成都金牛区幼儿园儿童心理行为预警征筛查现状及相关因素

白凤仪

doi:10.16835/j.cnki.1000-9817.2023.02.020

成都金牛区幼儿园儿童心理行为预警征筛查现状及相关因素

doi: 10.16835/j.cnki.1000-9817.2023.02.020

白凤仪

四川省成都市金牛区妇幼保健院保健科，610036

基金项目:

成都市卫生健康委员会医学科研课题 2021411

详细信息

作者简介:
白凤仪(1982-)，女，辽宁丹东人，硕士，主治医师，主要研究方向为儿童保健

利益冲突声明 所有作者声明无利益冲突。
中图分类号: B844.1 G617.8 R179
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出版历程
- 收稿日期: 2022-07-12
- 修回日期: 2022-11-06
- 网络出版日期: 2023-03-02
- 刊出日期: 2023-02-25

Current situation and related factors of screening for early warning signals in psychopathology in kindergarten children in Jinniu District of Chengdu

BAI Fengyi

Jinniu Disrict Maternal and Child Health Care Hospital, Chengdu(610036), China

摘要

摘要: 目的了解成都市金牛区幼儿园幼儿心理行为发育问题预警征筛查现状并分析可能的影响因素，为制定有效的防治策略提供参考。方法 2021年10—12月，以成都市金牛区幼儿园20 417名儿童为研究对象。采用适应年龄组的儿童心理行为发育问题预警征象(预警征)分别进行发育筛查。采用Logistic回归用于预警征筛查阳性的多因素分析。结果 2岁儿童预警征筛查阳性率最高为语言能区(6.12%)，2.5，3岁儿童最高为个人社交能区(1.70%, 1.76%)，4，5岁儿童预警征筛查阳性率最高为精细运动能区(2.04%，1.03%)；单因素和多因素分析表明预警征筛查阳性的相关因素有性别、家庭结构、异常出生史、每天电子屏幕暴露时间>2 h、每天夜间睡眠时长、年龄等(P值均 < 0.05)。结论在幼儿园定期进行预警征筛查十分必要。应结合儿童各年龄阶段有针对性地对照护人、幼儿园教职人员开展健康教育，帮助其建立正确的育儿观念；同时应重视儿童睡眠健康，减少电子屏幕暴露时间, 从而促进儿童身心健康发展。
- 精神卫生 /
- 行为 /
- 回归分析 /
- 儿童，学龄前
Abstract: Objective To describe screening situation and associated factors of early warning signals in psychopathology in kindergarten children, so as to provide reference for effective prevention and treatment strategies. Methods From October to December 2021, a cross-sectional study was conducted in kindergartens in Jinniu District of Chengdu. The age-appropriate early warning signals were screened among 20 417 kindergarten children for developmental problems. Chi-square test and Logistic regression were used for univariate and multivariate analysis of positive early warning signs screening, respectively. Results The positive screening of early warning signals among 2-year-old children was mainly distributed in the language domain (6.12%), personal-social domain for 2.5-year-old (1.70%) and 3-year-old children (1.76%), and fine-motor domain for 4-year-old (2.04%) and 5-year-old children (1.03%). Univariate and multivariate analysis showed that factors associated with positive screening of early warning signals included gender, family structure, history of diseases, electronic screen exposure >2 h/d, sleep duration at night, and age of children(P < 0.05). Conclusion It is necessary to carry out regular screening for early warning signals for psychopathology in kindergartens. Age-appropriate health education for early childhood development should be carried out against nurses and kindergarten teaching staff. Similarly, more attention should be paid to healthy sleep and media usage to improve physical and mental wellness among preschool children.
- Mental health /
- Behavior /
- Regression analysis /
- Child, preschool
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表 1 不同年龄段儿童预警征筛查阳性率比较

Table 1. Comparison of positive rates of early warning signs of psychological behavior in children of different ages

