Quality of Life of Obese Adolescent Students in Technical Institute of Health

Abstract

Summary O Besity is defined as abnormal or excessive fat accumulation that may impair health. Body mass index (BMI) is a simple index of weight-for-height that is commonly used to classify overweight and obesity in adults. It is defined as a person's weight in kilograms divided by the square of his height in meters (kg/m2).The WHO definition is a BMI greater than or equal to 25 is overweight. A BMI greater than or equal to 30 is obesity. BMI provides the most useful population-level measure of overweight and obesity as it is the same for both sexes and for all ages of adults, Both terms mean that a person's weight is higher than what is thought to be healthy for his or her height (Wadden, 2011). According to the Egyptian survey targeted adult men and women aged 15 - 65 years living in rural and urban areas in 10 governorates. Approximately two thirds of Egyptian populations (62.2%) are overweight and out of them one third (31.3%) is obese (WHO, 2012). Aim of the study:- The aim of this study is to assess the quality of life of obese adolescents' students in technical institute of health through:-  Identifying the magnetite of obese students in technical institute of health and its effect on health.  Assessing the students' knowledge about obesity.  Describing the quality of life of obese student in technical institute of health. Research Design:- This study is a descriptive analytic study was used to assess the quality of life of obese students. Setting:- This study was conducted at Technical Institute of health of Cairo (Imbaba) which comprised 12 departments. It is the only Institute that serves the greater Cairo governorate. Enrolled students from all countries due to the diversity of its departments. Sampling: A purposive sample of 180 (7.5%) obese students was selected from a total of 2400 students at academic year 2014- 2015 according to the following criteria. - Unmarried obese students. - Age between 16-19. - Body mass index>35. - Second Division. - Not under nutritional regime system. Technical design: - Tools for data collection Three tools were used for conducted this study.

First tool: A Self-Administered Questionnaire (Appendix I) It was developed by the investigator based on recent related literature and experts, opinion it includes four parts:- Part One: It included questions related to the socio- demographic characteristics regarding student age, sex, residence, family monthly income, parent's job, student self-income, and crowding index. Crowding index was calculated by using the following equation: No. of family members No. of home's rooms Part Two: It included items for assessing student's health history of obesity, eating habits regarding breakfast, snacks and health problems. Part Three: It included items for assessing student's knowledge about food pyramid, factors leading to obesity and related nutritional health problems. The total scores for students were in the form of knowledge multiple choice questions. Total knowledge was divided in to two levels satisfactory & unsatisfactory. For the students' knowledge correct response was scored 1and the incorrect zero. For each part, the scores of the items were summed-up and the total divvied by the number of the items. The student satisfactory if the percent score was 60% or more and unsatisfactory if less than 60%. Part four: It included items assessing student quality of life by using impact of weight on Quality of life. The scale was constructed by Harrington, and Kolotkin, (2010) which contains items related to physical domain, psychosocial domains, as self-esteem, public distress and work performance. Always score 3, usually score 2, and sometimes score 1. low quality of life < 50% and high quality of life > 50%. Second Tool: Physical examination (Appendix II) to asses • Physical body parts from head to toes constructed by Inselet, al. (2011).The physical examination include skin, hair, eyes, ear, teeth, gum, neck, legs, and skeletal posture. physical examination of the back was conducted by investigator through inspection in order to detect any deformities and by palpation of paravertable muscle spasm and joint tenderness over the spine. Regarding spinal motion as for flexion, extension, bending and rotation. • Anthropometric measurements included weight, height, mid arm circumference, mid arm- muscles circumference, skin folds thickness constructed by Fuller and Schaller (2012). • Height: measurement of standing height was done by using a non- stretchable tape for measurement the student stands erect without shoes with weight equally distributed on both feet and heel together and touching the vertical board, while arm hang freely at the side of the trunk, with palm facing the thigh looking straight ahead. • Weight: weight was measured using a bath-room scale. The student was in minimal clothing and without shoes. Standing with weight evenly distributed on both feet.

• BMI: was calculated from the weight and height data according to the following equation: BMI=Weight (kg.) Height (meter) 2 Accordingly, the scale of BMI was divided categories (Dudek, 2011):  BMI: 18- 25= normal weight.  BMI: 25- 30 = overweight.  BMI: > 35 = obesity.  BMI :35 -40= moderate  BMI : >40 = sever obesity BMI greater than 40 morbid obesity • Triceps Skin Fold Thickness: was done as follows: using the student's right arm flexed 90c at elbow, mark midpoint between acromion and olecranon on posterior aspect of arm with arm hanging freely, grasp a fold of skin between thumb and forefinger 1cm above mid-point. Gently pulls fold away from muscle and continue to hold until measurement is completed. Place caliper jaws over skin fold at mid-point mark, apply pressure with thumbs to align lines on caliper, estimate for nearest 1.5mm two to three seconds after applying pressure, take measurement until duplicates agree within 1mm. • Mid –Arm Circumference (MAC): measures skeletal muscle mass. The same procedure of skin fold is followed, but instead of grasping a fold of skin and using calipers, wrap a paper measuring tape around upper arm at midpoint. • Mid –Arm Muscle Circumference (MAMC): (MAMC) estimates skeletal muscle reserves or the amount of lean body mass and is derived from the (TSF) and (MAC) using the following formula: MAMC=MAC(CM) 3.14= in mm (Jarvis, 2010). N.B.T=Triceps S= Skin F=Fold (MAMC) decreases with under nutrition and increase with obesity. The severe muscle wasting of protein-calorie malnutrition is indicated by a MAMC of less than 15.2cm. Tools used for anthropometric measurements taken from lab of institute. Third Tool: Students Record analysis for assessing academic attainment (Appendix III) The scholastic achievement 2014-2015 (cognitive and practical) was recorded from the student's final examination result of the last year. This tool was conducted by the investigator. Accordingly, the scores <50% were recorded as (Poor), 50-80% were recorded as (Average) and scores >80- 100% were recorded as (Excellent). Student with institute absenteeism >30 days/academic year were considered to have irregular institute attendance. A pilot study:- Was applied on 10 of the study sample to test the study tools for applicability of the tools, its clarity, arrangement and the time required to filling. Data obtained from the pilot study was analyzed and accordingly, the study tool was done as the investigator was available in all time for emphasizing necessary explanation and students of a pilot sample included in the study. The main results obtained from study were as follow: