医学生手机使用与童年期虐待经历及睡眠质量关联

李若瑜; 李书琴; 蒋志成; 金正格; 汪瑞; 宋先兵; 张诗晨; 万宇辉

doi:10.16835/j.cnki.1000-9817.2022.01.018

医学生手机使用与童年期虐待经历及睡眠质量关联

doi: 10.16835/j.cnki.1000-9817.2022.01.018

1.
安徽医科大学公共卫生学院儿少卫生与妇幼保健学系/出生人口健康教育部重点实验室/人口健康与优生安徽省重点实验室, 合肥 230032
2.
安庆医药高等专科学校
3.
安徽医学高等专科学校

基金项目:

国家自然科学基金项目 81773453

安徽高校自然科学研究项目 KJ2020ZD70

安徽医专自然科学研究项目 YZ2020ZR001

详细信息

作者简介:
李若瑜(1996-), 女, 安徽淮南人, 在读硕士, 主要研究方向为青少年心理行为问题

通讯作者:
万宇辉, E-mail: wyhayd@163.com

利益冲突声明 所有作者声明无利益冲突。
中图分类号: G647.8 B844.2
计量
- 文章访问数: 807
- HTML全文浏览量: 349
- PDF下载量: 78
- 被引次数: 0
出版历程
- 收稿日期: 2021-04-28
- 修回日期: 2021-05-20
- 刊出日期: 2022-01-25

Association of mobile phone use with childhood abuse experiences and sleep quality in medical students

1.
Departmetn of Maternal, Child & Adolescent Health, School of Public Health/MOE Key Laboratory of Population Health across Life Cycle/Anhui Provincial Key Laboratory of Population Health & Aristogenics, Anhui Medical University, Hefei(230032), China

摘要

摘要: 目的探讨手机使用在不同类型童年期虐待经历与医学生睡眠质量关联中的中介效应及性别差异, 为促进医学生睡眠质量提供参考。方法采用纵向研究设计, 于2019年11—12月选取安徽省2所医学院校大一至大二年级在校生作为基线研究对象, 并于2020年5—6月收集随访资料, 共6 879名学生纳入研究。通过Mann-Whitney U检验医学生基线童年期虐待经历、基线手机使用及随访睡眠质量得分情况的性别间差异, 使用Spearman相关分析基线童年期虐待经历、基线手机使用和随访睡眠质量的关联; 通过自举(Bootstrap)程序和Process软件检验手机使用的中介效应。结果童年期虐待经历与手机使用和睡眠质量得分均呈正相关(r值分别为0.27, 0.24, P值均 < 0.01), 手机使用与睡眠质量得分呈正相关(r=0.31, P < 0.01)。总样本中, 调整混杂因素后, 手机使用在童年期虐待经历(包括情感虐待、躯体虐待、性虐待)和睡眠质量关联中起部分中介作用, 中介效应为18.08%(18.12%, 17.15%, 24.09%)。女生手机使用在童年期情感虐待、性虐待及童年期虐待与睡眠质量关联中的中介效应(18.32%, 28.05%, 18.24%)总体高于男生(17.81%, 18.94%, 17.63%)。结论手机使用在童年期虐待经历与医学生睡眠质量关联中起中介作用, 控制手机过度使用有助于童年期虐待经历医学生睡眠质量的改善。
- 便携式电话 /
- 虐待儿童 /
- 精神卫生 /
- 睡眠 /
- 学生
Abstract: Objective To explore the mediating effect and gender difference of mobile phone use in the association between different types of childhood abuse experiences and sleep quality of medical students, so as to provide reference for promoting sleep quality of medical students. Methods A longitudinal study design method was used to select freshmen and sophomores in two medical colleges in Anhui Province from November to December 2019, follow-up data were collected from May to June 2020, and a total of 6 879 students were included in this study. Spearman correlation was used to analyze the association between baseline childhood abuse experiences, baseline mobile phone use and follow-up sleep quality. Bootstrap program and Process software were applied to test the mediating effect of mobile phone use in the relationship between childhood abuse and sleep quality. Results Childhood abuse experiences were positively correlated with mobile phone use and sleep quality score (r=0.27, 0.24, P < 0.01), and mobile phone use was positively correlated with sleep quality score (r=0.31, P < 0.01). In the total sample, after adjusting for confounding factors, mobile phone use played a partial mediating role in childhood abuse experiences (including emotional abuse, physical abuse, sexual abuse) and sleep quality, and the mediating effect was 18.08% (18.12%, 17.15%, 24.09%). The mediating effect of mobile phone use on the relationship between childhood emotional abuse, sexual abuse, childhood abuse and sleep quality in girls(18.32%, 28.05%, 18.24%) was higher than in boys(17.81%, 18.94%, 17.63%). Conclusion Mobile phone use has a mediating effect on the relationship between childhood abuse and sleep quality, controlling mobile phone overuse may contribute to improving the sleep quality for those who have experienced childhood abuse. Cellular phone; Child abuse; Mental health; Sleep; Students
- Cellular phone /
- Child abuse /
- Mental health /
- Sleep /
- Students
注释:

