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计步器步行加动机性访谈方案对肥胖或超重泰国精神分裂症患者的影响:一项为期 12 周的随机对照试验。

Pedometer walking plus motivational interviewing program for Thai schizophrenic patients with obesity or overweight: a 12-week, randomized, controlled trial.

机构信息

Chiang Mai University, Chiang Mai, Thailand.

出版信息

Psychiatry Clin Neurosci. 2011 Jun;65(4):374-80. doi: 10.1111/j.1440-1819.2011.02225.x.

Abstract

AIM

The aim of this study was to design and examine a program called the 'pedometer walking plus motivational interviewing (PWMI) program' in schizophrenic patients who are obese or overweight.

METHODS

This was a 12-week, randomized, parallel, open-label, controlled trial in mildly ill schizophrenic patients with a body mass index (BMI) of 23.0 kg/m(2) or more. Each participant in the intervention or control group was given a leaflet entitled 'What is a healthy lifestyle?' The 1-week, PWMI program consisted of five 1-h sessions of individual motivational interviewing, group education, goal-setting, and practising of pedometer walking. The pedometers were given to the intervention group only. Weight, height, BMI and waist circumference were assessed at baseline, week 4, week 8, and week 12. The primary outcome of this trial was the changed bodyweight at week 4, week 8, and week 12.

RESULTS

Of 64 participants, 32 each were randomly allocated to intervention and control groups. All participants completed the study. Only the means of changed bodyweight at week 12 were significantly different between groups (P = 0.03). At this week, the bodyweight of the intervention group decreased significantly more than that of the control group with a mean difference of 2.21 kg (95% confidence interval of 4.12-0.29).

CONCLUSION

Increased physical activity by pedometer walking plus individual motivational interviewing may be an effective program for the reduction of bodyweight and BMI in Thai schizophrenic patients who are obese or overweight. Its efficacy may be comparable to other cognitive/behavioral programs. Further studies in larger sample sizes are warranted.

摘要

目的

本研究旨在设计并检验一种名为“计步器步行加动机性访谈(PWMI)方案”的程序,以治疗肥胖或超重的精神分裂症患者。

方法

这是一项为期 12 周、随机、平行、开放标签、对照临床试验,纳入的是病情较轻且 BMI 超过 23.0kg/m2 的精神分裂症患者。干预组和对照组的每位参与者均收到一份题为“什么是健康的生活方式?”的传单。为期 1 周的 PWMI 方案包括 5 次 1 小时的个体动机性访谈、小组教育、设定目标以及计步器步行练习。仅向干预组发放计步器。在基线、第 4 周、第 8 周和第 12 周评估体重、身高、BMI 和腰围。本试验的主要结局是第 4、8 和 12 周时的体重变化。

结果

64 名参与者中,每组 32 名被随机分配至干预组和对照组。所有参与者均完成了研究。仅第 12 周时的体重变化均值在组间存在显著差异(P = 0.03)。此时,干预组的体重较对照组显著降低,差值为 2.21kg(95%置信区间为 4.12-0.29)。

结论

计步器步行加个体动机性访谈可增加身体活动量,可能是降低泰国肥胖或超重精神分裂症患者体重和 BMI 的有效方案。其疗效可能与其他认知/行为方案相当。需要更大样本量的进一步研究。

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