Health Care Practitioner Training Assignment (pdf)

Topic: An Exploration of obesity in young Adult and
Nurse Engagement in this Issue.
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TABLE OF CONTENTS
Topic: An Exploration of obesity in young Adult and Nurse Engagement in this Issue.............1
CHAPTER ONE....................................................................................................... 6
1.1 Introduction..................................................................................................... 6
1.2 Research Question........................................................................................... 11
Literature review....................................................................................................... 11
CHAPTER TWO.................................................................................................... 17
2.1 Methodology and Design...................................................................................17
2.2. Research inclusion criteria................................................................................17
2.3 Database/Sourcing........................................................................................... 18
2.4 Analysis......................................................................................................... 19
2.5. Strength, weaknesses and limitations of literature reviews......................................20
2.6. Ethical considerations...................................................................................... 22
2.7. Justifications of the study................................................................................. 23
CHAPTER THREE................................................................................................. 24
3.1 Findings......................................................................................................... 24
3.1.1 Urbanisation.............................................................................................. 24
3.1.2 Family environment.................................................................................... 26
3.1.3 Screen times.............................................................................................. 27
3.1.4 Parental weight status.................................................................................. 28
3.1.5 Health Care Practitioner Training..................................................................29
CHAPTER FOUR................................................................................................... 31
4.1 Discussion...................................................................................................... 31
4.2 Implication for practice.................................................................................... 34
6.1 Conclusion..................................................................................................... 38
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REFERENCE......................................................................................................... 40
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ABSTRACT
Background:
Worldwide, obesity is the sixth most important risk factor contributing to the overall
burden of disease. In the UK, nearly a third of children aged between 2 to 15 presents as
clinically obese or overweight thus predisposing them to an adulthood plagued with type 2
diabetes, coronary heart diseases, depression, low self-esteem and some form of cancer.
Whilst it is recognised that engagement in physical activities is one of the intervention
approaches that can be employed to promote physical fitness and reduce overweight and
obesity among teenagers in the United Kingdom, the evidence available indicates that
sedentary behaviour influences weight and indeed, does contribute to weight gain in
teenagers.
Aim:
The aim of this study was to uncover the factors influencing the adoption of sedentary
lifestyle among overweight teenagers. Consequently, the study research question was: ‘what
are the factors that influence adoption of a sedentary lifestyle among overweight teenagers?’
Objective
 To explore lifestyle of teenager between age 12- 18.
 To identify impact of obesity among teenager health
 To identify factors influencing adoption of sedentary lifestyle on teenagers.
Method:
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A research proposal was submitted prior to commencing this study. The study
employed a critical literature review theoretically underpinned by a seven-step model
consisting of three phases - exploration, interpretation and communication.
Findings:
Five key themes were identified as the factors that influence the adoption of a
sedentary lifestyle among overweight teenagers. These factors were urbanisation, family
environment, screen time, parental weight status and health care practitioner training.
Conclusion:
Nurses have a key role to play in addressing overweight and obesity in teenagers.
Accordingly, it is important that nurses are able to have an honest and open conversation with
teenagers and their parents on overweight and sedentary practices. This is likely to be the first
step in empowering teenagers to change sedentary practices.
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CHAPTER ONE
1.1 Introduction
Whilst obesity was previously not a problem in the developing world, it is now
becoming prevalent and in industrialised countries on the contrary, it is now the most
prevalent form of malnutrition (Peeters and Backholer, 2012). Worldwide, obesity is the sixth
most important risk factor contributing to the overall burden of disease. Indeed, 10% of all
children and 1.1 billion adults are now classified as overweight or obese worldwide (Haslam
and James, 2010). Worldwide, 1 in 4 adults, and 3 in 4 adolescents (aged 11–17 years), do
not currently meet the global recommendations for physical activity set by The World Health
Organisation (WHO, 2018). It is projected that an estimated 38% of the world’s adult
population will be overweight and another 20% will be obese by 2030 (Adela and Frank,
2015). Worldwide, almost three million people die each year as a result of being overweight
or obese (WHO, 2017). Having excess weight triggers a plethora of health conditions such as
cardiovascular diseases, cancers, and type 2 diabetes (WHO, 2018).
