兒童肥胖與自尊關係及影響減重成效相關因素之探討

The research on the relationship between child obesity and self-esteem, and the influencing factors on the results of weight-losing program

王元玲(Yuan-Ling Wang)

指導教授 ： 梁培勇 ； 譚偉象

中原大學/理學院/心理學研究所/碩士(2003年)

https://doi.org/10.6840/cycu200300038

摘要

摘 要

本研究的目的（一）探討參與減重班兒童與正常體重兒童相比，肥胖是否對兒童的自尊發展狀態產生特殊的影響，若透過減重計劃後，是否減重與自尊提升有關。（二）探討父母參與的程度及兒童內外控傾向等心理社會因素，對兒童執行減重行為及立即減重成效（減重後立即BMI改變）的影響。
本研究採用立意取樣方式，以參加北部地區兩家醫學中心所辦暑期減重班之國小四到六年級兒童為研究對象，共45名（24男，21女），平均年齡10.2歲，另以國小五年級正常體重兒童為對照組，共43名（22男，21女），平均年齡10歲。兩組均接受「國小兒童自我概念量表」測量，並比較減重班肥胖兒童於減重前與對照組在自尊各向度的差異。在減重計劃介入後三個月追蹤測量，比較BMI下降兒童自尊前後測的差異，並以減重後BMI值與調節變項（性別、年齡、家庭社經地位、學業成績）預測減重後整體自尊。本研究另以「兒童減重班父母參與程度問卷」、「兒童內外控傾向量表」、「兒童執行減重行為表現評分表」為測量工具，測量與減重立即BMI改變的關係。
本研究主要統計方法有單因子變異數分析、單因子重複量數變異數分析及Pearson相關考驗各項假設。本研究的結果如下：
1. 減重班肥胖兒童的整體自尊顯著低於正常體重兒童。各自尊向度中，肥胖兒童的外貌自尊與身體自尊明顯低落。
2. 經減重計劃介入後，間隔三個月追蹤比較，兒童減重BMI下降者的整體自尊及家庭、學校、情緒等分向度自尊顯著提升，但無法以減重後追蹤BMI值作為最佳的解釋。
3. 父母參與程度（陪伴支持、調整食物烹調方式、計算營養及份量、控制環境線索、監督兒童飲食與運動的紀錄和執行）與兒童執行減重行為（上課表現、飲食紀錄、運動表現、動態生活紀錄、體重紀錄）的表現呈顯著正相關。
4. 內控、外控傾向兩組兒童在執行減重行為的表現無顯著差異。
5. 兒童執行減重行為愈多，減重立即BMI下降愈多，兩者呈負相關。
6. 父母參與程度得分愈多，減重立即BMI下降愈多，兩者呈負相關。
本研究結果可提供減重計畫介入與輔導上的應用及參考。

關鍵字

自尊 ； 減重 ； 兒童肥胖 ； 父母參與 ； 內外控傾向

並列摘要

Abstract

The purpose of this research was twofold:（1）to explore if there exists a difference between the self-esteem of obese children who join weight-losing programs and that of normal weight children, and to explore, with the intervention of weight-losing program, the relationship between the amount of weight lost and the degree of self-esteem increased;（2）to explore the influence of some psychological factors, namely, the degree of parents' involvement and children’s locus of control, on childrens’ weight-losing behaviors and the amount of the BMI reduced right at the end of the intervention.

The subjects were recruited with purposive sampling. The obese group consisted of 45 (24 boys, 21 girls) subjects with an average age of 10.2 from the weight-losing programs of two medical centers during summer vocation, and the control group consisted of 43 normal weight children（22 boys, 21 girls）with an average age of 10. All subjects were administrated with the Elementary Child Self-Concept Scale and the scores between different aspects of the self-esteem of these two groups were compared. Three months later, after the intervention of the weight-losing program, the subjects’ scores of self-esteem were measured again and compared with their previous ones. Prediction of the changes on self-esteem was made with the amount of BMI change and other mediators, namely, gender, age, socioeconomic status and academic achievement. In addition, the relationship of the variables measured with the Parents Involvement Degree Questionnaire, the Internal-External Control Scale for Children, and the Children Weight-Losing Behavior Scale and the amount of BMI reduced right at the end of the intervention were explored.

The data were analyzed with ONE-WAY ANOVA, one factor repeated measure ANOVA, and Pearson correlation. The main findings were stated as follows:

1. Before the intervention, the holistic self-esteem of the obese group was significantly lower than that of the control group, especially in regard of appearance esteem and body esteem.
2. Three months later, after the intervention, the holistic self-esteem and the family, school, and emotion dimensions of the BMI decrease group significantly increased, but this increment cannot be accounted by the amount of the BMI reduced.
3. There was a significant positive correlation between parents’ involvement（providing psychological support, making change on cooking method, calculating the amount of nutrition and food, controlling environment cues, and supervising upon children’s record and actions on diet and exercises） and children’s weight-losing behaviors（classroom performance, diet recording, exercise performance, daily activity recording and weight recording）.
4. There was no significant difference between internal control children and external control children regarding weight-losing behaviors.
5. There was a significant negative correlation between children’s weight-losing behaviors and the amount of the BMI reduced.
6. There was a significant negative correlation between parents’ involvement and the amount of the BMI reduced.

The results could be applied for weight-losing program designing and counseling.

並列關鍵字

parents involvement ； internal-external control ； weight loss ； child obesity ； self-esteem

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