Exercise and diet is considered to be an important determinant of health and sickness. Historically, a fat child means a healthy child, one who is free from infection. Today obesity or overweight in children, very often related to degenerative diseases is mainly due to improper exercise and dietary pattern. According to World Health Organization (2004), Body Mass Index between 25 and 29.99 is considered as overweight.
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Overweight is associated with the onset of major chronic diseases leading to complications and problems in children and adult. Childhood obesity/overweight is very often a risk factor for obesity in adulthood, compared to adult onset obesity. Hence close monitoring of overweight and taking timely preventive measures will be an effective approach in dealing with the problems. Incidence of childhood overweight is on the rise since last few decades and is still continuing to rise. Since the 1970s, the prevalence of overweight children has more than doubled for preschooler’s ages 2-5 years and adolescents aged 12-19 years and it has more than tripled for children 6-11 years. Nearly one third of children and adolescents of both sexes, aged 6-19 years (30%) are considered to be either at risk for overweight
(The Center for Health and Healthcare in Schools 2005). The transition in nutrition, sedentary life style, lack of exercise, increased television watching, computer addiction, improper dietary pattern adopted by children today are the major causes for overweight seen in children. The World Health Organization has identified school as important settings for promotion of physical activity among children. Physical education provided at school, is an ideal way to encourage activity and develop fitness among children. For this reason, the Centers for Disease Control and Prevention (CDC), the National Association for Sports and Physical Education (NASPE), and the American Heart Association all recommended comprehensive daily physical education for children Kindergarten to 12th standard.
The aim of this study was to assess the knowledge on body weight and its maintenance among overweight children and to assess the effectiveness of self instructional booklet.
The conceptual frame work used for this study was based on titler et al (2004) effectiveness model. A quasi experimental pre test post test control group design was used to assess the effectiveness of self-instructional booklet on body weight and its maintenance among over weight children.The study was conducted in a selected school with a sample of 60 overweight children studying in 7th to 12th standard; samples were selected by purposive sampling method. First 30 samples were assigned to the control group and the next 30 samples were assigned to the experimental group.
The tool for this study was a structured questionnaire. The questionnaire consisted of 2 parts.Part I was developed to assess the knowledge of over weight children in relation to body weight, diet and exercise. Each were consisted of 5 multiple response questions. Part II consisted of selected demographic variables such as age, educational qualification of father and mother, occupation of father and mother, family income, items at home, family food type and items.
FINDINGS OF THE STUDY
Demographic characteristics presents that almost in both the groups the children under the age group of 12-14 years, had family income above 10,000 and major facilities like television, bike and cycle. And most of the fathers were private employees and mothers were nonworking. All the mothers are literate and majority
20 – 23(66.7% – 76.7 %) of children in both the groups had Body Mass Index value between 25 and 27.5.
Body weight and its maintenance
Overweight children were grouped into two, experimental group and control group. It was noted that in both the groups the knowledge of children assessed were almost similar in before intervention. In after intervention children gained knowledge in experimental group and children remained same knowledge in control group.
Statistically there was no significant differences in the knowledge score between experimental and control group before intervention and statistically there is a significant difference of knowledge in experimental group between before and after intervention. This increase in knowledge of the experimental group could be attributed to the self-instructional booklet.
Good health leads to a normal life. To promote the health of the child and reduce the danger of over weight and obesity, it is important that children are encouraged to engage in some form of physical activity on a regular basis and good dietary pattern. These above facts highlight the need for self discipline in a child to live a healthy and active life. People are more lethargic when compared to their ancestors. Earlier children spent the majority of their free time playing outdoor games which meant that they were automatically getting more physical activity. Currently there are more organized sports activities but only fewer children participate in them. Many prefer to play video games or watch television which is assisting in their weight gain. The remote control, video games, the automobile, television, and to some extent the computer are all part of the environment which discourage people from being physically active.
Healthy eating and exercise habits should be thought as a pair, one cannot go without the other, for the child’s best health.This can be developed only through education. There is lot of education available today through magazines, televison, posters; internet etc. But these children don’t show any interest in that. Perhaps material is readily available in hand; children will read it and may follow it.
Exact response cannot be expected from the children. These self-reported data may not exactly reflect the reality of respondents.
The study has its implication in nursing practice, nursing education, nursing administration, nursing research, social pediatrics and community.
Nursing professionals can provide a better frame work for healthy life style and school based programs. Nurses understand the biologic, psychological, causative and social aspects of being an overweight and their impact on health. The nurse can render awareness through education of the parents and children at the school, hospital and community level.The nurse can also improve the knowledge of parents, children and school teachers by conducting education awareness program and by counseling. A healthy life style is important for the proper growth and development. Guidance and Counseling services should be arranged timely, provided with adequate knowledge, positive support to make the child as a healthy member of society in future.
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Findings of the study have some implication for nursing education. The health care system pays more attention on the training of nursing students and school teachers. So that they will acquire more knowledge and will be able to help oneself in knowing the importance of healthy lifestyle. Motivation to change and psychological counseling technique is the key to any lifestyle intervention. Teaching about healthy diet and the importance of maintaining moderate physical activity in young children is important as obesity is more easily prevented than treated. It is important to begin preventive efforts early in childhood.
Nursing administrators should be necessarily involved in formulating policies for health education program in the school, hospital as well as community settings. All the heath education and school based program should integrate education on healthy diet and regular physical activity in children.
There is a need for extensive research in this area. The findings of the study help to expand the scientific body of knowledge upon which further research can be conducted.
In the Community
The community health nurse has an important role as health educator, health promoter and health protector in the community. During home visits the nurse can identify the vulnerable overweight children and observe different lifestyle adopted by the family and children. Nursing personnel working in the community should be given in service education to update and improve their knowledge regarding overweight and life style practices. Within the healthcare community, the multidisciplinary team might include a primary physician, a diabetic educator, a nurse, a dietitian, a fitness counselor and a social worker as well as the patient and family. Educating and counseling the obese and over weight children and their parents through media is vital. Healthcare professionals should also become involved in setting up new community programs to promote healthy lifestyle.
Based on the findings of the study, the investigator proposed the following recommendations.
A replication of present study can be done with large sample.
Maximum publicity should be given through mass media for educating knowledge among children regarding body weight and its maintenance.
A similar type of comparative study can be done between urban and rural settings.
A present study can be conducted with long duration by assessing BMI and
Lifestyle practices before and after intervention.
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