Risk assessment of unintention injury among preschool children in Shunyi District of Beijing
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摘要:
目的 了解顺义区学龄前儿童发生伤害风险情况及其影响因素，为制定预防伤害干预措施提供参考。 方法 通过分层整群抽样的方法，选取顺义区3所幼儿园，采用自行设计的调查问卷对抽中幼儿园的所有家长进行网络平台线上调查。 结果 学龄前儿童伤害的低、中、高风险评估比例分别59.5%，37.5%和3.0%。学龄前儿童年龄和班级越高，伤害风险评估等级越高(χ2值分别为12.35，12.70，P值均 < 0.05)，伤害风险隔代照顾意外伤害高风险(3.7%)高于父母照顾(2.4%); 主要照护人文化程度、家庭年收入越高，伤害风险评估等级越低(χ趋势2值分别为11.23，14.10，P值均 < 0.05)。不同年龄、不同年级的儿童在烧烫伤风险、中毒风险、其他伤害风险、儿童伤害防范和伤害总得分差异均有统计学意义(F值分别为8.26，5.61，4.95，6.15，7.86;9.88，8.39，4.25，6.27，7.55，P值均 < 0.05);不同性别的儿童烧烫伤风险维度差异有统计学意义(t=-4.27，P < 0.05);不同居住地儿童伤害防范维度差异有统计学意义(t=9.11，P < 0.05);不同年龄、年级的儿童在风险来源中的行为监管差异均有统计学意义(P值均 < 0.05)。多元线性回归分析显示，主要照护人文化程度(大专：B=-2.66，95%CI=-4.69~-0.63;本科及以上：B=-3.80，95%CI=-5.90~-1.70)、家庭年收入(B=-2.82，95%CI=-4.80~-0.84)是学龄前儿童发生伤害风险的影响因素(P值均 < 0.05)。 结论 在开展学龄前儿童预防伤害的健康教育工作中，着重对家庭收入较低及文化程度偏低的主要照护人进行有针对性的干预，对进一步提高儿童伤害风险的预防有着积极意义。 Abstract:Objective To understand the current situation and associated factors of unintentional injury among preschool children in Shunyi District, and to provide reference for the development of unintentional injury intervention measures. Methods Three kindergartens in Shunyi district were selected through stratified cluster sampling method, and all the parents were surveyed online by self-designed questionnaire. Results The proportion of low, medium and high risk assessment of unintentional injury in preschool children were 59.5%, 37.5% and 3.0%, respectively. Risk of unintentional injury increased significantly with age and grade(χ2=12.35, 12.70, P < 0.05). The risk of unintentional injury in inter-generational care (3.7%) was higher than that in parental care(2.4%). The higher the education level of the primary caretaker and family income, the higher level of unintentional injury risk(χ2=11.23, 14.10, P < 0.05).There were significant differences in the risk for burning, poisoning, other accidental injury, prevention of accidental injury and total score of unintentional injury among children of different ages and classes(F=8.26, 5.61, 4.95, 6.15, 7.86;9.88, 8.39, 4.25, 6.27, 7.55, P < 0.05). There was statistical significance in burning risk between boys and girls(t=-4.27, P < 0.05). There was statistical significance in unintentional injury prevention between children of different residence(t=9.11, P < 0.05). There were significant differences in behavior supervision among risk among children of different ages and grades(P < 0.05). Multiple linear regression analysis showed that education level of primary caregivers (college: B=-2.66, 95%CI=-4.69-0.63; bachelor degree or higher: B=-3.80, 95%CI=-5.90-1.70), annual family income (B=-2.82, 95%CI=-4.80-0.84) were associated with unintentional injury risk of preschool children(P < 0.05). Conclusion Health education of unintentional injury prevention among preschool children should focus on the primary caretaker with low education and low family income, which is crucial for prevention of children's injury. -
