父母健康睡眠信念及知識與學齡期過重及肥胖兒童睡眠型態相關性之探討

Abstract

現今社會中，兒童的睡眠問題已成為公共議題，兒童睡眠不足及睡眠品質差除了影響生長發育，也容易降低學習成效及就學表現，已有多篇研究提及兒童的睡眠問題與肥胖息息相關，且近年來精緻飲食文化的生活型態造就高比例的肥胖兒童。過重及肥胖兒童的父母若缺乏兒童健康睡眠知識，可能容易忽略兒童潛在的睡眠問題。過去研究鮮少探討過重及肥胖兒童的父母，對於兒童睡眠的認知及睡眠知識的瞭解程度，故本研究目的為探討父母的健康睡眠信念及健康睡眠知識與兒童睡眠的相關性，利用問卷瞭解學齡期過重及肥胖兒童的父母，對於兒童健康睡眠的信念及睡眠知識，透過兒童睡眠習慣問卷及活動紀錄腕錶收集兒童的睡眠數據。採橫斷性研究設計於台北市的國小進行收案，共有 90 名 6 至 9 歲過重及肥胖兒童及其家長參與本研究，完成配戴活動紀錄腕錶至少四日，其家長完成父母健康睡眠信念問卷、父母健康睡眠知識問卷、兒童睡眠習慣問卷。 使用 SPSS 25.0 統計軟體進行描述性分析、皮爾森相關、單因子變異數分析、及多元回歸分析後，研究結果發現兒童的身體質量指數與父母健康睡眠信念呈現負相關（rp= -0.21；p<0.05），父母睡眠信念中六成父母認同孩子有充足的睡眠及健康的睡眠習慣，10 題父母睡眠知識中，74.4%答對 6 題以上，但僅一人全數答對。根據父母填寫之問卷結果顯示：父母健康睡眠信念越強，其孩童就寢時間及起床時 間皆越早（rp= -0.34，p<0.01；rp= -0.31，p<0.01）、孩童有睡眠問題的可能性較低（rp= -0.43，p<0.01），父母健康睡眠信念越強及睡眠知識越好，其孩童每週有較多天相同的睡前常規（rp= 0.32，p<0.01；rp= 0.32，p<0.01）。根據活動紀錄腕錶數據顯示：父母的健康睡眠信念越強、孩童也有較早的就寢及起床時間（rp= -0.31，p<0.01；rp= -0.25，p<0.05），但健康睡眠知識與活動紀錄腕錶的兒童睡眠型態無顯著相關。總結本研究結果，建議未來能夠強化過重及肥胖學齡期兒童父母之健康睡眠信念、加強健康睡眠知識，評估並篩查可能有潛在睡眠問題的學齡期過重及肥胖兒童。

Sleep problems in children have become a public health issue in recent years.Insufficient and poor quality of sleep affect not only children’s growth and development,but also reduce their effectiveness of learning and performance at school. Research shows that sleep problems in children are closely related to obesity; furthermore, the culture of processed food in modern lifestyles has resulted in a high prevalence of children with obesity. Parents of children with overweight and obesity who lack the knowledge of children’s healthy sleep may easily overlook their potential sleep problems. Parental awareness and knowledge about healthy sleep in children has seldom been discussed in past research; therefore, this study aimed to investigate the correlation between children’s sleep and parents’ attitudes and knowledge about healthy sleep. Questionnaires were utilized to understand the parents’ attitudes and knowledge about healthy sleep in school-age children with overweight and obesity. Actigraphy was utilized to collect objective sleep data from the children. A cross-sectional study design was employed for this research. A total of 90 overweight and obese children aged six to nine years old were recruited from elementary schools in Taipei City. The children were instructed to wear the actigraphy for a week, and the parents were asked to complete a questionnaire on their own healthy sleep beliefs and healthy sleep knowledge, as well as their children’s sleep habits. SPSS 25.0 was employed to conduct statistical analyses, including descriptive statistics, Pearson's correlation, One way Analysis of Variance (ANOVA) and multiple regression analysis. Results showed a negative correlation between the body mass index (BMI) of children and the healthy sleep belief of the parents (r=-0.21；p<0.05). Sixty percent of the parents agreed that their children had sufficient sleep and healthy sleep habits. On the questionnaires that included ten questions about healthy sleep knowledge,74.4% of parents answered six questions correctly, but only one answered every question correctly. According to the results of the questionnaire, stronger healthy sleep attitudes of the parents were positively correlated with an earlier bedtime and wake time for children (rp = -0.34, p<0.01; rp = -0.31, p<0.01), and a lower likelihood that their children suffer from sleep problems (rp = -0.43, p<0.01). Stronger healthy sleep attitudes and better healthy sleep knowledge among the parents were both also positively correlated with a higher frequency of a consistent bedtime routine every week (rp =0.32, p<0.01; rp =0.32,p<0.01). According to the actigraphy data, stronger healthy sleep attitudes among the parents were positively correlated with an earlier bedtime and wake time (rp =-0.31,p<0.01; rp =-0.25, p<0.05). There was no significant correlation between healthy sleep knowledge and children’s sleep as recorded by actigraphy. In conclusion, finding from our study suggest strengthening healthy sleep beliefs and knowledge of healthy sleep among parents of school-age children with overweight and obesity. Questionnaires should additionally be administered to evaluate and screen out children with potential sleep problems.