A Study to Assess the Emotional and Behavioral
problems among Overweight Children in Selected Schools at Mysuru
Mr. Proshob
Mathew1, Mr. Chandrashekar M2
1IInd
M.Sc Nursing, JSS College of Nursing, Mysore.
2Assistant
Professor, JSS
College of Nursing, Mysore.
*Corresponding Author Email: proshobm@gmail.com
ABSTRACT:
Introduction: Overweight has shown
an increasing trend in most developing countries. Childhood overweight would
impose numerous health-related problems. According to W H O in 2011 more than 40 million children
under the age of five were overweight. The
worldwide prevalence of childhood overweight and obesity increased from 4.2% in
1990 to 6.7% in 2010. Overweight has been hypothesized as a possible result of
psychological symptoms, and psychological symptoms have been hypothesized to be
a result of overweight.
Objective: This study was
conducted to assess the emotional and
behavioral problems among overweight children in selected schools at Mysuru.
Methods: A cross-sectional study was conducted
among 60 overweight school children (aged 6-12 years). Samples were selected by
purposive sampling method. For all students body mass index was measured. The
emotional-behavioral problems were evaluated by interview with checklist that
consists of 44 items for childhood emotional and behavioral problems.
Findings: Total emotional
problems were seen in 16.52%, behavioral problems were seen in 15.11% of the
overweight school children. The distribution of emotional problem seen in
overweight children is low self-esteem 21.48%, lack of confidence 18.73%,
inferiority 17.63%, irritation 15.15%, anger 14.87%, and un-acceptance 12.12%.
The distribution of behavioral problem seen in overweight children is dominance
over others 29.72%, quarrel with others 25.18%, withdrawal 23.42%, avoidance of
food 11.58% and isolation 10.07%. Emotional-behavioral problems had significant
positive correlation with in overweight school children.
Conclusion: Despite the individual
differences between children, yet there are similarities in the most of the
emotional-behavioral problems related to overweight. Overweight prevention may
be a primary preventive step for these problems in children.
KEYWORDS: Overweight, Emotional,
Behavioural, BMI.
INTRODUCTION:
Overweight refers to the state of weighing
more than average for height and body built. The BMI measurement of 95th
percentile will be used to define overweight. Children above this cut off are
very likely to be obese, to be at risk for remaining obese and to be obese as
adults. Children with a BMI between the 85th and 95th
percentile should be considered as risk for overweight.1
Childhood overweight and obesity is likely to
offer serious public health problems in the future, as today's obese children
become adults with a shorter life expectancy than today's adults. Treatment of
overweight and obesity in children is difficult and involves dietary modification,
increased physical activity, and behavior or lifestyle changes for the whole
family.1
Historically, a fat child meant a healthy
child, one who was likely to survive the rigors of under nourishment and
infection. In the past decade, however, excessive fatness has arguably become
the primary childhood health problem in developed nations and to some degree in
other parts of the world. Here we review the scope of the problem and discuss
developments in establishment of cause, prevention, and treatment of obesity.2
Overweight and obesity is one of the most
widespread and major problems affecting children and adolescents and is a
global nutritional concern. An increased prevalence is found in many countries
where the major nutritional disorder previously was malnutrition. An increase
in the prevalence of childhood obesity is associated with potential medical
complications of obesity noted in adolescence and especially in adulthood, like
