In the study, to find an article for the chosen theme that is child nursing certain keywords are used. The keywords are important in research as they help to determine related information regarding the search topic from vast information (Raamkumar et al., 2017). The keywords used in this study include “childhood obesity”, “poverty and children”, “health outcome of children”, “low income”, “socio-economic issues and children” and others.
The electronic search strategy is used mainly used in gathering information and identifying the articles in the study. This is because electronic search leads to create accurate and complete results by the use of keywords in evidence-based study to allow identifying quality articles and journals within less time and reduced expenditure of money (Kim et al., 2019). Moreover, it allows selecting articles from over the world without facing any geographical barriers due to which it ensures to develop an enriched study (Kim et al., 2019). The platforms used in executing the electronic search include CINHAL, MEDLINE, Google Scholar, Cochrane Library and others. The specific platforms are selected because they include wide amount of health-related articles and journals regarding child nursing in turn allowing the researcher to gather data from a pool of information.
Article: Gois, A., Sacker, A., and Kelley, Y. ( 2015) ‘ Why are poorer children at higher risk of obesity and overweight?- A UK cohort study’ European Journal of Public Health. 26 (1), pp. 7-13
The article by Gois et al. (2015) has the key aim of determining the reasons for poor children in the society to be at increased risk of experiencing overweight or obesity. The researchers focused on this aim because from the existing studies they found that there is limited evidence present that highlights the risk factors related with income inequality to cause childhood obesity and overweight and the reason behind these inequalities widens with increase in age of the children. This study is based in the United Kingdom to address the identified gaps and fulfil the aim of the research. For this purpose, the researcher at first tried to analyse the markers for family health behaviour along with environmental risk factors which are responsible for lowering income inequality in the UK regarding child obesity and overweight. In order to examine if the influences are similar across all the age group in children, two age points are considered which are 5 years and 11 years. The 5 years is referred as the reception age of the children and 11 years is referred to tween age of the children when they grow to make their own decision.
The researchers in the study for determining if the income inequalities expand with progressing age of the children they tried to determine whether children show likeness to move upward and less likely to face downward movement across the determine age categories. The third factor which was investigated in the study is which of the risk factors are effective to protect upward movement and which of them promotes movement towards downward across the mentioned age categories (Gois et al., 2015). In order to execute the analysis in the study, the researcher gathered huge population-based data on the basis of the UK Millennium Cohort Study. The Millennium Cohort Study based in the UK is a national prospective study executed on children. The population sampled in the study was retrieved from September 2000 to January 2002 which mainly indicated all live births in the UK that occurred within 19,244 families in the mentioned tenure (Gois et al., 2015).
In the study, the researchers used quintiles that are adjusted to OED scale of the family income to calculate the income inequalities along with socioeconomic inequalities in poor children. The family income was considered in determining reason of obesity among the poor children because it acts as the key resource which provides the children to have healthy food and execute physical exercise. Moreover, to determine the impact of behaviour of the mother during pregnancy as well as after birth on the children, calculation about the duration of breastfeeding and if the mother smoked during pregnancy is determined (Gois et al., 2015). This is because it is mentioned that lower breastfeeding tenure leads to early introduction of solid food to the children which makes them get exposed to unsaturated fats at early age leading the children to face obesity faster than others. In addition, the physical efficiency and sedentary lifestyle of the poor children are also analysed to determine to what extent they managed an active lifestyle that is important to avoid early occurrence of obesity. The nature of food consumed by the poor children was also identified and its rate of consumption is determined across age categories to determine the way it affected the children to become obese or overweight.
In the study, certain inclusion and exclusion criteria are considered to support enriched execution of the research. This is because the selection of the criteria leads the researcher to avoid addition of unwanted data and information in the study which could have hindered the validity and authenticity of the research. The exclusion criteria in the study were adiposity, children with implausible and children with below-normal BMI rate. Moreover, the twins and triplets were also excluded from the study which leads to 11,965 children of 5 years of age and 9,384 children of 11 years of age become the final participants in the study. The researchers used multinomial logistic regression for estimating the income gradients in relation to child obesity and overweight. In the reference group, the non-overweight children were included in the study. The analysis made was not divided on the basis of gender in the study. In order to calculate whether or not inequalities in income widened with age among the poor children to affect their obesity, two variables are created. One of the variables was to indicate if the children with normal weight at 5 years become overweight or obese at 11 years and the other variable indicated if the children being obese at 5 years returned become normal at the age of 11 years (Gois et al., 2015).
