The potentially life-threatening disease hereditary angioedema with C1-inhibitor deficiency (C1-I... more The potentially life-threatening disease hereditary angioedema with C1-inhibitor deficiency (C1-INH-HAE) can have considerable impact on the health-related quality of life (HRQoL) in adult patients. Half the patients with C1-INH-HAE develop symptoms before the age of 10 years. However, the HRQoL in children with C1-INH-HAE is almost unexplored. To investigate HRQoL in Danish children with C1-INH-HAE, including possible correlations to disease severity and attack frequency. All Danish children ages 2-18 years with C1-INH-HAE were invited to complete questionnaires regarding HRQoL; 14 (93%) agreed. Child self-report forms were used for children ages ≥5 years. The instruments used were the PedsQL (Child Self-Report and Parent Proxy-Report forms); the Children's Dermatology Life Quality Index; a nonvalidated, disease-specific quality-of-life questionnaire; and two visual analog scales that rated general health. The HRQoL scores in our study were comparable with the normal scores for...
Injuries and other consequences of falls are serious for the individual patient and costly for so... more Injuries and other consequences of falls are serious for the individual patient and costly for society. Reduced acuity of vision is common among elderly people, and falls are frequent. The relationship between instability and falls as well as the association between reduced vision and falls has been recognized, but it has not as yet been examined whether cataract surgery improves balance in elderly people and thereby promotes fall prevention.
Being a patient in an intensive care unit (ICU) and being mechanically ventilated is a scary and ... more Being a patient in an intensive care unit (ICU) and being mechanically ventilated is a scary and unpleasant experience to many patients. Qualitative studies describe these Patients' experiences, but the findings have not yet been synthesised. The aim of this study was to gather and synthesise interpreted knowledge from qualitative studies about Patients' experiences of being mechanically ventilated in an ICU. A qualitative metasynthesis was conducted on findings from nine qualitative studies performed in the period from 1994 to 2012. The studies were critically appraised according to the method defined by Sandelowski and Barosso, and the findings were extracted, edited, grouped and abstracted. Subsequently, the abstracted findings were analysed, using the constant comparison analysis. In the analysis, we used findings from patients with home ventilation and findings from patients admitted to an ICU, while they were not ventilated. Fifteen abstracted findings appeared from the metasynthesis and led to the synthesised finding: 'Being dependent on health professionals, without being able to communicate, causes experiences with anxiety, fear and loneliness. How intensively these feelings are experienced seems to depend on the health professionals' ability of being present with these patients. The presence of relatives can alleviate these experiences'. This study shows that patients being mechanically ventilated in an ICU experience an emic vulnerability, consisting of anxiety, fear and loneliness. In future practice, it is expected that patients will be more awake during mechanical ventilation. It is therefore important that health professionals have the knowledge that their presence and their support of the relationship between the patient and his/her relatives are of great importance in the care of patients.
Frail elderly people admitted to hospital often receive help from relatives in managing their dai... more Frail elderly people admitted to hospital often receive help from relatives in managing their daily lives. These relatives are likely to continue to feel responsible after admission, and to hold valuable knowledge, which may contribute to decision-making related to care and treatment. To illuminate nurses' experience of collaboration with relatives of frail elderly patients in acute hospital wards, and of the barriers and promoters for collaboration. The design was descriptive. Three acute units in a large Danish university hospital participated. Six registered nurses and two auxiliary nurses in charge of discharge planning for the patients were included. Open interviews using an interview guide. Manifest and latent content analysis was applied. The main theme Encountering relatives-to be caught between ideals and practice reflected the nurses' two sets of conflicting attitudes towards collaboration with relatives, one in accordance with professional nursing values, the other reflecting the values of every day practice. The dual attitudes were reflected in two themes The coincidental encounter-the collaboration and Relatives-a demanding resource, which appeared in the text along with a number of sub-themes. Ideally, collaboration was considered important and described as a planned process, but in practice encounters with relatives were coincidental. Relatives were ideally considered a resource but also experienced as demanding, and nurses sometimes even avoided them. The nurses seemed unaware of the conflict of values, and their response pattern of escape-avoidance and labelling of relatives as difficult may be an indication of counter transference as a reaction to moral conflict. Macro level factors, such as organisational and societal values, and micro level factors, such as organisation of care, nurse's competence and communication skills, seemingly governed nurses' collaboration with relatives. Although the nurses could be seen as mere victims of conflicting values, there appeared to be potential for improving collaboration practice within the restrictions of macro level factors by interventions at the micro level.
