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  • 學位論文

台中市學童之體型意識、體滿意度及病態飲食行為傾向之兩年變化及其受主要照顧者態度影響之調查

The body image, weight satisfaction and eating disorder tendency of school children in Taichung: two years follow up of changes and the relationship with caregivers’ eating attitudes

指導教授 : 翁玉青

摘要


本研究主要目的為繼由兩年後追蹤以瞭解台中市國小高年級學童之實際體型、體型意識及病態飲食行為傾向盛行率的改變情形,並進一步分析目前學童體型意識、病態飲食行為傾向盛行率與同儕、照顧者飲食教養態度等相關危險因子的探討。以自填式問卷為研究工具,問卷分為主要照顧者與學童兩部份,內容包括:(A) 基本資料 (B)體型意識與減重經驗 (C) 青春期發展量表 (D) 飲食態度測驗 (E) 因體型受嘲笑經驗與感受 (F) 同儕互動影響 (G) 家長飲食教養行為量表。結果發現:(1)男童之過重肥胖盛行率為 33.4%,女童為20.8%;而不滿意自己體重想變瘦的男童有40.6%,女童則是44.7%;具有減重經驗的男童有24.1%,女童為25.5%;過半數的學童有正確的自我體型認知,但是分別有13.0%的男童及25.1%的女童會高估自我實際體型,而低估體型的男學童高達34.5%;(2) 「自覺他人對自我體型認知」、「體型受嘲笑經驗與難過強度」、「減重經驗」、「實際體型」、「同儕互動」、「照顧者自我體型滿意度」、「照顧者認知孩童體型」、「照顧者對孩童體重和體型滿意度與期望」與學童自我的「體滿意度」有顯著關係;而照顧者的「專制性」及「放任性」的飲食教養態度及學童的「青春期發展」僅與女童體滿意度有關;(3) ChEAT-26平均分數為9.38±7.77,而有9.6%的男學童及12.3%的女學童具病態飲食行為傾向的高危險群 (ChEAT-26≧20,EAT (+)),總盛行率為10.93%;(4) 而「體重滿意度」、「自我認知體型與實際體型差」、「自我期望體型與實際體型差」、「體型受嘲笑經驗」、「減重經驗」為有效預測EAT (+)的危險因子;而「實際體型」、「同儕互動影響」、「照顧者對孩童體型與體重滿意度」與EAT (+)有顯著關係;(5) 而照顧者的飲食教養行為與學童EAT (+)無關;(6) 兩年後,男童的實際體型趨向變胖、自我認知體型、及自我期望體型的看法有顯著改變;而女童僅有自我認知體型的看法有顯著改變;(7) 兩年後,學童想變瘦的比例上升,尤以女孩較多,但「體重滿意度」並未達顯著改變;(8) 男童EAT (+)由10.4% 略降至10.1%, 女童EAT (+)由10.9% 增加至12.3%,病態飲食行為傾向總盛行率由10.6%略增為11.2%,學童兩年病態飲食行為傾向盛行率並未達顯著改變。學童過重肥胖及病態飲食行為盛行率居高不下,而學童之體型意識、減重經驗與照顧者的認知期望、減重行為有關。建議應注重學童的營養教育以改善不當的體型、體型意識與病態飲食行為之發展。

並列摘要


This is a two-year follow up study and aim to understand the change in the rate of eating disorder tendency, weight satisfaction and prevalence of obesity in elementary school children between 10 and 12 year old of age. Questionnaires contained the items of demographics, body image and expectation, teasing scales, puberty scale, peer interaction scale, EAT-26 Children version, food related parenting style scale and other’s opinions on weight were used for the data collection and distributed to both children and caregivers. Results included: (1) The prevalence of overweight and obesity were 15.3% and 18.1% respectively in boys and 11.2% and 9.6% in girls. A total of 40.6% boys and 44.7% girls desired to be thinner, and 24.1% boys and 25.5% had actually tried to lose weight. There were over fifty percent of children had correct self-perceived body weight categories, however 13.0% boys and 25.5% girls perceived themselves higher, and 34.5% boys perceived themselves lower than actual weight; (2) The “perceived body weight categories with significant others’ influence ”, “weight / shape-related teasing”, “actual body weight categories”, “caregivers’ perceived children’s body weight”, and “cargivers’ expected children’s body shape and weight development” were significant related to children’s body satisfaction; and “cargivers’ nonintervention or autocratic feeding style” was only related to girls’ body satisfaction; (3) The mean score of ChEAT-26 was 9.38±7.77, 9.6% of boys and 12.3% of girls had score above the cutoff point for eating attitude test (ChEAT-26≧20, EAT (+)); (4) Logistic regression analysis demonstrated the “body satisfaction”, “the perceived of body weight”, “desired of body weight”, “weight / shape-related teasing”, and “weight loss intention” were independently predictor factors of children’s eating disorders. And “actual body weight categories”, “peer influence”, “caregivers’ satisfaction about their children’s body weight or shape” were significant related to EAT (+); (5) Food-related parenting styles were no related to children’s EAT (+); (6) Compaired changes in two years, boys tended to become fatter, self-perceived body weight, and desired body weight had significiant differences; girls were only different in self-perceived body weight; (7) The percentage of children wanted to be thinner was increased, especially for girls, but had no significant differences; (8) The EAT (+) ratio decreased from 10.4% to 10.1% in boys, and increased from 10.9% to 12.3% in girls, but both had not reached significant level. Conclusion: The prevalence of obesity, overweight and eating disorders are increased, and children’s body concern and weight loss practices are related to caregivers’ concern about their children and their weight control practices. The children’s nutritional education should be paid attention to the importance in correct body image and eating attitudes for prevention occurrence of unhealthy body weight concerns and eating disorders.

參考文獻


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