学龄前儿童非故意伤害与心理行为问题的相关性

李梦月; 邵子瑜; 郭锋; 殷刚柱; 孙瑜

doi:10.16835/j.cnki.1000-9817.2021.07.017

学龄前儿童非故意伤害与心理行为问题的相关性

doi: 10.16835/j.cnki.1000-9817.2021.07.017

安徽省合肥市妇幼保健计划生育服务中心，230001

基金项目:

合肥市卫生健康委应用医学研究项目 hwk2018zc014

详细信息

作者简介:
李梦月(1979-)，女，安徽庐江人，大学本科，主治医师，主要从事儿童保健工作

通讯作者:
邵子瑜，E-mail: 245864461@qq.com

中图分类号: B844.1 G478
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- 文章访问数: 608
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- PDF下载量: 36
- 被引次数: 0
出版历程
- 收稿日期: 2021-02-18
- 修回日期: 2021-03-27
- 网络出版日期: 2021-07-23
- 刊出日期: 2021-07-25

Correlation between unintentional injury and behavioral problems in preschool children

Hefei Maternal and Child Health Care Center, Hefei(230001), China

摘要

摘要: 目的探讨学龄前儿童心理行为问题与非故意伤害发生的相关性，为有针对性开展儿童非故意伤害预防工作提供依据。方法 2019年9—10月采用分层整群方法抽取合肥市8所幼儿园2 062名3~6岁儿童及其家长，采用自编问卷收集儿童过去1年非故意伤害的发生情况，采用Conners量表父母问卷(PSQ)对儿童心理行为特征进行调查。结果合肥市学龄前儿童非故意伤害年发生率为14.55%(300名)，心理行为问题检出率为14.21%(293名)。发生非故意伤害儿童的心理行为问题检出率及品德问题、学习问题、心身问题、冲动-多动、焦虑、多动指数检出率分别为32.67%，2.33%，19.67%，15.00%，2.00%，1.00%，5.00%，未发生非故意伤害儿童分别为11.07%，0.45%，6.41%，4.88%，0.40%，0.17%，0.79%，差异均有统计学意义(χ²值分别为98.11，12.54，58.90，44.12，10.51，6.08，32.68，P值均 < 0.01)。多因素Logistic回归分析显示，心身问题(OR=3.13，95%CI=2.11~4.66)、学习问题(OR=2.73，95%CI=1.86~3.99)、多动指数异常(OR=3.16，95%CI=1.40~7.14)与学龄前儿童非故意伤害发生呈正相关(P值均 < 0.01)。结论心理行为问题是学龄前儿童非故意伤害的影响因素，在制定学龄前儿童非故意伤害防控措施时，应重视儿童心理行为问题的干预。
- 创伤和损伤 /
- 精神卫生 /
- 行为 /
- 回归分析 /
- 儿童, 学龄前
Abstract: Objective To explore the relationship between behavioral problems and accidental injuries among preschoolers, and to provide evidence for the targeted prevention of children's accidental injuries. Methods During September to October 2019, parent of 2 062 children aged 3 to 6 selected from 8 kindergartens in Hefei through stratified clustering method were investigated. The prevalence of accidental injuries and behavioral problems among preschoolers was collected by questionnaire survey. Results The prevalence of accidental injury during the past year was 14.55%(300), and behavioral problems 14.21%(293). Total rate of behavioral problems and rate of each dimensions in children with accidental injury were 32.67%, 2.33%, 19.67%, 15.00%, 2.00%, 1.00% and 5.00%, compared to 11.07%, 0.45%, 6.41%, 4.88%, 0.40%, 0.17% and 0.79% in children without accidental injury (χ²=98.11, 12.54, 58.90, 44.12, 10.51, 6.08, 32.68, P < 0.01). Multivariate Logistic regression analysis showed that psychosomatic problems(OR=3.13, 95%CI=2.11-4.66), learning problems(OR=2.73, 95%CI=1.86-3.99), abnormal hyperactivity index (OR=3.16, 95%CI=1.40-7.14) and left-behind children (OR=1.53, 95%CI=1.13-2.07) were associated with higher risk of accidental injuries(P < 0.05). Conclusion Behavioral problems are significantly associated with unintentional injuries among preschool children, which deserved further attention and intervention when formulating prevention and control measures for childhood accidental injury.
- Wounds and injuries /
- Mental health /
- Behaviors /
- Regression analysis /
- Child, preschool

