心理认知因素对肥胖儿童健康相关行为的影响  

Influence of psychological cognitive factors on health-related behaviors in obese children

作　　者：陈瑜洁 石鑫玥 胡爽 黄荣[1] 李晓南[1] Chen Yujie;Shi Xinyue;Hu Shuang;Huang Rong;Li Xiaonan(Department of Children Health Care,Children’s Hospital of Nanjing Medical University,Jiangsu,Nanjing 210008,China)

机构地区：[1]南京医科大学附属儿童医院儿童保健科,江苏南京210008

出　　处：《发育医学电子杂志》2025年第2期88-95,共8页Journal of Developmental Medicine (Electronic Version)

基　　金：国家自然科学基金(81773421);江苏省医学创新团队项目(CXTDA2017035)。

摘　　要：目的探究心理认知因素对肥胖儿童健康相关行为的影响,为未来临床针对肥胖儿童行为管理提供依据。方法选取2023年7月至12月于南京医科大学附属儿童医院儿童保健科就诊的274例7~16岁儿童作为研究对象,专人测量儿童身高、体质量和体脂肪含量,并计算身体质量指数(body mass index,BMI)。参考中国6~18岁学龄儿童超重与肥胖BMI参考界值点将研究对象分为肥胖组及对照组,其中肥胖组168名,对照组106名。通过问卷及量表收集儿童的一般资料,评估儿童体质量感知、健康相关行为(包括饮食行为、身体活动及睡眠情况)及心理健康状况。统计学方法采用t检验、Mann-Whitney U检验、χ^(2)检验、偏相关分析及线性回归分析。结果对照组儿童平均年龄(10.61±1.67)岁,肥胖组儿童平均年龄(10.88±2.03)岁。健康相关行为方面,肥胖组儿童过饱响应、进食缓慢分量表评分以及儿童身体活动问卷(Physical Activity Questionnaire for Older Children,PAQ-C)量表评分均低于对照组(t值分别为3.703、4.562、2.798,P值均<0.05),食物响应、食物喜好、渴望饮料、情绪性过度饮食分量表评分均高于对照组(t值分别为-8.759、-9.073、-3.362、-3.277,P值均<0.05),周末平均每日睡眠时间不足9小时的占比明显高于对照组(χ^(2)=14.536,P<0.001)。心理健康状况方面,肥胖组儿童生理功能、社会功能的生活质量评分明显低于对照组(t值分别为3.136、2.792,P值均<0.05),社交回避及苦恼维度评分显著高于对照组(t=-2.363,P=0.019)。多元线性回归矫正混杂因素后,社会功能与情绪性过度饮食评分呈负相关(β=-0.195,P=0.014),情感功能与食物响应评分呈负相关(β=-0.172,P=0.028),BMI与食物喜好评分呈正相关(β=0.318,P=0.001)。中介效应分析显示,肥胖儿童社会功能在体脂肪含量与身体活动关系间存在完全中介作用,中介占比21.05%。结论肥胖儿童表现出异常饮食行为�Objective To explore the influence of psychological cognitive factors on health-related behaviors in obese children,aiming to provide useful imformation for future clinical behavior management targeted at obese children.Method 274 children aged 7 to 16 years who hospitalized at the Department of Children Health Care,Children's Hospital of Nanjing Medical University from July to December 2023 were selected.Children's height,weight,percent body fat were measured,body mass index(BMI)were calculated.Based on the BMI reference threshold for overweight and obesity among Chinese children aged 6-18 years,the study subjects were divided into obesity group and control group,with 168 and 106 participants,respectively.General demographic information was collected through questionnaires and scales.Meanwhile,their weight perception,health-related behaviors,including dietary behavior,physical activity,and sleep condition,and mental health status were evaluated.The statistical methods performed by t-test,Mann-Whitney U test,χ^(2)test,partial correlation analysis,and linear regression analysis.Result The average age of children in the control group was(10.61±1.67)years,while the average age of children in the obese group was(10.88±2.03)years.In terms of health-related behaviors,food avoidant behaviors,including satiety responsiveness and slowness in eating,and Physical Activity Questionnaire for Older Children(PAQ-C)scored significantly lower than those in the control group(t=3.703,4.562,2.798,all P<0.05),while food approach behaviors,including food responsiveness,enjoyment of food,desire to drink,and emotional overeating scored higher than those in the obese children(t=-8.759,-9.073,-3.362,-3.277,all P<0.05).The proportion of the obese group children who slept less than 9 hours per day during weekends was significantly higher than that of the control group(χ^(2)=14.536,P<0.001).In terms of mental health status,the obese group exhibited significantly lower quality of life scores in physiological and social functions compared

关 键 词：肥胖儿童 健康相关行为 行为干预 身心健康 社会交往 

分 类 号：R47[医药卫生—护理学]