Abstract：
Globally, overweight and obesity are more prevalent in rural areas than in urban areas. The purpose of this study was to determine to what extent public health nurses in rural areas in Norway feel equipped to tackle the overweight and obesity epidemic within two sets of national guidelines: The National Guidelines for the Standardized Measurement of Height and Weight and The National Guidelines for the Prevention, Identification, and Treatment of Overweight and Obesity in Children and Adolescents. These guidelines are inspired by New Public Management (NPM) logic, which emphasises more market orientation within the public sector to obtain a more cost-effective supply of public goods. The focus is on the weighing of schoolchildren, available resources, inter-agency cooperation and the rural context.
The data were collected using a structured questionnaire among 40 public health nurses working with children in rural areas, as well as qualitative interviews with 25 informants involved in the prevention and treatment of overweight and obesity among rural children.
The study shows that rural public health nurses worry about the lack of resources for follow-up with children with a body mass index greater than what is characterised as \'normal\'. The public health nurses suggested better cooperation between different stakeholders to work around the lack of resources and at the same time be able to see the whole picture, considering that overweight and obesity are complex problems connected to different challenges. They believed that it is an advantage to see the individuals in their local surroundings, to know their family history, their leisure activities and so on. This might be easier in rural areas than in urban areas, as these areas are often more transparent.
There was consensus among the public health nurses involved in this study that national guidelines for treating overweight and obesity in children with the principles of NPM, and simplifying and standardising services, adds challenges instead of solutions. Such practices also hinder the use of experience-based knowledge about both the individual and the local context. There is a need for more flexible guidelines that can easily be adapted to the local (rural) context.
The data were collected using a structured questionnaire among 40 public health nurses working with children in rural areas, as well as qualitative interviews with 25 informants involved in the prevention and treatment of overweight and obesity among rural children.
The study shows that rural public health nurses worry about the lack of resources for follow-up with children with a body mass index greater than what is characterised as \'normal\'. The public health nurses suggested better cooperation between different stakeholders to work around the lack of resources and at the same time be able to see the whole picture, considering that overweight and obesity are complex problems connected to different challenges. They believed that it is an advantage to see the individuals in their local surroundings, to know their family history, their leisure activities and so on. This might be easier in rural areas than in urban areas, as these areas are often more transparent.
There was consensus among the public health nurses involved in this study that national guidelines for treating overweight and obesity in children with the principles of NPM, and simplifying and standardising services, adds challenges instead of solutions. Such practices also hinder the use of experience-based knowledge about both the individual and the local context. There is a need for more flexible guidelines that can easily be adapted to the local (rural) context.
摘要：
全球范围内,超重和肥胖在农村地区比在城市地区更普遍。这项研究的目的是确定挪威农村地区的公共卫生护士有能力在两套国家指南中应对超重和肥胖流行的程度：《国家身高和体重标准化测量指南》和《国家预防指南》，Identification,儿童和青少年超重和肥胖的治疗。这些指导方针的灵感来自新公共管理(NPM)逻辑，强调公共部门内部更多的市场导向，以获得更具成本效益的公共产品供应。重点是学童的体重，可用资源,机构间合作和农村背景。
这些数据是使用结构化问卷对农村地区与儿童一起工作的40名公共卫生护士进行收集的。以及对25名参与预防和治疗农村儿童超重和肥胖的线人的定性访谈。
研究表明，农村公共卫生护士担心缺乏对体重指数大于“正常”的儿童进行随访的资源。公共卫生护士建议不同利益相关者之间更好的合作，以解决资源不足的问题，同时能够看到整体情况，考虑到超重和肥胖是与不同挑战相关的复杂问题。他们认为，在当地环境中看到个人是一种优势，了解他们的家族史,他们的休闲活动等等。这在农村地区可能比在城市地区容易，因为这些领域往往更加透明。
参与这项研究的公共卫生护士达成共识，即采用NPM原则治疗儿童超重和肥胖的国家指南，简化和标准化服务，增加了挑战而不是解决方案。这种做法还阻碍了对个人和当地背景的基于经验的知识的使用。需要更灵活的准则，可以很容易地适应当地（农村）的情况。
这些数据是使用结构化问卷对农村地区与儿童一起工作的40名公共卫生护士进行收集的。以及对25名参与预防和治疗农村儿童超重和肥胖的线人的定性访谈。
研究表明，农村公共卫生护士担心缺乏对体重指数大于“正常”的儿童进行随访的资源。公共卫生护士建议不同利益相关者之间更好的合作，以解决资源不足的问题，同时能够看到整体情况，考虑到超重和肥胖是与不同挑战相关的复杂问题。他们认为，在当地环境中看到个人是一种优势，了解他们的家族史,他们的休闲活动等等。这在农村地区可能比在城市地区容易，因为这些领域往往更加透明。
参与这项研究的公共卫生护士达成共识，即采用NPM原则治疗儿童超重和肥胖的国家指南，简化和标准化服务，增加了挑战而不是解决方案。这种做法还阻碍了对个人和当地背景的基于经验的知识的使用。需要更灵活的准则，可以很容易地适应当地（农村）的情况。