The objective of the study was to investigate change and predictors of change in health-related q... more The objective of the study was to investigate change and predictors of change in health-related quality of life (HRQoL) in relatives of patients with severe traumatic brain injury (TBI) during rehabilitation, and to analyse associations between changes in HRQoL and symptoms of anxiety and depression. The Vitality (VT), Mental Health (MH), Social Function (SF) and the Role Emotional (RE) scales from the Short Form 36, and the anxiety and depression scales from the Symptom Checklist-90 - Revised were used. Of the 62 relatives, 24.6% experienced a reliable improvement on the VT scale, 53.2% on the MH scale, 27.4% on the SF scale and 16.1% on the RE scale. Of the relatives, 24.0% experienced clinically significant change (CSC) on the VT scale, 19.6% on the MH scale, 21.6% on the SF scale, and 19.2% on the RE scale. Relatives' age and higher patient Glasgow Coma Scale score predicted the experience of CSC in RE, and change on the Functional Independence Measure in patients predicted CSC on the MH scale. Improvements in VT as well as MH were associated with improvement in symptoms of anxiety and depression, and improvement in SF was associated with improvement in symptoms of depression. About one-fifth of the sample experienced a CSC on one of the four HRQoL measures. Relatives experiencing CSC tended to be related to patients who showed more improvement during rehabilitation. Improvements in HRQoL were associated with improvements in symptoms of anxiety and depression.
Journal of child health care : for professionals working with children in the hospital and community, Jan 17, 2014
The aim was to study how, and to what degree, health-related quality of life (HRQOL), as assessed... more The aim was to study how, and to what degree, health-related quality of life (HRQOL), as assessed by children and their mothers, was related to overweight and obesity among children aged seven to nine years. Mother-child pairs of 149 non-overweight, 95 overweight and 16 obese children participated. We assessed HRQOL by the children's self-report and parent proxy report module of the PedsQL™ 4.0 Generic Core Scales. We found that non-overweight children scored HRQOL slightly higher than overweight ones but significantly higher than did obese children. The same pattern was seen for the mothers' proxy HRQOL score and mothers in general scored higher than the children did. The results indicate that mothers in general were not sufficiently aware of how overweight and obesity affect their children's HRQOL. The psychosocial dimension of HRQOL was the most important aspect for the children. Thus, there is a need for information of mothers/parents about the impact of overweight a...
A study was undertaken to evaluate the feasibility of functional assessment scales regarding comp... more A study was undertaken to evaluate the feasibility of functional assessment scales regarding completion rate and ability to document functional changes in geriatric rehabilitation patients. Five functional assessment scales were implemented, and used on admission and discharge as part of standard care. Of 2,812 patients, 90 patients (3.2%) had no scales administered, 2,330 patients (82.9%) had between one and six scales administered and 392 (13.9%) had a complete data set (seven scales). The percentage of inpatients who were independent or almost independent in basic ADL functions improved from 30% to 60% during hospitalization; 53% had cognitive impairment, while 19% expressed depressive thoughts or depression on admission. Functional assessment scales were feasible in the clinical routine, gave important information on patients' functional status at baseline, and showed that patients improved their physical function considerably during hospitalization. Interdisciplinary teamwo...
