NURSING EVIDENCE BASED PRACTICE IN OBESITY

Nursing Evidence Based Practice in Obesity



NURSING EVIDENCE BASED PRACTICE IN OBESITY

Introduction

Nursing Evidence-Based Practice (EBP) has its origins in medicine, beginning its development in Canada from the discipline of clinical epidemiology, where the group Sackett, in the late 70's, trying to incorporate research clinical decision making for patients. Another Canadian group led by Guyatt in the 90's promoted the use of mathematical-based research and statistical evidence (Carey 1995, 76). At the same time the gap between books and periodical literature, the variability in clinical care in patients with the same disease (Monk, Barry, McClain, Weaver, Cooper, Franz 1995, 87), the gap between scientific and clinical practice, and the gap between research and practice facilitated the birth of this new paradigm. Evidence-Based Nursing (EBN) develops later in English-speaking countries, initially taking a positivist framework of medicine. In recent years there have been various definitions of EBE. All patients with obesity show events for normalization of body weight. Normal weight is now considered to be one in which body mass index of less than 25 kg/m2.

Discussion

The biggest challenge is itself a modification of the image of life for patients, especially with increased cardiovascular risk. At the beginning of therapy, the patient must be configured to maintain a food diary and physical activity. The diary is usually reflected the number of meals, their composition and the reasons behind the patient has, and all physical activity per day. This will help in the first place, the doctor determine those violations in the diet, which allows the patient, and secondly - mobilizes the patient, because it will "see" what and when he eats.

At the first visit is necessary to calculate calorie diet, using formulas (Kulkarni, Castle, Gregory, Holmes,Leontos, Powers, Snetselaar, Splett, Wylie 1997, 98). For most patients, reducing calorie intake by 500 a day leads to weight loss at 250-500 grams per week, which is quite acceptable and not associated with other risks. If possible, just specify the inclusion in the diet of the patient's large number of low-calorie foods, like fresh herbs, vegetables and fruits that can provide the body with the necessary fiber and vitamins.

The optimum ratio of nutrients needed during weight loss, remains the most frequently discussed issue. Indicators of weight loss is comparable to the most common currently dieting - it's an average of 2,1-3,3 kg per year, but the fact of the imbalance of macro-and micronutrients in this diet can lead to adverse consequences. Therefore, the optimal ratio is such a distribution of calories throughout the day: 55-60% are carbohydrates, 15-20% protein and 20-25% fats.

All patients should be encouraged daily exercise, at least 30 minutes. Intensive daily physical activity, even when errors in the diet lead to more pronounced results than simply caloric restriction without exercise.

This therapy requires a lot of time and effort as part of the physician, and from the patient. Therefore, long-term therapy of obesity usually requires the appointment of agents to reduce and maintain the achieved weight ...