Department of General Practice, Erasmus MC, University Medical Center, Rotterdam, The Netherlands.
Matern Child Nutr. 2013 Jan;9(1):3-22. doi: 10.1111/j.1740-8709.2012.00462.x. Epub 2012 Oct 1.
An increasing number of children worldwide are overweight, and the first step in treating obesity is to identify overweight. However, do parents recognise overweight in their child and which factors influence parental perception? The aim of the present review is to systematically study differences between parental perception and the actual weight status of children. Medline, EMbase, CINAHL and PsychINFO were searched. After screening 2497 abstracts and 106 full texts, two reviewers independently scored the methodological quality of 51 articles (covering 35 103 children), which fulfilled the inclusion criteria. The primary outcome parameters were sensitivity and specificity of parental perception for actual weight status of their child. The methodological quality of the studies ranged from poor to excellent. Pooled results showed that according to objective criteria 11 530 children were overweight; of these, 7191 (62.4%) were incorrectly perceived as having normal weight by their parents. The misperception of overweight children is higher in parents with children aged 2-6 years compared with parents of older children. Sensitivity (correct perception of overweight) of the studies ranged from 0.04 to 0.89, while specificity (correct perception of normal weight) ranged from 0.86 to 1.00. There were no significant differences in sensitivity or specificity for different cut-off points for overweight, or between newer and older studies. Therefore we can conclude that parents are likely to misperceive the weight status of their overweight child, especially in children aged 2-6 years. Because appropriate treatment starts with the correct perception of overweight, health care professionals should be aware of the frequent parental misperception of the overweight status of their children.
全球越来越多的儿童超重，治疗肥胖的第一步是确定超重。然而，父母是否能识别出孩子超重，哪些因素会影响父母的认知呢？本综述的目的是系统地研究父母对孩子体重的认知与实际体重状况之间的差异。我们检索了 Medline、EMbase、CINAHL 和 PsychINFO。在筛选了 2497 篇摘要和 106 篇全文后，两位审查员独立对符合纳入标准的 51 篇文章（共涵盖 35103 名儿童）的方法学质量进行了评分。主要的结局参数是父母对孩子实际体重状况的认知的敏感性和特异性。研究的方法学质量从差到优不等。汇总结果显示，根据客观标准，有 11530 名儿童超重；其中 7191 名（62.4%）被父母错误地认为体重正常。与年长儿童的父母相比，2-6 岁儿童的父母更有可能错误地认为超重儿童体重正常。研究的敏感性（正确识别超重）范围为 0.04 至 0.89，而特异性（正确识别体重正常）范围为 0.86 至 1.00。对于不同的超重截断值或新旧研究，敏感性或特异性没有显著差异。因此，我们可以得出结论，父母很可能会错误地判断超重孩子的体重状况，尤其是在 2-6 岁的孩子中。因为适当的治疗始于正确识别超重，所以医疗保健专业人员应该意识到父母经常错误地判断他们超重孩子的体重状况。