Archives of physical medicine and rehabilitation, 2014
To examine person, injury, and treatment characteristics associated with recovery trajectories of... more To examine person, injury, and treatment characteristics associated with recovery trajectories of people with severe traumatic brain injury (TBI) during inpatient rehabilitation. Observational prospective longitudinal study. TBI rehabilitation units. Adults (N=206) with severe nonpenetrating TBI admitted directly to inpatient rehabilitation from acute care. Participants were excluded for prior disability and intentional etiology of injury. Naturally occurring treatments delivered within comprehensive multidisciplinary teams were recorded daily in 15-minute units provided to patients and family members, separately. Motor and cognitive FIM were measured on admission, discharge, and every 2 weeks in between and were analyzed with individual growth curve methodology. Inpatient recovery was best modeled with linear, cubic, and quadratic components: relatively steep recovery was followed by deceleration of improvement, which attenuated prior to discharge. Slower recovery was associated wi...
Frail elderly people admitted to hospital often receive help from relatives in managing their dai... more Frail elderly people admitted to hospital often receive help from relatives in managing their daily lives. These relatives are likely to continue to feel responsible after admission, and to hold valuable knowledge, which may contribute to decision-making related to care and treatment. To illuminate nurses' experience of collaboration with relatives of frail elderly patients in acute hospital wards, and of the barriers and promoters for collaboration. The design was descriptive. Three acute units in a large Danish university hospital participated. Six registered nurses and two auxiliary nurses in charge of discharge planning for the patients were included. Open interviews using an interview guide. Manifest and latent content analysis was applied. The main theme Encountering relatives-to be caught between ideals and practice reflected the nurses' two sets of conflicting attitudes towards collaboration with relatives, one in accordance with professional nursing values, the other reflecting the values of every day practice. The dual attitudes were reflected in two themes The coincidental encounter-the collaboration and Relatives-a demanding resource, which appeared in the text along with a number of sub-themes. Ideally, collaboration was considered important and described as a planned process, but in practice encounters with relatives were coincidental. Relatives were ideally considered a resource but also experienced as demanding, and nurses sometimes even avoided them. The nurses seemed unaware of the conflict of values, and their response pattern of escape-avoidance and labelling of relatives as difficult may be an indication of counter transference as a reaction to moral conflict. Macro level factors, such as organisational and societal values, and micro level factors, such as organisation of care, nurse's competence and communication skills, seemingly governed nurses' collaboration with relatives. Although the nurses could be seen as mere victims of conflicting values, there appeared to be potential for improving collaboration practice within the restrictions of macro level factors by interventions at the micro level.
In-hospital patients may suffer unexpected death because of suboptimal monitoring. Early recognit... more In-hospital patients may suffer unexpected death because of suboptimal monitoring. Early recognition of deviating physiological parameters may enable staff to prevent unexpected in-hospital death. The aim of this study was to evaluate short- and long-term effects of systematic interprofessional use of early warning scoring, structured observation charts, and clinical algorithms for bedside action. A prospective non-randomized controlled study of unexpected in-hospital death before and after implementation of a clinical intervention in a medical and surgical ward setting at an urban Danish university hospital. Information was obtained over three four-month study periods - a pre-interventional one in 2009 (1st March-30th June), and two postinterventional ones in 2010 (1st September-31st December) and 2011 (1st March-30th June). The incidence of unexpected patient death, the primary study outcome, was calculated as the rate of unexpected patient mortality based on in-hospital risk time. The adjusted unexpected patient mortality rate was significantly lower during the second postinterventional study period than before the intervention, 17 versus 61 per 100 adjusted patient years (P=0.013), corresponding to a rate ratio of 0.271 (95% confidence interval (CI) 0.097-0.762). A tendency to reduced unexpected mortality was found during the first postinterventional study period (25 versus 61 per 100 adjusted patient years, P=0.053; rate ratio 0.404, CI 0.161-1.012). Clinical intervention comprising systematic monitoring practice, early warning scoring, an observation chart, and an algorithm for bedside management, implemented by interprofessional teaching, training, and optimization of communication and collaboration, may significantly reduce unexpected in-hospital mortality.
