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基于网络的心理教育对超重的绝经前妇女的情绪功能、饮食行为和身体形象的影响。

The effect of a web-based psychoeducation on emotional functioning, eating behaviors, and body image among premenopausal women with excess body weight.

机构信息

Institute of Psychology, University of Wroclaw, Wrocław, Poland.

Department of Experimental and Clinical Pharmacology, Medical University of Warsaw, Warsaw, Poland.

出版信息

Arch Womens Ment Health. 2021 Jun;24(3):423-435. doi: 10.1007/s00737-020-01077-1. Epub 2020 Nov 11.

Abstract

The aims of this study were twofold: (1) to investigate the effectiveness of web-based psychoeducation for emotional functioning, eating behaviors, and body image among premenopausal women with excess body weight, and (2) to compare the efficacy of two types of web-based psychoeducation. Three hundred individuals were asked to volunteer in the present study. All participants were recruited in Poland from September 2017 to July 2019. Finally, a total of 129 premenopausal women took part in the research and signed informed consent. Their ages ranged between 18 and 48 years old (M = 32.28, SD = 7.65). Self-reported weight and height were recorded. BMI was calculated using self-reported data. Their average body mass index was 30.54 kg/m (SD = 3.69). In our randomized experiment, the participants were allocated into three groups: experimental group I (EG I, N = 43), experimental group II (EG II, N = 46), and wait list control group (CG, N = 40). Five questionnaires were included in the online survey at the baseline measurement (Day 0), at the end of psychoeducational intervention (Day 16) and 75 days from the start of the 15-day intervention (Day 76). Measurement tools included the Difficulties in Emotion Regulation Scale, the Positive and Negative Affect Schedule, the Mindful Eating Scale, the Three-Factor Eating Questionnaire, and the Body Attitude Test. Our eHealth web-based psychoeducation consisted of three modules: emotional functioning module (EG I: theoretically consistent approach (TCA) vs EG II: eclectic approach; EA), eating behaviors module (EG I, EG II: based on mindfulness-based eating training; MET), body image module (EG I, EG II: based on Cash's prevention of body image disturbances; CPBID). The first experimental group (EG I) had intervention containing TCA, MET, and CPBID, while the second experimental group (EG II) EA, MET, and CPBID. According to between-group comparison, both types of web-based psychoeducation led to an increase in adaptive emotion regulation (Day 16: EG I vs CG: p < 0.001, EG II vs CG: p < 0.001; Day 76: EG I vs CG: p < 0.01, EG II vs CG: p < 0.001). In EG I, the intervention resulted in a higher reduction (than in CG) in emotional eating (Day 16: p < 0.01, Day 76: p < 0.01), uncontrolled eating (Day 16: p < 0.05, Day 76: p < 0.05), and negative appreciation of body size (Day 16: p < 0.01, Day 76: p < 0.01). In EG II, a lower level of emotional eating was found on Day 76 (EG II vs CG: p < 0.05). Two months after completion of the 15-day intervention, no statistically significant reduction for BMI was observed in either experimental group (p > 0.05). The effectiveness of both types of web-based psychoeducation was also confirmed in within-group comparison (Day 0 vs Day 16 and Day 0 vs Day 76). There was a significant increase in emotion regulation and mindful eating, as well as a decrease in emotional eating, uncontrolled eating, negative appreciation of body size, lack of familiarity with one's body, and the experiencing of negative emotions in both experimental groups (EG I, EG II). Both types of web-based psychoeducation might have to be considered in creating future web-based psychoeducation among premenopausal women with excess body weight.

摘要

本研究的目的有两个

(1)调查基于网络的心理教育对超重绝经前妇女情绪功能、饮食行为和身体形象的有效性;(2)比较两种基于网络的心理教育的功效。共有 300 人被要求参加本研究。所有参与者均于 2017 年 9 月至 2019 年 7 月在波兰招募。最终,共有 129 名绝经前妇女参加了研究并签署了知情同意书。她们的年龄在 18 岁至 48 岁之间(M=32.28,SD=7.65)。记录了自我报告的体重和身高。使用自我报告的数据计算 BMI。她们的平均体重指数为 30.54kg/m(SD=3.69)。在我们的随机实验中,参与者被分为三组:实验组 I(EG I,N=43)、实验组 II(EG II,N=46)和等待名单对照组(CG,N=40)。在基线测量(第 0 天)、心理教育干预结束时(第 16 天)以及干预开始后 75 天(第 76 天)进行了五次在线问卷调查。测量工具包括困难情绪调节量表、正性和负性情绪量表、正念饮食量表、三因素饮食问卷和身体态度测试。我们的电子健康基于网络的心理教育由三个模块组成:情绪功能模块(EG I:理论一致方法(TCA)与 EG II:折衷方法;EA)、饮食行为模块(EG I、EG II:基于正念饮食训练;MET)、身体形象模块(EG I、EG II:基于 Cash 的预防身体形象障碍;CPBID)。第一个实验组(EG I)的干预包含 TCA、MET 和 CPBID,而第二个实验组(EG II)的干预包含 EA、MET 和 CPBID。根据组间比较,两种类型的基于网络的心理教育都导致适应性情绪调节增加(第 16 天:EG I 与 CG:p<0.001,EG II 与 CG:p<0.001;第 76 天:EG I 与 CG:p<0.01,EG II 与 CG:p<0.001)。在 EG I 中,干预导致情绪进食(第 16 天:p<0.01,第 76 天:p<0.01)、失控进食(第 16 天:p<0.05,第 76 天:p<0.05)和身体大小的负性评价(第 16 天:p<0.01,第 76 天:p<0.01)的减少(比 CG 减少)。在 EG II 中,第 76 天发现情绪进食水平较低(EG II 与 CG:p<0.05)。在完成为期 15 天的干预后两个月,两个实验组(p>0.05)的 BMI 均无统计学显著降低。在组内比较中也证实了两种类型的基于网络的心理教育的有效性(第 0 天与第 16 天和第 0 天与第 76 天)。两组的情绪调节和正念饮食均显著增加,情绪进食、失控进食、身体大小的负性评价、对自身身体的不熟悉以及负性情绪的体验均显著减少(EG I、EG II)。超重绝经前妇女的未来基于网络的心理教育可能需要考虑这两种类型的基于网络的心理教育。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/8979/8116220/b99bb1e07b88/737_2020_1077_Fig1_HTML.jpg

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