Lynch Thuy, Azuero Andres, Lochman John E, Park Na-Jin, Turner-Henson Anne, Rice Marti
University of Alabama in Huntsville, AL, USA.
University of Alabama at Birmingham, AL, USA.
J Pediatr Nurs. 2019 Jan-Feb;44:42-49. doi: 10.1016/j.pedn.2018.10.007. Epub 2018 Oct 24.
The purpose of this study was to examine the influence of psychological stress and depressive symptoms on body mass and central adiposity in 10-to-12-year-old children and to determine the mediating role of cortisol in the relationships among psychological stress, depressive symptoms, body mass, or central adiposity.
The convenience sample included 147 children (84 females; 63 males) who were recruited from one middle school and three elementary schools in a rural area of a southeastern state. Height, weight, waist circumference (WC), and salivary cortisol were measured. Children completed the Rating Scale for Pubertal Development for screening, Children's Depression Inventory, and the Feel Bad Scale. Bivariate correlation, multiple regression analyses, and univariate regression techniques were used in data analyses.
A positive relationship between psychological stress and depressive symptoms (r = 0.559, p < .001) was found. Depressive symptoms explained a significant amount of the variance in body mass index (BMI) (β = 0.37, p ≤.001) and central adiposity (β = 0.40, p ≤ .001) when sex, race/ethnicity, puberty, and socioeconomic status were controlled. No statistically significant relationships were found between psychological stress and cortisol or between depressive symptoms and cortisol.
Depressive symptoms were reported by normoweight, overweight, and obese children. Depressive symptoms accounted for variance in body mass and central adiposity. Practice Implications In addition to regular screening of BMI and WC, nurses and other health care professionals need to consider psychological factors that contribute to childhood obesity.
本研究旨在探讨心理压力和抑郁症状对10至12岁儿童体重和中心性肥胖的影响，并确定皮质醇在心理压力、抑郁症状、体重或中心性肥胖之间关系中的中介作用。
便利样本包括从东南部某州农村地区的一所中学和三所小学招募的147名儿童（84名女性；63名男性）。测量了身高、体重、腰围（WC）和唾液皮质醇。儿童完成了青春期发育筛查评定量表、儿童抑郁量表和感觉不良量表。数据分析采用双变量相关性分析、多元回归分析和单变量回归技术。
发现心理压力与抑郁症状之间呈正相关（r = 0.559，p <.001）。在控制了性别、种族/民族、青春期和社会经济地位后，抑郁症状解释了体重指数（BMI）（β = 0.37，p ≤.001）和中心性肥胖（β = 0.40，p ≤.001）中显著的方差量。未发现心理压力与皮质醇之间或抑郁症状与皮质醇之间存在统计学上的显著关系。
正常体重、超重和肥胖儿童均报告有抑郁症状。抑郁症状解释了体重和中心性肥胖的方差。实践意义除了定期筛查BMI和WC外，护士和其他医护人员还需要考虑导致儿童肥胖的心理因素。
