动机访谈术结合同伴参与方式在青少年肥胖健康管理中的应用效果

吴健珍; 戴旻晖; 熊静; 刘海霞

doi:10.7499/j.issn.1008-8830.2016.07.015

PDF(1372 KB)

HTML

中国当代儿科杂志 ›› 2016, Vol. 18 ›› Issue (7) : 645-649. DOI: 10.7499/j.issn.1008-8830.2016.07.015

论著·临床研究

动机访谈术结合同伴参与方式在青少年肥胖健康管理中的应用效果

吴健珍¹, 戴旻晖², 熊静², 刘海霞³

作者信息 +

Effect of motivational interviewing combined with peer participation on obesity management in adolescents

WU Jian-Zhen¹, DAI Min-Hui², XIONG Jing², LIU Hai-Xia³

Author information +

文章历史 +

摘要

目的探讨采用动机访谈术结合同伴参与方式对青少年肥胖健康管理的效果。方法将100例单纯性肥胖青少年随机分为两组：传统管理组和同伴参与组（每组50例）。传统组接受传统健康管理；同伴参与组除接受传统健康管理外，还接受心理咨询师的动机访谈，且有同伴陪同参与整个健康管理过程。干预半年后比较两组体育锻炼行为、饮食行为以及人体成分分析指标的差异及综合干预效果。结果半年健康管理后，同伴参与组肥胖青少年在控制能量摄入、饮食结构调整、坚持中等及以上强度锻炼、瘦体重增加方面均优于传统组（P <0.05），体重、体脂含量、体重指数均低于传统组（P <0.05）。同伴参与组接受每周1次的多学科团队咨询指导次数全勤率高于传统组（89%vs57%，P <0.05），且健康管理有效率高于传统组（83%vs43%，P <0.05）。结论采用动机访谈术结合同伴参与方式对青少年肥胖健康管理能提高其减肥的依从性，改善综合干预减肥效果。

Abstract

Objective To investigate the effect of motivational interviewing combined with peer participation on obesity management in adolescents. Methods A total of 100 adolescents with simple obesity were randomly divided into traditional management and peer participation groups (n=50 each). The traditional management group received traditional health management. The peer participation group received motivational interviewing performed by psychological consultants combined with peer participation through the entire process in addition to traditional health management. The physical exercise, dietary behavior, differences in body composition parameters, and effect of comprehensive intervention were compared between the two groups after intervention for half a year. Results After the health management for six months, the peer participation group showed better improvements in the control of energy intake, adjustment of dietary structure, adherence to moderate/high intensity exercise, and increase in lean body mass compared with the traditional management group (P<0.05). The peer participation group had a significantly higher attendance rate for guidance and counseling performed by a multidisciplinary team once a week than the traditional management group (89% vs 57%; P<0.05), as well as a significantly higher response rate to health management than the traditional management group (83% vs 43%; P<0.05). Conclusions Motivational interviewing combined with peer participation for obesity management can improve the compliance and the effect of comprehensive intervention in losing weight in adolescents.

导出引用

吴健珍, 戴旻晖, 熊静, 刘海霞. 动机访谈术结合同伴参与方式在青少年肥胖健康管理中的应用效果[J]. 中国当代儿科杂志. 2016, 18(7): 645-649 https://doi.org/10.7499/j.issn.1008-8830.2016.07.015

WU Jian-Zhen, DAI Min-Hui, XIONG Jing, LIU Hai-Xia. Effect of motivational interviewing combined with peer participation on obesity management in adolescents[J]. Chinese Journal of Contemporary Pediatrics. 2016, 18(7): 645-649 https://doi.org/10.7499/j.issn.1008-8830.2016.07.015