We investigated mothers' ... more We investigated mothers' and children's assessments of body weight and their expectations about perceived body size in relation to overweight of the children. We performed a case-control study of 111 cases of overweight children and 149 controls of non-overweight children (mean age 8.1 years) and their mothers. All were examined and interviewed about their assessment of body weight and their perception of a normal, attractive and acceptable body size. Case children were less able than control children to correctly assess their own body weight (p < 0.001), as were mothers of overweight children (MOC) to assess their children's body weight (p < 0.001). The majority of mothers from both groups wished their children to have a normal body size, but 18% of MOC wished their children to have an overweight body size (p < 0.013). The majority of case children, control children and mothers found a normal body size for boys and girls to be the most attractive and socially acceptable, but more MOC found overweight among boys to be the most attractive (p = 0.006). Overweight children and their mothers show increased uncertainty in the assessment of overweight and obesity, but the perception of a normal, attractive and socially acceptable body size is not distorted.
We investigated mothers' ... more We investigated mothers' possession and display of action competence to counteract or prevent overweight and eventual obesity in their children. Action competence is defined as a personal resource where the most important aspect is the individual's wish to take action and to believe in its benefit. It unfolds within the room for action as experienced by the individual due to action obstacles and action potentials. In a case-control study, mothers of 111 overweight children (MOC) were compared with mothers of 149 non-overweight children (MNC). They underwent a semistructured interview about action competence, lifestyle, and their 7- to 9-year-old children. Compared to MNC, MOC considered it more important to change habits, both for themselves (p = 0.003) and their children (p < 0.001). MOC were more motivated to change habits (p < 0.001), assessed their action competence to be higher (p < 0.001), and felt to a greater extent that they supported their children to achieve an appropriate weight (p < 0.001) compared with MNC. No difference was found between MOC and MNC in the assessment of their own room for action and their children's room for action. Self-assessed room for action was not limited for either MOC or MNC, and MOC even assessed their action competence to be greater.
The potentially life-threatening disease hereditary angioedema with C1-inhibitor deficiency (C1-I... more The potentially life-threatening disease hereditary angioedema with C1-inhibitor deficiency (C1-INH-HAE) can have considerable impact on the health-related quality of life (HRQoL) in adult patients. Half the patients with C1-INH-HAE develop symptoms before the age of 10 years. However, the HRQoL in children with C1-INH-HAE is almost unexplored. To investigate HRQoL in Danish children with C1-INH-HAE, including possible correlations to disease severity and attack frequency. All Danish children ages 2-18 years with C1-INH-HAE were invited to complete questionnaires regarding HRQoL; 14 (93%) agreed. Child self-report forms were used for children ages ≥5 years. The instruments used were the PedsQL (Child Self-Report and Parent Proxy-Report forms); the Children's Dermatology Life Quality Index; a nonvalidated, disease-specific quality-of-life questionnaire; and two visual analog scales that rated general health. The HRQoL scores in our study were comparable with the normal scores for...
Injuries and other consequences of falls are serious for the individual patient and costly for so... more Injuries and other consequences of falls are serious for the individual patient and costly for society. Reduced acuity of vision is common among elderly people, and falls are frequent. The relationship between instability and falls as well as the association between reduced vision and falls has been recognized, but it has not as yet been examined whether cataract surgery improves balance in elderly people and thereby promotes fall prevention.