年龄/岁	人数	语言	个人社交	精细运动	大运动
2	49	3(6.12)	0	0	0
2.5	411	2(0.49)	7(1.70)	0	0
3	5 453	21(0.39)	96(1.76)	76(1.39)	10(0.18)
4	6 577	41(0.62)	56(0.85)	134(2.04)	23(0.35)
5	6 709	33(0.49)	4(0.06)	69(1.03)	18(0.27)
6	1 218	3(0.25)	9(0.74)	3(0.25)	1(0.08)
χ²值		35.85	108.46	38.24	7.64
P值		< 0.01	< 0.01	< 0.01	0.18
注： ()内数字为检出率/%。

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表 2 儿童预警征筛查阳性单因素分析

Table 2. Univariate analysis of positive screening of early warning signs of psychological behavior in children

因素	选项	人数	异常人数	χ²值	P值
幼儿园等级	1	3 150	66(2.10)	4.22	0.12
	2	14 160	334(2.36)
	3	3 107	89(2.86)
幼儿园性质	部队园	365	9(2.47)	7.07	0.07
	部门园	3 164	69(2.18)
	教办园	4 526	88(1.94)
	民办园	12 362	323(2.61)
性别	男	10 557	355(3.36)	87.56	< 0.01
	女	9 860	134(1.36)
家庭结构	单亲	460	15(3.26)	16.27	< 0.01
	隔代	280	16(5.71)
	核心	12 688	284(2.24)
	直系及联合	6 989	174(2.49)
主要看护人	初中及以下	2 309	79(3.42)	13.49	< 0.01
最高学历	高中	4 305	102(2.37)
	大专及本科	11 654	268(2.30)
	硕士及以上	2 149	40(1.86)
家庭人均月	< 2 000	665	23(3.46)	9.08	0.11
收入/元	2 000~ < 3 000	1 497	45(3.01)
	3 000~ < 5 000	4 551	104(2.29)
	5 000~ < 10 000	7 985	194(2.43)
	10 000~ < 20 000	4 477	90(2.01)
	≥20 000	1 242	33(2.66)
异常出生史	无	17 465	395(2.26)	9.20	< 0.01
	有	2 952	94(3.18)
每天室外活	< 1	2 649	75(2.83)	3.30	0.35
动时长/h	1~ < 2	12 758	289(2.27)
	2~4	3 915	98(2.50)
	>4	1 095	27(2.47)
每天电子屏幕暴	否	19 304	442(2.29)	16.82	< 0.01
露时长>2 h	是	1 113	47(4.22)
每天夜间睡眠时	< 8	644	27(4.19)	12.22	0.01
长/h	8~ < 9	10 374	256(2.47)
	9~10	8 537	182(2.13)
	>10	862	24(2.78)
儿童年龄/岁	2	49	3(6.12)	52.08	< 0.01
	2.5	411	9(2.19)
	3	5 453	167(3.06)
	4	6 577	194(2.95)
	5	6 709	102(1.52)
	6	1 218	14(1.15)
合计		20 417	489(2.40)
注： ()内数字为检出率/%。

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表 3 儿童预警征筛查阳性影响因素的非条件Logistic回归分析(n=20 417)

Table 3. Non conditional Logistic regression analysis of the influencing factors of the positive screening for early warning signs in children of psychological behavior(n=20 417)

