青少年留守状态与健康危险行为的关联性

汪宬琛; 侯皓; 戴星宇; 杨冰香; 周洋

doi:10.16835/j.cnki.1000-9817.2025297

青少年留守状态与健康危险行为的关联性

doi: 10.16835/j.cnki.1000-9817.2025297

汪宬琛^{1, 2},
侯皓^{3, 4},
戴星宇³,
杨冰香^{3, 4},
周洋^{1, 2, ,}

1.
武汉市精神卫生中心精神科，湖北 430012
2.
武汉市心理医院精神科，湖北 430012
3.
武汉大学护理学院精神心理智慧护理研究中心，湖北 430012
4.
武汉大学人民医院精神科，湖北 430012

基金项目:

国家心理健康和精神卫生防治中心项目 XS24A035

国家自然科学基金项目 72174152

详细信息

作者简介:
汪宬琛(1991-)，女，湖北武汉人，大学本科，主管护师，主要研究方向为青少年心理护理

通讯作者:
周洋，E-mail: 2022js0013@hust.edu.cn

利益冲突声明 所有作者声明无利益冲突。
中图分类号: R179 C913.5 G78
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- 文章访问数: 8
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- PDF下载量: 2
- 被引次数: 0
出版历程
- 收稿日期: 2025-03-17
- 修回日期: 2025-05-09
- 刊出日期: 2025-10-25

Association between left-behind status and health risk behaviors among adolescents

WANG Chengchen^{1, 2},
HOU Hao^{3, 4},
DAI Xingyu³,
YANG Bingxiang^{3, 4},
ZHOU Yang^{1, 2
, ,}

