Analyzed The Status And Influencing Factors Of Self-Regulation Of Eating In Preschool Children With Asthma Based On The Empowerment Theory

Objectives1.To form the Chinese version of Self-Regulation of Eating Questionnaire and test the reliability and validity of the Self-Regulation of Eating Questionnaire in preschool children;2.To compare the differences between the Self-Regulation of Eating of children with asthma and that of normal children,describe the current situation and characteristics of the eating self-regulation ability of preschool children with asthma,and analyze the influencing factors of the eating self-regulation ability of preschool children with asthma based on the empowerment theory.Methods1.Form the Chinese version of Self-Regulation of Eating Questionnaire:After obtaining the authorization of the questionnaire from the original author,the Chinese version of the selfregulation of eating questionnaire was formed after the translation,back translation,crosscultural debugging and pre-survey(Caregivers of 30 preschoolers)of the English version.Using convenient cluster sampling,the researchers conducted a cross-sectional survey among 553 preschool children from 2 kindergartens in rural and urban areas of Yizheng City in December 2021.The survey instrument was the preschool children’s eating behavior questionnaire designed by the research group,including the general information questionnaire,the Children’s Self-regulation of Eating questionnaire,and the Children’s Eating Behavior Questionnaire.The data were analyzed using SPSS 26.0 and AMOS 26.0,and the critical ratio method and total question correlation method were used to analyze the questionnaire items;the content validity,structural validity,and correlation validity were all assessed.The validity criteria were used to assess the questionnaire’s validity and internal consistency.The questionnaire’s reliability was evaluated using reliability,retest reliability,and fold-half reliability.To compare the eating self-regulation ability of preschool children under different conditions,the independent sample t-test and one-way ANOVA were used.2.Analysis of the current situation and influencing factors of self-regulation of eating in pre-school children:From December 2021 to May 2022,a simple random sampling method was adopted to select 3～6 years old preschool children with asthma and their primary caregivers from the pediatric outpatient department of 2 tertiary care hospitals in Yangzhou City as the asthma group.From December 2021 to January 2022,one public kindergarten in the county and one public kindergarten in the countryside were selected by convenient cluster sampling method in Yangzhou City,and preschool children aged 3～6 and their main caregivers were selected as the control group.The survey instrument was self-designed"Preschool Children’s Eating Behavior Questionnaire",which consisted of general information questionnaire,Children’s Self-regulation of Eating Questionnaire,Parent-Child Relationship Questionnaire,Parental Feeding Style Questionnaire and Caregiver Feeding Questionnaire.The PSM 1:1 closest matching method was used.The group of children with asthma was used as the base group to match cases with healthy controls,and the follow-up study was conducted after balancing the general demographic characteristics between the two groups.Statistical analysis was performed using SPSS 26.0 software to explore the current status and influencing factors of eating self-regulation in preschool asthmatic children.Statistical methods included:descriptive analysis,independent sample t-test,one-way ANOVA,correlation analysis,and multiple stepwise linear regression.Results1.The Chinese version of SREQ questionnaire consisted of 9 items,and the critical ratio CR of each item met the discriminant criteria(CR>3,P<0.05).The content validity index(ICVI)at the item level ranged from 0.833 to 1.000,and the average content validity index(SCVI/Ave)at the scale level was 0.983.Two common factors were extracted by exploratory factor analysis,and the cumulative variance contribution rate was 52.170%.Confirmatory factor analysis showed that the two-factor model fit well.The questionnaire’s overall Cronbach’α coefficient was 0.759,and the Cronbach’α coefficients of the two dimensions were 0.675 and 0.755,respectively.The half-point reliability was 0.701,and the retest reliability was 0.756.Part of the questionnaire adopts Likert 5-level scoring method,the options are from "never" to "always",and the score is 1～5 points.For the remaining items,parents will select the answers from the three options,the score is 1-3 points.The higher the score,the higher the level of eating in the absence of hunger,and the worse the compensatory eating ability,that is,the worse the self-regulation ability of eating.2.In this part of the study,109 asthmatic cases and 109 healthy controls were matched as case group and control group for follow-up study.The results showed that the score of selfregulation ability of eating in preschool asthmatic children reported by asthma group was higher than that of normal children(26.50±5.46 vs 25.15±4.35).In addition,there were statistically significant differences in the total score of self-regulation of children eating and the dimension of eating compensation(P<0.05).Independent samples t-test,one-way ANOVA revealed significant differences in eating self-regulation scores on parenting style,child food allergy(P<0.05);self-control(r=-0.413)was significantly negatively associated with eating self-regulation scores,and child involvement in eating scores(r=0.182),parentchild conflict scores(r=0.294)and parent-child intimacy scores(r=0.274)were significantly positively correlated with eating self-regulation scores.Multiple stepwise linear regression showed that:child autonomy control,child involvement in eating,parenting style and parentchild intimacy were the factors influencing eating self-regulation ability of preschool asthmatic children.Conclusions1.The results showed that the Chinese version of the Eating Self-Regulation Questionnaire has good reliability and validity among preschool children and can be used as a tool to assess the eating self-regulation ability of preschool children in China.Future studies can be extended to other age groups and conducted in multiple regions and centers to determine the current status of children’s eating self-regulation and to further test the applicability of the questionnaire.2.In this study,we explored the differences in eating self-regulation ability between preschool asthmatic children and normal children through PSM,and found that child autonomy control,child participation in eating,parental feeding style and parent-child relationship were the influencing factors of eating self-regulation ability in preschool asthmatic children.The above results suggest that we can combine the predictor variables with child empowerment theory in the future to encourage children to learn to choose food and plan the subjectivity and initiative of their own eating behavior in a child-centered manner;parents should take the initiative to create a healthy home food environment for children,provide appropriate dietary guidance and respect children’s choices and needs to increase their eating self-regulation ability and promote their long-term health.