Wybrane aspekty funkcjonowania współczesnego człowieka w obszarze zdrowia i choroby

We współczesnej literaturze powszechnie podkreśla się zmiany w charakterze chorób oraz przyczynach zgonów, jakie dokonały się na przestrzeni ostatnich kilkudziesięciu lat. O ile w 1900 roku ludzie umierali głównie z powodu grypy i zapalenia płuc, gruźlicy i ostrych nieżytów przewodu pokarmowego, to współcześnie ludzie tracą życie przede wszystkim na skutek chorób serca, nowotworów oraz różnego rodzaju wypadków. Część chorób daje od samego początku wyraźne objawy, lecz inne rozwijają się bezobjawowo (jak choćby nadciśnienie tętnicze). Zmianie uległy również uciążliwości dnia powszedniego. Bywa, że normą staje się to, co bywało patologiczne, zaś za patologię uznaje się zjawiska fizjologiczne, traktowane dotąd jako norma. Ludzie coraz częściej poddają się diagnostyce i jednocześnie coraz więcej jednostek chorobowych ujmuje się w nowych klasyfikacjach diagnostycznych. […

Mama-komputer i tata-telewizor jako potencjalne źródła zaburzeń w funkcjonowaniu somatycznym i społecznym dzieci

Jak wcześniej wspomniano, powyższe wyniki nie mają stricte charakteru badań naukowych i stanowią niejako „odkrycie przypadkowe”, towarzyszące konsultacjom psychologicznym. W przyszłości warto przeprowadzić badania silnie osadzone w rygorach metodologicznych, które pozwolą głębiej poznać obserwowane zjawisko oraz jego uwarunkowania. Niewątpliwie jednak uzyskane wyniki już na tym etapie pozwalają dostrzec, że długi czas spędzany przed telewizorem i komputerem od najmłodszych lat może sprzyjać występowaniu nieprawidłowych zachowań, objawów somatycznych oraz psychosomatycznych u dzieci. Niepokojący jest fakt, iż dzieci coraz częściej wybierają niekorzystny styl życia: samotność i stagnację ruchową, izolując się od bliskich i rówieśników i przenosząc się do świata wirtualnego. Narasta u nich bezkrytycyzm w wyborze zajęć i jednostronny wybór najłatwiejszych opcji w zachowaniu. Obcowanie z telewizorem i komputerem ma oczywiście wiele zalet i celem niniejszego artykułu absolutnie nie jest ich negowanie. Trudno wyobrazić sobie współczesnego człowieka nieoglądającego telewizji czy też nieznającego wynalazku, jakim jest komputer. Już dzieci w wieku przedszkolnym czy wczesnoszkolnym poszukują informacji w świecie wirtualnym, nawiązują internetowe znajomości, posługują się możliwościami, jakie dają im komunikatory, i doskonale wiedzą, w jaki sposób skontaktować się z najbliższymi przebywającymi obecnie na drugim końcu świata. Jak pokazują liczne badania, nasze życie powoli przenosi się do świata wirtualnego: chętnie płacimy rachunki przez Internet, dokonujemy zakupów w Sieci czy wręcz leczymy się online. Nie można jednak zapominać, że zastąpienie naturalnego życia społecznego życiem wirtualnym, zwłaszcza w przypadku dzieci, ma swoje negatywne konsekwencje. Ani telewizor, ani komputer nie powinny zastępować dzieciom zabawy z rówieśnikami czy z rodzeństwem, wzajemnych kontaktów w rodzinie i nie powinny stać się podstawową formą spędzania wolnego czasu. Z drugiej strony nie sposób oczywiście pominąć roli, jaką telewizor i komputer mogą pełnić w życiu dzieci niepełnosprawnych, stając się formą komunikacji i stymulując ich rozwój. Do funkcji, jaką pełni telewizja, zalicza się w literaturze funkcję wychowawczo‑poznawczą, informacyjną, rozrywkowo-odpoczynkową, ale i kompensacyjną, podkreślając, iż zastępuje ona często inne formy aktywności oraz kontakty społeczne, wpływając na organizację dnia, na zdrowie fizyczne i psychiczne oraz na wybór określonych zachowań. Na zakończenie warto przypomnieć jedną, powszechnie znaną prawdę: dzieci nie są zminiaturyzowanymi dorosłymi. Mają inne potrzeby, mniejszą dojrzałość emocjonalną, społeczną i uboższe doświadczenia. Zaburzenia emocjonalne związane z nieprawidłowym funkcjonowaniem systemu rodzinnego, z brakiem wsparcia i właściwej opieki otrzymywanej od najbliższych mogą mieć u nich poważniejsze konsekwencje niż u osób dorosłych, zaburzając rozwój w różnych jego sferach. W psychopatologii rozwojowej rodzinę traktuje się jako podstawowy i najważniejszy kontekst rozwoju dziecka. Postawy wychowawcze, relacje rodzinne, a przede wszystkim zainteresowanie i czas poświęcony dziecku wpływają na jego funkcjonowanie nie tylko w dzieciństwie, ale i w późniejszym życiu. Dlatego tak ważne jest umiejętne gospodarowanie zasobami rodzinnymi, by wśród codziennych obowiązków i problemów odnaleźć czas dla najbliższych. Aby matką pozostała matka, a nie komputer, a roli ojca nie przejął telewizor

