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İştahsızlıkta Davranış Değişikliği Tedavisi ve Etkinliği

Yıl 2020, Cilt: 42 Sayı: 1, 54 - 60, 01.01.2020
https://doi.org/10.20515/otd.500245

Öz

İştahsızlık çocukluk çağında sık
karşılaşılan bir problem olup, tedavide ortak bir yaklaşım bulunmamaktadır. Bu
çalışmanın amacı; organik hastalığa bağlı olmayan iştahsızlıkta önerilen
davranış değişikliği tedavisinin uygulanabilirlik ve etkinliğini araştırmaktır.
Aynı zamanda uygulama sonrası ailelerden alınan geri bildirimlerle çocukların
günlük kalori alımlarında artışa neden olup olmadığını değerlendirmektir.
Çalışmaya Ağustos- Kasım 2017 tarihleri arasında hastanemiz çocuk polikliniklerine
iştahsızlık şikayeti ile başvuran ve yapılan değerlendirme sonucu organik
hastalık tanısı olmayan iki-on yaş arası 96 çocuk alındı. Çocukların
antropometrik değerleri ölçülerek, anket yoluyla beslenme özellikleri
sorgulandı. Ailelerden çocukların üç günlük yemek listeleri alınarak;
uygulamaları için beslenme kuralları verildi. İki ay sonunda ailelere tekrar
hangi kurallardan fayda gördüklerine dair anket uygulandı. Çalışma başındaki
kalori ve protein alımları iki aylık davranış değişikliği sonrasındaki
değerleriyle karşılaştırıldı. Ayrıca çocuklar iki- dört yaş, beş- yedi yaş,
sekiz- on yaş olmak üzere üç gruba bölünerek davranış değişikliği tedavisinin
yaşlara göre uygulanabilirliği saptandı Ailelerin %84,3’ünün beslenme
kurallarını uygulayabildiği ve bu ailelerden %79’nun kurallardan fayda gördüğü
öğrenildi. Çalışma başında hesaplanan çocukların aldığı kalori değerlerinin
almaları gereken miktardan ortalama %25 düşük olduğu ve bunun annenin
bildirdiği iştah durumuyla uyumlu olduğu saptandı. Çocukların başlangıçtaki
değerlerine göre çalışma sonunda alınan kalori değerlerinde istatistiksel
olarak anlamlı artış olduğu gözlendi. Organik hastalığa bağlı olmayan
iştahsızlığı olan çocuklarda kalori alımının annenin bildirdiği iştah durumuyla
uyumlu olarak yaşa göre düşük olduğunu saptadık. Davranış değişikliği
uygulamasının tedavide etkili olduğu, ailelerin uygulamadan fayda gördüğü ve
davranış değişikliği tedavisinin özellikle sekiz yaşından önce uygulandığında
faydalı olabileceği sonucuna vardık.