1) 利益冲突声明 所有作者声明无利益冲突。

HTML全文

表 1 不同性别医学生童年期虐待经历、手机使用和睡眠质量得分比较[M(P₂₅，P₇₅)]

Table 1. Distribution characteristics of childhood abuse experiences, mobile phone use and sleep quality[M(P₂₅, P₇₅)]

性别	人数	情感虐待	躯体虐待	性虐待	童年期虐待	手机使用	睡眠质量
男	1 750	6(5，7)	5(5，6)	5(5，5)	16(15，19)	19(15，26)	3(1，4)
女	5 129	6(5，8)	5(5，5)	5(5，5)	16(15，19)	20(15，26)	3(1，4)
合计	6 879	6(5，8)	5(5，5)	5(5，5)	16(15，19)	20(15，26)	3(1，4)
Z值		-5.41	-6.54	-10.88	-0.24	-1.53	-2.72
P值		< 0.01	< 0.01	< 0.01	0.81	0.13	0.01

下载: 导出CSV

表 2 医学生童年期虐待经历和手机使用与睡眠质量得分的相关分析(r值)

Table 2. Correlations analysis of childhood abuse experiences, mobile phone use and sleep quality score among medical students(r)

性别	变量	情感虐待	躯体虐待	性虐待	总虐待	手机使用
男生(n=1 750)	躯体虐待	0.48
	性虐待	0.30	0.24
	总虐待	0.90	0.69	0.48
	手机使用	0.23	0.15	0.15	0.24
	睡眠质量	0.21	0.13	0.15	0.22	0.30
女生(n=5 129)	躯体虐待	0.44
	性虐待	0.25	0.23
	总虐待	0.95	0.61	0.37
	手机使用	0.27	0.15	0.15	0.27
	睡眠质量	0.23	0.14	0.12	0.24	0.32
总样本	躯体虐待	0.44
(n=6 879)	性虐待	0.25	0.24
	总虐待	0.94	0.63	0.40
	手机使用	0.26	0.15	0.14	0.27
	睡眠质量	0.23	0.13	0.12	0.24	0.31
注：P值均 < 0.01。

下载: 导出CSV

表 3 医学生手机使用在童年期虐待经历与睡眠质量关联中的中介效应值

Table 3. Mediating effect of mobile phone use in the association between childhood abuse experiences and sleep quality among medical students

童年期虐待经历	模型	童年期虐待- 手机使用	手机使用- 睡眠质量	中介效应	直接效应	中介效应比例/%
情感虐待	1	0.80	0.08	0.06(0.05~0.08)	0.16(0.14~0.18)	28.39
	2	0.79	0.08	0.06(0.05~0.07)	0.15(0.12~0.17)	29.58
	3	0.52	0.04	0.02(0.02~0.03)	0.10(0.08~0.13)	18.12
躯体虐待	1	0.74	0.09	0.07(0.05~0.08)	0.17(0.13~0.21)	27.89
	2	0.76	0.09	0.07(0.05~0.08)	0.15(0.11~0.20)	29.79
	3	0.49	0.05	0.02(0.02~0.03)	0.11(0.07~0.15)	17.15
性虐待	1	1.22	0.09	0.11(0.08~0.14)	0.19(0.13~0.25)	36.28
	2	1.26	0.09	0.11(0.08~0.14)	0.19(0.12~0.25)	37.01
	3	0.87	0.05	0.04(0.03~0.06)	0.13(0.07~0.19)	24.09
总虐待	1	0.49	0.08	0.04(0.03~0.05)	0.10(0.08~0.11)	28.43
	2	0.49	0.08	0.04(0.03~0.05)	0.09(0.08~0.11)	29.68
	3	0.33	0.04	0.01(0.01~0.02)	0.06(0.05~0.08)	18.08
注：模型1为单因素分析；模型2为调整年龄，性别，家庭所在地，独生子女，父母受教育水平，家庭经济状况；模型3为调整基线人口学统计指标及基线睡眠得分。()内数据为下限值~上限值。