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表 1 不同人口统计学特征儿童非故意伤害发生率比较

Table 1. Prevalence of accidental injury among children with different demographic characteristics

人口统计学指标	选项	人数	伤害人数	χ²值	P值
性别	男	1 134	166(14.64)	0.02	0.90
	女	928	134(14.44)
年龄/岁	3~	639	90(14.08)	1.29	0.52
	4~	712	98(13.76)
	5~6	711	112(15.75)
是否本市户籍	是	1 513	219(14.47)	0.03	0.87
	否	549	81(14.75)
是否独生子女	是	896	143(15.96)	2.54	0.11
	否	1 166	157(13.46)
是否留守儿童	是	357	70(19.60)	8.89	0.00
	否	1 705	230(13.49)
父亲文化程度	初中及以下	552	96(17.39)	4.93	0.09
	高中/中专	557	74(13.29)
	大专及以上	953	130(13.64)
母亲文化程度	初中及以下	654	100(15.29)	1.40	0.50
	高中/中专	505	78(15.45)
	大专及以上	903	122(13.51)
家庭人均月	< 4 000	430	79(18.37)	7.86	0.01
收入/元	4 000~8 000	1 011	146(14.44)
	>8 000	621	75(12.08)
注： ()内数字为发生率/%。

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表 2 不同性别年龄组是否发生伤害儿童心理行为问题检出率比较

Table 2. Prevalence of behavioral problems and accidental injury among children by gender and age groups

性别与年龄		发生伤害		未发生伤害		χ²值
性别与年龄		人数	心理行为问题人数	人数	心理行为问题人数	χ²值
性别	男	166	68(40.96)	968	156(16.12)	55.19
	女	134	30(22.39)	794	39(4.91)	50.88
年龄/岁	3~	90	22(24.44)	549	49(8.93)	18.86
	4~	98	28(28.57)	614	71(11.56)	20.42
	5~6	112	48(42.86)	599	75(12.52)	60.70
注： ()内数字为检出率/%；P值均 < 0.01。

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表 3 是否发生伤害儿童PSQ各因子检出率比较

Table 3. Comparison of detection prevalence of PSQ between two groups

分组	人数	品行问题	学习问题	心身问题	冲动-多动	焦虑	多动指数
发生伤害	300	7(2.33)	59(19.67)	45(15.00)	6(2.00)	3(1.00)	15(5.00)
未发生伤害	1 762	8(0.45)	113(6.41)	86(4.88)	7(0.40)	3(0.17)	14(0.79)
χ²值		12.54	58.90	44.12	10.51	6.08	32.68
P值		< 0.01	< 0.01	< 0.01	< 0.01	0.04	< 0.01
注： ()内数字为检出率/%。

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表 4 学龄前儿童非故意伤害影响因素的Logistic回归分析(n=2 062)

Table 4. Logistic regression analysis on influence factors of accidental injury in preschool children(n=2 062)

自变量与常量	β值	标准误	Wald χ²值	P值	OR值(OR值95%CI)
心身问题	1.14	0.20	31.91	< 0.01	3.13(2.11~4.66)
学习问题	1.00	0.19	26.65	< 0.01	2.73(1.86~3.99)
多动指数	1.15	0.42	7.61	< 0.01	3.16(1.40~7.14)
留守儿童	0.43	0.16	7.38	< 0.01	1.53(1.13~2.07)
常量	-2.10	0.08	684.87	< 0.01	0.12

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参考文献(30)