Strategie radzenia sobie rodziców chorych dzieci z ograniczonym dostępem do świadczeń medycznych

The article raises the issue of problem managing by parents of ill children with a limited access to medical services, connected with an organizational-legal situation of Polish health service nowadays. Empirical studies, conducted on the group of 250 parents allowed for defining the nature of the preventive strategies used, their conditioning and mutual relations. The results show that the biggest restrictions for parents are connected with the lack of centralized medical services in one place, waiting too long for services and high prices of medicaments. Parents blame doctors and centres in which their child is treated for taking medical decisions most often. In order to overcome restrictions they most frequently turn to the doctor when the first illness symptoms appear or, on the contrary, postpone it till the condition of a child gets worse substantially. What is common is treating children on one’s own, though parents admit that they seldom make use of professional sources of information. They often look for support among their relatives. The majority of parents feel a strong sense of anger, evoked by an inappropriate functioning of health service in their opinion. Functioning in the so-called “Polish culture of complaining” on a daily basis, facilitates the expression of negative opinions, but also allows for obtaining and deepening social bonds supporting negative emotions. Despite a publicized phenomenon of the existence of a “grey area” in health service, the majority of parents clearly objected to giving bribes to doctors and nurses, admitting, at the same time, that they look for people who can accelerate medical services willingly. In spite of difficulties in obtaining medical services, a low inclination to resign from and small readiness to make complaints was observed

Family system characteristics from the obese child and parent perspective – a pilot study

Objective: The aim of the study was to assess family system functioning in obese children from the perspective of child and parent. Material and methods: Forty-six dyads (child-parent) were included into the study. Children group comprises of 48% boys and 52% girls, aged 11-18 years (13.0 ± 1.9 years), with simple obesity (BMI > 97 percentile, BMI z-score 2.1 ± 0.3). In parents’ group, 87% mothers and 13% fathers were examined. The weight and height were measured, BMI, and BMI z-score were calculated, and Polish version of Family Adaptability and Cohesion Evaluation Scales by D. Olson was performed in all dyads. In parents, a questionnaire formulated for the research was applied. Results: Only parents of 2 (7%) children had BMI within the normal range. According to the information given in the questionnaire, problems with weight in the family were declared by significantly less parents: 22 (48%). In parent’s opinion, low physical activity (87%) and inappropriate diet (87%) were the most common reasons for obesity, whereas psychological problems (65%) and poor physical fitness (65%) were the most its common consequences. The most effective therapeutic factors were to comply with diet (87%), increase physical activity (72%), and change of lifestyle of the child (65%). The families were assessed as balanced according to 57% of children and 30% of parents (p = 0.01). Also, cohesion index and main index were significantly higher in children’s perception then parents’ (p = 0.02, p = 0.004). Conclusions: Most of parents, in majority also obese, underline the need of change only in child’s functioning; they do not see the need to change of their own habits and deny the presence of obesity in the family. Moreover, parents perceived cohesion in their families lower than children. Our observation confirms that obesogenic family with some aberration in its functioning could lead to many difficulties in treatment of obesity