hypertension, coronary artery disease, diabetes mellitus, dyslipidemia,
cholecystitis, pancreatitis, sleep apnea, and
osteoarthritis.3
Evaluation of overweight in childhood is
important for several reasons. Firstly, it offers the best hope for preventing
obesity and secondly preventing progression of disease which is associated with
many diseases in adulthood.3
NEED FOR THE
STUDY:
According to W H O in 2011 more than 40
million children under the age of five were overweight.4 Global
trends of childhood obesity show huge shifts in recent times. Surveys from 144
countries suggest that 43 million preschool children (35 million in developing
countries) are overweight and obese and 92 million are at risk of overweight. The
worldwide prevalence of childhood overweight and obesity increased from 4.2% in
1990 to 6.7% in 2010. This trend is likely to continue and the prevalence is
expected to reach 9.1%, or 60 million, in 2020. The estimated prevalence of
childhood overweight and obesity in Africa in 2010 was 8.5% and is expected to
reach 12.7% in 2020. The prevalence is lower in Asia (4.9% in 2010) than in
Africa, but the number of affected children (18 million) is higher in Asia. Reports
from various parts of India suggest significant heterogeneity in the
distribution and growth of childhood obesity prevalence rates.5
Schools have more continuous and intensive
contact with children during their first two decades of life than any other
institution. Schools can make a positive impact on children’s health by
promoting physical activity, providing healthy foods, and educating children on
nutrition. Hunger and inadequate nutritional status can interfere with
cognitive functioning and lead to lower academic achievement. Severely
overweight children and adolescents are four times more likely than their
healthy weight peers to report impaired school functioning related to health
issues.6
Psychological or behavioral problems in
childhood have been examined as both causes and effects of overweight. That is,
overweight has been hypothesized as a possible result of psychological
symptoms, and psychological symptoms have been hypothesized to be a result of
overweight. Further evidence for the relationship between overweight and behavioural problems is provided by treatment studies that
have shown decreased levels of psychological and behavioural
problems in children subsequent to treatment for overweight.7
OBJECTIVES OF
THE STUDY:
1.
To assess the BMI
among school children.
2.
To assess the
emotional problems in overweight school children.
3.
To assess the behavioural problems in overweight school children.
4.
To find the
relationship of emotional and behavioural problems of
overweight school children.
5.
To find the
association of emotional and behavioural problems of
overweight school children with their selected personal variables.
HYPOTHESES:
H1: There will be
significant relation between emotional and behavioural
problems of overweight school children.
H2: There will be
significant association between emotional and behavioural
problems of overweight school children with their selected personal variables.
METHODOLOGY:
Research Design: The research design selected for study was
descriptive design.
Sampling
technique: Purposive sampling
technique.
Sample: The sample of the
present study comprised of 60 overweight children of selected schools at Mysuru in the age group of 6-12 years.
VARIABLES:
Dependent variable:
Overweight, emotional
problems, behavioural problems.
Demographic variables:
Age, gender, religion,
type of family, family income, number of sibling, duration of physical
activity, daily television watching time, daily
electronics games time, consumption of fried foods and bicycling.
SETTING:
The present
study was conducted in 60 overweight children in selected Schools of Mysuru city.
DATA
COLLECTION TECHNIQUE:
Section
A- Personal
proforma to assess the sample characteristics.