[1]	WHO. World Health Organization on child injury prevention[M]. Geneva: WHO, 2008.
[2]	金曦, 罗荣, 曹彬, 等. 中国0~6岁儿童生存发展策略: 从证据到行动[R]. 北京: 北京大学医学出版社, 2017: 8-13. JIN X, LUO R, CAO B, et al. Strategies for the survival and developmentamong 0-6 years children in China: from evidence to action[R]. Beijing: Peking Universilty Press, 2017: 8-13.
[3]	耳玉亮, 陆治名, 汪媛, 等. 中国2018年伤害监测系统0~5岁儿童伤害病例特征分析[J]. 中国学校卫生, 2020, 41(7): 971-975. doi: 10.16835/j.cnki.1000-9817.2020.07.004 ER Y L, LU Z M, WANG Y, et al. Analysis of the characteristics of injury among children aged 0-5 years: results from Chinese National Injury Surveillance System in 2018[J]. Chin J Sch Health, 2020, 41(7): 971-975. doi: 10.16835/j.cnki.1000-9817.2020.07.004
[4]	国务院妇女儿童工作委员会. 中国儿童发展纲要(2011-2020年)[EB/OL]. [2011-08-28]. http://www.nwccw.gov.cn/2017-04/05/content_149166.htm. Nation Working Committee on Children and Women Under State Council of the People's Republic of China. Outline for the Development of Children in China (2011-2020)[EB/OL]. [2011-08-28]. http://www.nwccw.gov.cn/2017-04/05/content_149166.htm.
[5]	张春旭, 阐玉英, 王新, 等. 儿童意外伤害影响因素研究进展[J]. 齐鲁护理杂志, 2017, 23(18): 60-62. doi: 10.3969/j.issn.1006-7256.2017.18.026 ZHANG C X, CHAN Y Y, WANG X, et al. Research progress on influencing factors of accidental injury in children[J]. J Qilu Nurs, 2017, 23(18): 60-62. doi: 10.3969/j.issn.1006-7256.2017.18.026
[6]	AMEETA D, ALISON M, HALA T. Childhood behavior problems and unintentional injury: a longitudinal, population-based study[J]. J Dev Behav Pediatr, 2010, 31(4): 276-285. doi: 10.1097/DBP.0b013e3181da7785
[7]	ZHANG H, LI Y, CUI Y X, et al. Unintentional childhood injury: a controlled comparison of behavioral characteristics[J]. BMC Pediatr, 2016, 16(1). DOI 10.1186/s12887-016-0558-1. doi: 10.1186/s12887-016-0558-1
[8]	BRADBURY K, JANICKE D M, RILEY A M, et al. Predictors of unintentional injuries to school-age children seen inpediatric primary care[J]. J Pediatr Psychol, 1999, 24(5): 423-433. doi: 10.1093/jpepsy/24.5.423
[9]	JAQUESS D L, FINNEY J W. Previous injuries and behavior problem predict childrens, injuries[J]. J Pediatr Psychol, 1994, 19(1): 79-89. doi: 10.1093/jpepsy/19.1.79
[10]	彭迎春, 倪进发, 陶芳标, 等. 学龄儿童行为问题与伤害关系的前瞻性队列研究[J]. 中华流行病学杂志, 2003, 24(8): 684-688. doi: 10.3760/j.issn:0254-6450.2003.08.011 PENG Y C, NI J F, TAO F B, et al. A prospective cohort study on injuries among school-age children with and without behavior problems[J]. Chin J Epidemiol, 2003, 24(8): 684-688. doi: 10.3760/j.issn:0254-6450.2003.08.011
[11]	国家卫生和计划生育委员会. 儿童青少年伤害监测方法GB/T 31180-2104[S]. 北京: 中国标准出版社, 2015: 1-8. National Health and Family Planning Commission of PRC. Methods for injury surveillance child and adolescent GB/T 31180-2104[S]. Beijing: Standards Press of China, 2015: 1-8.