Depression, anxiety and self-esteem in adolescent girls with polycystic ovary syndrome

Objectives: Objective of the study was to evaluate the depression, anxiety and perceived stress level in adolescent girls with diagnosed polycystic ovary syndrome (PCOS), as well as to assess their body and self-esteem and its impact on emotional status. Material and methods: In 27 adolescent girls with confirmed diagnosis of PCOS (study group) as well as 27 healthy, regularly menstruating, age and BMI matched girls (control group) Hospital Anxiety and Depression Scale (HADS), Perceived Stress Scale-10 (PSS-10), Rosenberg Self-Esteem Scale (RSES) and Body-Esteem Scale (BES) containing three subscales (sexual attractiveness, weight concern, physical condition) were performed. Results: There were no significant differences between PCOS group and control group in depression and PSS-10 scores, but the anxiety score was significantly higher in control than in PCOS group (9.6 ± 3.0 vs 7.3 ± 3.9, p = 0.02). Moreover, in BES subscales’ scores there were no significant differences between the groups, whereas RSES score was significantly higher in PCOS group (25.0 ± 7.1 vs 28.3 ± 4.6, p = 0.04). In PCOS group anxiety score was related to PSS-10 score (r = 0.56, p = 0.005). Moreover, we found that obesity was negatively related to anxiety (rƴ = –0.4, p = 0.04), depression (rƴ = –0.48, p = 0.02), PSS-10 (rƴ = –0.59, p = 0.004) and physical condition scores (rƴ = –0.44, p = 0.04). In girls with PCOS the more severe depression the worse weight control (rƴ = –0.56, p = 0.04). Conclusions: We conclude that in adolescent girls PCOS is not related to anxiety and depressive symptoms as well as poor self-esteem

Are Psychosocial Consequences of Obesity and Hyperandrogenism Present in Adolescent Girls with Polycystic Ovary Syndrome?

The objective of this study was to evaluate whether body weight status and clinical hyperandrogenism may influence social competencies and psychological gender features in adolescent girls. Design and Participants. In 104 adolescent girls, psychological gender inventory (PGI) and social competencies questionnaire (SCQ) (assessing social abilities in three aspects: intimacy (I), social exposure (SE), and assertiveness (AS)) were performed. Subjects were divided into four subgroups: G1—24 nonobese girls without hyperandrogenism, G2—18 obese girls without hyperandrogenism, G3—30 nonobese hyperandrogenic girls, and G4—32 obese girls with hyperandrogenism. Results. There were no significant differences in all parts of SCQ and PGI between the study and control groups. The feminine woman type dominated in all groups; in G3 and G4, masculine woman type appeared more often than in G1 and G2 (13.3% and 12.5% versus 4.0% and 0.0%, resp.). In G4, positive relationship between BMI z-score and SCQ (, ) was found. In G1, the relationship was opposite (, ). Hirsutism correlated negatively with SCQ (, ), I (, ), and AS (, ) only in G1; in other groups, this relationship was insignificant. In G4, higher testosterone level was associated with lower SCQ (, ) and AS (, ). In G2, testosterone concentration correlated positively with SCQ (, ), SE (, ), and AS (, ). Conclusion. In adolescent girls, neither body weight nor clinical features of hyperandrogenism seem to be the source of evaluated disorders in psychological functioning

Different Eating Habits Are Observed in Overweight and Obese Children Than in Normal-Weight Peers