The results of the study inform that high prevalence of obesity is seen among poor children who belonged from bottom quintile of income (6.6% children of 5 years and 7.9% children of 11 years are obese) compared to children who belong at the top of the quintile (3.5 % children of 5 years and 2.9 children of 11 years are obese). The results also revealed that children from the bottom quintal of income expressed to have mothers who smoked during pregnancy, did not breastfeed or executed shorter breastfeeding of the children, introduced the child at early age to solid food, made children perform less sports and physical activities, allowed more time to the children in leading sedentary lifestyle by watching television and others. Moreover, the children from the bottom quintal of income mentioned to have less healthy fruits, avoided breakfast and others. In the results, it was mentioned that dietary and physical activity are the key risk factors that are attenuating income inequalities. It is mentioned that children in the bottom quintile of income at the age of 11 expressed 1.4% increased risk of obesity compared to the children in the highest income quintile. The results also revealed that children in the lower quintile of income expressed increased upward movement in weight with progressing age compared to children in the high quintile of income (Gois et al., 2015).
The discussion based on the results mentioned that efforts to manage and curb increased obesity among poor children are to be initiated at an early age. This is because in the early stage the family has more profound influence on the children in having food and executing physical exercise and thus executing intervention at the early stage would provide better impact on the children in developing healthy activities along with continue it with progressing age to avoid obesity or being overweight. The discussion also informs that discouraging smoking during pregnancy and ensuring health eating by mothers and children would impact on curbing obesity issues among the poor children. It is also discussed that inclusion of various healthcare policies and programs such as Change4Life program are to be made to tackle the issue of obesity among the poor children (Gois et al., 2015).
The strength of the study is that a large population was able to be analysed and national examination of obesity among poor children could be made due to the use of the Millennium Cohort Study information. However, the first limitation is that the statistical models included in the study failed explain the way income inequality affects adiposity of children, in turn, creating opportunity that further risk factors could be explored in future studies. The other limitation is that mentioned results fail to make conclusion regarding causality between income inequality and risk factors related to overweight and obesity. The results also fail to inform the way maternal BMI rate plays an active role in promoting obesity or overweight in poor children. In addition, BMI rate is mainly used for detection regarding obesity but it do not reveal the different between fat mass and lean body mass. It resulted to create limitation in determining how the income inequalities affected change in fat mass and lean body mass among the children of different age groups. The other limitation is that the current study is a longitudinal research due to which follow-up results could be identified that may have created biased interpretation in some cases (Gois et al., 2015).
The discussion and summarisation of the selected article are relevant to my future role as a nurse as it is going to lead me have effective understanding about the concept and factors that leads to increased prevalence of obesity among the poor children. According to Hardy et al. (2019), the role of the nurse is to identify the key causes that are leading individuals to face health issues. This is because is it would lead the nurse to take effective care actions for the individuals in helping them overcome the influence of the factors to ensure them enhanced well-being. The current articles help me as a nurse to understand the key risk factors such as diet, less physical activity, reduced breastfeeding and others that are raised due to income inequality to be focussed in case of poor children and families to manage and reduce increased prevalence of obesity or overweight among them. Thus, it leads me to meet one of the key roles of the nurse. In this case, the other article by Nobari et al. (2019) supports the facts of the main article by making me understand that bearing increased household cost among the low income and poor family has led to raise the risk of improper diet, less physical activity and others among the children to make them obese.
The nurses have the role to frame appropriate care plan and provide interventions to the patients for enhancing their health condition (Schroeder et al., 2016). The current articles help me to meet this role as a nurse because it highlights the main interventions to be present in the care plan such as promoting physical activity, intake of healthy food, reducing sedentary time and others to care for the poor children to assist them overcome obesity. The nurses have the role to act in best interest of the patients for their early recovery and enhanced health condition (Kracht et al., 2019). In this respect, the main article relates to my role as a nurse by making me understand about the nature of best practice to be made in effectively overcoming obesity among poor children at the early stage. This is evident as the article mentioned that inclusion of family in early care of the obese children leads them to overcome obesity more easily. In addition, the other article by Min et al. (2018) supported the main article by highlighting as a nurse the nature of early care to be focussed such as improving sedentary and eating behaviour in the poor children to help them overcome obesity.
It is the role of the nurse to educate the patients and their family members about the actions to be performed to avoid the risk of occurrence or relapse of any health disorder. For this purpose, the nurses need to have direction based on which they are to impart knowledge to the patient and their family members regarding the health issue (Turner et al., 2016). The current article helps me as a nurse to fulfil this role by directing about the aspects such as diet, physical activity, lifestyle choices and others to be focussed during creation of awareness and education regarding obesity for the poor children and their families. Moreover, the other article by Min et al.(2018) supports the facts n the main article to led me understand the importance of focussing on the following aspects to tackle childhood obesity among the poor.
The current article also helps me as a nurse to identify the key socio-economic issue that is to be resolved for ensuring better health of the obese poor children. The nurses have the role to collaborate with effective professionals to form a care team to plan enhanced care for the patient (Braga et al., 2020). In this respect, the article is useful as it informs me to develop ideas about the nature of different professionals to be included in the care of the poor obese children so that their health condition can be improved. It is evident as it mentions that physical activity and diet are key issues that lead to obesity in turn informing me that dieticians and physical health professionals are to be included in caring for poor children who are suffering from obesity to deliver them seamless care.
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