Key words:
- Wounds and injuries /
- Risk adjustment /
- Regression analysis /
- Child, preschool
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表 1 不同人口学特征学龄前儿童的伤害风险等级分布比较
Table 1. Assessment results of accidental injury risk level about different preschool children's characteristics
人口学指标 人数 低风险 中风险 高风险 χ2值 P值 性别 男 989 583(58.9) 381(38.5) 25(2.5) 2.12 0.35 女 887 533(60.1) 323(36.4) 31(3.5) 年龄/岁 3 623 387(62.1) 220(35.3) 16(2.6) 12.35 0.02 4 702 434(61.8) 245(34.9) 23(3.3) 5~6 551 295(53.5) 239(43.4) 17(3.1) 年级 小班 738 457(61.9) 261(35.4) 20(2.7) 12.70 0.01 中班 650 401(61.7) 228(35.1) 21(3.2) 大班 488 258(52.9) 215(44.1) 15(3.0) 居住地 城镇 909 541(59.5) 345(38.0) 23(2.5) 1.31 0.52 农村 967 575(59.5) 359(37.1) 33(3.4) 主要照护人 父母 1 071 656(61.3) 389(36.3) 26(2.4) 4.40 0.04 隔代 805 460(57.1) 315(39.1) 30(3.7) 主要照护人文化程度* 高中及以下 817 453(55.4) 333(40.8) 31(3.8) 11.23 0.02 大专 358 223(62.3) 126(35.2) 9(2.5) 本科及以上 701 440(62.8) 245(35.0) 16(2.3) 父亲文化程度* 高中及以下 206 125(60.7) 71(34.5) 10(4.8) 5.43 0.25 大专 431 264(61.3) 159(36.9) 8(1.8) 本科及以上 1 239 727(58.6) 474(38.3) 38(3.1) 母亲文化程度* 高中及以下 136 83(61.0) 47(34.6) 6(4.4) 3.68 0.45 大专 427 261(61.1) 158(37.0) 8(1.9) 本科及以上 1 313 772(58.8) 499(38.0) 42(3.2) 是否独生子女 是 902 539(59.8) 341(37.8) 22(2.4) 1.79 0.41 否 974 577(59.2) 363(37.3) 34(3.5) 家庭年收入/万元* < 8 257 140(54.5) 103(40.1) 14(5.4) 14.10 0.01 8~ < 12 265 178(67.2) 82(30.9) 5(1.9) ≥12 1 354 798(58.9) 519(38.4) 37(2.7) 家庭类型 核心家庭 738 431(58.4) 288(39.0) 19(2.6) 1.66 0.44 大家庭 1 138 685(60.2) 416(36.6) 37(3.3) 合计 1 876 1 116(59.5) 704(37.5) 56(3.0) 注： *表示等级变量采用趋势χ2检验; ()内数字为构成比/%。 
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表 2 不同人口统计学指标学龄前儿童伤害风险维度得分比较(x±s)
Table 2. Analysis results of risk dimensions of accidental injury of preschool children with different characteristics(x±s)
人口统计学指标 选项 人数 统计值 烧烫伤风险 跌倒坠落伤风险 溺水风险 中毒风险 交通伤害风险 其他伤害风险 生活环境伤害风险 伤害防范 总得分 年龄/岁 3 623 13.57±3.38 16.89±3.27 5.96±1.69 6.52±1.98 12.19±2.62 10.94±2.80 4.44±1.14 6.90±1.96 77.41±10.95 4 702 14.11±3.50 16.73±3.39 6.08±1.83 6.43±2.05 12.23±2.48 10.92±2.83 4.53±1.34 7.13±2.06 78.15±11.68 5~6 551 14.40±3.89 17.12±3.29 6.05±1.74 6.81±2.11 12.41±2.58 11.39±3.11 4.50±1.24 7.32±2.09 80.01±11.88 F值 8.26 2.14 0.87 5.61 1.23 4.95 0.80 6.15 7.86 P值 < 0.01 0.12 0.42 < 0.01 0.29 0.01 0.45 < 0.01 < 0.01 性别 男 989 13.86±3.45 16.98±3.18 6.07±1.77 6.57±2.06 12.28±2.45 11.12±2.97 4.48±1.26 7.04±1.96 78.40±11.18 女 887 14.20±3.74 16.80±3.47 