太原市120名儿童饮食行为问题调查研究

[目的]对太原市120名儿童的饮食行为问题进行调查,旨在为早期干预提供依据。[方法]采用IMFeD工具对120名儿童的主要看护人进行调查,并观察主要看护人对儿童饮食行为问题的影响。[结果]儿童以胃口差、不良进食习惯、对某种食物特别偏好和父母过度关心4种饮食行为问题较常见,主要看护人与儿童的关系及其文化程度对儿童饮食行为问题有影响。[结论]儿童饮食行为问题较为普遍,可根据IMFeD工具提供的健康处方进行干预。     

儿童家庭饮食环境评估和干预

<正>儿童家庭饮食环境(family dietary environment)是指儿童家庭中影响和塑造儿童饮食行为的各种因素[1],其对儿童饮食行为的形成、体格发展的近期和远期影响均得到了广泛的证实。通过正确科学的评估,早期发现儿童家庭饮食环境中的问题,及时采取干预措施,能将家庭中影响和塑造儿童饮食行为的各种负     

儿童镇静程度评估工具的研究进展

镇静程度评估可指引镇静行为,是制订患儿镇静管理方案的重要依据。该文对常用的儿童镇静评估工具的主要内容、特点、优势及局限性进行综述,并对各评估工具的基本情况及临床应用情况进行比较,以期为临床护士选择合适的评估工具,提高镇静评估准确性提供参考。     

营养健康教育扑克牌模式对改善单纯性肥胖儿童营养认知水平的效果观察

目的观察营养健康教育扑克牌模式与传统教育模式对改善单纯性肥胖儿童营养认知水平的影响。方法于2015年1月至2016年6月选取我院管辖下的某社区单纯性肥胖儿童180例,并采用随机数字法等分为观察组和对照组,观察组采用营养健康教育扑克牌模式干预;对照组采用传统教育模式干预,对比两组儿童的不同营养认知水平。结果干预前,两组儿童的营养知识、饮食态度、饮食行为得分差异无统计学意义(P0.05);干预后,观察组儿童的营养知识、饮食态度、饮食行为得分均高于对照组(P0.05)。干预前,两组儿童的饮食行为比较差异无统计学意义(P0.05);干预后,两组患者的饮食行为明显改善(P0.05),且观察组儿童饮食行为改善程度优于对照组(P0.05)。结论对单纯性肥胖儿童应用营养健康教育扑克牌模式干预,能够提高儿童的营养认知水平,改善儿童的饮食态度及饮食行为。     

中文版行为疼痛评估工具的研究进展

介绍了适用于儿童疼痛行为量表(FLACC)、适用于认知障碍病人的晚期老年痴呆疼痛评估量表(PAINAD)和老年痴呆病人疼痛评估量表(Doloplus-2)、成人重症病人行为疼痛量表(BPS)、重症监护疼痛观察工具(CPOT)、非语言成人疼痛评估量表(PAINAD)、非语言疼痛评估工具(NPAT)及修订版非语言疼痛评估工具(NVPS-R)。6个量表均经过汉化及信效度测定,适用于不具备交流能力(包括言语和非言语交流能力)病人的行为疼痛评估,指出量表在使用过程中的注意事项,为医务人员对特殊群体病人开展疼痛评估提供工具应用上的借鉴     

莆田市学龄前儿童睡眠习惯对饮食行为影响的分层分析

目的:探索莆田市学龄前儿童睡眠习惯对饮食行为的影响,运用分层分析肥胖对结果的影响。方法:2019年3—6月期间,整群抽样选取639名莆田市学龄前儿童,采用儿童睡眠习惯问卷(CSHQ)、儿童饮食行为问题诊断,及管理评估问卷(IMFeD)和自制问卷进行调查。结果:学龄前儿童的CSHQ总分为(45.28±8.27)分,睡眠习惯问题检出率50.55%,饮食行为问题检出率为59.62%。Logistic回归显示:问题睡眠(OR=1.490,95%CI为1.076～2.065)、肥胖(OR=2.012,95%CI为1.266～3.209)、早产(OR=2.013,95%CI为1.078～3.757)、三餐主要照顾者为(外)祖父母(OR=1.661,95%CI为1.203～2.295)是学龄前儿童问题饮食行为的影响因素。分层分析显示,无肥胖学龄前儿童中,问题睡眠组儿童的胃口差、害怕进食比例高于正常睡眠组(χ~2=4.627,12.154,P=0.031,0.000);肥胖学龄前儿童中,问题睡眠组儿童的胃口差比例高于正常睡眠组(χ~2=4.892,P=0.027)。结论:莆田市学龄前儿童问题睡眠习惯和问题饮食行为发生率较高,问题睡眠习惯会导致胃口差和害怕进食等问题饮食行为,应采取针对性措施改善睡眠习惯和饮食行为。     

