ʼn Holistiese maatskaplikewerk-ondersteuningsprogram vir die kind in die middelkinderjare wat leef met oorgewig of vetsug

PhD (Social Work), North-West University, Potchefstroom Campus, 2017Die doel van hierdie navorsing is om ʼn kritiese ontleding te doen van die oorsaaklikheidsfaktore wat bydra tot die gewigsprobleem, die ontwikkelings-behoeftes van die kind en veral die kind wat met oorgewig of vetsug leef, ten einde ’n holistiese maatskaplikewerk-ondersteuningsprogram saam te stel om die kind by te staan in die behandeling van die fenomeen sodat moontlike optimale funksionering bewerkstellig kan word. Die navorsingsverslag word in ses hoofstukke met die volgende temas uiteengesit: 'n metodologiese ondersoek; ’n oorsig van oorgewig of vetsug; die invloed van oorgewig of vetsug op die ontwikkeling van die kind in die middelkinderjare; empiriese navorsing ten opsigte van kinders wat tydens die middelkinderjare met oorgewig en/of vetsug leef; ’n holistiese maatskaplikewerk-ondersteuningsprogram wat die behoeftes van die kind in die middelkinderjare wat met oorgewig of vetsug leef, hanteer; en laastens word die samevattende gevolgtrekkings en aanbevelings weergegee. In Hoofstuk 2 word die oorsaaklikheidsfaktore van oorgewig of vetsug by die kind in die middelkinderjare vanuit die literatuur en kwalitatiewe bevindinge binne die endogene en eksogene faktore geklassifiseer en toon ’n interafhanklikheid van mekaar. Daar is bevind dat die oorsaak en gevolg van oorgewig of vetsug nie op ’n liniêre of sirkulêre wyse aangetoon moet word nie, maar wel volgens die oorsaak-gevolg-effek van ’n dinamiese spiraal waarin die onderskeie sisteme waarbinne die kind beweeg teenwoordig is. Die volgende oorsaaklikheidsfaktore is geïdentifiseer, naamlik: die genetiese, die biologiese, omgewings-, psigososiale, emosionele en gedragsdeterminante, waar elke determinant onomwonde bydra tot die gewigsprobleem van die kind in die middelkinderjare. Hoofstuk 3 sluit die gedrag en ervarings van die kind binne sy verskeie sisteme waarbinne hy of sy beweeg, in. Uit die ontleding van die literatuur blyk dit duidelik dat die kind se kognitiewe, motoriese, en emosionele ontwikkeling ten opsigte van oorgewig of vetsug by die aanbieding van 'n holistiese maatskaplikewerk-ondersteuningsprogram in ag geneem moet word. Die holistiese maatskaplikewerk-ondersteuningsprogram, Hoofstuk 5, is vanuit die verkennende, fenomenologiese ontwerp binne die paradigma van kwalitatiewe navorsing, begrond vanuit die sosiaal-konstruktivistiese perspektief, ontwikkel. Intervensienavorsing het die nodige raamwerk gebied waarvolgens die navorsingsproses gerig is en het ʼn ondersteunende vloei van fases tot die ondersoek gebied. Semi-gestruktureerde onderhoude, aan die hand van ’n onderhoudskedule, met ouers van kinders wat met oorgewig of vetsug leef en met kundiges op die gebied van oorgewig of vetsug of kinderontwikkeling as deelnemers, het die hooftemas en subtemas, Hoofstuk 4, vir die voorgestelde holistiese maatskaplikewerk-ondersteuningsprogram aangedui. Die program is nie in die praktyk getoets nie vanweë die gewysigde vereistes vir die betrokkenheid van kinders in navorsing en die afhandelingstyd van die ondersoek. Die program is egter aan kundiges voorgelê om kommentaar daarop te lewer wat dan ook in die program geakkommodeer is. In die finale hoofstuk, Hoofstuk 6, word die belangrikste bevindings, gevolgtrekkings en aanbevelings uiteengesit. The aim of this research is to do a critical analysis of the causality factors which contribute to a weight problem, the development needs of the child, and especially the child who is overweight or lives with obesity, in order to compile a holistic social work support programme to assist the child in treating the phenomenon so that the child can reach optimal functioning in life. The research report are divided in six chapters with the following themes: a methodological investigation; an overview of overweight and obesity; the influence of being overweight and/or obesity on the child’s development in the middle childhood years; empirical research with regard to children who are overweight and/or live with obesity; a holistic social work support programme, which handles the needs of the child who is overweight or lives with obesity; and lastly, conclusions and recommendations are provided. In Chapter 2, the causal factors of being overweight and obesity for the child in the middle childhood years are classified from the literary study and qualitative findings from within the endogenic and exogenous factors, which indicate a co-dependency on each other. It was found that the cause and effect cannot be illustrated in a linear or circular manner, but rather according to the cause-effect pattern of a dynamic spiral in which all the different systems in which the child lives are present. The following causality factors were identified, namely: the genetic, biological, environmental, psycho-social, emotional and behavioural determinants, where each determinant contributes outright to the weight problem of the child in the middle childhood years. Chapter 3 includes the behaviour and experience of the child within his or her different systems in which he or she functions. From the literature analysis, it is evident that the child’s cognitive, motor and emotional development with regards to overweight and obesity must be taken into consideration when a holistic social work support programme is presented. The holistic social work support programme, Chapter 5, was developed from the explorative, phenomenological design within the paradigm of qualitative research and grounded in the social-constructivist perspective. Intervention research provided the necessary framework which directed the research process and also offered a supportive flow of the phases in the investigation. The main theme and the subthemes, Chapter 4, for the proposed holistic programme were derived from semi-structural interviews, according to an interview schedule, conducted with parents of children who are overweight or live with obesity, as well as with experts in the field of overweight and obesity or child development as the respondents. The programme has not been tested in practice due to the amended requirements for the involvement of children in research and the time in which the investigation had to be finalised. However, the programme has been presented to experts for comments and recommendations, which were accommodated in the programme. The most important results, conclusions and recommendations are provided in the final chapter.Doctora