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躯体主诉和社交能力可预测儿童超重治疗的效果。

Somatic complaints and social competence predict success in childhood overweight treatment.

作者信息

de Niet Judith, Timman Reinier, Rokx Casper, Jongejan Mieke, Passchier Jan, van Den Akker Erica

机构信息

Department of Medical Psychology and Psychotherapy, Erasmus University Medical Centre, Rotterdam, the Netherlands.

出版信息

Int J Pediatr Obes. 2011 Jun;6(2-2):e472-9. doi: 10.3109/17477166.2011.575145. Epub 2011 May 24.

Abstract

OBJECTIVE

To determine baseline predictors of treatment success in terms of Body Mass Index-Standard Deviation Scores (BMI-SDS) in a multidisciplinary family-based behavioural lifestyle intervention for overweight and obese children.

METHODS

Overweight and obese children (N = 248; age 8-14 years) and their caregivers participated in a prospective study and attended a lifestyle intervention. Baseline data assessment included anthropometrics, demographics, breakfast behaviour, competence and behavioural problems (Child Behaviour Checklist [CBCL]), family functioning (Family Adaptability and Cohesion Evaluation Scales [FACES] III), and personality (Dutch Personality Questionnaire-Youth [NPV-J]). BMI-SDS was measured at start and after 3, 9, and 12 months of treatment. Mixed modelling was used for analysis.

RESULTS

Greater BMI-SDS reductions over the course of one year were found in children with Caucasian parents, with lower baseline BMI-SDS, and higher CBCL-social competence scores. Furthermore, children with non-overweight parents, younger children, and children with lower CBCL-somatic scores were more successful in BMI-SDS reduction. No effects on treatment success were found for the number or position of siblings, having divorced parents or a working mother, educational level of the parents, breakfast behaviour, family functioning, and personality.

CONCLUSIONS

These results suggest that screening for baseline characteristics in childhood obesity treatment could identify who will benefit most from a paediatric lifestyle intervention. Tailored programs should be developed and the treatment team should focus on children who are less successful in achieving weight reductions. Future research should study by which mechanisms somatic complaints and social competence influence treatment success.

摘要

目的

在一项针对超重和肥胖儿童的多学科家庭行为生活方式干预中,根据体重指数标准差评分(BMI-SDS)确定治疗成功的基线预测因素。

方法

超重和肥胖儿童(N = 248;8 - 14岁)及其照顾者参与了一项前瞻性研究并参加了生活方式干预。基线数据评估包括人体测量学、人口统计学、早餐行为、能力和行为问题(儿童行为检查表 [CBCL])、家庭功能(家庭适应性和凝聚力评估量表 [FACES] III)以及个性(荷兰青少年个性问卷 [NPV-J])。在治疗开始时以及治疗3个月、9个月和12个月后测量BMI-SDS。采用混合模型进行分析。

结果

在父母为白种人的儿童、基线BMI-SDS较低以及CBCL社会能力得分较高的儿童中,发现一年中BMI-SDS降低幅度更大。此外,父母非超重的儿童、年龄较小的儿童以及CBCL躯体得分较低的儿童在降低BMI-SDS方面更成功。未发现兄弟姐妹数量或排行、父母离异或母亲工作、父母教育水平、早餐行为、家庭功能和个性对治疗成功有影响。

结论

这些结果表明,在儿童肥胖治疗中筛查基线特征可以确定谁将从儿科生活方式干预中获益最大。应制定量身定制方案,治疗团队应关注那些在减轻体重方面不太成功的儿童。未来研究应探讨躯体不适和社会能力通过何种机制影响治疗成功。

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