMI by 0.01 ± 0.50, while children in the intervention group decreased zBMI by 0.08 ± 0.52. The intervention effect on zBMI-change for children with overweight was –0.11, with a 95% confidence interval of –0.24 to 0.01 (p = 0.07). The estimated additional costs of the Child-Centered Health Dialogue for children with overweight were 167 euros per child with overweight and the incremental cost-effectiveness ratio was 183 euros per 0.1 zBMI unit prevented.ConclusionsThis low-intensive multicomponent child-centered intervention for the primary prevention of child obesity did not show statistical significant effects on zBMI, but is suggested to be cost-effective with the potential to be implemented universally in the Child Health Services. Future studies should investigate the impact of socio-economic factors in universally implemented obesity prevention programs.
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| 4. |
- Derwig, Mariette, et al.
(författare)
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Changes in perceived parental self-efficacy after a Child-Centred Health Dialogue about preventing obesity
- 2022
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Ingår i: Acta Paediatrica, International Journal of Paediatrics. - : Wiley. - 0803-5253. ; 111:10, s. 1956-1965
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Tidskriftsartikel (refereegranskat)abstract
- Aim: This randomised controlled trial evaluated changes in parental self-efficacy and children's weight, after a Child-Centred Health Dialogue about preventing obesity. Methods: We randomly assigned 37 Child Health Centres in Skåne county Sweden to provide usual care or the dialogue intervention. They included centres from high and low socioeconomic areas. The outcomes were changes in parental self-efficacy and any moderating effect on their children's body mass index 1 year later. Results: The baseline data were based on 1115 mothers and 869 fathers representing 1197 children (52% females) aged 4 years (3.9–4.2) with a standardised body mass index (zBMI) of 0.1 ± 0.9. The participation rates at follow-up, 1.1 ± 0.2 years after the intervention were 817 mothers and 508 fathers. Overall, parental self-efficacy had decreased by the 1-year follow-up. There was a significant intervention effect on maternal self-efficacy in promoting physical activity, however with unclear clinical relevance. Mothers' change in perceived self-efficacy in promoting a healthy diet seemed to moderate the intervention effect on zBMI change in children with zBMI > 0 with −0.01 (95% CI: −0.025 to −0.001; p = 0.03). Conclusion: Our study suggested a possible link between increased maternal self-efficacy in promoting a healthy diet and a favourable development of zBMI.
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| 5. |
- Derwig, Mariette, et al.
(författare)
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Child-centred health dialogue for primary prevention of obesity in child health services – a feasibility study
- 2019
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Ingår i: - : S. Karger AG. ; , s. 02-092
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Konferensbidrag (refereegranskat)abstract
- Aims: The aim of this study was to test a Child-Centred Health Dialogue model for primary prevention of obesity for 4-year-old children in Child Health Services, for its feasibility and the responsiveness of its outcomes.Methods: A feasibility study was set up with a non-randomised quasi-experimental cluster design comparing usual care with a structured multicomponent child-centred health dialogue consisting of two parts: 1) a universal part directed to all children and 2) a targeted part for families where the child is identified with overweight. Results: 203 children participated in child-centred health dialogue while 582 children received usual care. Nurses trained in the model were able to execute both the universal health dialogue and the targeted part of the intervention. Tutorship enabled the nurses to reflect on and discuss their experiences, which strengthened their confidence and security. One year after the intervention fewer normal-weight 4-year-olds in the intervention group had developed overweight at the age of 5 compared to the control group and none had developed obesity. Conclusions: This study demonstrates that a child-centred, multicomponent, interactive intervention for the promotion of healthy lifestyles and primary prevention of obesity for all 4-year-old children participating in Child Health Services is feasible on a small scale. As almost all parents make use of Child Health Services in Sweden, the findings should be confirmed in a randomised controlled trial before the intervention can be implemented on a larger scale.
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| 6. |
- Derwig, Mariette, et al.
(författare)
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Child-Centred Health Dialogue for primary prevention of obesity in Child Health Services – a feasibility study
- 2021
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Ingår i: Scandinavian Journal of Public Health. - : SAGE Publications. - 1403-4948 .- 1651-1905. ; 49:4, s. 384-392
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Tidskriftsartikel (refereegranskat)abstract
- Aims: The aim of this study was to test a Child-Centred Health Dialogue model for primary prevention of obesity for 4-year-old children in Child Health Services, for its feasibility and the responsiveness of its outcomes. Methods: A feasibility study was set up with a non-randomised quasi-experimental cluster design comparing usual care with a structured multicomponent Child-Centred Health Dialogue consisting of two parts: (1) a universal part directed to all children and (2) a targeted part for families where the child is identified with overweight. Results: In total, 203 children participated in Child-Centred Health Dialogue while 582 children received usual care. Nurses trained in the model were able to execute both the universal health dialogue and the targeted part of the intervention. Tutorship enabled the nurses to reflect on and discuss their experiences, which strengthened their confidence and security. One year after the intervention fewer normal-weight 4-year-olds in the intervention group had developed overweight at the age of five compared with the control group, and none had developed obesity. The difference in overweight prevalence at follow-up did not reach statistical significance. Conclusions: This study demonstrates that a child-centred, multicomponent, interactive intervention for the promotion of healthy lifestyles and primary prevention of obesity for all 4-year-old children participating in Child Health Services is feasible on a small scale. As almost all caregivers make use of Child Health Services in Sweden, the findings should be confirmed in a randomised controlled trial before the intervention can be implemented on a larger scale.
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| 7. |
- Derwig, Mariette, et al.
(författare)
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Elucidating the child’s perspective in health promotion: children’s experiences of child-centred health dialogue in Sweden
- 2020
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Ingår i: Health Promotion International. - : Oxford University Press (OUP). - 1460-2245. ; , s. 1-11
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Tidskriftsartikel (refereegranskat)abstract
- Promoting young children's health through health promotion activities is an investment for the future. In the Child Health Services in the south of Sweden a structured Child-Centred Health Dialogue (CCHD) directed to all 4-year-old children was developed using illustrations based on the most important health messages associated with the promotion of healthy lifestyle in preschool children. The aim of this study was to explore the experiences of children participating in CCHD using 21 non-participant observations during their 4-year health visit and additionally 16 individual interviews 0-7 days after their visit, conducted in the child's home in the presence of a caregiver. Children participated as social actors when guided to express their views based upon their own understanding was the overall main category generated from the qualitative content analysis. The children showed that they liked to participate actively but could influence their choice to participate. They expressed their views based on their daily life and wanted to understand the meaning of the information with which they interacted. The study revealed that 4-year-old children given the opportunity to speak for themselves-elucidating the child's perspective-interpreted the health messages in a different way than the intended meaning of the illustrations developed by adults. These findings are important for the improvement of CCHD and underline the utmost importance of including children in research on health promotion. This study supports the view that 4-year-old children can take an active role in their health and are capable of making health information meaningful.
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