Section B- Measuring the height and weight to assess the BMI of children
Section
C-
Checklist to assess the selected emotional and behavioural
problems among overweight school children.
RESULTS:
SECTION
I-DESCRIPTION OF SELECTED PERSONAL VARIABLES
TABLE 1-Frequency
and percentage distribution of school children according to their selected
personal variables n=60
|
SL.NO |
SAMPLE CHARAECTERISTICS |
FREQUENCY |
PERCENTAGE (%) |
|
1 |
Age in years |
|
|
|
|
a) 7 -9years |
36 |
60 |
|
|
b) 10-12 years |
24 |
40 |
|
2 |
Gender
|
|
|
|
|
a) Male |
38 |
63.3 |
|
|
b) Female |
22 |
36.7 |
|
3 |
Religion
|
|
|
|
|
a) Hindu |
47 |
78.3 |
|
|
b) Muslim |
9 |
15 |
|
|
c) Christian |
4 |
6.7 |
|
|
d) Others |
|
|
|
4 |
Diet |
|
|
|
|
a. Veg |
42 |
70 |
|
|
b. Mixed |
18 |
30 |
|
5 |
Family type |
|
|
|
|
a. Nuclear |
45 |
75 |
|
|
b. Joint |
15 |
25 |
|
6 |
Monthly
family income in rupees |
|
|
|
|
a) < 5000 |
|
|
|
|
b) 5001-10000 |
|
|
|
|
c) 10001-15000 |
15 |
25 |
|
|
d) >15000 |
45 |
75 |
|
7 |
Number
of siblings |
|
|
|
|
a) Nil |
34 |
56.7 |
|
|
b) 1 |
23 |
38.3 |
|
|
c) 2 |
1 |
1.7 |
|
|
d) 3 or more |
2 |
3.3 |
|
8 |
Duration
of physical activity |
|
|
|
|
a) < 30 minutes |
48 |
80 |
|
|
b) 30-60 minutes |
11 |
18.3 |
|
|
c) >60 minutes |
1 |
1.7 |
|
9 |
Daily
television Watching time |
|
|
|
|
a) <30 minutes |
3 |
5 |
|
|
b) 30-60 minutes |
22 |
36.7 |
|
|
c) >60 minutes |
35 |
58.3 |
|
10 |
Duration
of electronic games play |
|
|
|
|
a) <30 minutes |
2 |
3.3 |
|
|
b) 30-60 minutes |
51 |
85 |
|
|
c) >60 minutes |
7 |
11.7 |
|
11 |
Consumption
of fried foods |
|
|
|
|
a) Daily |
8 |
13.3 |
|
|
b) Once in two days |
38 |
63.3 |
|
|
c) Weekly |
9 |
15 |
|
|
d) Occasionally |
5 |
8.3 |
|
12 |
Bicycling |
|
|
|
|
d) <30 minutes |
45 |
75 |
|
|
e) 30-60 minutes |
15 |
25 |
|
|
f) >60 minutes |
|
|
SECTION 2-EMOTIONAL AND BEHAVIORAL
PROBLEMS AMONG OVERWEIGHT SCHOOL CHILDREN.
a.
Description of
emotional problem among overweight school children.
TABLE-2-Frequency and percentage distribution of emotional problem
scores of overweight school children.
|
Level
of emotional problem |
f |
Percentage
(%) |
|
Mild
emotional problem |
54 |
90% |
|
Moderate emotional problem |
06 |
10% |
|
Severe emotional problem |
0 |
0% |
b.
Description of behavioural problem among overweight school children.
TABLE
3-Frequency and
percentage distribution of behavioral problem scores of overweight school
children.
|
Level
of behavioral problem |
f |
Percentage
(%) |
|
Mild
behavioral problem |
54 |
90% |
|
Moderate behavioral problem |
06 |
10% |
|
Severe behavioral problem |
0 |
0% |
c.
Mean, median, range and standard deviation of aspect wise emotional
problems of overweight children
Table 4-Mean, median, range and standard deviation of aspect wise emotional
problems of overweight school children n=60
|
Sl.no |
Emotional problems |
Mean |
Median |
Range |
Standard Deviation |
|
1.
|
Anger |
1.31 |
1 |
0-3 |
±0.515 |
|
2.
|
Inferiority |
1.48 |
1 |
0-4 |
±0.727 |
|
3.
|
Irritation |
1.30 |
1 |
0-4 |
±0.672 |
|
4.
|
Lack of confidence |
1.44 |
1 |
0-3 |
±0.612 |
|
5.
|
Low self esteem |
1.52 |
1 |
0-3 |
±0.696 |
|
6.
|
Un-acceptance |
1.22 |
1 |
0-3 |
±0.477 |
|
|
Combined |
8.27 |
6 |
2-15 |
±3.699 |
d.
Mean, median, range and standard deviation of aspect wise behavioural
problems of overweight school children
Table 5-Mean, median, range and standard deviation of
aspect wise behavioural problems of overweight school children n=60
|
Sl.no |
Behavioural problems |
Mean |
Median |
Range |
Standard deviation |
|
1.
|
Avoidance of food |
1.39 |
1 |
0-3 |
±0.539 |
|
2.
|
Dominance over others |
2.07 |
2 |
0-4 |
±0.952 |
|
3.
|
Isolation |
1.75 |
2 |
0-4 |
±0.843 |
|
4.
|
Quarrel with others |
1.33 |
1 |
0-3 |
±0.528 |
|
5.
|
Withdrawal |
1.60 |
1 |
0-3 |
±0.693 |
|
|
Combined |
8.14 |
7 |
2-13 |
±3.555 |
SECTION 3
RELATIONSHIP BETWEEN EMOTIONAL AND BEHAVIOURAL PROBLEMS OF OVERWEIGHT
SCHOOL CHILDREN.