Being a patient in an intensive care unit (ICU) and being mechanically ventilated is a scary and ... more Being a patient in an intensive care unit (ICU) and being mechanically ventilated is a scary and unpleasant experience to many patients. Qualitative studies describe these Patients' experiences, but the findings have not yet been synthesised. The aim of this study was to gather and synthesise interpreted knowledge from qualitative studies about Patients' experiences of being mechanically ventilated in an ICU. A qualitative metasynthesis was conducted on findings from nine qualitative studies performed in the period from 1994 to 2012. The studies were critically appraised according to the method defined by Sandelowski and Barosso, and the findings were extracted, edited, grouped and abstracted. Subsequently, the abstracted findings were analysed, using the constant comparison analysis. In the analysis, we used findings from patients with home ventilation and findings from patients admitted to an ICU, while they were not ventilated. Fifteen abstracted findings appeared from the metasynthesis and led to the synthesised finding: 'Being dependent on health professionals, without being able to communicate, causes experiences with anxiety, fear and loneliness. How intensively these feelings are experienced seems to depend on the health professionals' ability of being present with these patients. The presence of relatives can alleviate these experiences'. This study shows that patients being mechanically ventilated in an ICU experience an emic vulnerability, consisting of anxiety, fear and loneliness. In future practice, it is expected that patients will be more awake during mechanical ventilation. It is therefore important that health professionals have the knowledge that their presence and their support of the relationship between the patient and his/her relatives are of great importance in the care of patients.
Frail elderly people admitted to hospital often receive help from relatives in managing their dai... more Frail elderly people admitted to hospital often receive help from relatives in managing their daily lives. These relatives are likely to continue to feel responsible after admission, and to hold valuable knowledge, which may contribute to decision-making related to care and treatment. To illuminate nurses' experience of collaboration with relatives of frail elderly patients in acute hospital wards, and of the barriers and promoters for collaboration. The design was descriptive. Three acute units in a large Danish university hospital participated. Six registered nurses and two auxiliary nurses in charge of discharge planning for the patients were included. Open interviews using an interview guide. Manifest and latent content analysis was applied. The main theme Encountering relatives-to be caught between ideals and practice reflected the nurses' two sets of conflicting attitudes towards collaboration with relatives, one in accordance with professional nursing values, the other reflecting the values of every day practice. The dual attitudes were reflected in two themes The coincidental encounter-the collaboration and Relatives-a demanding resource, which appeared in the text along with a number of sub-themes. Ideally, collaboration was considered important and described as a planned process, but in practice encounters with relatives were coincidental. Relatives were ideally considered a resource but also experienced as demanding, and nurses sometimes even avoided them. The nurses seemed unaware of the conflict of values, and their response pattern of escape-avoidance and labelling of relatives as difficult may be an indication of counter transference as a reaction to moral conflict. Macro level factors, such as organisational and societal values, and micro level factors, such as organisation of care, nurse's competence and communication skills, seemingly governed nurses' collaboration with relatives. Although the nurses could be seen as mere victims of conflicting values, there appeared to be potential for improving collaboration practice within the restrictions of macro level factors by interventions at the micro level.
The objective of the study was to investigate change and predictors of change in health-related q... more The objective of the study was to investigate change and predictors of change in health-related quality of life (HRQoL) in relatives of patients with severe traumatic brain injury (TBI) during rehabilitation, and to analyse associations between changes in HRQoL and symptoms of anxiety and depression. The Vitality (VT), Mental Health (MH), Social Function (SF) and the Role Emotional (RE) scales from the Short Form 36, and the anxiety and depression scales from the Symptom Checklist-90 - Revised were used. Of the 62 relatives, 24.6% experienced a reliable improvement on the VT scale, 53.2% on the MH scale, 27.4% on the SF scale and 16.1% on the RE scale. Of the relatives, 24.0% experienced clinically significant change (CSC) on the VT scale, 19.6% on the MH scale, 21.6% on the SF scale, and 19.2% on the RE scale. Relatives' age and higher patient Glasgow Coma Scale score predicted the experience of CSC in RE, and change on the Functional Independence Measure in patients predicted CSC on the MH scale. Improvements in VT as well as MH were associated with improvement in symptoms of anxiety and depression, and improvement in SF was associated with improvement in symptoms of depression. About one-fifth of the sample experienced a CSC on one of the four HRQoL measures. Relatives experiencing CSC tended to be related to patients who showed more improvement during rehabilitation. Improvements in HRQoL were associated with improvements in symptoms of anxiety and depression.
