ABSTRACT
Abstract Objective: To investigate the effects of multidisciplinary treatment with and without psychological counseling on obese adolescents' self-reported quality of life. Methods: Seventy-six obese adolescents (15.87 ± 1.53 y) were allocated into psychological counseling group (PCG; n = 36) or control group (CG; n = 40) for 12 weeks. All participants received the same supervised exercise training, nutritional and clinical counseling. Participants in PCG also received psychological counseling. QOL was measured before and after 12 weeks of intervention by Generic Questionnaire for the Evaluation of Quality of Life (SF-36). Results: The dropout rate was higher in GC (22.5%) when compared with PCG (0.0%) (p < 0.001). After 12 weeks, participants from PCG presents lower body weight, relative fat mass and higher free fat mass (p < 0.001 for all) compared to GC. QOL improved among adolescents from both groups (p < 0.05), however, a better QOL was reported from those adolescents enrolled in PCG. Conclusion: The inclusion of a psychological counseling component in multidisciplinary treatment for adolescent obesity appears to provide benefits observed for improved QOL as compared with treatment without psychological counseling.
Resumo Objetivo: Investigar os efeitos do tratamento multidisciplinar com e sem aconselhamento psicológico voltado para a qualidade de vida de adolescentes obesos. Métodos: Foram alocados 76 adolescentes obesos (15,87 ± 1,53 ano) em um grupo de aconselhamento psicológico (GAP; n = 36) e um grupo de controle (GC; n = 40) por 12 semanas. Todos receberam o mesmo treinamento físico supervisionado e aconselhamento nutricional e clínico. Os participantes no GAP também receberam aconselhamento psicológico. A qualidade de vida foi avaliada antes e depois das 12 semanas de intervenção por meio do Questionário Genérico de Avaliação da Qualidade de Vida (SF-36). Resultados: O abandono do tratamento foi maior no GC (22,5%) em comparação com o GAP (0,0%) (p < 0,001). Após 12 semanas, os participantes do GAP apresentam menor peso corporal, massa gorda relativa e maior massa livre de gordura (p < 0,001 para todos) em comparação com o GC. A qualidade de vida melhorou entre os adolescentes de ambos os grupos (p < 0,05); contudo, uma melhor qualidade de vida foi relatada pelos adolescentes incluídos no GAP. Conclusão: A inclusão de aconselhamento psicológico no tratamento multidisciplinar dos adolescentes obesos parece proporcionar benefícios observados na melhoria da qualidade de vida, em comparação com o tratamento sem aconselhamento psicológico.
Subject(s)
Humans , Male , Female , Adolescent , Quality of Life , Patient Compliance/psychology , Pediatric Obesity/psychology , Pediatric Obesity/therapy , Case-Control Studies , Surveys and Questionnaires , Combined Modality Therapy , CounselingABSTRACT
Aims: To identify the reasons why obese adolescents seek weight loss therapy and what barriers they face in losing weight. Study Design: Cross-sectional study. Place and Duration of Study: Department of Physical Education and School Medical Science, University of Pernambuco 2009-11. Methodology: The study was conducted with 128 obese adolescents (76 girls [BMI=35.46±3.92] and 52 boys [BMI=33.70±2.88]), aged between 12 to 18 years old Personal reasons for seeking weight loss treatment and barriers to losing weight were obtained by an individual semi-structured interview (8 questions) conducted by a psychologist. All individual interviews lasted approximately 20 min and were performed in a quiet room. Adolescents’ answers were semi-transcribed by the researcher and the content was anonymously analyzed in order to categorize the data. Results: The main reason for girls to start a weight loss program was to become healthy (39.47%), followed by to fit in clothes (30.26%), personal appearance (30.26%), and bullying (28.95%). Physical fitness (40.38%) was the most important reason to seek weight loss for boys, followed by to become healthy (36.54%), and bullying (25%). For both genders, the main barriers described were lack of self-control (47.37% - 36.54%), lack of social support (27.63% - 30.77%), and self-motivation (22.37% - 21.15%). Conclusion: Obese adolescents had several reasons for seeing weight loss. Overall, becoming healthy was the main motivation for weight loss and lack of self-control was the main barrier. This information can be used to help develop more effective weight loss strategies for obese adolescents.
ABSTRACT
Se describen y analizan dos iniciativas de cooperación en salud pública en las cuales participan representantes de la sociedad civil, la academia, el sector público y sector privado de las Américas. Una de ellas -el Diálogo Multipartito- promueve la aproximación intersectorial en su más amplio concepto, mientras que la otra -el Foro de Socios- si bien representa una iniciativa institucional, asigna mayor atención a las enfermedades crónicas no transmisibles. Ambas constituyen un llamado a la acción para los gobiernos y ofrecen alternativas para enfrentar más efectivamente los problemas de la salud regional.
Two cooperative public health initiatives involving representatives of civil society, academia, and the public and private sectors of the Americas are described and analyzed. One of them-the Multipartite Dialogue-promotes an intersectoral approach in its broadest sense, and the other-the Partners Forum-while it represents an institutional initiative, pays particular attention to chronic noncommunicable diseases. Both are a call to action for governments and offer alternatives to tackle regional health problems more effectively.