Faculty of Language and Literature, Humanities, Arts and Education, University of Luxembourg;, Esch-sur-Alzette, Luxembourg.
Department of Population Health, Luxembourg Institute of Health (LIH), Strassen, Luxembourg.
BMJ Open. 2017 Sep 3;7(9):e014811. doi: 10.1136/bmjopen-2016-014811.
The current study aimed to identify factors that could predict attrition in youths starting ambulatory treatment to control or lose weight.
Retrospective longitudinal study.
Paediatric clinic: ambulatory treatment programme.
A youth sample (n=191; 89 boys; aged 7-17 years) completed measures of demographic characteristics, and health and psychosocial traits before starting an ambulatory weight management programme. Anthropometric and biological markers related to obesity were also obtained. Tests of mean differences and regression analyses were used to investigate the relationship between these variables and attrition after 1 year.
The χand t test results showed both psychosocial and health indicators differentiated between participants who continued attending the treatment programme and those who dropped out. More specifically, youths that dropped out of treatment were significantly older, had higher body mass index z scores, higher levels of insulin, triglycerides and HOMA-IR, reported poorer health, had more conduct problems and were more dissatisfied with themselves and their bodies before starting treatment. Results of regression analyses revealed that weight status (anthropometric and biological markers), age and body dissatisfaction predicted attrition (overall prediction success 73%; prediction success for continued attendance 90/91%; prediction success for dropouts 42/44%).
Attrition, but especially the continued attendance in treatment, can be successfully predicted by age, weight status and body dissatisfaction. For patients who present with one or more risk factors, careful consideration is needed to decide which (combination of) inpatient or outpatient programme may facilitate prolonged engagement of the patient and hence may be most effective in establishing weight loss.
本研究旨在确定可预测开始门诊治疗以控制或减轻体重的青少年流失的因素。
回顾性纵向研究。
儿科诊所:门诊治疗计划。
青少年样本(n=191;89 名男孩;年龄 7-17 岁)在开始门诊体重管理计划之前完成了人口统计学特征、健康和心理社会特征的测量。还获得了与肥胖相关的人体测量和生物学标志物。使用均值差异检验和回归分析来研究这些变量与 1 年后流失之间的关系。
χ和 t 检验结果表明,在继续参加治疗计划和退出治疗计划的参与者之间,心理社会和健康指标存在差异。具体而言,退出治疗的青少年年龄较大,体重指数 z 评分较高,胰岛素、甘油三酯和 HOMA-IR 水平较高,报告健康状况较差,行为问题较多,对自己和身体的满意度较低。回归分析的结果表明,体重状况(人体测量和生物学标志物)、年龄和身体不满预测了流失(总体预测成功率为 73%;继续参加治疗的预测成功率为 90/91%;退出者的预测成功率为 42/44%)。
流失,尤其是持续参加治疗,可以通过年龄、体重状况和身体不满成功预测。对于出现一个或多个风险因素的患者,需要仔细考虑选择哪种(组合)住院或门诊治疗方案可以促进患者的长期参与,从而最有效地建立减肥效果。