5.99±1.75 6.57±2.04 12.25±2.66 11.00±2.85 4.50±1.23 7.18±2.12 78.50±11.95 t值 -4.27 1.49 0.97 < 0.01 0.04 0.73 -0.16 -2.27 -0.03 P值 0.04 0.22 0.33 0.97 0.84 0.39 0.69 0.13 0.86 年级 小班 738 13.58±3.35 16.87±3.28 6.02±1.76 6.51±1.97 12.24±2.60 10.98±2.82 4.48±1.19 6.91±1.96 77.59±10.97 中班 650 14.20±3.62 16.73±3.34 6.03±1.78 6.41±2.09 12.19±2.49 10.92±2.83 4.51±1.30 7.16±2.10 78.15±11.91 大班 488 14.44±3.84 17.16±3.35 6.04±1.73 6.89±2.10 12.41±2.56 11.39±3.13 4.49±1.25 7.32±2.05 80.14±11.74 F值 9.88 2.40 0.01 8.39 1.02 4.25 0.11 6.27 7.55 P值 < 0.01 0.09 0.99 < 0.01 0.36 0.01 0.89 < 0.01 < 0.01 居住地 城镇 909 14.00±3.65 16.79±3.21 6.09±1.84 6.59±2.06 12.17±2.61 11.05±2.92 4.47±1.18 7.24±2.08 78.12±11.36 农村 967 14.03±3.54 16.99±3.43 5.98±1.68 6.56±2.04 12.36±2.50 11.08±2.90 4.51±1.30 6.96±1.99 78.76±11.71 t值 -0.04 -1.73 1.93 0.14 -2.73 -0.08 -0.41 9.11 -1.44 P值 0.85 0.19 0.17 0.71 0.10 0.77 0.52 < 0.01 0.23 合计 1 876 14.02±3.59 16.90±3.32 6.03±1.76 6.57±2.05 12.27±2.55 11.07±2.91 4.49±1.24 7.11±2.04 78.45±11.54
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表 3 学龄前儿童发生伤害风险影响因素的多元线性回归分析(n=1 876)
Table 3. Multiple linear regression analysis of risk factors in preschool children(n=1 876)
自变量 选项 B值(B值95%CI) 标准误 t/F值 P值 年龄/岁 3 1.00 4 1.49(-0.76~3.74) 1.15 1.30 0.19 5~6 2.35(-1.30~6.01) 1.86 1.26 0.21 性别 女 1.00 男 -0.12(-1.16~0.93) 0.53 -0.22 0.83 年级 小班 1.00 中班 -0.48(-2.74~1.78) 1.15 -0.42 0.67 大班 0.79(-2.89~4.48) 1.88 0.42 0.68 主要照护人 父母 1.00 隔代 -1.28(-3.14~0.58) 0.95 -1.35 0.18 主要照护人文化程度 高中及以下 1.00 大专 -2.66(-4.69~-0.63) 1.04 -2.57 0.01 本科及以上 -3.80(-5.90~-1.70) 1.07 -3.55 < 0.01 父亲文化程度 高中及以下 1.00 大专 -1.06(-3.12~1.00) 1.05 -1.01 0.31 本科及以上 -0.05(-2.10~-1.99) 1.04 -0.05 0.96 母亲文化程度 高中及以下 1.00 大专 0.83(-1.92~3.57) 1.40 0.59 0.56 本科及以上 2.38(-0.44~5.19) 1.44 1.65 0.10 是否独生子女 是 1.00 否 0.34(-0.72~1.40) 0.54 0.63 0.53 家庭年收入/万元 < 8 1.00 8~ < 12 -2.82(-4.80~-0.84) 1.01 -2.80 0.01 ≥12 -1.57(-3.21~0.08) 0.84 -1.87 0.06 家庭类型 核心家庭 1.00 大家庭 -0.38(-1.48~0.72) 0.55 -0.68 0.50
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表 4 学龄前儿童不同人口统计学指标伤害风险来源得分比较(x±s)
Table 4. Analysis results of risk sources of accidental injury of preschool children with different characteristics(x±s)
人口统计学指标 选项 人数 统计值 环境隐患 行为监管 年龄/岁 3 623 29.75±5.22 47.65±7.51 4 702 30.17±5.53 47.98±8.06 5~6 551 30.42±5.21 49.58±8.53 F值 2.38 9.60 P值 0.09 < 0.01 性别 男 989 29.99±5.13 48.41±7.92 女 887 30.23±5.56 48.27±8.22 t值 -0.91 0.14 P值 0.34 0.71 年级 小班 738 29.92±5.30 47.67±7.41 中班 650 30.06±5.48 48.09±8.35 大班 488 30.44±5.22 49.70±8.46 F值 1.42 9.92 P值 0.24 < 0.01 居住地 城镇 909 29.93±5.19 48.19±7.97 农村 967 30.27±5.48 48.49±8.15 t值 -1.94 -0.63 P值 0.16 0.43 合计 1 876 30.10±5.34 48.34±8.06
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