Journal of child health care : for professionals working with children in the hospital and community, Jan 17, 2014
The aim was to study how, and to what degree, health-related quality of life (HRQOL), as assessed... more The aim was to study how, and to what degree, health-related quality of life (HRQOL), as assessed by children and their mothers, was related to overweight and obesity among children aged seven to nine years. Mother-child pairs of 149 non-overweight, 95 overweight and 16 obese children participated. We assessed HRQOL by the children's self-report and parent proxy report module of the PedsQL™ 4.0 Generic Core Scales. We found that non-overweight children scored HRQOL slightly higher than overweight ones but significantly higher than did obese children. The same pattern was seen for the mothers' proxy HRQOL score and mothers in general scored higher than the children did. The results indicate that mothers in general were not sufficiently aware of how overweight and obesity affect their children's HRQOL. The psychosocial dimension of HRQOL was the most important aspect for the children. Thus, there is a need for information of mothers/parents about the impact of overweight a...
A study was undertaken to evaluate the feasibility of functional assessment scales regarding comp... more A study was undertaken to evaluate the feasibility of functional assessment scales regarding completion rate and ability to document functional changes in geriatric rehabilitation patients. Five functional assessment scales were implemented, and used on admission and discharge as part of standard care. Of 2,812 patients, 90 patients (3.2%) had no scales administered, 2,330 patients (82.9%) had between one and six scales administered and 392 (13.9%) had a complete data set (seven scales). The percentage of inpatients who were independent or almost independent in basic ADL functions improved from 30% to 60% during hospitalization; 53% had cognitive impairment, while 19% expressed depressive thoughts or depression on admission. Functional assessment scales were feasible in the clinical routine, gave important information on patients' functional status at baseline, and showed that patients improved their physical function considerably during hospitalization. Interdisciplinary teamwo...
Archives of physical medicine and rehabilitation, 2014
To examine person, injury, and treatment characteristics associated with recovery trajectories of... more To examine person, injury, and treatment characteristics associated with recovery trajectories of people with severe traumatic brain injury (TBI) during inpatient rehabilitation. Observational prospective longitudinal study. TBI rehabilitation units. Adults (N=206) with severe nonpenetrating TBI admitted directly to inpatient rehabilitation from acute care. Participants were excluded for prior disability and intentional etiology of injury. Naturally occurring treatments delivered within comprehensive multidisciplinary teams were recorded daily in 15-minute units provided to patients and family members, separately. Motor and cognitive FIM were measured on admission, discharge, and every 2 weeks in between and were analyzed with individual growth curve methodology. Inpatient recovery was best modeled with linear, cubic, and quadratic components: relatively steep recovery was followed by deceleration of improvement, which attenuated prior to discharge. Slower recovery was associated wi...
Frail elderly people admitted to hospital often receive help from relatives in managing their dai... more Frail elderly people admitted to hospital often receive help from relatives in managing their daily lives. These relatives are likely to continue to feel responsible after admission, and to hold valuable knowledge, which may contribute to decision-making related to care and treatment. To illuminate nurses' experience of collaboration with relatives of frail elderly patients in acute hospital wards, and of the barriers and promoters for collaboration. The design was descriptive. Three acute units in a large Danish university hospital participated. Six registered nurses and two auxiliary nurses in charge of discharge planning for the patients were included. Open interviews using an interview guide. Manifest and latent content analysis was applied. The main theme Encountering relatives-to be caught between ideals and practice reflected the nurses' two sets of conflicting attitudes towards collaboration with relatives, one in accordance with professional nursing values, the other reflecting the values of every day practice. The dual attitudes were reflected in two themes The coincidental encounter-the collaboration and Relatives-a demanding resource, which appeared in the text along with a number of sub-themes. Ideally, collaboration was considered important and described as a planned process, but in practice encounters with relatives were coincidental. Relatives were ideally considered a resource but also experienced as demanding, and nurses sometimes even avoided them. The nurses seemed unaware of the conflict of values, and their response pattern of escape-avoidance and labelling of relatives as difficult may be an indication of counter transference as a reaction to moral conflict. Macro level factors, such as organisational and societal values, and micro level factors, such as organisation of care, nurse's competence and communication skills, seemingly governed nurses' collaboration with relatives. Although the nurses could be seen as mere victims of conflicting values, there appeared to be potential for improving collaboration practice within the restrictions of macro level factors by interventions at the micro level.
