哈尔滨市儿童饮食行为问题干预策略研究

Children’s Eating Behavior Problems and Intervention Strategies

目的了解有饮食行为问题儿童微量元素的缺乏情况,探讨儿童饮食行为问题有效的解决方法。方法在儿童健康体检门诊采用爱饭达(IMFeD)诊断方法筛选出1～4岁有饮食行为问题的儿童共94例,其中男孩50例,女孩44例。分成两组,综合干预组(以IMFeD策略为主进行综合干预)59例,常规干预组35例。通过基线调查问卷、为期6个月的随访干预问卷和终末调查问卷分析统计,对两组干预效果进行比较,基线调查问卷时对94例儿童全部进行微量元素检测和骨密度测量。结果通过对两组有饮食行为问题的儿童进行干预,两组干预方法均有效。但对于儿童不良进食习惯、儿童父母过度关心儿童饮食、儿童害怕进食等问题,经对两组重复测量方差分析比较发现,综合干预组终末调查的分数低于基线调查分数,差别具有统计学意义;而常规干预指导组变化不显著。有饮食行为问题的儿童其微量元素铁缺乏和锌缺乏检出率分别为50.00%和51.90%,明显高于在儿童健康体检门诊就诊的儿童(18.98%、23.12%),差异有统计学意义;其钙缺乏和骨密度低的发生率也较高,但与儿童健康体检门诊就诊的儿童相比,没有显著性差异。结论与常规干预方法相比,以"IMFeD"干预策略为主的综合干预方法对儿童饮食行为问题有更好的作用,干预效果更显著。建议综合干预应在常规指导基础上采用"IMFeD"干预策略,同时应考虑微量元素的检测和补充。

OBJECTIVE To discuss the solving methods in eating behavior problem among children and to know the situation of the lack of trace elements in those children. METHODS Using diagnostic tools of ＂IMFeD＂, 94 eating behavior problems children aged 1-4 years were divided into two groups, in which comprehensive interention group（mainly IMFeD strategy to comprehensive intervention） 59 patients and the conventional intervention group 35 examples in children＇s health medical clinic. Two groups of intervention effects are compared. The children of 94 cases were tested trace elements and bone mineral density. RESULTS The two groups＇methods are effective in solving of children＇s eating behavior problem. The fractions of comprehensive intervention group in terminal of the survey below baseline survey scores and and the differences are significant for children of poor food habits, parents pay too much concern to ehlid＇s diet, and for the children of fearing to eat. The score differences are not significant in conventional intervention group. The detection rate of children who lack of iron and zinc were 50.00% and 51.90% for The children of eating behavior problem , the difference was statistically significant. CONCLUSION Intervention should take to method of comprehensive giving priority to ＂IMFeD＂ among 1-4 years old children of feeding behavior problems. Comprehensive interference should based on conventional guidance and ＂IMFeD＂ intervention strategies, and should also consider to detect and complement the trace elements.