Chang C T
Faculty of Medicine & Health Sciences, Universiti Malaysia Sarawak, Malaysia.
Rural Remote Health. 2007 Oct-Dec;7(4):864. Epub 2007 Dec 5.
There is an increase in the prevalence of overweight and obesity in Malaysia. Besides prevalence studies, not much is known about either overweight or obese individuals. The objective of this study was to determine the stages of change in losing weight and the self-efficacy in eating control of three indigenous groups of overweight and obese adults in Sarawak, Malaysia.
A cross-sectional study was conducted in one rural region in Sarawak using a purposive sample. A structured questionnaire, which included two scales: (1) Weight: Stages of change (SOC) to assess readiness to change; and (2) Weight Efficacy Lifestyle Questionnaire (WEL) (both adopted from the transtheoretical model of change); and a set of pre-tested questionnaires on socio-demographic data, the presence of health problems and self-assessment of weight appropriateness, was used to interview respondents.
The stage distribution for weight loss of these adults respondents (n = 271) showed that 60.5% (n = 164) were in the pre-contemplation stage, 20.7% (n = 56) were in the contemplation stage, 8.5% (n = 23) were in the preparation stage, and 8.9% (n = 24) were in the action stage, while only 1.5% (n = 4) were in the maintenance stage. Except for education, the stage differences were generally stable across age, sex, race, household income, presence or absence of health problem, self-perceived weight and presence of overweight or obesity. Respondents were least able to control their eating under social pressure and food availability, according to their WEL score.
A large proportion of the overweight or obese adults was not intending to lose weight. The factor structure of the two WEL original subscales enabled partial differentiation between respondents who were able or unable to resist eating in situations where there were availability of food and experienced physical discomfort. The study results indicate the importance of assessing individuals' SOC score in order to implement stage-matched intervention strategies. More studies should be performed in order to validate the WEL questionnaire for use with a Malaysian sample.
马来西亚超重和肥胖的患病率呈上升趋势。除了患病率研究外，对于超重或肥胖个体了解不多。本研究的目的是确定马来西亚砂拉越三个土著超重和肥胖成年人群体在减肥方面的改变阶段以及饮食控制的自我效能感。
在砂拉越的一个农村地区采用目的抽样法进行了一项横断面研究。使用一份结构化问卷，其中包括两个量表：（1）体重：改变阶段（SOC），用于评估改变的准备程度；（2）体重效能生活方式问卷（WEL）（均采用跨理论模型改编）；以及一组关于社会人口数据、健康问题的存在情况和体重适宜性自我评估的预测试问卷，对受访者进行访谈。
这些成年受访者（n = 271）的减肥阶段分布显示，60.5%（n = 164）处于未考虑阶段，20.7%（n = 56）处于考虑阶段，8.5%（n = 23）处于准备阶段，8.9%（n = 24）处于行动阶段，而只有1.5%（n = 4）处于维持阶段。除了教育程度外，各阶段差异在年龄、性别、种族、家庭收入、是否存在健康问题、自我感知体重以及超重或肥胖的存在情况方面总体较为稳定。根据他们的WEL得分，受访者在社会压力和食物可得性情况下最难以控制饮食。
很大一部分超重或肥胖成年人无意减肥。两个WEL原始子量表的因素结构能够部分区分在有食物供应和身体不适情况下能够或无法抵制进食的受访者。研究结果表明评估个体的SOC得分以实施阶段匹配干预策略的重要性。应该进行更多研究以验证WEL问卷在马来西亚样本中的适用性。
