Hemetek U, Ernert A, Wiegand S, Bau A-M
Fachbereich Pflege und Gesundheit, Hochschule Fulda, Fulda.
Institut für Biometrie und klinische Epidemiologie, Charité Universitätsmedizin Berlin, Berlin.
Gesundheitswesen. 2015 Nov;77(11):888-94. doi: 10.1055/s-0034-1384564. Epub 2014 Aug 11.
The alarming increase in the prevalence of childhood obesity is recognised as a major public health concern. Currently, structured multi-modal therapy programmes present the gold standard of therapy strategies for obese children and adolescents. However, effects of these treatments are still a matter of discussion. Failure to isolate and understand the external and internal factors contributing to successful, long-term weight reduction may well be contributing to the ineffectiveness of current treatment interventions.
A qualitative approach was chosen in order to identify subjectively perceived resources and barriers to weight maintenance after previous weight reduction. The research question focused on how these resources and barriers affect success of participants. Additionally the question arose as to how and to what extent parents should and could be involved in the therapy process. The results can deliver important starting points for the development of therapy programmes and future research.
7 participants of a weight reduction and maintenance programme and 7 of their parents were interviewed on their personal experiences during and after the treatment. The interviews were analysed based on the qualitative content analysis.
Continuous motivation, especially after the initial weight reduction phase, was identified as the strongest predictor of successful weight maintenance. Successful weight maintainers generally showed characteristics of higher self-efficacy, internal motivation concerning physical activity and flexible self-control concerning food intake. Unsuccessful weight gainers stated a lack of motivation concerning physical activity and lost control over their eating habits. Concerning the role of parents in the therapy process, the results show that higher parental involvement does not predict greater success. The general relationship between parents and their children seems to be more significant, especially concerning the issues of responsibility.
It is disputable to what extent the post treatment intervention contributed to the development of intrinsic motivation. More attention should be paid to the age (children or adolescents) of participants of therapy programmes, especially concerning the involvement of parents. It is assumed that general aspects of education should be discussed with parents.
儿童肥胖患病率惊人上升,这被视为一个重大的公共卫生问题。目前,结构化多模式治疗方案是肥胖儿童和青少年治疗策略的黄金标准。然而,这些治疗的效果仍存在争议。未能分离和理解导致成功长期减重的外部和内部因素,很可能是当前治疗干预无效的原因。
选择一种定性方法,以确定在先前减重后主观感知到的维持体重的资源和障碍。研究问题聚焦于这些资源和障碍如何影响参与者的成功。此外,还出现了父母应如何以及在何种程度上参与治疗过程的问题。研究结果可为治疗方案的制定和未来研究提供重要的起点。
对一个减重和维持体重项目的7名参与者及其7名父母就他们在治疗期间和之后的个人经历进行了访谈。基于定性内容分析对访谈进行了分析。
持续的动力,尤其是在初始减重阶段之后,被确定为成功维持体重的最强预测因素。成功维持体重者通常表现出更高的自我效能感、对体育活动的内在动力以及对食物摄入的灵活自我控制。未能成功维持体重者表示缺乏体育活动的动力,并且失去了对饮食习惯的控制。关于父母在治疗过程中的作用,结果表明父母更高程度的参与并不能预测更大的成功。父母与子女之间的总体关系似乎更为重要,尤其是在责任问题上。
治疗后干预在多大程度上促进了内在动力的发展存在争议。应更多关注治疗项目参与者的年龄(儿童或青少年),尤其是父母的参与情况。假定应与父母讨论教育的一般方面。