家长近视防控认知和技能与小学生健康用眼行为的关联

章小花; 童敏; 张卫华; 徐加伟; 曹斌; 沈洁; 田倩倩; 史慧静

doi:10.16835/j.cnki.1000-9817.2024204

家长近视防控认知和技能与小学生健康用眼行为的关联

doi: 10.16835/j.cnki.1000-9817.2024204

章小花^{1, 2},
童敏²,
张卫华¹,
徐加伟¹,
曹斌¹,
沈洁^{3, 4},
田倩倩^{3, 4},
史慧静^2, ,

1.
上海市浦东新区眼病牙病防治所预防科，201399
2.
复旦大学公共卫生学院
3.
上海交通大学医学院
4.
上海交通大学中国医院发展研究院

基金项目:

上海市进一步加快中医药传承创新发展三年行动计划(2021—2023年)项目 ZY(2021—2023)-0105

浦东新区公卫特色学科项目 PWYgts2021-03

上海市加强公共卫生三年行动计划(2023—2025年)重点学科建设项目 GWVI-11.1-32

详细信息

作者简介:
章小花(1982-)，女，江西新干人，在读硕士，主管医师，主要研究方向为眼病防治

通讯作者:
史慧静，E-mail: hjshi@fudan.edu.cn

利益冲突 所有作者声明无利益冲突。
中图分类号: R179 R778.1⁺¹ G78
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出版历程
- 收稿日期: 2024-04-17
- 修回日期: 2024-05-11
- 网络出版日期: 2024-07-27
- 刊出日期: 2024-07-25

Association of parental knowledge and skills in myopia prevention and control with healthy eye behavior in primary school children

ZHANG Xiaohua^{1, 2},
TONG Min²,
ZHANG Weihua¹,
XU Jiawei¹,
CAO Bin¹,
SHEN Jie^{3, 4},
TIAN Qianqian^{3, 4},
SHI Huijing^{2
, ,}