[12]	卫生部卫生统计信息中心, 北京协和医院. 世界疾病分类合作中心国际疾病(ICD-10)指导手册[M]. 2001. Health Statistics and Information Centre, Ministry of Health, Peking Union Medical College Hospital. World Collaborating Center for Classification of Diseases International Disease (ICD-10) Guideline[M]. 2001.
[13]	刘湘云, 陈荣华, 赵正言. 儿童保健学[M]. 4版. 南京: 江苏科技出版社, 2014: 350-356. LIU X Y, CHEN R H, ZHAO Z Y. Child health care[M]. 4th ed. Nanjing: Jiangsu Science and Technology Press, 2014: 350-356.
[14]	中华预防医学会伤害预防与控制分会. 关于伤害界定标准的决定[J]. 中华疾病控制杂志, 2011, 15(1): 9. https://www.cnki.com.cn/Article/CJFDTOTAL-JBKZ201101005.htm Prevention and Control of Chinese Preventive Medicine Association. Decision on criteria for the definition of harm[J]. Chin J Dis Control Prev, 2011, 15(1): 9. https://www.cnki.com.cn/Article/CJFDTOTAL-JBKZ201101005.htm
[15]	苏林雁, 李雪荣, 黄春香. Conners父母症状问卷的中国城市常模[J]. 中国临床心理学杂志, 2001, 9(4): 241-243. doi: 10.3969/j.issn.1005-3611.2001.04.001 SU L Y, LI X R, HUANG C X. Norms of The Conners Parent Symptom Questionnaire in Chinese urban children[J]. Chin J Clin Psychol, 2001, 9(4): 241-243. doi: 10.3969/j.issn.1005-3611.2001.04.001
[16]	王文超, 张玉霞. 上海部分地区儿童意外伤害的临床调查与分析[J]. 中国儿童保健学杂志, 2014, 22(8): 865-868. https://www.cnki.com.cn/Article/CJFDTOTAL-ERTO201408027.htm WANG W C, ZHANG Y X. Clinical investigation and analysis of children's unintentional injury in part of Shanghai[J]. Chin J Child Health Care, 2014, 22(8): 865-868. https://www.cnki.com.cn/Article/CJFDTOTAL-ERTO201408027.htm
[17]	余杏侠, 魏捷, 杨卫泽. 儿童意外伤害482例原因及特点分析[J]. 中国儿童保健学杂志, 2019, 27(6): 687-689, 696. https://www.cnki.com.cn/Article/CJFDTOTAL-ERTO201906029.htm YU X X, WEI J, YANG W Z. Analysis on causes and characteristics of unintentional injuries among children[J]. Chin J Child Health Care, 2019, 27(6): 687-689, 696. https://www.cnki.com.cn/Article/CJFDTOTAL-ERTO201906029.htm
[18]	卢良坚, 卢雪珍, 吴奇, 等. 广州珠海区托幼机构集体儿童意外伤害现状及分析[J]. 河南预防医学杂志, 2016, 27(12): 881-883. LU L J, LU X Z, WU Q, et al. The status and analysis on accidental injury of preschool children in kindergartens in Zhuhai District of Guangzhou[J]. Henan J Prev Med, 2016, 27(12): 881-883.
[19]	唐超, 李林熹, 竹晋雯, 等. 南充市城区学龄前儿童意外伤害发生情况及家长认知调查[J]. 中国循证医学杂志, 2018, 18(7): 657-661. https://www.cnki.com.cn/Article/CJFDTOTAL-ZZXZ201807005.htm TANG C, LI L X, ZHU J W, et al. The occurrence and parents'cognition of accidental injury among pre-school children in Nanchong City: a questionnaire survey[J]. Chin J Evidence-Based Med, 2018, 18(7): 657-661. https://www.cnki.com.cn/Article/CJFDTOTAL-ZZXZ201807005.htm
[20]	何峰宁, 谢文静, 吴金灿, 等. 九江市学龄前儿童意外伤害发生情况及影响因素研究[J]. 华南预防医学, 2018, 44(1): 7-11. https://www.cnki.com.cn/Article/CJFDTOTAL-GDWF201801003.htm HE F N, XIE W J, WU J C, et al. Incidence and influencing factors of accidental injuries in preschool children in Jiujiang[J]. South Chin J Prev Med, 2018, 44(1): 7-11. https://www.cnki.com.cn/Article/CJFDTOTAL-GDWF201801003.htm
