Perceptions of Exercise in Obese School-Aged Children

肥胖學童的運動知覺感受

李碧霞(Pi-Hsia Lee)；賴香如(Hsiang-Ru Lai)；周雨樺(Yu-Hua Chou)；張綠怡(Lu-I Chang)；張文英(Wen-Ying Chang)

運動行為 ； 焦點團體 ； 肥胖 ； 無意圖期 ； 學童 ； exercise behavior ； focus group ； obesity ； precontemplation ； stage ； school children

The Journal of Nursing Research

17卷3期（2009 / 09 / 01）

170 - 178

英文

背景　雖然世界各國的肥胖盛行率持續增加，但有關肥胖學童對運動看法的研究，則尚付之闕如。 目的　本研究之目的旨在探索肥胖學童的運動知覺感受。 方　法　本研究設計為質性研究。採立意取樣，以臺北市二所公立國小，1，714名年齡在11~13歲的學童為對象，最後有11位處於無運動意圖的肥胖學童參與研究。以五題開放式訪談大綱，兩所學校各進行一場焦點團體訪談。資料則以內容分析法進行分析。 結果　共找出六個有意義的主題：(a)對運動的正向印象、(b)不做運動時的不良影響、(c)運動後的不舒服感覺、(d)自我矛盾、(e)對運動的錯誤信念、(f)找藉口不運動。 結論／實務應用　研究結果所提供的資訊，除更加了解肥胖學童的運動知覺感受外，也可協助肥胖學童增加其運動量，改善其健康。

Background: Although the prevalence of obesity continues to increase worldwide, information related to obese school-aged children's perceptions of exercise remains limited. Purpose: This study aimed to explore perceptions of exercise held by obese school-aged children. Methods: This study used a qualitative research design. Using purposive sampling, 11 obese students who were 11 to 13 years old, currently enrolled at two primary schools, and in the precontemplation stage were recruited from a total population of 1, 714 to participate in the study. An interview guide with five open-ended questions was used to guide focus group discussions. Data were analyzed using content analysis to identify significant themes. Results: Six themes emerged from collected data, including (a) positive impressions about doing exercise, (b) recognition of negative effects associated with not doing exercise, (c) feelings of discomfort after exercise, (d) self-ambivalence, (e) false beliefs about exercise, and (f) making excuses for not doing exercise. Conclusions/Implications for Practice: Study findings provided information giving a better understanding of exercise perceptions among obese children. Such may be used to assist obese children to increase exercise levels as part of efforts to improve health in this vulnerable population.

