Quality of life in school-age children with obesity, the experiences of school nurses, and moral distress associated with care delivery
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Date
2016-11-16
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Authors
Powell, Shannon Baker
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Publisher
East Carolina University
Abstract
Childhood obesity is a multifaceted, complex problem that is associated with many other chronic health conditions. School nurses are well positioned to assess, intervene, and evaluate efforts to positively impact this population, however school nurse practice for obesity varies greatly. The purpose of this dissertation was to examine concepts related to the role of school nurse providing care to school age children with obesity using both quantitative and qualitative methods. Study 1 examined the self-reported physical and psychosocial quality of life of school age children with obesity and included descriptive comments from the school nurses providing their case management. The study found that the students with obesity had lower self-reported quality of life when compared to a healthy weight sample and comments from the school nurses reported the complex physical and psychosocial dynamics for students with obesity in the school setting. These findings supported that school-based interventions need to consider both physical psychological issues experienced by students to lead to successful outcomes. Study 2 investigated the experiences of school nurses providing care to students with overweight or obesity including perceived barriers and ways that school nurses successfully implement interventions with these students. The findings of this study suggest that limited time, heavy workload, limited resources, and supervisor pressure may prevent obesity interventions thus leading school nurses to use a "seize the moment" approach where they use any contact time with students to provide interventions and suggest that activities requiring small amounts of time may be best suited for successful implementation by school nurses. Nurses in this study described experiences associated with moral distress, a concept that has not been previously studied in school nurses. Study 3 examined the level of moral distress that exists in school nurses and its relationship to common moral dilemmas and school nurse characteristics. School nurses were found to experience moral distress and it was strongly related to many of the moral dilemmas experienced by school nurses. This study provides an awareness of this issue for school nurses and includes policy implications for school nursing practice.