儿童化疗性口腔黏膜炎测评工具的研究进展

目的 探究儿童化疗性口腔黏膜炎的普适、特异的测评工具。方法 通过 PubMed、百度学术、美国国立指南库、CNKI、维普、万方数据库等全面检索国内外儿童化疗性口腔黏膜炎的评估工具,对儿童化疗性口腔黏膜炎评估的工具及应用情况进行综述。结果 儿童化疗性口腔黏膜炎的评估工具有5种：儿童国际口腔黏膜炎评估量表、口腔评估指南、口腔黏膜炎评估量表、口腔黏膜炎每日自评问卷、美国国家癌症研究常见新毒性标准与疼痛量表。结论 选择有效的儿童化疗性口腔黏膜炎评估工具,能早期识别儿童化疗性口腔黏膜炎,判断化疗性口腔黏膜炎的严重程度,并为口腔黏膜炎的预防和处置的措施选择和效果判断提供依据。     

240名学龄前儿童饮食行为现状及影响因素分析

目的 调查学龄前儿童饮食行为问题发生情况,分析其相关家庭因素,为预防和干预措施的制定提供参考依据。方法 采用便利抽样法,选取2018年1月—2019年7月在空军军医大学第二附属医院儿童保健中心进行健康体检的240名学龄前儿童为研究对象,采用一般情况调查问卷、儿童饮食行为问题诊断及管理评估问卷、学龄前儿童家庭养育环境量表、儿童喂养问卷对其进行调查。采用二分类Logistic回归分析探讨学龄前儿童饮食行为问题的影响因素。结果 本组学龄前儿童饮食行为问题检出率为64.6%;二分类Logistic回归分析结果显示：平均每日活动时间>1 h（OR=0.915,P=0.016）、高活动多样性/游戏参与评分（OR=0.966,P=0.006）、高环境气氛评分（OR=0.941,P=0.013）是学龄前儿童饮食行为问题的保护因素;照护者为（外）祖父母（OR=1.122,P<0.001）、高限制饮食评分（OR=3.787,P=0.046）、高逼迫进食评分（OR=2.615,P=0.029）、高忽视/干预/惩罚评分（OR=12.912,P=0.001）,是学龄前儿童饮食行为问题的危险因素。结论 学龄前儿童饮食行为问题发生率较高,平均每日活动时间>1 h、儿童照护者为父母、低限制饮食评分、低逼迫进食评分、低忽视/干预/惩罚评分、高活动多样性/游戏参与评分、高环境气氛评分的学龄前儿童更不容易发生饮食行为问题。照护者应遵循生长发育规律,培养儿童科学健康的饮食行为习惯,充分发挥儿童自身对饱腹感和饥饿感的感知和调控能力,多鼓励儿童进行户外活动,同时营造轻松愉悦的家庭氛围,减少饮食行为问题的发生。     

1型糖尿病患儿自我管理评估工具的研究进展

目的 总结国内外儿童青少年1型糖尿病患者自我管理评估工具,为开展相关研究提供依据。方法 通过检索 PubMed、Web of Science、CINAHL、Embase、Sinomed、CNKI、维普和万方等数据库,归纳总结儿童青少年1型糖尿病自我管理评估工具,数据库检索时限为建库至 2021年8月。结果 共检索到8个评估工具,青少年1型糖尿病自我管理量表、1型糖尿病行为评定量表、糖尿病自我管理概况量表、糖尿病自我管理概况自我报告版、自我护理量表、糖尿病管理问卷、儿童糖尿病常规问卷和胰岛素注射自我管理量表。结论 上述8个评估工具具有较好的信度和效度,能从多维度反映儿童青少年1型糖尿病自我管理的情况。其中青少年1型糖尿病自我管理量表和1型糖尿病行为评定量表已被我国学者汉化,已逐步被使用。     