Background: Obesity is diagnosed in 13.6% of early primary school children in Poland. Its presence at this age increases the risk of obesity occurrence in adulthood. Therefore, it is important to properly shape eating behaviors at the stage of childhood and identify incorrect eating styles. Methods: This study aimed to investigate whether overweight and obese children differ significantly from children with normal body weights in terms of their eating styles. For the materials and methods, 43 mothers of overweight or obese children aged 3–10 years and 88 mothers of normal-weight children aged 3–10 years completed a questionnaire related to sociodemographic factors and the Children’s Eating Behaviour Questionnaire. Results: The overweight and obese children, compared with normal-weight children, scored higher on the food responsiveness (p = 0.009) and emotional overeating (p = 0.013) scales and lower on the satiety responsiveness (p = 0.025) and slowness in eating scales (p < 0.0001). No significant difference was found for other subscales between the studied groups. In the group of overweight and obese children, the child’s age correlated negatively with enjoyment of food, as did the mother’s BMI with slowness in eating. Conclusions: The results indicate the presence of significant differences in eating styles between normal-weight children and overweight or obese children. Identifying families at high risk of inappropriate eating behaviors and educating them appropriately can reduce the risk of children becoming overweight or obese

Validation of the Children’s Eating Behaviour Questionnaire in Poland

Introduction: Obesity is increasingly diagnosed in pre-school and early primary school children. Eating styles displayed by the youngest children may contribute to the development of overweight and obesity. Their assessment may be extremely important in diagnosing the causes of obesity, but also in planning treatment. Aim of the study: In view of the need to introduce a tool for assessing eating behaviours in children in Poland, the aim of the study was to develop the Polish adaptation of the Children’s Eating Behaviour Questionnaire (CEBQ). Material and methods: The study group consisted of 151 mothers of children aged 3–10 years (M = 6.77, SD = 2.34), who completed the Polish version of the CEBQ. In order to assess the validity of the questionnaire, a factor analysis was conducted, using the principal components method with the Oblimin rotation and Kaiser normalization. To assess the reliability of the questionnaire, its internal consistency was checked by calculating Cronbach’s alpha consistency coefficient. The external validity of the CEBQ was also checked by correlating its scales with those of the Temperament Questionnaire (EAS-C). Results: The principal components analysis extracted an eight-factor scale from the 35 items of the questionnaire in which a total of 60.57% of the common variance was explained. The validity of such an eight-factor solution was confirmed by the Kaiser method. Satisfactorily high values of Cronbach’s alpha internal consistency coefficient were obtained (0.78). Positive correlations were found between emotionality and emotional undereating and overeating, between shyness and fussiness and negative correlations between activity and slowness in eating, sociability and fussiness and slowness in eating and between shyness and enjoyment of food. Conclusions: The Polish version of the CEBQ is characterized by the acceptable validity and reliability and has a satisfactory criterion accuracy; therefore, it can be used as a psychometric tool to assess eating behaviours in Polish children

Adult attachment styles and mothers’ life satisfaction in relation to eating behaviors in the families with overweight and obese children

Family plays a significant role in shaping children’s eating behaviors. The aim of the study was to assess whether mothers’ attachment style, their life satisfaction and their own body weight can be associated with family eating behaviors. The results from 52 dyads (mothers/ children) covered by the Metabolic Disease Clinic were analyzed. A targeted sample selection was used, taking into account the weight (overweight/obesity) and age (11 years) criteria of the child. The results have shown that the mother’s body weight is a significant determinant of her child’s body weight. The anxiety-ambivalent attachment style in mothers is a significant predictor of behaviors aimed at regulating and controlling affective states by food. A decrease in the knowledge of nutrition is associated with an increase in the level of anxiety-ambivalent and avoidant style. The avoidant attachment style is significantly associated with the nutrition organisation and control. Dysfunctional eating behaviors predominate among mothers with a lower level of life satisfaction. The lower the level of life satisfaction, the greater the tendency to regulate affective states and family relationships through nutrition, and to manifest improper organisation of nutrition. Mothers with obesity, compared to mothers with overweight and with normal body weight show a higher level of regulating emotions through food, improper organisation of nutrition and lower control in this area. The research results indicateshow significant relationships between insecure attachment styles, life satisfaction, and the mother’s weight with eating behaviors unfavorable to health. It is therefore necessary to include family factors in the process of creating effective intervention strategies