Significance of correlation between emotional and behavioural
problems among overweight school children.
TABLE 6-Correlation between emotional and behavioural
problem among overweight school children. n=60
|
Variable |
Mean score |
r |
|
Emotional
problem Behavioural problem |
8.27 8.14 |
0.327* |
r(58) = 0.263; p < 0.05; * = Significant
SECTION 4- FINDING
RELATED TO ASSOCIATION OF EMOTIONAL AND BEHAVIOURAL PROBLEM IN OVERWEIGHT
SCHOOL CHILDREN WITH THEIR SELECTED PERSONAL VARIABLES
a.
Association of emotional
problems of overweight school children with their selected personal variables.
TABLE 7- Association between the emotional problems of overweight school children with their selected
personal variables. n=60
|
Sl. No |
Sample characteristics |
Below median |
Median and above median |
Chi-square |
|
1 |
Age in years |
|
|
|
|
|
1.1
7-9 years |
11 |
25 |
1.447
|
|
|
1.2 10-12 years |
11 |
13 |
|
|
2 |
Gender |
|
|
|
|
|
1.1.
Male |
12 |
26 |
1.155
|
|
|
1.2.
Female |
10 |
12 |
|
|
3 |
Religion |
|
|
|
|
|
1.1.
Hindu |
18 |
29 |
0.249# |
|
|
1.2.
Others |
04 |
09 |
|
|
4 |
Diet |
|
|
|
|
|
4.1.
Veg |
18 |
24 |
2.310# |
|
|
4.2.
Mixed |
04 |
04 |
|
|
5 |
Family type |
|
|
|
|
|
5.1.
Nuclear |
15 |
30 |
0.861
|
|
|
5.2.
Joint |
07 |
08 |
|
|
6 |
Monthly family income in
rupees |
|
|
|
|
|
6.1.
< 15,000 |
06 |
09 |
0.96
|
|
|
6.2.
> 15,000 |
16 |
29 |
|
|
7 |
Number of siblings |
|
|
|
|
|
7.1.
Nil |
11 |
23 |
0.629
|
|
|
7.2.
One and above |
11 |
15 |
|
|
8 |
Duration of physical
activity |
|
|
|
|
|
8.1.
< 30 minutes |
17 |
31 |
0.161
|
|
|
8.2.
> 30 minutes |
05 |
07 |
|
|
9 |
Daily television Watching time |
|
|
|
|
|
9.2.
< 30 minutes |
01 |
02 |
0.015# |
|
|
9.2.
> 30 minutes |
21 |
36 |
|
|
10 |
Daily electronic games
play time |
|
|
|
|
|
10.1.<30 minutes |
01 |
01 |
0.158# |
|
|
10.2.>30 minutes |
21 |
37 |
|
|
11 |
Consumption of fried
foods |
|
|
|
|
|
11.1. Daily |
02 |
06 |
0.541# |
|
|
11.2.Not daily |
20 |
32 |
|
|
12 |
Bicycling |
|
|
|
|
|
12.1.< 30 minutes |
15 |
30 |
0.861
|
|
|
12.2. >30 minutes |
07 |
08 |
|
χ2 (1) = 3.84, (p>0.05), # =Yates
correction done.
The data presented
in Table 7 shows that the no personal variables of overweight school children is associated with emotional
problems at 0.05 level of signifance.
b.
Association of behavioural problems of overweight school children with
their selected personal variables.
TABLE 8-Association between the behavioural problems of overweight
school children with their selected personal variables. n=60
|
Sl.
No |
Sample
characteristic |
Below
median |
Median
and above median |
Chi-square |
|
1 |
Age
in years |
|
|
|
|
|
1.1.
