비만도와 체력이 비만 아동의 자기 효능감, 삶의 질, 자아개념에 미치는 영향
The Effect of BMI and Physical Ability on Self-efficacy, Quality of Life, and Self-esteem in Overweight and Obese Children.
정경미 (연세대학교)
전용관 (연세대학교)
초록
본 연구에서는 초등학교 4-6학년을 대상으로 첫째, 비만도에 따른 아동의 심리사회적 적응과 체력 수준의 차이를 밝히고, 둘째, 비만도와 체력이 과체중 이상 아동의 심리사회적 적응에 미치는 영향을 살펴보았다. 과체중 이상 아동은 ‘한국 비만 아동의 신체 활동과 건강(KOCPA)' 연구의 비만 캠프 프로그램에서, 대조군 아동은 서울 시내 초등학교에서 표준 성장도표의 체질량지수를 기준으로 모집되었다. 심리사회적 변인으로 자아 효능감 검사(식이 자아 효능감, 체중 조절 효능감, 신체 효능감), 자아개념검사, 소아용 삶의 질 검사가 사용되었으며, 신체 계측 및 체력은 직접 측정되었다. 연구 결과, 비만도가 증가할수록 심리사회적 적응과 체력 수준이 낮은 것으로 나타났다. 또한 과체중 및 비만 아동은 정상체중 대조군에 비해 유의하게 낮은 효능감 및 자아개념, 삶의 질을 보고하였다. 과체중 및 비만 아동을 대상으로 심리사회적 적응에 비만도와 체력, 두 변인의 상호작용이 미치는 영향을 알아본 결과, 체력이 좋을수록 높은 체중조절 효능감, 신체 효능감, 삶의 질이 예측되었다. 또한 비만도와 체력의 상호작용 효과가 비만 아동의 자아개념 수준을 예측하였는데, 이는 비만도가 그리 높지 않은 아동들은 체력 수준의 향상이 자아개념을 유지할 것이라고 예측 가능하지만 비만도가 상대적으로 매우 높을 경우에는 우선적으로 비만도의 감소가 우선적으로 이루어져야 함을 시사한다. 본 결과를 바탕으로 본 연구의 함의와 한계점에 대해 논의하였다.
- keywords
- 비만 아동, 심리사회적 적응, 비만도, 체력, 상호작용 효과, childhood obesity, BMI, physical fitness, psychological factors.
Abstract
The purpose of this study was two-fold. First, comparisons on the psychological and physical attributes of normal weight, overweight, and obese children were conducted. Second, the influence of BMI and physical fitness interaction on psychological adaptation in children with obesity was explored. Participants were 245 children between the ages of 9 and 13 years (64.5% males). Data on children considered overweight (n = 45) or obese (n = 78) were gathered from the Korean Obese Children's Physical Activity (KOCPA) projects. Normal weight children (n = 122) were recruited from two Seoul elementary schools. Psychological measurements included Weight Efficacy Life-style Questionnaire (WEL), Physical Self-efficacy Scale (PSES), Child Dietary Self-efficacy Scale (CDSS), Self-concept Inventory (SCI), and the Korean version of the Pediatric Quality of Life Intervention TM Version 4.0 Generic Core Scales (PedsQLTM4.0). BMI (kg/m2) and physical fitness (e.g., aerobic endurance, flexibility) were recorded by experts in exercise physiology. Results showed that children in the high BMI group reported poorer psychological adaption and demonstrated lower physical fitness when compared to the remaining groups. Compared to normal weight children, children considered overweight and obese were found to have lower physical self-efficacy, more negative self-concept, and poorer quality of life. Further, these children also had significantly lower physical fitness levels than their normal weight counterparts. Physical fitness was found to have a significant main effect on weight efficacy (WEL), physical self-efficacy (PSES), and quality of life (PedsQL) in children considered overweight or obese. A significant BMI-physical fitness interaction effect was found for self-concept (SCI) only. Children with higher BMI reported poorer self-concept regardless of fitness level whereas children with lower BMI and higher fitness reported more positive self-concept. Implications and limitations are discussed.
- keywords
- 비만 아동, 심리사회적 적응, 비만도, 체력, 상호작용 효과, childhood obesity, BMI, physical fitness, psychological factors.
참고문헌
강윤주, 홍창호, 홍영진, (1997). 서울시내 초․중․고학생들의 최근 18년간 ( 1979 - 1996년 ) 비만도 변화 추이 및 비만아 증가 양상. 한국영양학회지, 30(7), 832-839.
김경희, (2001). 비만아동을 위한 체중조절 프로그램의 효과. 한국식생활문화학회지, 16(2), 89-98.
김주희, 정경미, 전용관(2010) 통합적 비만 캠프 프로그램에 참여한 과체중 아동의 식이 효능감과 식습관 향상이 비만도 감소에 미치는 영향. 한국심리학회: 건강, 15(3), 389-408
박광배, (1999). 변량분석과 회귀분석. 학지사: 서울
보건복지부. (2005). 국가 비만관리 종합대책.
