「運動─飲食行為控制策略」對肥胖智障學生減重成效之研究

A Study on the effect of “Sporting-Dietary Behaviors Control Strategy” on the weight reduction of obese handicapped students

孟儀華(Yi-hwa Meng)

指導教授 ： 杜正治 ； 吳訓生 ； 潘裕豐

國立臺灣師範大學/教育學院/特殊教育學系在職進修碩士班/碩士(2002年)

摘要

本研究旨在探討「運動-飲食行為控制策略」對肥胖智障學生減重之成效，並瞭解其維持效果以及對個案適應行為的影響。
本研究採單一受試研究法的跨受試設計為研究方法，研究對象為三名國立桃園啟智學校高職部學生，選取身體質量指數（BMI）值大於26之肥胖住宿學生，且為單純性肥胖，排除症狀型肥胖（如唐氏症）或伴隨其他附屬障礙及生理疾病（如：癲癇）,經家長同意且其本身具備減重意願者。
其中「運動-飲食行為控制策略」是指研究者與個案訂立減重契約後，對個案進行每日三餐用餐順序、進食速度、零食及含糖飲料、進食份量之監控，另包括實驗期間固定時段（每日放學後至晚餐前40分鐘）之有氧體能訓練。
本研究主要結果如下：
一、「運動-飲食行為控制策略」能有效降低個案的體重：
策略介入後，個案甲體重下降3.72公斤，BMI指數下降1.37。個案乙的體重下降3.58公斤，BMI指數下降1.33。個案丙的體重下降2.84公斤，BMI指數減少1.35。
二、 「運動-飲食行為控制策略」介入後追蹤個案體重略有回升：
個案甲實驗甫結束時的體重為76.38公斤,實驗結束後第二、三、四個月追蹤分別是78.46公斤、78.9公斤、79.12公斤。個案乙實驗結束時的體重為67.96公斤，追蹤體重分別是69.12公斤、69公斤及69.36公斤出現回升。個案丙實驗結束時的體重是63.96公斤，追蹤階段體重為65.2公斤、65.86公斤及64.98公斤。
三、 「運動-飲食控制策略」介入後個案適應行為的改變不顯著：
三名個案的適應行為部分並未顯現出明顯的改變。蓋因適應行為屬發展性的行為，時間為重要因素，亦即需要長期的訓練與學習，本實驗週期僅短短8至12週，要改變這些行為非短時間能奏效；此外本實驗之個案在這些負面行為的表現次數普遍偏低，因而不易造成顯著的差異。但在家長及導師的意見調查問卷上仍有變化情形之描述可供參考。
本研究並針對未來研究以及教學上的事項提出建議。

關鍵字

肥胖智障學生 ； 適應行為 ； 運動-飲食行為控制策略

並列摘要

The study was to examine the effects of “Sporting—Dietary Behaviors Control Strategy” on the weight reduction of obese handicapped students and its influence on personal adaptive behaviors.
The research employs the multiple-baseline across-subject design. Participants consisted of three students who are studying in Secondary Division of Taoyuan School for Students with Disabilities. They are obese with the value of BMI over 26. However, their obesity is sheer obesity, rather than symptomatic obesity (such as Down Syndrome) or accompanied by other additional handicaps or physiological diseases (such as epilepsia). We obtained consents in advance from both their parents and themselves.
“Sporting—Dietary Behaviors Control Strategy” means researcher and the selected persons reached weight-reduction agreements to monitor and control their order of food and speed of eating, including nibbles between meals, drinks containing sugar and quantity of food in three meals everyday during experiment. We also prescribed them with aerobic fitness training in fixed periods of time (about 40 minutes between after school and dinner) during experiment.
The main results of the research were listed as follows:
1.“Sporting—Dietary Behaviors Control Strategy” can effectively reduce the weight of participating students. To illustrate, after intervention, Student A reduced 3.58 kilograms, BMI dropped 1.37; B reduced 3.58 kilograms, BMI dropped 1.33; and C reduced 2.84 kilograms, BMI dropped 1.35.
2.In follow-up, their weights came back a little. Student A’s weight was 76.38 kilograms at the end of experiment, and his weights are 78.46, 78.9 and 79.12 kilograms respectively after two, three and four months. Student B’s weights was 67.96 kilograms at the end of experiment, and in follow-up his weights seemed to come back a little to 69.12, 69 and 69.36 kilograms respectively. C’s weight was 63.96 and in the follow-up, his weights are 65.2, 65.86 and 64.98 kilograms respectively.
3.After the intervention, the participants’ of adaptive behaviors did not changed significantly. The main reason is because adaptive behavior is one of developmental behaviors, so time is one of important factors. That is, it takes a long period of time to change either through training or learning. The period of this experiment is as short as eight to twelve weeks and it is hard to change these behaviors in such a short period of time. Besides, the subjects rarely showed these negative behaviors and therefore a significant difference is hard to show. However, we found a the study did make a difference based on the social validity checked by participants’ parents, teachers and significant others.
The study also provides some suggestions and recommendations for future studies and applications.

並列關鍵字

obese handicapped students ； adaptive behaviors ； Sporting—Dietary Behaviors Control Strategy

參考文獻

李蘭、潘文涵、陳重弘、李燕鳴（民83）：台北市八十學年度國中新生的肥胖盛行調查─不同篩選指標的比較。中華衛誌，13（1），11-19。

裴馰（民90）：減肥的迷思。中華民國內分泌記糖尿病學會會訊，14（2），25-28。

林素玲（民91）：營養教育與運動介入對肥胖者之體位、血壓、血糖、血脂質、尿酸及血清鈣鎂鋅銅影響之研究。靜宜大學食品營養學系碩士論文。

許惠玉（民92）：台北市兒童體位、飲食行為與家長營養知識、行為及飲食教養之關係。台北醫學院保健營養學系碩士論文。

江姿瑩（民87）：肥胖者與正常體重者飲食、營養狀況及其相關因素的探討。台北醫學院保健營養學研究所碩士論文。