According to the WHO (2017), most of the world’s population live in a country where
there are more people overweight compared to individuals who are underweight. Crucially,
this encompasses all high-income and middle-income countries. Moreover, it is generally
acknowledged that obesity is caused by consuming more calories than is burnt off through
physical activity (Berthoud and Klein, 2017; Kohorst et al. 2018). Globally, the prevalence of
obesity has doubled from 1980 to 2014 (Health and Social Care Information Centre, 2016).
Here in the United Kingdom (UK), in 2015, 68% of men and 58% of women were obese
(NHS, 2017). With regards to children, in 1991, only 4.2% of children were classed as being
either overweight or obese. However, by 2015, 26.9% of children were either overweight or
obese (Health and Social Care Information Centre, 2016). Worryingly, it is projected that by
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2020 in the UK, the number of obese and overweight teenagers will double with an
associated cost to the National Health Service (NHS) of £17.6 billion (Glasper, 2010).
More worrying however, is the exponential rise of obesity in children with nearly a
third of children aged between 2 to 15 presenting clinically as obese or overweight (Health
and Social Care Information Centre, 2015). Associated clinical consequence of obesity
include type 2 diabetes, coronary heart diseases, depression, low self-esteem and some form
of cancers (Foss and Dyrstad, 2011). These associated costs place a significant burden on the
health economy and positions tackling obesity as a government wide priority in the UK
(Selbie, 2018). Indeed, this is evidenced in the UK Government's childhood obesity plan
which is aimed at creating healthier choices and reducing the rates of obesity in the most
deprived sections of our communities (Department of Health, 2016). However, and despite
the UK government’s childhood obesity plan, obesity among adolescents has continued to
increase significantly prompting major concern amongst public health practitioners in light of
the associated medical consequence of progressing into adulthood with obesity (Meyer and
Gulotta, 2012; Berman, Snyder and Frandsen, 2015; Sharman and Nobles, 2016).
Available evidence implicates sedentary lifestyle as an underpinning trigger for
obesity and overweight in adolescents (Kohorst et al. 2018). Sedentary lifestyle is
underpinned by inactivity and is a lifestyle characterised by insufficient amounts of physical
activity on a regular basis (Kim, 2018). This lifestyle is closely aligned with sedentary
activities such as the frequent watching of TV, sitting, reclining, lying down and playing of
video games (Meetoo, 2010). The WHO (2018b) corroborates this indicating that sedentary
behaviour is any waking behaviour such as sitting, lying down or reclining in which an
energy of ≤ 1.5 metabolic equivalents is not expanded. In addition, the emphasis on
intellectual activities at the expense of physical education in the school curriculum has also
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been implicated as a factor fuelling sedentary lifestyle in adolescents (Meetoo, 2010). More
worryingly, available evidence indicates that sedentary behaviour negatively impacts weight
independent of other factors which could be confounders in the association such as genetics,
diet and physical activity. Corroborating this, a study which prospectively examined sitting
time and mortality in a representative sample of 17,013 Canadians for 12 years indicated that
a higher risk of mortality is associated with being sedentary (Katzmarzyk, Church, Craig and
Bouchard, 2010). Furthermore, this association of sedentary behaviour with adverse health
outcomes was also uncovered in a study examining the association between sedentary
behaviour and obesity among 12-year-old children, while adjusting for confounding variables
(Mitchell et al. 2010). This study indicated that even after controlling for moderate physical
activity defined as any movement of the body that is produced by skeletal muscles which
requires energy expenditure, being sedentary was strongly associated with the likelihood of
children becoming obese and thus progressing into their teenage years with obesity. This is
further supported by the WHO (2018b) which indicates that sedentary practices such as
sitting for long periods of time are associated with abnormal glucose metabolism and hence
could lead to cardio metabolic disease.
Furthermore, research indicates that there is a strong correlation between physical
inactivity and the prevalence of non-contagious chronic illnesses, particularly circulatory
system diseases (Darch, Baillie, and Gillison, 2017). For instance, Lobstein et al (2015)
indicate that cerebrovascular diseases as well as ischemic heart illnesses increase by 25% due
to the adoption of a sedentary lifestyle. This becomes particularly worrying in light of the fact
that 47% of all deaths are caused by circulatory system diseases (Stankov, Olds, and Cargo,
2012). Consequently, the need to promote adoption of programs that will make teenagers
adopt active lifestyles cannot be underestimated. In achieving this, the UK government
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