송인섭, 이경화, 고진영 (2006). 자아개념검사. 학지사:서울
안을섭, 박형섭(2006) 비만아동의 정신사회학적 특성에 대한 연구. 한국유아체육학회지, 7, p43-62
이미경. (2009). 비만아동의 6박7일 캠프 참여가 비만도, 심혈관 질환 위험요인 및 염증지표에 미치는 영향. 체육연구논문집, 16(1), 159-224
질병관리본부, 대한소아과학회, 소아․청소년 신체발육표준치 제정위원회. (2007). 2007년 소아․청소년 표준 성장도표 해설.
최주연, 권정혜, 이재현. (2001). 행동수정 프로그램이 비만아동의 체중감소에 미치는 효과, 한국심리학회: 임상, 20(4), 611-623
홍선옥. (1996). 운동참여가 신체적 자기효능감과 성역할 유형 변화에 미치는 영향. 부산대학교 박사학위논문.
Aiken, L. S., & West, S. G. (1991) Multiple regression : testing and interpreting interactions. Sage Publications: Thousand Oaks, CA, US.
Breat, C., Mervielde, I. & Vandereycken, W. (1997). Psychological aspects of childhood obesity: a controlled study in a clinical and nonclinical sample. Journal of Pediatric Psychology, 22(1),59-71.
Britz, B., Siegfried, W., Ziegler, A., Lamertz, C., Herpertz-Dahlmann, B.M., Remschmidt, H., et al. (2000). Rates of psychiatric disorders in a clinical study group of adolescents with extreme obesity and in obese adolescents ascertained via population based study. International Journal of Obesity, 24, 1707– 1714.
Caspersenm, C. J., Powell, K. E., & Christenson, G M. (1985). Physical activity, exercise, and physical fitness: definitions and distinctions for health-related research. Public Health Rep., 100(2), 126–131.
Clark, M. M., Abrams, D. B., & Niaura, R. S. (1991). Self-Efficacy in Weight Management. Journal of Consulting and Clinical Psychology, 59(5), 739-744.
D'Hondt, E., Deforche, B., De Bourdeaudhuij, I., & Lenoir, M. (2009). Relationship between motor skill and Body Mass Index in 5- and 10-year-old children. Adapted Physical Activity Qualterly, 26, 21-37.
Fontaine, K. R. & Barofsky, I. (2001). Obesity and health-related quality of life. The International Association for the Study of Obesity, Obesity reviews 2. 173-182.
Franklin, J., Denyer, G., Steinbeck, K. S., Caterson, I. D., & Hill, A. J. (2010). Obesity and risk of low self-esteem: A statewide survey of Australian children. Pediatrics, 118(6), 2481-2487.
Friedlander, S. L., Larkin, E. K., Rosen, C. L., Palermo, T. M., & Redline, S. (2003). Decreased quality of life associated with obesity in school-aged children. Archives of Pediatrics & Adolescent Medicine, 157, 1206-1211.
Goran, MI, Reynolds, KD., & Lindquist, CH. (1999). Role of physical activity in the prevention of obesity in children. International Journal of Obesity, 23(3), S18-33.
Gould, R. A. & Clum, G. A. (1993) A meta-analysis of self-help treatment approaches. Clinical Psychology Review, 13(2), 169-186
Kook, S. H., & Varni, J. W. (2008) Validation of the Korean version of the pediatric quality of life inventory™ 4.0 (PedsQL™) generic core scales in school children and adolescents using the rasch model. Health and Quality of Life Outcomes, 6: 41
Manus, H. E., & Killeen, M. R. (1995). Maintenance of self-esteem by obese children. Journal of Child and Adolescent Psychiatric Nursing, 8(1), 17-27.
Marsh, H. W. & Schavelson, R. J. (1985) Self-concept: Its multifaceted, hierarchical structure. Educational Psychologist, 20, 107-125.
McCullough, N., Muldoon, O., & Dempster, M. (2009) Self-perception in overweight and obese children: a cross-sectional study, Child: care, health and development, 35(3), 357–364.
Molnar, D. & Linvingstone, B. (2000). Physical activity in relation to overweight and obesity in childeren and adolescents. European Journal of Pediatrics, 159, S45-S55
Morano, M., Colella, D., Robazza, C., Bortoli, L., & Capranica, L. (2010). Physical self-perception and motor performance in normal-weight, overweight and obese children. Scandinavian Journal of Medicine & science sports, 1-9.
Mossberg, H. (1989). 40-year follow-up of overweight children. The Lancet, 334(8661), 491-493.
Mustillo, S., Worthman, C., Erkanli, A., Keeler, G., Angold, A., & Costello, E. J. (2003). Obesity and psychiatric disorder: Developmental trajectories. Pediatrics, 111, 851-859.