7-9 years |
19 |
17 |
2.222
|
|
|
1.2.
10-12 years |
08 |
16 |
|
|
2 |
Gender |
|
|
|
|
|
1.1.
Male |
12 |
26 |
7.542*
|
|
|
1.2.
Female |
15 |
07 |
|
|
3 |
Religion |
|
|
|
|
|
1.1.
Hindu |
23 |
24 |
1.358# |
|
|
1.2.
Others |
04 |
09 |
|
|
4 |
Diet |
|
|
|
|
|
4.1.
Veg |
20 |
22 |
0.388
|
|
|
4.2.
Mixed |
07 |
11 |
|
|
5 |
Family type |
|
|
|
|
|
1.3.
Nuclear |
22 |
23 |
1.100
|
|
|
1.4.
Joint |
05 |
10 |
|
|
6 |
Monthly family income in rupees |
|
|
|
|
|
6.1.
< 15,000 |
06 |
09 |
2.202# |
|
|
6.2.
> 15,000 |
21 |
24 |
|
|
7 |
Number of siblings |
|
|
|
|
|
7.1.
Nil |
15 |
19 |
0.25
|
|
|
7.2.
One and above |
12 |
14 |
|
|
8 |
Duration of physical activity |
|
|
|
|
|
8.1.
< 30 minutes |
22 |
26 |
0.067 |
|
|
8.2.
> 30 minutes |
05 |
07 |
|
|
9 |
Daily
television Watching time |
|
|
|
|
|
9.1.
< 30 minutes |
01 |
02 |
0.174# |
|
|
9.2.
> 30 minutes |
26 |
31 |
|
|
10 |
Daily electronic games play time |
|
|
|
|
|
10.1
<30 minutes |
01 |
01 |
1.693
|
|
|
10.2.>30-minutes |
27 |
31 |
|
|
11 |
Consumption of fried foods |
|
|
|
|
|
11.1. Daily |
02 |
06 |
0.541# |
|
|
11.2. Not daily |
20 |
32 |
|
|
12 |
Bicycling |
|
|
|
|
|
12.1
. < 30 minutes |
15 |
30 |
0.861
|
|
|
12.2.
> 30 minutes |
07 |
08 |
|
χ2 (1) = 3.84, p>0.05,p<0.05, #
=Yates correction done, * - Significant
The data presented
in Table 8 shows that the personal variable gender
of overweight school children is associated with behavioural problems at 0.05 level of significance.
CONCLUSION:
The findings of the study revealed that, emotional problems
were seen in 16.52%, behavioral problems were seen in 15.11% of the overweight
school children. The distribution of emotional problem seen in overweight
children is low self-esteem 21.48%, lack of confidence 18.73%, inferiority
17.63%, irritation 15.15%, anger 14.87%, and un-acceptance 12.12%. The
distribution of behavioral problem seen in overweight children is dominance
over others 29.72%, quarrel with others 25.18%, withdrawal 23.42%, avoidance of
food 11.58% and isolation 10.07%. Emotional-behavioral problems had significant
positive correlation with in overweight school children.
The results of the study also showed that no
personal variable had significant association with emotional problems of
overweight school children, were as gender had a significant association with
behavioural problems of overweight school children.
Thus,
it was concluded that, though there is mild emotional and behavioural problems
among overweight school children. Hence there is a need to sensitise and alert
them regarding overweight and its effects and thus the hazards of overweight
can be prevented thereby enabling them to be a fruitful citizenry.
RECOMMENDATIONS:
1.
Similar study can be carried out on a larger
sample for broader generalization.
2.
Similar study can be carried out to assess
the physical problems of overweight children.
3.
The similar study can be done to assess the
correlation of emotional and behavioural problems of
obese and overweight children.
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Received on 20.05.2015 Modified
on 21.06.2015
Accepted on 26.06.2015
© A&V Publication all right reserved
Asian J. Nur. Edu. and Research 5(4): Oct.-
Dec.2015; Page 451-456
DOI: 10.5958/2349-2996.2015.00092.0