1.
Department of Prevention, Eye and Dental Clinic of Pudong New District, Shanghai (201399), China

摘要

摘要: 目的探讨家长近视防控的认知和技能水平与小学生健康用眼行为之间的关联, 为开展家庭精准宣教提供依据。方法 2022年10—12月，采取分层整群随机抽样方法抽取上海市浦东新区8所小学一至五年级共4 979名学生，采用自制问卷调查小学生健康用眼行为及其家长对近视防控的认知与技能水平。采用χ²检验、独立样本t检验及Logistic回归分析家长近视防控认知和技能与小学生健康用眼行为的关联。结果小学生家长对近视防控的认知和技能水平较高者分别占50.97%和56.36%。认知条目中，中低年级小学生家长在“知道孩子近视的主要原因”“知道正确的近视防控知识”“知道在控制和治疗孩子近视过程中，家庭成员间要相互支持”“懂得引导孩子科学正确用眼是家长的职责”条目得分上均高于高年级小学生家长(3.05±1.21，2.97±1.20；5.92±0.86，5.83±0.86；4.46±0.88，4.40±0.93；3.88±1.04，3.72±1.07)，差异均有统计学意义(t值分别为2.04，3.39，2.00，4.87，P值均＜0.05)；技能条目中，不同年级小学生家长在所有条目得分上差异均有统计学意义(t=2.93~7.31，P值均＜0.05)。认知水平中，家长在“知道孩子近视的主要原因”“知道正确的近视防控知识”“知道《综合防控儿童青少年近视实施方案》”“担心孩子未来的求学和就业因近视会受到影响”“懂得引导孩子科学正确用眼是家长的职责”等方面得分为满分者占比较低，分别为12.71%，22.90%，19.30%，21.83%，22.47%。技能水平中，家长在“孩子做作业、读书、写字的时候提醒孩子休息眼睛”“与孩子共处时会刻意回避使用手机”“过去一年带孩子去医院屈光筛查的次数”“会给孩子布置额外的学习任务”等方面满分者占比较低，分别为33.26%，15.12%，9.00%，5.36%。相对于认知而言，家长近视防控的技能对不同学段学生健康用眼行为4个维度(读写、视屏、户外活动和睡眠时长)的作用更加凸显(OR=1.41~3.37，P值均 < 0.05)。结论家长近视防控的认知和技能还存在薄弱环节，与小学生健康用眼行为存在关联。应强化对家长近视防控的精准健康宣教，培养小学生健康用眼行为，减少其近视的发生。
- 近视 /
- 认知 /
- 眼 /
- 行为 /
- 回归分析 /
- 学生
Abstract: Objective To investigate the association of parental knowledge and skills in myopia prevention and control with healthy eye behavior in primary school children, so as to provide a basis for accurate family education. Methods A total of 4 979 students in grades 1-5 from eight elementary schools in Pudong New Area were sampled between October and December in 2022 by using a stratified cluster sampling method. A self-administered questionnaire was used to assess healthy eye behavior in primary school children and parental knowledge and skills in myopia prevention and control. The Chi-squared test, independent samples t-test and Logistic regression were used to analyse the association between parental knowledge and skills in myopia prevention and control and healthy eye behaviour in primary school children. Results Parents of primary school children with a high level of knowledge and skills in myopia prevention and control were 50.97% and 56.36%, respectively. The knowlegde entry scores for parents of lower and middle elementary school students were higher than those of parents of upper primary students with respect to their understanding, on the main causes of myopia in their children, the correct knowledge of myopia prevention and control, the role of family members in helping each other to manage and treat myopia in their children and the parents' responsibility to teach their children to use their eyes correctly and scientifically (3.05±1.21, 2.97±1.20; 5.92±0.68, 5.83±0.86; 4.46±0.88, 4.40±0.93; 3.88±1.04, 3.72±1.07); all differences were statistically significant (t=2.04, 3.39, 2.00, 4.87, P < 0.05). The differences in the scores of parents of primary school children in different grades for all items were statistically significant (t=2.93-7.31, P < 0.05) in the skill entries. Parental knowledge levels were poor for items of full scores that assessed the following: knowing the main causes of their children's myopia, awareness of the correct knowledge of myopia prevention and control measures, awareness of Comprehensive Prevention and Control Strategy for Children and Adolescents with Myopia, and concerning that their children's future education and employment will be affected by myopia, understanding the responsibility of parents for guiding children to use their eyes scientifically and correctly, with 12.71%, 22.90%, 19.30%, 21.83% and 22.47% respectively. Parental skills were poor for items of full scores that assessed the following: reminding their children to rest their eyes when doing homework, reading or writing, deliberately avoiding mobile phone use when spending time with their children, the number of times which taking children to the hospital for refractive screening in the past year, and giving their children extra learning tasks, with 33.26%, 15.12%, 9.00% and 5.36% respectively. Compared to parental knowledge in myopia prevention and control, parental skills had a more pronounced effect on the four dimensions of healthy eye behavior (reading and writing, screen time, outdoor activities, and sleep duration) among students in different grades (OR=1.41-3.37, P < 0.05). Conclusions Parental knowledge and skills in myopia prevention and control are still insafficient, associated with healthy eye behavior in primary school children. There is a need to strengthen accurate health education for parents on the prevention and control of myopia, to cultivate healthy eye behaviour among primary school students and reduce the incidence of myopia among them.
- Myopia /
- Cognition /
- Eye /
- Behavior /
- Regression analysis /
- Students
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表 1 近视防控认知条目均分在不同年级小学生家长间比较(x ± s)

Table 1. Comparison of mean scores of myopia prevention and control awareness entries among parents of primary school students in different grades(x ± s)