[21]	CHOU A K, CHEN D R. Socioeconomic status and deaths due to unintentional injury among children: a socio-spatial analysis in Taiwan[J]. Geospat Health, 2019, 14(1): 25-34. http://www.researchgate.net/publication/333098670_Socioeconomic_status_and_deaths_due_to_unintentional_injury_among_children_A_socio-spatial_analysis_in_Taiwan
[22]	易泉英, 骆庆明, 王馨, 等. 影响学龄前儿童发生中度意外伤害的心理行为和家庭因素分析[J]. 中国民康医学, 2020, 32(7): 112-114. doi: 10.3969/j.issn.1672-0369.2020.07.047 YI Q Y, LUO Q M, WANG X, et al. Analysis of psychological behavior factors and family factors affecting children's moderate accidental injuries[J]. Med J Chin People's Health, 2020, 32(7): 112-114. doi: 10.3969/j.issn.1672-0369.2020.07.047
[23]	邱学兰, 刘思美, 蒋昭伦. 意外伤害儿童心理学特点及干预对策[J]. 临床儿科杂志, 2010, 28(9): 854-858. doi: 10.3969/j.issn.1000-3606.2010.09.015 QU X L, LIU S M, JIANG Z L. Analysis and intervention of psychologic problems in children with accidental injury[J]. J Clin Pediatr, 2010, 28(9): 854-858. doi: 10.3969/j.issn.1000-3606.2010.09.015
[24]	HU H W, GAO J M, JIANG H C, et al. A comparative study of unintentional injuries among schooling left-behind, migrant and residential children in China[J]. Int J Equit Health, 2018, 17(1): 47. doi: 10.1186/s12939-018-0767-3
[25]	MA S, JIANG M M, WANG F, et al. Left-behind children and risk of unintentional injury in rural China: a cross-sectional survey[J]. Int J Environ Res Public Health, 2019, 16(3): 403. doi: 10.3390/ijerph16030403
[26]	周玉明, 戚艳杰, 张之霞, 等. 4~6岁农村留守儿童心理行为问题检出率及影响因素分析[J]. 临床精神医学杂志, 2019, 29 (3): 157-160. doi: 10.3969/j.issn.1005-3220.2019.03.006 ZHOU Y M, QI Y J, ZHANG Z X, et al. Analysis of incidence and influencing factors of psychological behavior problems of left-behind children aged 4-6 in rural areas[J]. J Clin Psychiatry, 2019, 29(3): 157-160. doi: 10.3969/j.issn.1005-3220.2019.03.006
[27]	WANG Y Y, XIAO L, RAO W W, et al. The prevalence of depressive symptoms in left-behind children in China: a meta-analysis of comparative studies and epidemiological surveys[J]. J Affect Disord, 2019, 244: 209-216. doi: 10.1016/j.jad.2018.09.066
[28]	TANG W J, WANG G, HU T, et al. Mental health and psychosocial problems among Chinese left-behind children: a cross-sectional comparative study[J]. J Affect Disord, 2018, 241: 133-141. doi: 10.1016/j.jad.2018.08.017
[29]	ZHAO C Y, WANG F, LEAH L, et al. Long-term impacts of parental migration on Chinese children's psychosocial well-being: mitigating and exacerbating factors[J]. Soc Psychiatry Psychiatr Epidemiol, 2017, 52: 669-677. doi: 10.1007/s00127-017-1386-9
[30]	陶芳标. 儿童青少年意外伤害预防的可控性和优先领域[J]. 中国学校卫生, 2018, 39(2): 163-166. doi: 10.16835/j.cnki.1000-9817.2018.02.003 TAO F B. Preventability and priority for unintentional injury control in children and adolescents[J]. Chin J Sch Health, 2018, 39(2): 163-166. doi: 10.16835/j.cnki.1000-9817.2018.02.003