Nursing management of paediatric obesity : literature review

Paediatric obesity is increasingly rising worldwide, affecting children of all ages. It can cause several health, psychological and social problems including the cardiovascular system, pulmonary system and gastrointestinal system as well as orthopaedic. Managing obesity in children can be a greater challenge not only to parents and guardians but also to nurses. Nurses play vital roles in the management of childhood obesity starting from the time the child is born or even when the mother is pregnant. This literature review was thus conducted to provide knowledge and information on how nurses can manage paediatric obesity hence prevent its health related risks and complications in children. The thesis discusses nursing interventions in paediatric obesity in addition to the roles of nurses in the management of childhood obesity. The aim of this thesis, was, nonetheless, to provide paediatric nurses with information on how they can manage obesity in children. The data collection of this thesis was systematically researched from Cochrane, Medscape, Google scholar and Pubmed among others. Other nursing and healthcare journals were also searched and read. Related books were read from the libraries. Some literature were purchased. This thesis was analyzed using an inductive content analysis approach- where raw data were grouped into similar themes and useful information were extracted from the raw data in order to help answer the research questions. The findings of this thesis demonstrated that preventing childhood obesity is the best, safe and recommended way of managing it. Even though some medical treatment options (e.g. medications and bariatric surgery) are available for extremely obese teens, nurses should work together with parents and aim at its prevention without waiting until its onset. The best way to prevent childhood obesity is through healthy eating and reducing sedentary lifestyles in children. Nurses can promote these through multifactorial nursing interventions (i.e. behavioural, dietary and physical interventions) in children and their families. The findings of this thesis are neither presented nor reported for further arguments, discussions or analysis since the thesis is a descriptive literature review. Nevertheless, this thesis recommends that in cases where children are already obese or are at a risk of being obese and their parents or guardians are showing no efforts nor interest in helping them, the nurses should take the responsibility of helping the child. In addition, the thesis suggests that further studies should be done on the best ways in which nurses can take responsibilities of helping obese children from such families. This thesis can be used mainly by nurses in any clinical setting that deals with children between the age of zero and eighteen, in childrens’ healthcare centres, in pre and post-natal clinics, by any nurse addressing families on healthy living styles and by educational programs addressing childhood obesity.Pediatrinen lihavuus on lisääntymässä yhä enemmän mailmanlaajuisesti vaikuttaen kaiken ikäisiin lapsiin. Se voi aiheuttaa monia terveydellisiä, psykologisia ja sosiaalisia ongelmia sen lisäksi, että se vaikuttaa moniin kehon toimintoihin kuten sydämen ja verisuonien toimintaan, keuhkoihin, ruoansulatukseen sekä lisäksi luihin ja niveliin. Lasten lihavuuden torjunta ja hallinta voi olla suuri haaste vanhemmille, mutta myös sairaanhoitajille. Sairaanhoitajat ovat tärkeässä roolissa lasten lihavuuden hoidossa ja ennaltaehkäisyssä äidin raskausajasta alkaen. Tämän kirjallisen tutkielman tarkoitus on tuoda esiin informaatiota siitä, kuinka sairaanhoitajat voivat toimia pediatrisen lihavuuden saralla. Tutkielma käsittelee sekä sairaanhoidon väliintuloa pediatrisen lihavuuden yhteydessä että hoitajien roolia lapsuusiän lihavuuden hallinnassa. Tämän tutkielman päämääränä on tarjota pediatrisille sairaanhoitajille tietoa siitä, kuinka toimia lasten lihavuuden suhteen. Tämän tutkielman tiedot ovat työstetty seuraavista lähteistä: Cochrane, Medscape, Google scholar ja Pubmed. Tietoja löytyi myös muista sairaan- ja terveydenhoidon artikkeleista. Aiheeseen liittyviä kirjoja on myös käytetty lähteinä tietojen etsimiseen. Tutkielman tiedot on analysoitu käyttäen induktiivista analyysiä, jossa käsittelemätön aineisto on kerätty ryhmiin teemojen mukaan ja tarpeelliset osat informaatiosta käytetty tutkielman kysymyksiin vastaamiseen. Saadut tiedot osoittivat, että turvallisin, suositelluin ja paras tapa hallita lapsuusiän lihavuutta on sen ennaltaehkäisy. Vaikka erityisen ylipainoisille teineille on tarjolla joitakin lääketieteellisiä vaihtoehtoja (esim. lääkehoito ja leikkaus), tulisi sairaanhoitajien tehdä yhteystyötä vanhempien kanssa, jotta ylipainolta vältyttäisiin eikä jäätäisi odottamaan, että siitä on tullut ongelma. Paras keino estää lapsuusiän ylipaino on terveellinen ruokavalio sekä passiivisen elämäntyylin välttäminen. Sairaanhoitajat voivat ajaa tätä asiaa informoimalla lapsia ja perheitä näistä tärkeistä asioista. Tämä tutkielma on kirjallisuuskatsaus ja sen tiedot perustuvat aiempiin tutkimuksiin, jotka on tässä tutkielmassa esitetty sellaisinaan eikä tarkoitus ole tuoda esiin uusia argumentteja tai analyysejä. Kuitenkin, tutkielma suosittelee, että niissä tapauksissa, joissa lapset ovat jo ylipainoisia tai riskinä on ylipainoiseksi tuleminen eivätkä vanhemmat näytä tekevän asialle mitään, sairaanhoitajien tulisi ottaa vastuu lapsen auttamisesta. Lisäksi tutkielmassa ehdotetaan, että tulisi tehdä lisätutkimuksia siitä mitkä ovat parhaat keinot, joiden avulla sairaanhoitajat voivat ottaa vastuuta lihavien lapsien auttamisesta niissä perheissä, joissa vanhemmat eivät ota vastuuta asiasta. Tutkielmaa voivat pääasiassa käyttää sairaanhoitajat missä tahansa terveydenhoidon ympäristössä, jossa ollaan tekemisissä 0 - 18-vuotiaiden lasten kanssa, lasten terveyskeskuksissa, neuvoloissa, synnytysklinikoilla, sekä sairaanhoitajat, jotka tekevät opetuksellisia esityksiä lasten lihavuudesta tai ohjaavat perheitä terveellisiin elintapoihin

