Exploring Literature Review and it Significance to Present Health and Social Care

Exploring Literature Review and it Significance to Present Health and Social Care

The aim of this assignment is to undertake a secondary research in exploring literature review and it significance to present health and social care. Clinical question will be formulated with rationale given for choice of topic by undertaking an extensive review of the literature. Following the systematic search, the student will critically evaluate literatures and other evidenced based information in order to discuss and answer the question. The design methods and data analysis will be discussed. It will also consider evidence based practice and the applications of research studies on nursing practice. Producing a dissertation that draws conclusion and makes recommendations for nursing practice will be deliberated.

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PURPOSE OF CHAPTER

This chapter will introduce the background of the review, its rationale, research question, aims and objectives.

BACKGROUND

The World Health Organisation (WHO, 20010) defines obesity as a complex condition, one with serious social and psychological manifestations that affects virtually any age and socioeconomic groups and threatens to overtake developed and developing countries. Obesity is the commonest form of malnutrition and is reacting epidemic proportions in developed and undeveloped countries around the world (Wadden et al. 2002). Arterburn et al. (2008) also defines obesity as a chronic condition characterised by an excess of body fat. It is often diagnosed in adults by using the Body Mass Index (BMI), which is calculated by measuring weight in kilograms and dividing this figure by height in metres squared (kg/ m²) ( Shepherd, 2009). Individuals with BMI ranging from 25Kg/m² indicate overweight whiles 30+ kgm² indicates obesity in adults. Overweight occurs when energy intake exceeds energy needs. Weight gain occurs when individuals for whatever reasons overeat or under exercise (Ahearne – Smith, 2008).

Obesity is a complex, costly and debilitating condition. The health implications of obesity are vast and the cost of treating this condition is a burden on the NHS, in terms of finance and resources. (Department of Health (DH) 2009a). Estimates put the cost of treating obesity and its associated complications at over one billion pounds per year in the UK, this figure is predicted to rise to £45 billion by the year 2050 (Wintour, 2007). Research has estimated that in England, 6.8% of all deaths attributes to obesity (NHS, 2010). A recent study looking at data for 27 year period concluded that about one quarter of deaths in England was directly or indirectly related to obesity (Duncan et al. 2010). Predicted trends in obesity amongst men and women in England extrapolated to 2010 indicates that 26% of men and 28% of women will be clinically obese, imposing huge burden on the healthcare (National Audit Office, 2001).

Evidence indicates that there is a complex interrelationship between genetics, environment, childhood, family and non genetic factors (Kipping et al. 2008). There is also growing body of evidence that describes obesity as a polygenic disorder, with many genes being linked to or associated with a predisposition to adiposity (Batch and Baur, 2005). One of the latest genes to be associated with an increased risk of obesity is the fat, mass and obesity gene (Loos and Bouchard, 2008), which is thought to confer a predisposition to the disease through the control of food intake (Cecile et al 2008). Cairns and Stead (2009) discusses the increase in weight as a reflection of the trend in the western world generally and has been attributed to an abundance of food combined with disposition towards less physical activity of our daily lives. It further explains the diminished physical activity stems not only from changing employment patterns, but also from the many aids available to the average house holder, the ubiquitous motor car, and trends in the design of buildings and cities.

Obesity is a chronic metabolic disease, considered to be one of the main risk factors for cardiovascular disease and correlating with increased morbidity and mortality (NHS, 2010). Research shows that there is a link between excess body fat and the risk of developing a number of serious disease including diabetes, hypertension, cerebrovascular disease, arthritis and some cancers (Swain and Sacher, 2009). It has been confirmed that overweight individuals decreases their risk of premature death by doing physical activity even if their weight doesn’t change. People who are overweight can be limited in their ability to carry out physical activity because of reduced oxygen uptake capacity and painful muscles and joints. This limitations in locomotive power influences movement behaviour and lead to problems in activities of daily living.

Weight loss reduces blood pressure and improves metabolic profile. It also reduces the symptoms and improves several obesity related chronic conditions such as diabetes, obstructive sleep apnoea and osteoarthritis (SIGN, 2010). Weight loss is also associated with improvement of vascular morphology and function. Research by Pierce et al. (2008) demonstrated that short term, energy intake restricted weight loss alone is an effective intervention for improving endothelial function in obese subjects.

The impact of being overweight and obese has been studied from the perspective of health related quality of life (HRQL). Although, there is no standard definition of HRQL, It is generally accepted that it is subjective, multi dimensional assessment of the physical health, emotional wellbeing and psychosocial functioning (Hassan et al. 2003). There is also a growing body of cross – sectional data that support strong relationship between obesity and quality of life, in that quality of life tends to decrease as function of weight increase. Literature also supports that even small weight reducti……………………………………………………………