下载: 导出CSV

表 4 不同性别医学生手机使用在童年期虐待经历与睡眠质量关联中的中介效应值

Table 4. Mediating effect of mobile phone use on the association between childhood abuse experiences and sleep quality among medical students of different genders

童年期虐待经历	性别	童年期虐待- 手机使用	手机使用- 睡眠质量	中介效应	直接效应	中介效应比例/%
情感虐待	男	0.59	0.04	0.02(0.01~0.04)	0.11(0.06~0.17)	17.81
	女	0.50	0.04	0.02(0.02~0.03)	0.10(0.07~0.13)	18.32
躯体虐待	男	0.43	0.05	0.02(0.01~0.04)	0.09(0.02~0.16)	17.85
	女	0.52	0.05	0.02(0.02~0.04)	0.12(0.07~0.17)	16.59
性虐待	男	0.78	0.04	0.03(0.01~0.08)	0.15(0.04~0.25)	18.94
	女	0.92	0.05	0.05(0.03~0.07)	0.11(0.03~0.20)	28.05
总虐待	男	0.30	0.04	0.01(0.01~0.02)	0.06(0.03~0.09)	17.63
	女	0.34	0.04	0.02(0.01~0.10)	0.07(0.05~0.08)	18.24
注：均调整基线人口统计学指标和基线睡眠得分。()内数据为下限值~上限值。

下载: 导出CSV

参考文献(32)