1.
Department of Psychiatry, Wuhan Mental Health Center, Wuhan 430012, Hubei Province, China

摘要

摘要: 目的分析青少年留守状态与健康危险行为(HRB)的相关性，为发现HRB高危人群并制定干预措施提供实证依据。方法 2023年10—11月，采用方便抽样与整群抽样相结合的方法选取湖北省某县级市6所学校(3所初中及3所高中)及湖南省某县级市7所初中14 964名青少年为研究对象，根据留守状态将青少年分为父母均未外出、仅父亲外出、仅母亲外出、父母均外出打工组，采用自编HRB调查表了解研究对象12种HRB报告率及其共存情况。采用多因素Logistic回归和无序多分类Logistic回归分析分别探究青少年留守状态与单一类别HRB及HRB共存的关联。结果在控制性别、年龄、独生子女、主观社会经济地位后，多因素Logistic回归分析结果显示，仅父亲外出打工与青少年学习日(OR=1.15，95%CI=1.05~1.26)和休息日(OR=1.16，95%CI=1.06~1.26)屏幕使用过长相关；仅母亲外出打工与青少年吸烟(OR=1.68，95%CI=1.22~2.32)，学习日屏幕使用过长(OR=1.19，95%CI=1.00~1.41)，休息日屏幕使用过长(OR=1.36，95%CI=1.16~1.59)，不吃早餐(OR=1.20，95%CI=1.03~1.39)，不吃晚餐(OR=1.20，95%CI=1.01~1.43)，不吃水果(OR=1.34，95%CI=1.12~1.61)，含糖饮料摄入(OR=1.30，95%CI=1.09~1.55)风险增加均有关；父母均外出打工与青少年休息日屏幕使用过长(OR=1.51，95%CI=1.38~1.65)，不吃晚餐(OR=1.15，95%CI=1.04~1.27)，不吃水果(OR=1.80，95%CI=1.62~1.99)，非自杀性自伤(OR=1.16，95%CI=1.04~1.29)均呈正相关，与快餐消费呈负相关(OR=0.72，95%CI=0.65~0.79)(P值均 < 0.05)。无序多分类Logistic回归分析结果显示，母亲外出打工与HRB中和高共存风险升高相关(OR=1.25，95%CI=1.06~1.47；OR=1.67，95%CI=1.30~2.13)，父母均外出打工与HRB高度共存风险呈正相关(OR=1.29，95%CI=1.11~1.50)(P值均 < 0.05)。结论父亲外出打工仅与青少年屏幕使用时间相关，母亲外出打工与双亲外出打工的青少年是HRB预防的重点人群。
- 危险行为 /
- 回归分析 /
- 青少年 /
- 问卷调查
Abstract: Objective To examine the association between the left-behind status and health risk behaviors (HRB) among adolescents, so as to provide empirical evidence for identifying high-risk groups and developing intervention measures for HRB. Methods From October to November 2023, by using a combination of convenient sampling and cluster sampling, 14 964 adolescents from 6 schools in a county-level city in Hubei Province (3 junior high schools and 3 senior high schools) and 7 schools in a county-level city in Hunan Province (all junior high schools) were selected as the research subjects. The adolescents were divided into non-left-behind, father-absent, mother-absent, and both parents absent groups based on their left-behind status. A self-designed adolescent HRB questionnaire was utilized to investigate the prevalence of 12 types of HRBs and their co-existence among the subjects. Multifactorial Logistic regression and unordered multinomial Logistic regression analyses were used to explore the association between the left-behind status of adolescents and the occurrence of individual HRBs as well as the co-existence of multiple HRBs. Results After controlling for gender, age, only child, and subjective socioeconomic status, the results of the multiple factor Logistic regression analysis showed that having father in absence for working was positively associated with screen use long time on school days (OR=1.15, 95%CI=1.05-1.26) and rest days (OR=1.16, 95%CI=1.06-1.26); having mother in absence for working was significantly associated with increased risks of smoking (OR=1.68, 95%CI=1.22-2.32), spending long time on screen during school days (OR=1.19, 95%CI=1.00-1.41)and rest days (OR=1.36, 95%CI=1.16-1.59), skipping breakfast (OR=1.20, 95%CI=1.03-1.39), skipping dinner (OR=1.20, 95%CI=1.01-1.43), not eating fruit (OR=1.34, 95%CI=1.12-1.61), and consuming sugar-sweetened beverages (OR=1.30, 95%CI=1.09-1.55); having both parents in absence for working was positively associated with screen use on rest days (OR=1.51, 95%CI=1.38-1.65), skipping dinner (OR=1.15, 95%CI=1.04-1.27), not eating fruit (OR=1.80, 95%CI=1.62-1.99), and non-suicidal self-injury (OR=1.16, 95%CI=1.04-1.29), and negatively associated with fast food consumption (OR=0.72, 95%CI=0.65-0.79)(all P < 0.05).The results of unordered multiclass Logistic regression analysis showed that mother absence for working was associated with an increased risk of moderate and high co-occurrence of HRBs (OR=1.25, 95%CI=1.06-1.47; OR=1.67, 95%CI=1.30-2.13), both parents absence for working was also positively correlated with a high co-occurrence risk of HRBs (OR=1.29, 95%CI=1.11-1.50) (all P < 0.05). Conclusion Father absence for working is only related to adolescents' screen time, while adolescents with mother absence or both parents absent for working are priority groups for HRB prevention.
- Dangerous behavior /
- Regression analysis /
- Adolescent /
- Questionnaires
注释:

1) 利益冲突声明 所有作者声明无利益冲突。

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表 1 不同留守状态青少年健康危险行为状况比较

Table 1. Comparison of health risk behaviors among adolescents with different left-behind conditions

