To break the weight gain-A qualitative study on the experience of school nurses working with overweight children in elementary school.

AIMS AND OBJECTIVES: To describe the experiences of school nurses working with overweight schoolchildren.

BACKGROUND: School nurses play an important role in health promotion of overweight children. Lifestyle changes and interventions to address being overweight can improve health outcomes and decrease the risk for future health problems.

DESIGN: A descriptive and qualitative design with a phenomenological approach was used. Data were gathered through interviews with school nurses working with overweight schoolchildren in Swedish elementary school; the data were subsequently analysed for meanings.

RESULTS: Working with overweight children was perceived as demanding and challenging by the school nurses who found conversations on this topic emotionally loaded and complex. In addition, the school nurses needed to be sensitive and supportive to succeed in their support for a healthier everyday life for the schoolchildren. It was stated as important to find ways to break the child's weight gain and to cooperate with the parents in this work. The children's decrease in weight was experienced to be more successful when making small, step-by-step changes together with the child and his or her parents.

CONCLUSIONS: This study concludes that health talks about being overweight may be a challenge for school nurses. Strategies used to manage and succeed in this work included engaging in motivational conversations, working step by step and cooperating with the child's parents. Furthermore, the nurses experienced that they needed to provide emotional support for overweight children during school time.

RELEVANCE TO CLINICAL PRACTICE: The school nurses' health promotion needs to focus on how to break weight gain in overweight children. In this work, the nurses' sensitiveness seems pivotal. Further research is needed on school nurses' work with health promotion and support of overweight children concerning how to perform efficient communication and cooperation with the children and their parents.