1. Agnew, B.(2002).Barriers to exercise.Diabetes Forecast,55(8),89-92.
2. Borra, S. T.,Kelly, L.,Shirreffs, M. B.,Neville, K.,Geiger, C. J.(2003).Developing health messages: Qualitative studies with children, parents, and teachers help identify communications opportunities for healthful lifestyles and the prevention of obesity.Journal of American Dietetic Association,103(6),721-728.
3. Caprio, S.,Daniels, S. R.,Drewnows, A.,Kaufman, F. R.,Palinkau, L. A.,Rosenbloom, A.(2008).Influence of race, ethnicity, and culture on childhood obesity: Implications for prevention and treatment: A consensus statement of shaping America's Health and the Obesity Society.Diabetes Care,3(11),2211-2221.
4. Carvalhal, M. M.,Padez, M. C.,Moreira, P. A.,Rosado, V. M.(2006).Overweight and obesity related to activities in Portuguese children, 7-9 years.European Journal of Public Health,17(1),42-46.
5. Datar, A.,Sturm, R.(2006).Childhood overweight and elementary school outcomes.International Journal of Obesity and Related Disorders,30(9),1449-1457.
6. Definition of obesity for children and adolescents in Taiwan
7. BMI overweight and obesity among adolescent in Taiwan
8. A national health survey reports in 2005 academic year
9. Dugan, S. A.(2008).Exercise for preventing childhood obesity.Physical Medicine and Rehabilitation Clinics of North America,19(2),205-216.
10. Edmunds, L. D.(2008).Social implications of overweight and obesity in children.Journal for Specialists in Pediatric Nursing,13(3),191-200.
11. America's children in brief: Key national indicators of well-being, 2008
12. Gibson, L. Y.,Byrne, S. M.,Blair, E.,Davis, E. A.,Jacoby, P.,Zubrick, S. R.(2008).Clustering of psychosocial symptoms in overweight children.Australian and New Zealand Journal of Psychiatry,42(2),118-125.
13. Graf, C.,Koch, B.,Dordel, S.,Schindler-Marlow, S.,Icks, A.,Schuller, A.(2004).Physical activity, leisure habits and obesity in first-grade children.European Journal of Cardiovascular Prevention and Rehabilitation,11(4),284-290.
14. Griffiths, L. J.,Wolke, D.,Page, A. S.,Horwood, J. P.,the ALSPAC Study Team.(2006).Obesity and bullying: Different effects for boys and girls.Archives of Disease in Childhood,91(2),121-125.
15. Hesketh, K.,Waters, E.,Green, J.,Salmon, L.,Williams, J.(2005).Healthy eating, activity and obesity prevention: A qualitative study of parent and child perceptions in Australia.Health Promotion International,20(1),19-26.
16. Hills, A. P.,King, N. A.,Armstrong, T. P.(2007).The contribution of physical activity and sedentary behaviours to the growth and development of children and adolescents: Implications for overweight and obesity.Sports Medicine,37(6),533-545.
17. Hughes, A. R.,Henderson, A.,Ortiz-Rodriguez, V.,Artinou, M. L.,Reilly, J. J.(2006).Habitual physical activity and sedentary behaviour in a clinical sample of obese children.International Journal of Obesity,30(10),1494-1500.
18. Jackson, D.,McDonald, G.,Mannix, J.,Faga, P.,Firtko, A.(2005).Mother's perceptions of overweight and obesity in their children.Australian Journal of Advanced Nursing,23(2),8-13.
19. Janssen, I.,Craig, W. M.,Boyce, W. F.,Pickett, W.(2004).Associations between overweight and obesity with bullying behaviors in school-aged children.Pediatrics,113(5),1187-1194.
20. Joosse, L.,Stearns, M.,Anderson, H.,Hartlaub, P.,Euclide, J.(2008).Fit Kids/Fit Families: A report on a countywide effort to promote healthy behaviors.Wisconsin Medical Journal,107(5),231-236.
21. Kautiainen, S.,Koivusilta, L.,Lintonen, T.,Virtanen, S. M.,Rimpela, A.(2005).Use of information and communication technology and prevalence of overweight and obesity among adolescents.International Journal of Obesity and Related Disorders,29(8),925-933.
22. Koniak-Griffin, D.,Nyamathi, A.,Vasquez, R.,Russo, A. A.(1994).Risk-taking behaviors and AIDS knowledge: Experiences and beliefs of minority adolescent mothers.Health Education Research,9(4),449-463.
23. Krueger, R. A.(1994).Focus group: A practical guide for applied research.Thousand Oaks, CA:Sage.
24. Lee, P. H.,Chou, Y. H.,Lai, H. R.(2007).Perceptions of exercise and exercise promoting strategies among obese children in the preparation stage of exercise.Journal of Health Education,27,157-175.
25. Lee, P. H.,Lai, H. R.(2004).Application of transtheoretical model to exercise behavior in children with obesity.Taipei:National Science Council.
26. Lee, W. W.(2007).An overview of pediatric obesity.Pediatric Diabetes,8(9),76-87.
27. Lincoln, Y. S.,Guba, E. G.(1985).Naturalistic inquiry.Newbury Park, CA:Sage.
28. A report of the exercise participation among school children in 2006
29. Morgan, D. L.(1988).Focus group as qualitative research.Thousand Oaks, CA:Sage.
30. Nigg, C. R.,Courneya, K. S.(1998).Transtheoretical model: Examining adolescent exercise behavior.Journal of Adolescent Health,22(3),214-224.
31. Prochaska, J. O.,DiClemente, C. C.(1982).Transtheoretical therapy: Toward a more integrative model of change.Psychotherapy: Theory, Research and Practice,19,276-288.
32. Sharma, M.,Wagner, D. I.,Wilkerson, J.(2005).Predicting childhood obesity prevention behaviors using social cognitive theory.International Quarterly of Community Health Education,24(3),190-202.
33. Sleap, M.,Warburton, P.(1992).Physical activity levels of 5-11-year-old children in England as determined by continuous observation.Research Quarterly for Exercise & Sport,63(3),238-245.
34. Sparks, P.,Harris, P. R.,Lockwood, N.(2004).Predictors and predictive effects of ambivalence.The British Journal of Social Psychology,13(3),371-383.
35. Taras, H.,Datema-Potts, W.(2005).Obesity and student performance at school.Journal of School Health,75(8),291-295.
36. Watson, R.(2008).EU parliament backs 30 minutes' exercise a day for all children to tackle obesity.British Medical Journal,337,1892.
37. Weir, L. A.,Etelson, D.,Brand, D. A.(2006).Parents' perceptions of neighborhood safety and children's physical activity.Preventive Medicine,43(3),212-217.
38. Wells, J. C.,Hallal, P. C.,Reichert, F. F.,Menezes, A. M.,Araujo, C. L.,Victora, C. G.(2008).Sleep patterns and television viewing in relation to obesity and blood pressure: Evidence from an adolescent Brazilian birth cohort.International Journal of Obesity,32(7),1042-1049.
39. Xu, F.,Li, J.,Ware, R. S.,Owen, N.(2008).Associations of television viewing time with excess body weight among urban and rural high-school students in regional mainland China.Public Health Nutrition,11(9),891-896.
40. Zeller, M. H.,Reiter-Purtill, J.,Ramey, C.(2008).Negative peer perceptions of obese children in the classroom environment.Obesity,16(4),755-762.