Kaynakça

  • 1. Neyzi O, Ertuğrul T. [Nutrition and Nutrition disorders]. Kurdoğlu G, eds. Pediatri. 3 rd ed. İstanbul: Nobel Tıp Kitabevleri; 2002. p. 166
  • 2. Osborn L, DeWitt T, First L, Zenel J. [Principles of Nutrition]. Williams P, Christensen NK, eds .Pediatri. 1 st ed. Ankara: Güneş Kitabevi; 2007. p. 145-51.
  • 3. Kerzner B. Clinical investigation of feeding difficulties in young children: a practical approach. Clinical pediatrics. 2009;48(9):960-5.
  • 4. Saltık-Temizel İN. [Child with low appetite]. Cocuk sagligi ve hastaliklari dergisi. 2008;51:176-81.
  • 5. Bithoney W. Failure to thrive/growth deficiency. Pediatr Rev. 1992;12:453-60.6. Ünal F. [Clinical Approach to Children With Low Appetite]. The Journal of Current Pediatrics. 2011;1(9):79-84.
  • 7. Lee K, Song Y-M. Parent-reported appetite of a child and the child’s weight status over a 2-year period in Korean children. Journal of the American Dietetic Association. 2007;107(4):678-80.
  • 8. WHO/FAO/UNU. Expert Consultation : Human energy requirments. Rome; 2004;28.
  • 9. Saarilehto S, Lapinleimu H, Keskinen S, Helenius H, Talvia S, Simell O. Growth, energy intake, and meal pattern in five-year-old children considered as poor eaters. The Journal of pediatrics. 2004;144(3):363-7.
  • 10. Lindberg L, Östberg M, Isacson IM, Dannaeus M. Feeding disorders related to nutrition. Acta Paediatrica. 2006;95(4):425-9.
  • 11. Ünlü G, Aras Ş, Güvenir T, Büyükgebiz B, Bekem Ö. Family Functioning, Personality Disorders, and Depressive and Anxiety Symptoms in the Mothers of Children with Food Refusal]. Turk psikiyatri dergisi. 2006; 17(1):12-21
  • 12. Carruth BR, Skinner J, Houck K, Moran III J, Coletta F, Ott D. The phenomenon of “picky eater”: a behavioral marker in eating patterns of toddlers. Journal of the American College of Nutrition. 1998;17(2):180-6.13. Parental strategies for influencing the diet of their children - A qualitative study from disadvantaged areas. Norman Å, Nyberg G, Elinder LS, Berlin A. Appetite. 2018 Jun 1;125:502-511
  • 14. Sadock BJ, Sadock VA. Kaplan and Sadock's Comprehensive Textbook of Psychiatry. 8 th ed. Ankara: Güneş Kitabevi; 2007. p. 3217-27.
  • 15. Sweetman C, Wardle J, Cooke L. Soft drinks and'desire to drink'in preschoolers. International Journal of Behavioral Nutrition and Physical Activity. 2008;5(1):60.
  • 16. Wardle J, Guthrie CA, Sanderson S, Rapoport L. Development of the children's eating behaviour questionnaire. The Journal of Child Psychology and Psychiatry and Allied Disciplines. 2001;42(7):963-70.
  • 17. Wright CM, Parkinson KN, Shipton D, Drewett RF. How do toddler eating problems relate to their eating behavior, food preferences, and growth? Pediatrics. 2007;120(4):e1069-e75.
  • 18. Byrne LK, Cook KE, Skouteris H, Do M. Parental status and childhood obesity in Australia. Pediatric Obesity. 2011;6(5‐6):415-8.
  • 19. Ford C, Ward D, White M. Television viewing associated with adverse dietary outcomes in children ages 2–6. obesity reviews. 2012;13(12):1139-47.20.
  • 20. Kerr MA, McCrorie TA, Rennie KL, Wallace JM, Livingstone MBE. Snacking patterns according to location among Northern Ireland children. Pediatric Obesity. 2010;5(3):243-9.
  • 21. Yu D, Zhang B, Zhao L, Wang H. Snacks consumption in Chinese children and adolescents at theages of 3-17 years. Weisheng yan jiu=Journal of hygiene research. 2008;37(6):710-3.22. Systematic Review of Tools and Methods to Measure Appetite in Undernourished Children in the Context of Low- and Middle-Income Countries. Ickes SB, Hossain M, Ritter G, Lazarus M, Reynolds K, Nahar B, Ahmed T, Walson J, Denno DM. Adv Nutr. 2018 Nov 1;9(6):789-812

Evaluation Of Behavioral Modification For Children With Poor Appetite

Yıl 2020, Cilt: 42 Sayı: 1, 54 - 60, 01.01.2020
https://doi.org/10.20515/otd.500245

Öz

Poor appetite is a frequent
problem in childhood and there is no common approach for treatment. The aim of
this study is to investigate the feasibility and effectiveness of the treatment
of behavioral modification proposed for the poor appetite in the absence of
organic disease. Concurrently, in the light of feedback received from the
families, it is evaluated whether children have an increase in their daily
calorie intake. A total of 96 children aged between two to ten years old who
referred to the outpatient clinics of our hospital with the complaint of poor
appetite between August-November 2017. The ones who were not diagnosed with an
organic disease were included in the study. Anthropometric values of children
were measured and nutrition characteristics were investigated through
questionnaire. Three-day meal lists of children were obtained from families;
and then, nutrition rules were given to families to apply for two months. At
the end of two months, a questionnaire was administered to the families to investigate
which rules they benefited from. Calories and protein intake at the beginning
of the study were compared with the values attained after two months of
behavioral modification. In addition, children were divided into three groups
as two-four-year-old, five-seven-year-old, eight-ten-year-old, and the
feasibility of the behavioral modification was analyzed according to age. It
was found that 84.3% of the families could apply the nutritional rules and 79%
of the families benefited from them. According to the results, the calorie
intake of the children calculated at the beginning of the study were 25% lower
than the amount they should take and this was consistent with the appetite
status reported by the mother. Compared with the initial values of the children,
there is a statistically significant increase in caloric values obtained at the
end of the study. We found that calorie intake in children with poor appetite
unrelated to an organic disease was low in terms of the age of the children,
compatible with the statement of the mother. We concluded that behavioral
modification is effective in treatment, families benefit from practice, and
behavior modification treatment may be beneficial especially when administered
before the age of eight. 