NCHS, (1999) National Health Interview Survey: Research for the 1995–2004 redesign. Vital Health Stat Series 2 No. 126, National Center for Health Statistics.Hyattsville, MD.
Nowicka, P. & Flodmark, C-E. (2006). Physical activity - key issues in treatment of childhood obesity, Acta Paediatrica, 96, 39-45
O'Dea, J. A. (2008) Gender, ethnicity, culture and social class influences on childhood obesity among Australian schoolchildren: implications for treatment, prevention and community education. Health & Social Care in the Community, 16(3), 282–290.
Parcel, G. S., Edmundson, E., Perry, C. L., Feldman, H. A., O'Hara-Tompkins, N., Nader, P. R., Johnson, C. C., & Stone, E. J. (1995). Measurement of self-efficacy for diet-related behaviors among elementary school children. The Journal of School Health, 65(1), 23-27.
Raustorp, A., Stahle, A., Gudasic, H., Kinnunen, A., & Mattsson, E. (2005). Physical activity and self-perception in school children assessed the children and youth – physical self-perception profile. Scandinavian Journal of Medicine & science Sports, 15, 126-134.
Rippe, J. M., & Hess, S. (1998) The role of physical activity in the prevention and management of obesity. Journal of the American Dietetic Association, 98(2), S31-38.
Ryckman, R. M., Robbins, M. A., Thornton, B., & Cantrell, P. (1982). Development and validation of a Physical Self-efficacy Scale. Journal of Personality and Social Psychology, 891-900.
Sallis, JF. & Saelens, BE. (2000). Assessment of physical activity by self-report: status, limitations, and future directions. Res Q Exerc Sport. 71(2), S1-14.
Shoup, J. A., Gattshall, M., Dandamudi, P., & Estabrooks, P. (2008). Physical activity, quality of life, and weight status in overweight children. Quality of life research, 17, 407-412.
Sollerhed, A. C., Apitzsch, E., Rastam, L., & Ejlertsson, G. (2008). Factors associated with young children’s self-perceived physical competence and self-reported physical activity. Health education research, 23(1), 125-136.
Steinsbekk, S., Jozefiak, T., Odegard, R., & Wichstrom, L. (2009) Imparied parentreported quality of life in treatment-seeking children with obesity is mediated by high levels of psychopathology. Quality of Life Research, 18, 1159-1167.
Strauss, R. S. (1999) Comparison of measured and self-reported weight and height in a cross-sectional sample of young adolescents. International Journal of Obesity, 23(8), 904-908.
Strauss, R. S. (2000). Childhood obesity and self-esteem. Pediatrics, 105, e1-15.
Strauss, R. S., Rodzilsky, D., Burack, G., & Colin, M. (2001). Psychosocial correlates of physical activity in health children. Archives of Pediatrics & Adolescent Medicine, 155, 897-902.
Sung, RVT, Yu, CW, So, RCH, Lam, PKW, & Hau, KT. (2005). Self-perception of physical competences in preadolescent overweight Chinese children. European Journal of Clinical Nutrition, 59, 101-106.
Varni, J. W., Limbers, C. A., & Burwinkle, T. M. (2007). Impaired health-related quality of life in children and adolescents with chronic conditions: a comparative analysis of 10 disease clusters and 33 disease categories/severities utilizing the PedsQLTM 4.0 Generic Core Scales. Health and Quality of Life Outcomes, 5, 43-58.
Varni, J. W., Seid, M., & Kurtin, P. S. (2001). PedsQLTM 4.0: Reliability and validity of the Pediatric Quality of Life InventoryTM Version 4.0 generic core scales in healthy and patient Populations. Medical Care, 39(8), 800-812.
Wardle, J. & Cooke, L. (2005). The impact of obesity on psychological well-being. Best Practice & Research Clinical Endocrinology & Metabolism, 19(3), 421-440.
Whitaker, R. C., Wright, J. A., Pepe, M. S., Seidel, K. D., & Dietz, W. H. (1997). Predicting Obesity in Young Adulthood from Childhood and Parental Obesity. The New England Journal of Medicine, 337(13), 869-873
Young-Hyman, D., Schlundt, D. G., Herman- Wenderoth, L., & Bozylinski, K. (2003). Obesity, apperance, and psychosocial adaptation in young african american children. Journal of pediatric psychology, 28(7), 463-472.
Zametkin, A. J., Zoon, C. K., Klein, H. W. & Munson, S. (2004) Psychiatric aspects of child and adolescent obesity: A review of the past 10 years. Focus, 2, 625-641
Zeller, M. H. & Modi, A. C. (2009). Psychosocial factors related to obesity in children and adolescents. In Jelalian, E. & Steele, R. G. (Eds.), Handbook of Childhood and Adolescent Obesity. (PP 25-42).
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