EFFECT OF APPLICATION FAMILY-CENTER NURSING THEORY AT FAMILY

CASE WITH CHILDREN UNDER FIVE YEARS OLD EATING DISORDERS

1.1 Bacground

Difficult problem eating is a problem common to preschoolers. trouble

eating disorders in children are caused by many factors including the fact the
interaction between family factors, social, and psychological (
Judarwanto,2004 ). family factors in this case related to the structure of the
role. Parents were then divided according to their control scores. Children
whose parents indicated greater attempts to control their child's diets reported
higher intakes of both healthy and unhealthy snack foods. In addition, those
children whose parents indicated a greater use of food as a means to control
their child's behaviour reported higher levels of body dissatisfaction . structure
the role of family members of the mother chiefly affects the trouble eating
disorders in children. Parental attitudes must certainly affect their children
indirectly through the foods purchased for and served in the household.....
influencing the children's exposure and... their habits and preferences. Some
evidence supports an important role for parents For example, Klesges et
al.(Klesges et al., 1991) showed that children selected different foods when
they were being watched by their parents compared to when they were not.
Oliveraet al. (Olivera et al., 1992) reported a correlation between mothers' and
children's food intakes for most nutrients in pre-school children, and suggested
targeting parents to try to improve children's diets. Likewise, Contentoet
al.(Contento et al., 1993) found a relationship between mothers' health
motivation and the quality of children's diets. families who have reluctantly
eating habits, it will have difficulty eating. this is the show by a study that
children age 5 who had mothers with anorexia then, will have a greater
incidence of depression and difficulty eating (Khomsan, 1998; Natenson,
2005).
The incidence is estimated between 16-75% ( Eppright et al, 1969;
Minde & Mind, 1986 dalam Holden & MacDonald, 2000). reportedly one of
three preschoolers having trouble eating and half suffer from malnutrition. in
2003 as many as, 27.5% of children in Indonesia suffered under the age of five
are malnourished moderate to severe (Atmarita, 2005). According Judarwanto
(2005), feeding difficulties experienced by about 25% at the age of the child.
the amount will be increased by about 40-70% in children born prematurely or
with chronic diseases. the research found that the preschool children 4-6 years
in jakarta, pravalensi difficulty eating by 33.6% and 79.2% most of which
have lasted more than three months. children become less active as a result,
unable to concentrate, and physical growth are incompatible. The next will
grow into men, teens and adults who are also malnourished so will prolong the
cycle of malnutrition. While according to Black et.al 2013, Child
malnutrition still represents a major public health concern in many
lower- and middle income countries. However, what was mainly a problem
of under-nutrition in past decades, with high rates of stunting (low height
for age) and wasting (low weight for height), is now a combined
problem of high prevalence of stunting and anemia accompanied by an
increasing risk of overweight and obesity (Black et.al., 2013, Fernald and
Neufeld, 2007, Lobstein et.al, 2015 Popkin et.al, 2012, Uauy et.al., 2008).
Stuart (1987, in Judarwanto, 2004) states that nutritional deficiencies such as
vitamins, minerals, and other nutrients affect the metabolism in the brain that
disrupt the formation of DNA in the nervous system. it resulted in disruption
of the growth of new brain cells or brain cell myelination mainly under 3 years
old, so it is related to the child's mental development and intelligence.
Walter (2003, in judarwanto 2004/2005) examined 825 severely
malnourished children turned out to have lower intellectual ability than
children who have good nutrition. trouble eating disorders in children will
have an impact on the dynamics of family change. families will have difficulty
to run the family duties which meet the needs of children. The next family will
feel anxiety, feelings of helplessness, conflicts arise between family members
that will aggravate the disorder is difficult to eat in children (Willgerodt &
Killen, 2006). according to Friedman (1998); Friedman, Bowden and Jones
(2003); Neuman, (1982); Fawcett (2002) (in Allender & Spradley, 2005) says
that the individual is an open system in constant and reciprocal interaction
with the environment. family environment that is not cohesive, a lot of conflict
and lack of support, interaction antr family members are rigid are the factors
that contribute to the disorder difficult eating in children (Minuchin et al,
1978, in Holden & MacDonald, 2000; Kirschenbaum, 1986; Stren et al, 1989;
Laliberte et al, 1999, in Allen, 2005). According Allender and Spradley (2005)
says that stressors can come from internal and external environment. the
internal environment of the aggregate child difficult to eat include a high
proportion of low-income families, unhealthy eating behaviors, while the
external environment include economic adanyakrisi food industry that
produces unhealthy food. widespread impact can be seen from the indicators
of human development index (HDI) of Indonesia is still low, is ranked 112 out
of 174 countries, lower than neighboring countries. low HDI is very
influenced by the low nutritional status and health status of the population.
More than half the deaths of infants and toddlers are caused by poor
nutritional status of children under five (Anwar, 2005).
Based on the above background underlying researchers to conduct
research on the application of Family-Center Nursing Theory in cases of
families with toddlers difficult to eat using the model by providing deep and
clear guidance from assessment to evaluation of children who have difficulty
eating. one of the concepts the solution in addressing the problem on
aggregate children who experience eating disorders difficult to use Family-
Center Nursing Theory. Aside from that one concept of the solution to solve
the problem is to make policies related to difficult problems eating in
developed countries which can be classified into policy at the level of
research, education, and prevention and treatment (WHO, 2006). Policies in
the level of research include the identification number, form the central
institution of training, action research, prevention and setting schools,
communities and homes. policy in which it's recommended for education,
prevention and treatment include education and training for all health workers,
training and education for staff education, public education and cooperation.
the government's policy in dealing with nutritional problems among others
through supplementary feeding in the social safety net (JPS) and the
improvement of nutrition services through training the treatment of
malnutrition for health workers, and family members
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