Kaynakça

  • 1. Neyzi O, Ertuğrul T. [Nutrition and Nutrition disorders]. Kurdoğlu G, eds. Pediatri. 3 rd ed. İstanbul: Nobel Tıp Kitabevleri; 2002. p. 166
  • 2. Osborn L, DeWitt T, First L, Zenel J. [Principles of Nutrition]. Williams P, Christensen NK, eds .Pediatri. 1 st ed. Ankara: Güneş Kitabevi; 2007. p. 145-51.
  • 3. Kerzner B. Clinical investigation of feeding difficulties in young children: a practical approach. Clinical pediatrics. 2009;48(9):960-5.
  • 4. Saltık-Temizel İN. [Child with low appetite]. Cocuk sagligi ve hastaliklari dergisi. 2008;51:176-81.
  • 5. Bithoney W. Failure to thrive/growth deficiency. Pediatr Rev. 1992;12:453-60.6. Ünal F. [Clinical Approach to Children With Low Appetite]. The Journal of Current Pediatrics. 2011;1(9):79-84.
  • 7. Lee K, Song Y-M. Parent-reported appetite of a child and the child’s weight status over a 2-year period in Korean children. Journal of the American Dietetic Association. 2007;107(4):678-80.
  • 8. WHO/FAO/UNU. Expert Consultation : Human energy requirments. Rome; 2004;28.
  • 9. Saarilehto S, Lapinleimu H, Keskinen S, Helenius H, Talvia S, Simell O. Growth, energy intake, and meal pattern in five-year-old children considered as poor eaters. The Journal of pediatrics. 2004;144(3):363-7.
  • 10. Lindberg L, Östberg M, Isacson IM, Dannaeus M. Feeding disorders related to nutrition. Acta Paediatrica. 2006;95(4):425-9.
  • 11. Ünlü G, Aras Ş, Güvenir T, Büyükgebiz B, Bekem Ö. Family Functioning, Personality Disorders, and Depressive and Anxiety Symptoms in the Mothers of Children with Food Refusal]. Turk psikiyatri dergisi. 2006; 17(1):12-21
  • 12. Carruth BR, Skinner J, Houck K, Moran III J, Coletta F, Ott D. The phenomenon of “picky eater”: a behavioral marker in eating patterns of toddlers. Journal of the American College of Nutrition. 1998;17(2):180-6.13. Parental strategies for influencing the diet of their children - A qualitative study from disadvantaged areas. Norman Å, Nyberg G, Elinder LS, Berlin A. Appetite. 2018 Jun 1;125:502-511
  • 14. Sadock BJ, Sadock VA. Kaplan and Sadock's Comprehensive Textbook of Psychiatry. 8 th ed. Ankara: Güneş Kitabevi; 2007. p. 3217-27.
  • 15. Sweetman C, Wardle J, Cooke L. Soft drinks and'desire to drink'in preschoolers. International Journal of Behavioral Nutrition and Physical Activity. 2008;5(1):60.
  • 16. Wardle J, Guthrie CA, Sanderson S, Rapoport L. Development of the children's eating behaviour questionnaire. The Journal of Child Psychology and Psychiatry and Allied Disciplines. 2001;42(7):963-70.
  • 17. Wright CM, Parkinson KN, Shipton D, Drewett RF. How do toddler eating problems relate to their eating behavior, food preferences, and growth? Pediatrics. 2007;120(4):e1069-e75.
  • 18. Byrne LK, Cook KE, Skouteris H, Do M. Parental status and childhood obesity in Australia. Pediatric Obesity. 2011;6(5‐6):415-8.
  • 19. Ford C, Ward D, White M. Television viewing associated with adverse dietary outcomes in children ages 2–6. obesity reviews. 2012;13(12):1139-47.20.
  • 20. Kerr MA, McCrorie TA, Rennie KL, Wallace JM, Livingstone MBE. Snacking patterns according to location among Northern Ireland children. Pediatric Obesity. 2010;5(3):243-9.
  • 21. Yu D, Zhang B, Zhao L, Wang H. Snacks consumption in Chinese children and adolescents at theages of 3-17 years. Weisheng yan jiu=Journal of hygiene research. 2008;37(6):710-3.22. Systematic Review of Tools and Methods to Measure Appetite in Undernourished Children in the Context of Low- and Middle-Income Countries. Ickes SB, Hossain M, Ritter G, Lazarus M, Reynolds K, Nahar B, Ahmed T, Walson J, Denno DM. Adv Nutr. 2018 Nov 1;9(6):789-812
Toplam 19 adet kaynakça vardır.

Ayrıntılar

Birincil Dil Türkçe
Konular Sağlık Kurumları Yönetimi
Bölüm ORİJİNAL MAKALELER / ORIGINAL ARTICLES
Yazarlar

Selma Çetin Bu kişi benim 0000-0001-7823-4112

Emine Esin Yalınbaş 0000-0002-3944-7972

Saime Ergen Dibeklioğlu 0000-0003-2412-8837

Yayımlanma Tarihi 1 Ocak 2020
Yayımlandığı Sayı Yıl 2020 Cilt: 42 Sayı: 1

Kaynak Göster

Vancouver Çetin S, Yalınbaş EE, Ergen Dibeklioğlu S. İştahsızlıkta Davranış Değişikliği Tedavisi ve Etkinliği. Osmangazi Tıp Dergisi. 2020;42(1):54-60.


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