组别	人数	吸烟	饮酒	体力活动不足	学习日屏幕使用过长	休息日屏幕使用过长	不吃早餐	不吃晚餐	快餐消费
父母均未外出打工	7 220	254(3.52)	659(9.13)	6 298(87.23)	5 209(72.15)	2 252(31.19)	2 953(40.90)	1 508(20.89)	2 107(29.18)
仅父亲外出打工	3 776	149(3.95)	331(8.77)	3 300(87.39)	2 827(74.87)	1 313(34.77)	1 591(42.13)	809(21.42)	1 055(27.94)
仅母亲外出打工	799	46(5.76)	89(11.14)	703(87.98)	605(75.72)	301(37.67)	367(45.93)	193(24.16)	225(28.16)
父母均外出打工	3 169	128(4.04)	267(8.43)	2 773(87.50)	2 250(71.00)	1 277(40.30)	1 372(43.29)	747(23.57)	720(22.72)
总体	14 964	577(3.86)	1 346(8.99)	13 074(87.37)	10 891(72.78)	5 143(34.37)	6 283(41.99)	3 257(21.77)	4 107(27.45)
χ²值		10.35	6.14	0.38	29.84	27.10	10.58	10.09	33.10
P值		0.02	0.11	0.93	< 0.01	< 0.01	0.01	0.01	< 0.01

组别	人数	含糖饮料摄入	不吃水果	高自杀风险	非自杀性自伤	共存指数
组别	人数	含糖饮料摄入	不吃水果	高自杀风险	非自杀性自伤	低共存组	中共存组	高共存组
父母均未外出打工	7 220	5 238(72.55)	1 249(17.30)	243(3.37)	1 235(17.11)	2 939(40.71)	3 612(50.03)	669(9.27)
仅父亲外出打工	3 776	2 718(71.98)	689(18.25)	125(3.31)	688(18.22)	1 506(39.89)	1 892(50.11)	378(10.01)
仅母亲外出打工	799	618(77.35)	175(21.90)	31(3.88)	154(19.27)	272(34.04)	420(52.57)	107(13.39)
父母均外出打工	3 169	2 310(72.89)	857(27.04)	110(3.47)	625(19.72)	1 224(38.62)	1 581(49.89)	364(11.49)
总体	14 964	10 884(72.73)	2 970(19.85)	509(3.40)	2 702(18.06)	5 941(39.70)	7 505(50.15)	1 518(10.14)
χ²值		11.53	41.22	0.24	10.35	29.72
P值		0.02	< 0.01	0.87	0.01	< 0.01
注： ()内数字为报告率或构成比/%。

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表 2 留守状态与青少年健康危险行为的Logistic回归分析[OR值(95%CI)，n=14 964]

Table 2. Logistic regression analysis of the association between left-behind conditions and health risk behaviors among adolescents[OR(95%CI), n=14 964]

组别	吸烟	学习日屏幕使用过长	休息日屏幕使用过长	不吃早餐	不吃晚餐	快餐消费
仅父亲外出打工	1.13(0.92~1.39)	1.15(1.05~1.26)^**	1.16(1.06~1.26)^**	1.04(0.96~1.12)	1.01(0.92~1.12)	0.94(0.86~1.03)
仅母亲外出打工	1.68(1.22~2.32)^**	1.19(1.00~1.41)^*	1.36(1.16~1.59)^**	1.20(1.03~1.39)^*	1.20(1.01~1.43)^*	0.96(0.81~1.13)
父母均外出打工	1.17(0.94~1.45)	0.94(0.85~1.03)	1.51(1.38~1.65)^**	1.08(0.99~1.18)	1.15(1.04~1.27)^**	0.72(0.65~0.79)^**

组别	含糖饮料摄入	不吃水果	非自杀性自伤	共存指数
组别	含糖饮料摄入	不吃水果	非自杀性自伤	中共存组	高共存组
仅父亲外出打工	0.97(0.89~1.06)	1.04(0.94~1.16)	1.06(0.95~1.17)	1.00(0.92~1.09)	1.06(0.92~1.22)
仅母亲外出打工	1.30(1.09~1.55)^**	1.34(1.12~1.61)^**	1.11(0.92~1.34)	1.25(1.06~1.47)^**	1.67(1.30~2.13)^**
父母均外出打工	1.02(0.93~1.12)	1.80(1.62~1.99)^**	1.16(1.04~1.29)^**	1.03(0.94~1.13)	1.29(1.11~1.50)^**
注：共存指数采用无序多分类回归，以低共存组为参照；^P < 0.05，^*P < 0.01。

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