244例学龄前儿童饮食行为问题的调查

[目的]了解学龄前儿童饮食行为问题,为早期干预提供科学依据。[方法]自行设计调查问卷对因饮食行为问题来我院门诊就诊的244例学龄前儿童进行调查,并分析不同人口学特征对儿童饮食行为问题的影响。[结果]244例儿童中101例发生1种饮食行为,86例发生2种饮食行为,83例发生3种饮食行为,71例发生4种饮食行为,无5种和6种饮食行为的儿童。不同居住地在不良习惯方面比较,差异有统计学意义(P0.05);不同居住状况、抚养人、抚养人文化程度、家庭月收入在儿童胃口差、食物偏好、不良习惯、父母过度关心、害怕进食方面比较,差异有统计学意义(P0.05)。[结论]不良习惯、胃口差、食物偏好、父母过度关心、害怕进食是学龄前儿童主要的饮食行为问题,对不良的饮食行为应采取有针对性的干预措施。     

Eating behaviors among school-age children associated with perceptions of stress

Eating has been theorized to be useful as a coping strategy in response to stressful situations. However, investigation of this behavior in children is limited. The present study is a secondary cross-sectional analysis of longitudinal data that were collected from cohorts of fourth-, fifth-, and sixth-grader students. Perceived stress was correlated with unhealthy eating behaviors (r = .13, p < .001), as well as with the use of eating as a coping mechanism (r = .24, p < .001). Hispanic children reported using eating as a coping mechanism most frequently, followed by African-American and Caucasian children. School-age children who experience high levels of stress may be at risk for developing unhealthy eating habits in order to cope; continued examination of these relationships is suggested. Future research should focus on the development of interventions to encourage positive coping mechanisms and healthy eating behaviors.     

Children at play: an innovative method for studying and teaching nutritional behaviors

Children under 6 years of age are one of the key groups for interventions establishing lifelong nutritional behaviors that will promote health and prevent obesity. Adults in young children's social environments play important roles in encouraging healthy nutritional behaviors. Parents, childcare providers, and teachers must teach children healthy eating behaviors in age-appropriate and applicable ways. Researchers need to determine as completely as possible how children learn nutritional behaviors. Current research methods and teaching approaches continue to challenge researchers and parents alike in achieving these important goals. This article details the need for developing new approaches to nutritional behavior development in children and describes the theoretical background and practical applications of one such novel approach: play-based settings. It explores the possibilities play-based settings offer for studying and developing healthy nutritional behaviors in young children. Following further refinement of this method, future research and practice in children's nutritional behavior development should benefit from this new approach.     

精神发育迟滞伴行为障碍患者的安全问题及管理对策

目的探讨精神发育迟滞伴行为障碍患者住院期间存在的安全问题,为护理干预提供可靠依据。方法选择2008年8月至2010年3月收治的精神发育迟滞伴行为障碍患者165例为研究对象,对患者出现的安伞问题进行分析、整理、总结。结果存在攻击他人的患者60例,占36．36％;出走33例,占20．00％;毁物28例,占16．97％;饮食障碍26例,占15．76％;自伤18例,占10．91％。结论针对精神发育迟滞伴行为障碍患者主要存在攻击他人、出走、毁物、饮食障碍、白伤的问题制订相关措施,建立评估系统及干预措施,制订安全、有效、可行的安全管理措施,进而确保护理安全。     

Parental influence on models of primary prevention of cardiovascular disease in children.

BACKGROUND: Lifestyle behaviors such as overeating and physical inactivity contribute significantly to CVD, the leading cause of morbidity and mortality among adults globally. CVD risk factors that begin in children often track into adulthood. Parents are believed to influence the health behaviors of their children. OBJECTIVE: To review the literature on parental influence on children's health beliefs and behaviors, particularly eating and exercise behaviors as indicators of CV health, school-based CVD risk reduction programs, and racial/ethnic, gender and socioeconomic considerations for models of primary prevention of CVD in children. METHODS: Seventeen studies that included parents as either a source of information, change agent or participant in a CVD risk reduction intervention were identified searching the Medline, CINAHL and PsycINFO databases from 1980 through 2002. RESULTS: Children's lifestyle health beliefs and behaviors are significantly influenced by positive parental modeling and involvement in exercise and healthy eating; parental influence on children's behavior lasts beyond adolescence; parents are effective teachers of health habits at home when prompted by health educators; and parental influences vary by ethnicity/race, socioeconomics and gender. CONCLUSIONS: A broader base of knowledge that is socioculturally sensitive must be developed about what parents and children believe is healthy, how parents model beliefs and behaviors for their children, and how to build self-efficacy for positive health behaviors.     

Orthorexia Nervosa: A Review of the Literature

Background: The phenomenon of orthorexia nervosa (ON) has been noted by clinicians since 1996 and described in the scientific literature, and yet there is no formal recognition of ON as a psychiatric diagnosis. Objective: Review the latest available literature regarding diagnoses similarities, presentation uniqueness, assessment/assessment tools, and suggested treatments of ON. Method/Design: A literature search of four databases focusing on articles published between 2000 and 2016 was conducted to evaluate the status of the literature on Orthorexia. Results: Among the 15 articles selected for this review, similarities with other psychiatric disorders emerged, confusion about use of assessment tools existed, and the lack of evidence based treatments for ON was pronounced. Conclusion: More research is needed to determine the prevalence of pathologically unhealthy, obsessive, “self-defined healthy,” eating behaviors, and to determine if ON is a unique eating disorder or just a subset of another disorder.     

Sexual behaviors in children: evaluation and management

Sexual behaviors in children are common, occurring in 42 to 73 percent of children by the time they reach 13 years of age. Developmentally appropriate behavior that is common and frequently observed in children includes trying to view another person's genitals or breasts, standing too close to other persons, and touching their own genitals. Sexual behaviors become less common, less frequent, or more covert after five years of age. Sexual behavior problems are defined as developmentally inappropriate or intrusive sexual acts that typically involve coercion or distress. Such behaviors should be evaluated within the context of other emotional and behavior disorders, socialization difficulties, and family dysfunction, including violence, abuse, and neglect. Although many children with sexual behavior problems have a history of sexual abuse, most children who have been sexually abused do not develop sexual behavior problems. Children who have been sexually abused at a younger age, who have been abused by a family member, or whose abuse involved penetration are at greater risk of developing sexual behavior problems. Although age-appropriate behaviors are managed primarily through reassurance and education of the parent about appropriate behavior redirection, sexual behavior problems often require further assessment and may necessitate a referral to child protective services for suspected abuse or neglect.     

单纯性肥胖儿童心理相关因素的变化

目的 发现与儿童单纯性肥胖相关的心理问题，并寻找有效的干预措施。方法 对23名7～15岁单纯性肥胖儿童和同地区31名健康儿童进行了肥胖心理相关因素的问卷调查。将结果首先进行单因素分析，然后分层进行多因素分析，用logistic回归进行统计学处理。结果 不良的摄食行为和进食心理与肥胖的发生相关，进食心理似乎比摄食行为更能影响肥胖的发生；运动心理以及每日看电视时间对肥胖的发生有较大的影响；肥胖不仅对身体健康不利，对心理状态和发展也有不利影响。一方面，肥胖小儿对自己身材的满意率较低；另一方面，他们又似乎更认可这一事实。结论 通过健康教育使肥胖儿童能自觉地克服不良的进食心理，改变不良的摄食行为，纠正不良社会心理状态，这将是肥胖的干预中极为重要的一环。此次调查还发现：课间、课后和饭后很少活动的小儿在两组所占的比例均较大，应引起家长、学校和社会的共同重视。     

Measuring elderly dysphagic patients' performance in eating – a review

Purpose.?This review aims to identify psychometrically robust assessment tools suitable for measuring elderly dysphagic patients' performance in eating for use in clinical practice and research.

Method.?Electronic databases, related citations and references were searched to identify assessment tools integrating the complexity of the eating process. Papers were selected according to criteria defined a priori. Data were extracted regarding characteristics of the assessment tools and the evidence of reliability, validity and responsiveness. Quality appraisal was undertaken using developed criteria concerning the study design, the statistics used for the psychometric evaluation and the reported values.

Results.?Eight of fourteen identified assessment tools met the inclusion criteria. Three assessment tools were specific to dementia, two were specific to stroke and three targeted a range of neurological and geriatric conditions. The rigor of the assessment tools' psychometric properties varied from no evidence available to excellent evidence. Only two assessment tools were rated adequate to excellent.

Conclusion.?‘The Minimal Eating Observation Form-Version II’ to be used for screening and ‘The McGill Ingestive Skills Assessment’ to be used for treatment planning and monitoring appeared to be psychometrically robust for clinical practice and research. However, further research on their psychometric properties is needed.