Psychosocial Work Environment and Mental Wellbeing of Platform Workers : A Study of Food Delivery Workers in Helsinki, Finland

Food delivery is the most visible type of platform work in Finland. It is still a new phenomenon which has not been widely studied. Its psychosocial work environment is poorly understood. Thus, this study bridges this knowledge gap by generating new scientific knowledge towards understanding its psychosocial work environment and how it associates with the mental wellbeing of its couriers in Helsinki. The aim of this study was to understand how food delivery platform workers in Helsinki perceive their psychosocial work environment in relation to their mental wellbeing at work. The findings of this study derive from twenty in-depth semi-structured interviews with food delivery platform workers in Helsinki. The collected data were analysed through inductive thematic analysis where the six steps of thematic analysis were rigorously followed. Accordingly, the findings ascertained that, while food delivery platform work provided labour market opportunities and income to its couriers, its psychosocial work environment was psychologically burdening, thus posing enormous challenges to occupational mental wellbeing of couriers. Though these food delivery platforms portray themselves with notions of flexibility and autonomy to its couriers, this study found a divergent reality. Couriers were instead faced with high levels of precarity, high work intensity, longer working hours, poor work relationships and illusionary flexibility and autonomy. One platform applied high algorithmic control that monitored, evaluated and penalized couriers, which is contrary to the image they portray. Thus, couriers were short of flexibility and autonomy while collaborating with this platform. Also, the platform was not fully transparent to its couriers on their wages and incentives. These findings accentuate the occupational mental health of these couriers. Therefore, future research is recommended to rigorously examine the relationship between food delivery platform work and occupational mental health of its couriers. Food delivery platform work being relatively new in Finland, interventions and policies aiming to improve its psychosocial work environment are highly needed for a healthier work environment

Algorithmic management, wellbeing and platform work: understanding the psychosocial risks and experiences of food couriers in Finland

Digitalisation has made algorithmic management a defining feature of platform work. This study explores the psychosocial stresses and risks associated with different algorithmic management practices and analyses the applicability of Job Demand-Control-Support model in examining food delivery platform work. Our findings draw from 30 semi-structured interviews with platform food couriers in Finland. We applied Job Demand-Control-Support framework as the analysis matrix to inductive qualitative content analysis and compared the algorithmic management practices of the two dominant food delivery platforms in Finland. This study established that algorithmic management had direct and indirect intertwined negative psychosocial influence on couriers. These impacts were varied and were related to how algorithmic management was employed by the platforms. We also found that algorithmic management can increase work demands, decrease couriers’ control over their work, and limit workplace support. The study demonstrated that Job Demand-Control-Support model is suitable for analysing stress related to algorithmic management and platform work. This supports its application in future quantitative analyses. Our study deepens the understanding of psychosocial issues associated with the emerging trend of algorithmic management in workplaces, which is a fundamental dimension of the future of work. It highlights the need for regulatory measures relevant in ensuring healthy work environments.Peer reviewe

Globalization, platform work, and wellbeing—a comparative study of Uber drivers in three cities: London, Helsinki, and St Petersburg

Abstract Background Globalization of platform work has become a challenge for wider social and employment relations and wellbeing of workers, yet on-location work remains governed also by local regulatory context. Understanding common challenges across countries and potential for regulatory measures is essential to enhance health and wellbeing of those who work in platform economy. Our comparative study on platform work analyzed concerns of Uber drivers in three cities with a different regulatory and policy context. Methods Drawing from current understanding on employment and precarity as social determinants of health we gathered comparative documentary and contextual data on regulatory environment complemented with key informant views of regulators, trade unions, and platform corporations (N = 26) to provide insight on the wider regulatory and policy environment. We used thematic semi-structured interviews to examine concerns of Uber drivers in Helsinki, St Petersburg, and London (N = 60). We then analysed the driver interviews to identify common and divergent concerns across countries. Results Our results indicate that worsening of working conditions is not inevitable and for drivers the terms of employment is a social determinant of health. Drivers compensated declining pay with longer working hours. Algorithmic surveillance as such was of less concern to drivers than power differences in relation to terms of work. Conclusions Our results show scope for regulation of platform work especially for on-location work concerning pay, working hours, social security obligations, and practices of dismissal