序号	条目	中低年级(n=3 394)	高年级(n=1 585)	总体(n=4 979)	t值	P值
1	知道使用低浓度阿托品滴眼液和/或OK镜(角膜塑形镜)控制近视进展	2.41±2.50	2.44±2.50	2.42±2.50	-0.39	0.70
2	知道孩子近视的主要原因	3.05±1.21	2.97±1.20	3.02±1.21	2.04	0.04
3	知道正确的近视防控知识	5.92±0.86	5.83±0.86	5.89±0.86	3.39	< 0.01
4	知道散瞳验光	1.19±1.47	1.26±1.48	1.21±1.47	-1.76	0.08
5	知道《综合防控儿童青少年近视实施方案》	2.56±1.49	2.59±1.49	2.57±1.49	-0.66	0.51
6	认同控制孩子近视进展是家庭现阶段最重要的事之一	4.31±0.71	4.19±0.76	4.27±0.72	0.66	0.51
7	担心孩子未来的求学和就业因近视会受到影响	3.72±0.92	3.76±0.91	3.73±0.92	-1.44	0.15
8	认为家庭成员在对待孩子近视方面存在分歧	4.26±1.55	4.17±1.63	4.23±1.58	1.95	0.05
9	知道在控制和治疗孩子近视过程中，家庭成员间要相互支持	4.46±0.88	4.40±0.93	4.44±0.89	2.00	< 0.05
10	懂得引导孩子科学正确用眼是家长的职责	3.88±1.04	3.72±1.07	3.83±1.05	4.87	< 0.01

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表 2 近视防控技能条目均分在不同年级小学生家长间比较(x ± s)

Table 2. Comparison of mean scores of myopia prevention and control skills among parents of primary school children in different grades(x ± s)

序号	条目	中低年级(n=3 394)	高年级(n=1 585)	总体(n=4 979)	t值	P值
1	认同预防孩子近视或控制近视加深需要家长付出很多的时间和精力	3.52±0.66	3.40±0.71	3.48±0.68	5.84	< 0.01
2	会提醒孩子注意读写姿势和距离	3.49±0.60	3.37±0.65	3.45±0.63	6.14	< 0.01
3	在孩子做作业、读书、写字的时候提醒孩子休息眼睛	3.15±0.81	2.98±0.84	3.10±0.82	6.82	< 0.01
4	会控制孩子电脑、手机、平板和电视等电子产品的使用时间	3.52±0.61	3.46±0.64	3.50±0.62	4.96	< 0.01
5	与孩子共处时会刻意回避使用手机	2.67±0.83	2.54±0.82	2.63±0.83	2.93	< 0.01
6	孩子视力出现异常会带去医院	3.87±0.50	3.82±0.59	3.86±0.53	2.93	< 0.01
7	过去一年带孩子去医院屈光筛查的次数	1.86±0.95	2.03±1.01	1.91±0.97	-5.98	< 0.01
8	会给孩子布置额外的学习任务	2.43±0.79	2.59±0.78	2.48±0.79	-6.66	< 0.01
9	关注孩子在学校视力检查的结果	3.51±0.61	3.37±0.64	3.46±0.62	7.31	< 0.01
10	孩子近视需要配镜会选择去医院做视力检查	3.92±0.49	3.81±0.73	3.88±0.58	5.24	< 0.01

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表 3 家长近视防控认知和技能与不同年级小学生健康用眼行为的关联分析[OR值(95%CI)，n=4 979]

Table 3. Analysis of the association between healthy eye behaviour and parents' knowledge and skills in myopia prevention and control in primary school children of different grade levels[OR(95%CI), n=4 979]

自变量	年级	每日课外读写时长≤1 h	每日视屏时长≤2 h	每日户外活动时长≥2 h	每日睡眠时长≥10 h
认知	中低	1.04(0.89~1.22)	1.23(1.06~1.44)^*	1.34(1.02~1.75)^*	0.96(0.55~1.69)
	高	0.98(0.73~1.31)	1.26(1.00~1.57)^*	1.21(0.73~2.00)	2.39(0.85~6.68)
	总体	1.01(0.86~1.19)	1.21(1.05~1.40)^*	1.14(0.85~1.52)	1.26(0.67~2.36)
技能	中低	1.42(1.21~1.66)^*	2.36(2.02~2.75)^*	1.41(1.07~1.87)^*	2.41(1.26~4.62)^*
	高	1.57(1.18~2.10)^*	1.88(1.52~2.33)^*	1.72(1.04~2.83)^*	3.37(1.09~10.44)^*
	总体	1.43(1.25~1.65)	2.20(1.95~2.49)^*	1.54(1.21~1.96)^*	2.63(1.52~4.66)^*
注：*P < 0.05。

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