Brewer-Smyth Kathleen
College of Health Sciences, University of Delaware, Newark, Delaware, USA.
Rehabil Nurs. 2014 Jul-Aug;39(4):183-91. doi: 10.1002/rnj.150. Epub 2014 Mar 25.
This study tested the hypothesis that obesity is related to history of traumatic brain injury (TBI), severity and frequency of childhood physical (CPA) and sexual abuse (CSA), and suicide attempts, adjusting for related variables in a high risk female population.
This cross-sectional study of 81 females compared obese to non-obese.
All variables were verified by private interviews, physical examination, and documented evidence, then statistically analyzed with logistic regression.
Obesity at the time of interview was related to history of a decreased number of TBIs per person, greater CSA, suicide attempts, and decreased CPA, adjusting for current smoking, depression, currently using selective serotonin reuptake inhibitors, and age.
Number of TBIs per person and CPA were inversely related to obesity, adjusting for related variables. Greater CSA frequency and severity, and having attempted suicide were significantly related to greater risk of obesity, adjusting for related variables. Though causes of obesity cannot be determined by this design, and findings should be viewed with caution, this study provides new insight into the obesity epidemic that requires further investigation.
Rehabilitation nurses are in ideal settings when patient's conditions are less acute, providing opportunities to address complex serious underlying etiologies of obesity. Obesity has not been alleviated by teaching about diet and exercise because obesity may be the result of dietary self-medication of pain from previous experiences. CSA is a very serious problem that could precipitate suicide attempts, obesity, and multifaceted poor health outcomes throughout the life span; subsequently placing individuals at greater risk of requiring rehabilitation services.
本研究检验了以下假设,即在对相关变量进行调整后,肥胖与创伤性脑损伤(TBI)病史、儿童期身体虐待(CPA)和性虐待(CSA)的严重程度及频率以及自杀未遂有关,研究对象为高危女性人群。
这项横断面研究对81名女性进行了比较,分为肥胖组和非肥胖组。
所有变量均通过个人访谈、体格检查和书面证据进行核实,然后采用逻辑回归进行统计分析。
在对当前吸烟、抑郁、目前使用选择性5-羟色胺再摄取抑制剂和年龄进行调整后,访谈时的肥胖与每人TBI次数减少的病史、更严重的CSA、自杀未遂以及CPA减少有关。
在对相关变量进行调整后,每人TBI次数和CPA与肥胖呈负相关。在对相关变量进行调整后,更高的CSA频率和严重程度以及曾有自杀未遂经历与更高的肥胖风险显著相关。尽管本研究设计无法确定肥胖的原因,研究结果应谨慎看待,但本研究为肥胖流行问题提供了新的见解,需要进一步调查。
当患者病情不太危急时,康复护士处于理想的工作环境,有机会解决肥胖这一复杂严重的潜在病因。关于饮食和运动的教育并未减轻肥胖,因为肥胖可能是对以往疼痛进行饮食自我治疗的结果。CSA是一个非常严重的问题,可能导致自杀未遂、肥胖以及一生中多方面的不良健康后果;随后使个体更有可能需要康复服务。