[1]	陈晓, 王昆明. 正念冥想训练对大学生心理健康和睡眠质量的干预作用[J]. 中国健康心理学杂志, 2017, 25(2): 276-281. https://www.cnki.com.cn/Article/CJFDTOTAL-JKXL201702031.htm CHEN X, WANG K M. The effects of mindfulness meditation on improving university students' mental health and quality of sleep[J]. Chin J Health Psychol, 2017, 25(2): 276-281. https://www.cnki.com.cn/Article/CJFDTOTAL-JKXL201702031.htm
[2]	谢阳, 伍晓艳, 陶舒曼, 等. 大学生手机依赖与焦虑及睡眠质量的关系[J]. 中国学校卫生, 2020, 41(11): 1621-1624. doi: 10.16835/j.cnki.1000-9817.2020.11.006 XIE Y, WU X Y, TAO S M, et al. Moderating effect of sleep quality on the relationship between problematic mobile phone use and anxiety of college students[J]. Chin J Sch Health, 2020, 41(11): 1621-1624. doi: 10.16835/j.cnki.1000-9817.2020.11.006
[3]	LI Y, BAI W, ZHU B, et al. Prevalence and correlates of poor sleep quality among college students: a cross-sectional survey[J]. Health Qual Life Outcomes, 2020, 18(1): 210. doi: 10.1186/s12955-020-01465-2
[4]	陈江媛, 吴冉. 大学生的睡眠质量与抑郁、焦虑的关系[J]. 中国健康心理学杂志, 2021, 29(4): 608-614. https://www.cnki.com.cn/Article/CJFDTOTAL-JKXL202104029.htm CHEN J Y, WU R. Relations of sleep qualtiy to depression and anxiety in college students[J]. Chin J Health Psychol, 2021, 29(4): 608-614. https://www.cnki.com.cn/Article/CJFDTOTAL-JKXL202104029.htm
[5]	WHO. Child maltreatment. (2020-06-08). http://who.int/news-room/fact-sheets/detail/child-matlreatment.
[6]	FLORES-TORRES M H, COMERFORD E, SIGNORELLO L, et al. Impact of adverse childhood experiences on cardiovascular disease risk factors in adulthood among Mexican women[J]. Child Abuse Negl, 2020, 99: 104175. doi: 10.1016/j.chiabu.2019.104175
[7]	MCCURLEY J L, GUTIERREZ A P, BRAVIN J I, et al. Association of social adversity with comorbid diabetes and depression symptoms in the hispanic community health study/study of latinos sociocultural ancillary study: a syndemic framework[J]. Ann Behav Med, 2019, 53(11): 975-987. doi: 10.1093/abm/kaz009
[8]	KIM Y, KIM K, CHARTIER K G, et al. Adverse childhood experience patterns, major depressive disorder, and substance use disorder in older adults[J]. Aging Ment Health, 2021, 25(3): 484-491. doi: 10.1080/13607863.2019.1693974
[9]	THAYER Z, BARBOSA-LEIKER C, MCDONELL M, et al. Early life trauma, post-traumatic stress disorder, and allostatic load in a sample of American Indian adults[J]. Am J Hum Biol, 2017, 29(3): 10.1002/ajhb. 22943. http://www.onacademic.com/detail/journal_1000039752229910_095d.html
[10]	XIAO D, WANG T, HUANG Y, et al. Gender differences in the associations between types of childhood maltreatment and sleep disturbance among Chinese adolescents[J]. J Affect Disord, 2020, 265: 595-602. doi: 10.1016/j.jad.2019.11.099
[11]	李羽萱, 柴晓运, 刘勤学, 等. 童年期心理虐待经历与大学生手机成瘾: 自尊和心理弹性的作用[J]. 中国临床心理学杂志, 2019, 27(3): 506-509, 514. https://www.cnki.com.cn/Article/CJFDTOTAL-ZLCY201903017.htm LI Y X, CHAI X Y, LIU Q X, et al. Childhood psychological maltreatment and smartphone addiction of undergraduates: the role of self-esteem and resilience[J]. Chin J Clin Psychol, 2019, 27(3): 506-509, 514. https://www.cnki.com.cn/Article/CJFDTOTAL-ZLCY201903017.htm
[12]	刘婷婷, 周兰, 唐小丽, 等. 医学专科生手机成瘾与睡眠和学业的关系研究[J]. 中国药物依赖性杂志, 2017, 26(1): 33-37. https://www.cnki.com.cn/Article/CJFDTOTAL-YWYB201701007.htm LIU T T, ZHOU L, TANG X L, et al. Investigation of the relationship between mobile addiction and sleep and academic achievement in medical collgeg students[J]. Chin J Drug Depend, 2017, 26(1): 33-37. https://www.cnki.com.cn/Article/CJFDTOTAL-YWYB201701007.htm
[13]	TAMURA H, NISHIDA T, TSUJI A, et al. Association between excessive use of mobile phone and insomnia and depression among Japanese adolescents[J]. Int J Environ Res Public Health, 2017, 14(7): 701. doi: 10.3390/ijerph14070701
[14]	SIEBEN A, LUST K, CROSE A, et al. Race and sex differences in adverse childhood experiences among Asian/Pacific Islander college students[J]. J Am Coll Health, 2019: 1-8. DOI: 10.1080/07448481.2019.1677671.
[15]	赵晓宁, 孙权, 曹友琴, 等. 贵阳高校新生睡眠质量与体重指数的相关性分析[J]. 现代预防医学, 2020, 47(23): 4312-4316. https://www.cnki.com.cn/Article/CJFDTOTAL-XDYF202023021.htm ZHAO X N, SUN Q, CAO Y Q, et al. Correlation analysis of sleep quality and body mass index of college freshmen, Guiyang[J]. Mod Prev Med, 2020, 47(23): 4312-4316. https://www.cnki.com.cn/Article/CJFDTOTAL-XDYF202023021.htm
[16]	赵幸福, 张亚林, 李龙飞, 等. 中文版儿童期虐待问卷的信度和效度[J]. 中国临床康复, 2005, 9(20): 105-107. https://www.cnki.com.cn/Article/CJFDTOTAL-XDKF200520049.htm ZHAO X F, ZHANG Y L, LI L F, et al. Reliability and validity of the Chinese version of childhood trauma questionnaire[J]. Chin J Tissue Eng Res, 2005, 9(20): 105-107. https://www.cnki.com.cn/Article/CJFDTOTAL-XDKF200520049.htm
