学龄期肥胖哮喘患儿及其父母运动恐惧体验的质性研究

Qualitative analysis on the status and factors of the fear of physical activity in school-age obese children with asthma and their parents

目的 基于恐惧-回避模型,探讨学龄期肥胖哮喘患儿及其父母对运动恐惧的体验,为制订针对性的运动干预方案提供依据。方法 采用目的抽样法,选取2021年10月—2022年1月在扬州市某三级甲等医院儿科哮喘门诊就诊的13例学龄期肥胖哮喘患儿及其父母作为研究对象,对其进行半结构式深度访谈,采用Colaizzi 7步分析法对资料进行分析、归纳并提炼主题。结果 基于恐惧-回避模型共提炼出3个主题。(1)对运动存在多种错误认知:认为运动会诱发多种不适症状;混淆运动后生理性不适症状及哮喘急性发作;部分父母对患儿肥胖产生过度警觉,强制患儿运动。(2)对运动恐惧采取消极的应对方式:患儿主动回避运动;部分父母限制患儿运动。(3)感知到运动恐惧的不良后果:久坐行为增加,运动耐力降低,进一步加重肥胖和运动恐惧;与同伴的交流减少,引发自卑感。结论 学龄期肥胖哮喘儿童及其父母对运动存在多种错误认知,常采取回避的应对方式,进而加重肥胖和运动恐惧。临床医护人员应加强健康宣教,协助患儿及其父母制订运动计划,提供相关支持,以减轻运动恐惧,促进患儿科学锻炼。

Objective To explore the experience and feelings of school-age obese children with asthma and their parents on fear of physical activity based on fear-avoidance model,in order to provide a basis for the construction of targeted exercise intervention programs for children with asthma. Methods From October 2021 to January2022,the purposive sampling was used to select 13 cases of school-age obese asthmatic children and their parents for semi-structured in-depth interviews in the pediatric asthma outpatient department of a tertiary A hospital in Yangzhou City. Data was analyzed by Colaizzi phenomenon analyzing methods. Results Combined with the fearavoidance model,3 themes are summarized,including the unscientific cognition of physical activity(physical activity can induce a variety of uncomfortable symptoms;parents can’t tell if discomfort after physical activity is an acute attack of asthma;some parents are over-alert to obesity and force children to physical activity);the way to deal with the fear of physical activity(children actively avoid physical activity;parents limit children’s physical activity);the adverse consequences of fear of physical activity(the increasing sedentary behavior affects the exercise endurance of children,further aggravating their obesity and fear of physical activity;communication between children and peers was reduced,triggering a sense of inferiority,further aggravating the fear of physical activity). Conclusion The experience and feelings of fear of physical activity in school-age children with obesity and asthma and their parents were more complex with some unscientific cognitions. In clinical practice,measures should be taken to improve the cognitive level of children and their parents on appropriate and moderate physical activity,avoid excessive vigilance on exercise,reduce fear of physical activity,and promote scientific physical activity in children.