In-hospital patients may suffer unexpected death because of suboptimal monitoring. Early recognit... more In-hospital patients may suffer unexpected death because of suboptimal monitoring. Early recognition of deviating physiological parameters may enable staff to prevent unexpected in-hospital death. The aim of this study was to evaluate short- and long-term effects of systematic interprofessional use of early warning scoring, structured observation charts, and clinical algorithms for bedside action. A prospective non-randomized controlled study of unexpected in-hospital death before and after implementation of a clinical intervention in a medical and surgical ward setting at an urban Danish university hospital. Information was obtained over three four-month study periods - a pre-interventional one in 2009 (1st March-30th June), and two postinterventional ones in 2010 (1st September-31st December) and 2011 (1st March-30th June). The incidence of unexpected patient death, the primary study outcome, was calculated as the rate of unexpected patient mortality based on in-hospital risk time. The adjusted unexpected patient mortality rate was significantly lower during the second postinterventional study period than before the intervention, 17 versus 61 per 100 adjusted patient years (P=0.013), corresponding to a rate ratio of 0.271 (95% confidence interval (CI) 0.097-0.762). A tendency to reduced unexpected mortality was found during the first postinterventional study period (25 versus 61 per 100 adjusted patient years, P=0.053; rate ratio 0.404, CI 0.161-1.012). Clinical intervention comprising systematic monitoring practice, early warning scoring, an observation chart, and an algorithm for bedside management, implemented by interprofessional teaching, training, and optimization of communication and collaboration, may significantly reduce unexpected in-hospital mortality.
We investigated mothers' ... more We investigated mothers' and children's assessments of body weight and their expectations about perceived body size in relation to overweight of the children. We performed a case-control study of 111 cases of overweight children and 149 controls of non-overweight children (mean age 8.1 years) and their mothers. All were examined and interviewed about their assessment of body weight and their perception of a normal, attractive and acceptable body size. Case children were less able than control children to correctly assess their own body weight (p < 0.001), as were mothers of overweight children (MOC) to assess their children's body weight (p < 0.001). The majority of mothers from both groups wished their children to have a normal body size, but 18% of MOC wished their children to have an overweight body size (p < 0.013). The majority of case children, control children and mothers found a normal body size for boys and girls to be the most attractive and socially acceptable, but more MOC found overweight among boys to be the most attractive (p = 0.006). Overweight children and their mothers show increased uncertainty in the assessment of overweight and obesity, but the perception of a normal, attractive and socially acceptable body size is not distorted.
We investigated mothers' ... more We investigated mothers' possession and display of action competence to counteract or prevent overweight and eventual obesity in their children. Action competence is defined as a personal resource where the most important aspect is the individual's wish to take action and to believe in its benefit. It unfolds within the room for action as experienced by the individual due to action obstacles and action potentials. In a case-control study, mothers of 111 overweight children (MOC) were compared with mothers of 149 non-overweight children (MNC). They underwent a semistructured interview about action competence, lifestyle, and their 7- to 9-year-old children. Compared to MNC, MOC considered it more important to change habits, both for themselves (p = 0.003) and their children (p < 0.001). MOC were more motivated to change habits (p < 0.001), assessed their action competence to be higher (p < 0.001), and felt to a greater extent that they supported their children to achieve an appropriate weight (p < 0.001) compared with MNC. No difference was found between MOC and MNC in the assessment of their own room for action and their children's room for action. Self-assessed room for action was not limited for either MOC or MNC, and MOC even assessed their action competence to be greater.
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