[17]	刘贤臣, 唐茂芹, 胡蕾, 等. 匹兹堡睡眠质量指数的信度和效度研究[J]. 中华精神科杂志, 1996, 29(2): 103-107. https://www.cnki.com.cn/Article/CJFDTOTAL-ZHMA199602018.htm LIU X C, TANG M Q, HU L, et al. Reliability and validity of the pittsburgh sleep quality index[J]. Chin J Psychiatry, 1996, 29(2): 103-107. https://www.cnki.com.cn/Article/CJFDTOTAL-ZHMA199602018.htm
[18]	陶舒曼, 付继玲, 王惠, 等. 青少年手机使用依赖自评问卷编制及其在大学生中的应用[J]. 中国学校卫生, 2013, 34(1): 226-229. http://www.cjsh.org.cn/article/id/zgxxws201301009 TAO S M, FU J L, WANG H, et al. Development of Self-rating Questionnaire for Adolescent Problematic Mobile Phone Use and the psychometric evaluation in undergraduates[J]. Chin J Sch Health, 2013, 34(1): 226-229. http://www.cjsh.org.cn/article/id/zgxxws201301009
[19]	HAYES A F. Introduction to mediation, moderation, and conditional process analysis: a regression-based approach[J]. J Educ Meas, 2013, 51(3): 335-337. http://psycnet.apa.org/psycinfo/2013-21121-000
[20]	ROJO-WISSAR D M, DAVIDSON R D, BECK C J, et al. Sleep quality and perceived health in college undergraduates with adverse childhood experiences[J]. Sleep Health, 2019, 5(2): 187-192. doi: 10.1016/j.sleh.2018.11.007
[21]	LI W, ZHANG X, CHU M, et al. The impact of adverse childhood experiences on mobile phone addiction in chinese college students: a serial multiple mediator model[J]. Front Psychol, 2020, 11: 834. doi: 10.3389/fpsyg.2020.00834
[22]	HOLGERSON A A, CLARK M M, AMES G E, et al. Association of adverse childhood experiences and food addiction to bariatric surgery completion and weight loss outcome[J]. Obes Surg, 2018, 28(11): 3386-3392. doi: 10.1007/s11695-018-3370-1
[23]	LEE J E, JANG S I, JU Y J, et al. Relationship between mobile phone addiction and the incidence of poor and short sleep among korean adolescents: a longitudinal study of the Korean children & youth panel survey[J]. J Korean Med Sci, 2017, 32(7): 1166-1172. doi: 10.3346/jkms.2017.32.7.1166
[24]	PARK E J, KIM S Y, KIM Y, et al. The relationship between adverse childhood experiences and sleep problems among adolescent students: mediation by depression or anxiety[J]. Int J Environ Res Public Health, 2020, 18(1): 236. doi: 10.3390/ijerph18010236
[25]	MCPHIE M L, WEISS J A, WEKERLE C. Psychological distress as a mediator of the relationship between childhood maltreatment and sleep quality in adolescence: results from the Maltreatment and Adolescent Pathways (MAP) Longitudinal Study[J]. Child Abuse Negl, 2014, 38(12): 2044-2052. doi: 10.1016/j.chiabu.2014.07.009
[26]	胡静波. 大学生童年期创伤对手机成瘾倾向的影响[J]. 中国健康心理学杂志, 2020, 28(7): 1071-1076. https://www.cnki.com.cn/Article/CJFDTOTAL-JKXL202007027.htm HU J B. The influence of childhood trauma on mobile phone addiction tendency in college students[J]. Chin J Health Psychol, 2020, 28(7): 1071-1076. https://www.cnki.com.cn/Article/CJFDTOTAL-JKXL202007027.htm
[27]	罗晓, 胡春男. 大学生睡眠问题对手机社交媒体依赖的影响: 孤独感的中介作用[J]. 中国健康心理学杂志, 2021, 29(5): 776-781. https://www.cnki.com.cn/Article/CJFDTOTAL-JKXL202105028.htm LUO X, HU C N. Influence of sleep problems on mobile social media dependence in college students: mediating effect of loneliness[J]. Chin J Health Psychol, 2021, 29(5): 776-781. https://www.cnki.com.cn/Article/CJFDTOTAL-JKXL202105028.htm
[28]	HUANG Q, LI Y, HUANG S, et al. Smartphone use and sleep quality in chinese college students: a preliminary study[J]. Front Psychiatry, 2020, 11: 352. http://www.ncbi.nlm.nih.gov/pubmed/32435208
[29]	郑晓妮, 易淑明, 陈烨, 等. 以运动为主的综合干预对大学生手机依赖及睡眠质量的影响[J]. 卫生职业教育, 2019, 37(7): 125-127. https://www.cnki.com.cn/Article/CJFDTOTAL-ZDYX201907072.htm ZHENG X N, YI S M, CHEN Y, et al. Effects of comprehensive intervention based on exercise on mobile phone dependence and sleep quality of college students[J]. Health Vocat Educ, 2019, 37(7): 125-127. https://www.cnki.com.cn/Article/CJFDTOTAL-ZDYX201907072.htm
[30]	KIM Y H. Associations of adverse childhood experiences with depression and alcohol abuse among Korean college students[J]. Child Abuse Negl, 2017, 67: 338-348. doi: 10.1016/j.chiabu.2017.03.009
[31]	USTUNER TOP F, CAM H H. Childhood maltreatment among university students in Turkey: prevalence, demographic factors, and health-related quality of life consequences[J]. Psychol Health Med, 2020, 20: 1-12. doi: 10.1080/13548506.2020.1768274?scroll=top&
[32]	WANG Y, LI Y, LIU X, et al. Gender-specific prevalence of poor sleep quality and related factors in a Chinese rural population: the Henan rural cohort study[J]. Sleep Med, 2019, 54: 134-141. doi: 10.1016/j.sleep.2018.10.031