参考文献

[1] Zhao W, Zhai Y, Hu J, et al. Economic burden of obesity-related chronic diseases in Mainland China[J]. Obes Rev, 2008, 9 (Suppl 1): 62-67.
[2] 中华儿科杂志编辑委员会; 中华医学会儿科学分会儿童保健学组. 儿童期单纯肥胖症防治常规[J]. 中华儿科杂志, 2000, 38(9): 568-570.
[3] Tester JM, Lang TC, Laraia BA. Disordered eating behaviours and food insecurity: A qualitative study about children with obesity in low-income households[J]. Obes Res Clin Pract, 2015 Dec 12. doi: 10.1016/j.orcp.2015.11.007. [Epub ahead of print].
[4] Nemiary D, Shim R, Mattox G, et al. The relationship between obesity and depression among adolescents[J]. Psychiatr Ann, 2012, 42(8): 305-308.
[5] Vander Wal JS, Mitchell ER. Psychological complications of pediatric obesity[J]. Pediatr Clin North Am, 2011, 58(6): 1393- 1401.
[6] 周雪莲, 傅君芬, 金菊花, 等. 肥胖对中枢性性早熟女童 GnRH 激发试验促黄体生成素峰值及相关激素的影响[J]. 中国当代儿科杂志, 2015, 17(8): 763-768.
[7] Shihabuddin B. Obesity: changing the landscape of pediatric practice [J]. South Med J, 2016, 109(1): 51-52.
[8] Andersen LB, Harro M, Sardinha LB, et al. Physical activity and clustered cardiovascular risk in children: a cross-sectional study (The European Youth Heart Study)[J]. Lancet, 2006, 368(9532): 299-304.
[9] World Health Organizaton. Report of the Commission on Ending Childhood Obesity[EB/OL]. [January, 2016]. http:// apps.who.int/iris/bitstream/10665/204176/1/9789241510066_ eng.pdf?ua=1.
[10] 张洪锡, 杨会萍, 赖灿, 等. 超声筛检肥胖儿童脂肪肝的价值评估[J]. 中国当代儿科杂志, 2014, 16(9): 873-877.
[11] Miller WR, Rollnick S. Motivational Interviewing: Helping People Change[M]. New York: Guilford Press, 2012.
[12] Bar low SE; Exper t Commi t tee. Exper t commi t tee recommendations regarding the prevention, assessment, and treatment of child and adolescent overweight and obesity: summary report[J]. Pediatrics, 2007, 120 (Suppl 4): 164-192.
[13] Tudor-Locke C, Craig CL, Beets MW, et al. How many steps/ day are enough? for children and adolescents[J]. Int J Behav Nutr Phys Act, 2011, 8(1): 78.
[14] Wang X, Ouyang Y, Liu J, et al. Fruit and vegetable consumption and mortality from all causes, cardiovascular disease, and cancer: systematic review and dose-response meta-analysis of prospective cohort studies[J]. BMJ, 2014, 349: g4490.
[15] Fisher EB, Fitzgibbon ML, Glasgow RE, et al. Behavior matters[J]. Am J Prev Med, 2011, 40(5): e15-e30.
[16] Dahlén EM, Tengblad A, Länne T, et al. Abdominal obesity and low-grade systemic inflammation as markers of subclinical organ damage in type 2 diabetes [J]. Diabetes Metab, 2014, 40(1): 76-81.
[17] Nantel J, Mathieu ME, Prince F. Physical activity and obesity: biomechanical and physiological key concepts[J]. J Obes, 2011, 2011: 650230.
[18] Soenen S, Hochstenbach-Waelen A, Westerterp-Plantenga MS. Efficacy of α-lactalbumin and milk protein on weight loss and body composition during energy restriction[J]. Obesity (Silver Spring), 2011, 19(2): 370-379.
[19] Thøgersen-Ntoumani C, Ntoumanis N. The role of selfdetermined motivation in the understanding of exercise-related behaviours, cognitions and physical self-evaluations[J]. J Sports Sci, 2006, 24(4): 393-404.
[20] Zeller MH, Reiter-Purtill J, Ramey C. Negative peer perceptions of obese children in the classroom environment[J]. Obesity(Silver Spring), 2008, 16(4): 755-762.
[21] Crosnoe R, McNeely C. Peer relations, adolescent behavior, and public health research and practice[J]. Fam Community Health, 2008, 31(Suppl 1): S71-S80.