Conceptualisation and evaluation of a cognitive-behavioural training programme for children and adolescents with obesity
Conceptualisation and evaluation of a cognitive-behavioural training programme for children and adolescents with obesity
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肥胖儿童和青少年认知行为训练计划的概念化和评估
DOI：
10.1038/sj.ijo.0801708
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发表时间：
2001
影响因子：
4.9
通讯作者：
J. Oepen
中科院分区：
文献类型：
--
作者：
P. Warschburger;C. Fromme;F. Petermann;N. Wojtalla;J. Oepen
目的：肥胖在儿童和青少年中很常见，其发病率在国内和国际上都在增加。其原因是复杂和多方面的，肥胖症与高发病率和死亡率以及心理困扰有关。在治疗这一慢性疾病方面，需要多方面的方案，以改变饮食和体育活动习惯。制定并评价了一项认知行为培训方案。结合饮食和运动，这个特殊的团体计划，包括完善的行为方法，预计将导致长期减肥和减少与肥胖有关的心理困扰。设计：作为巴特克罗伊茨纳赫Viktoriastift医院为期六周的儿童和青少年住院康复项目的一部分，（实验组，EG）与仅在心理干预部分不同的方案（而不是具体的训练方案，他们进行肌肉放松训练，对照组，CG）进行了比较 。测量：在五个时间点评估躯体（如体重状况）、行为（如饮食行为）和心理（如生活质量）结果：干预前两周、项目开始和结束时以及干预后六个月和一年。这项研究始于1997年春。结果：干预前后的测试显示，与对照组相比，实验组自我报告的饮食行为有显著改善（F=6.38，P<0.05）;这些变化与年龄和性别无关。两组干预后即刻和随访时体重状况（体重超重百分比与身高相关）均降低（F=16.51，P<0.01）。肥胖患病率的降低在EG中往往高于CG（15% vs 10%）。自我报告的生活质量从干预前到随访的增加，EG比CG更多（F=3.27，P=0.08）。总之，接受的行为病人教育programme是好的。结论：总之，评估结果表明，认知行为训练计划是一个很有前途的方法来改变肥胖相关的习惯，减少身体和心理社会的后果。预计两年后的长期影响将突出这些结果。
OBJECTIVE: Obesity is common in children and adolescents with incidence rates increasing both nationally and internationally. Its causes are complex and multifaceted, and obesity is associated with high morbidity and mortality as well as psychological distress. Multidimensional programmes are necessary in the treatment of this chronic disease in order to change eating and physical activity habits. A cognitive-behavioural training programme was developed and evaluated. In combination with diet and exercise, this special group programme that includes well established behavioural methods, was expected to result in long-term weight reduction and decrease of psychological distress in connection with obesity.DESIGN: As part of the six week in-patient rehabilitation for children and adolescents at Viktoriastift in Bad Kreuznach, the three-part programme (experimental group, EG) was compared with a programme that differed only in the psychological intervention component (instead of the specific training programme they undertook muscle relaxation training, comparison group, CG).SUBJECTS: In total, 197 children and adolescents between 9 and 19 y-of-age were recruited into the study.MEASUREMENTS: Somatic (eg weight status), behavioural (eg eating behaviour) and psychological (eg quality of life) outcomes were assessed at five points in time: two weeks before the intervention, at the beginning and end of the programme, as well as six months and one year post-intervention. The study started in spring 1997. Main outcomes will be presented.RESULTS: Pre- vs post-intervention-tests showed significant improvements in self-reported eating behaviours for the EG compared with the CG (F=6.38, P<0.05); these changes were independent of age and sex. The weight status measured as the percentage of overweight dependent on height was reduced in both groups immediately after the intervention and at follow-up (F=16.51, P<0.01). Reduction in the prevalence of obesity tended to be higher in the EG than in the CG (15% vs 10%). Self-reported quality of life increased from before the intervention to follow-up more in the EG than in the CG (F=3.27, P=0.08). In all, the acceptance of the behavioural patient education programme was good.CONCLUSION: In summary, evaluation results indicate that the cognitive-behavioural training programme is a promising approach to alter obesity-related habits and to reduce somatic and psychosocial consequences. Long-term effects after two years are expected to underscore these results.