自变量	选项	β值	标准误	Wald χ²值	P值	OR值(OR值95%CI)
性别	女	-0.93	0.10	82.50	< 0.01	0.39(0.32~0.48)
家庭结构	隔代家庭					1.00
	单亲家庭	-0.94	0.27	12.03	< 0.01	0.39(0.23~0.66)
	核心家庭	-0.82	0.28	8.79	< 0.01	0.44(0.26~0.76)
	直系及联合家庭	-0.58	0.37	2.42	0.12	0.56(0.27~1.16)
主要照护人最高学历	初中及以下					1.00
	高中	-0.27	0.16	2.75	0.10	0.77(0.56~1.05)
	大专及大学	-0.24	0.16	2.31	0.13	0.79(0.58~1.07)
	硕士及以上	-0.45	0.23	3.91	0.05	0.64(0.41~1.00)
异常出生史	有	0.27	0.12	5.39	0.02	1.31(1.04~1.66)
每天室外活动时长/h	< 1					1.00
	1~ < 2	-0.20	0.13	2.17	0.14	0.82(0.63~1.07)
	2~4	-0.16	0.16	1.04	0.31	0.85(0.62~1.16)
	>4	-0.20	0.23	0.74	0.39	0.82(0.52~1.29)
每天电子屏幕暴露时长/h	>2	0.52	0.16	10.44	< 0.01	1.68(1.23~2.30)
每天夜间睡眠时间/h	< 8					1.00
	8~ < 9	-0.44	0.21	4.30	0.04	0.64(0.43~0.98)
	9~10	-0.60	0.22	7.59	0.01	0.55(0.36~0.84)
	>10	-0.36	0.29	1.51	0.22	0.70(0.39~1.24)
年龄/岁	2					1.00
	2.5	-1.12	0.69	2.62	0.11	0.33(0.09~1.27)
	3	-0.73	0.61	1.42	0.23	0.49(0.15~1.60)
	4	-0.82	0.61	1.82	0.18	0.44(0.13~1.45)
	5	-1.51	0.61	6.14	0.01	0.22(0.07~0.73)
	6	-1.86	0.66	7.89	0.01	0.16(0.04~0.57)

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表 4 儿童预警征个人社交能区、精细运动筛查阳性影响因素的非条件Logistic回归分析(n=20 417)

Table 4. Nonconditional Logistic regression analysis of the influencing factors of the positive screening for early warning signs of individual social energy zones and fine motion in children(n=20 417)

自变量	选项	个人社交			精细运动
自变量	选项	β值	P值	OR值(OR值95%CI)	β值	P值	OR值(OR值95%CI)
性别	女	-0.66	< 0.01	0.52(0.38~0.72)	-0.67	< 0.01	0.51(0.37~0.71)
家庭结构	隔代			1.00			1.00
	单亲家庭	-1.41	< 0.01	0.24(0.11~0.52)	-1.44	< 0.01	0.24(0.11~0.51)
	核心家庭	-1.23	< 0.01	0.29(0.14~0.63)	-1.20	< 0.01	0.30(0.14~0.65)
	直系及联合家庭	-0.46	0.37	0.63(0.23~1.74)	-0.76	0.17	0.47(0.16~1.40)
主要照护人最高学历	初中及以下			1.00			1.00
	高中	-0.74	< 0.01	0.48(0.29~0.79)	-0.70	0.01	0.50(0.30~0.83)
	大专及大学	-0.77	< 0.01	0.47(0.29~0.75)	-0.74	< 0.01	0.48(0.29~0.78)
	硕士及以上	-0.64	0.06	0.53(0.27~1.03)	-0.74	0.04	0.48(0.24~0.96)
异常出生史	有	-0.03	0.87	0.97(0.64~1.47)	< 0.01	0.98	1.00(0.66~1.53)
每天室外活动时间/h	< 1			1.00			1.00
	1~ < 2	-0.47	0.03	0.62(0.41~0.96)	-0.52	0.02	0.60(0.39~0.92)
	2~4	-0.40	0.12	0.67(0.40~1.11)	-0.42	0.11	0.66(0.40~1.09)
	>4	-0.27	0.44	0.76(0.38~1.52)	-0.35	0.33	0.70(0.34~1.43)
每天电子屏幕暴露时间/h	>2	0.36	0.20	1.43(0.83~2.48)	0.39	0.16	1.48(0.85~2.55)
孩子年龄/岁	6			1.00			1.00
	2	-16.01	1.00	0	-15.98	1.00	0
	2.5	1.05	0.04	2.86(1.04~7.83)
	3	1.07	< 0.01	2.91(1.45~5.83)	1.07	< 0.01	2.90(1.45~5.82)
	4	0.26	0.48	1.30(0.64~2.64)	0.25	0.48	1.29(0.63~2.63)
	5	-2.45	< 0.01	0.09(0.03~0.28)	-2.45	< 0.01	0.09(0.03~0.28)

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