Prevalence of common illness among primary school freshmen in Guiyang and parental health management service needs after the examination
-
摘要:
目的 了解贵阳市小学新生健康状况及家长检后健康管理服务需求，为构建家校医三方共防、共治的学校健康管理工作提供参考依据。 方法 于2024年9—10月，在贵阳市采用分层随机整群抽样的方法，分别抽取3 210名参与本年度小学入学体检的新生及其家长3 133名为研究对象。收集学生人口统计学指标、体格检查指标、实验室检查指标，自编问卷调查家长对于学生检后健康管理服务需求。采用多重线性回归分析家长检后健康管理服务需求的相关因素。 结果 小学新生常见病检出率分别为龋齿60.22%、筛查性近视17.23%、肥胖6.11%、缺铁性贫血3.86%、脊柱侧弯1.15%。体检新生多病共患率为23.89%(767名)，其中筛查性近视+龋齿(8.22%)及肥胖+龋齿(4.27%)检出率较高。有63.80%的家长表示体检项目较简单，2 366名(75.52%)表示对检后健康管理服务有需求；家长对检后健康服务需求的平均得分为(3.12±0.70)分。从各维度来看，营养健康的得分均值(3.58±0.74)最高，中医保健得分均值(2.77±0.67)最低，其他分别为运动干预(3.29±0.79)、心理监测(3.17±0.58)、健康教育与签约服务(2.81±0.73)。多重线性回归分析结果显示，父母文化程度(初中、高中/中专、大专/本科及以上)、居住情况(流动)、孩子患病情况(1，2，≥3种)是新生入学检后家长健康管理服务需求的相关因素(B值分别为2.16，3.07，3.68；-2.19；3.14，3.34，3.11，P值均 < 0.05)。 结论 贵阳市小学新生常见病患病率单病负担较重，多病共患情况凸显。入学体检后，家长对于后续健康管理服务需求明显，检后健康管理服务应根据家长需求且融入多病共防理念。 Abstract:Objective To understand the health status of primary school freshmen in Guiyang and the health management service needs of parents after examination, so as to provide a reference for establishment of a collaborative health management framework involving schools, families, and healthcare providers. Methods From September to October 2024, a stratified random cluster sampling method was used in Guiyang City to select 3 210 students and 3 133 parents who participated in the physical examination for primary school freshmen. Demographic indicators, physical examination indicators and laboratory examination indicators of students were collected, and parents' needs for post examination health management service were investigated by self-designed questionnaire. Multiple linear regression analysis was adopted to investigate the related factors of parents' health management service needs after the examination. Results The detection rates of common illness among primary school freshmen were 60.22% for dental caries, 17.23% for screening myopia, 6.11% for obesity, 3.86% for iron deficiency anemia, and 1.15% for scoliosis. The co-occurrence rate of common illness among freshmen during the physical examination was 23.89% (n=767), among which the comorbidity rate of screening myopia and dental caries (8.22%) and obesity and dental caries (4.27%) were higher. About 63.80% parents indicated that the physical examination items were simple, and 2 366 parents (75.52%) indicated a demand for post-examination management services; the average score of parents' demands for post-examination services was (3.12±0.70). In terms of the scores of each dimension, the mean score of nutrition and health (3.58±0.74) was the highest, while the lowest mean score was for traditional Chinese medicine health care (2.77±0.67). The mean scores for the other dimensions were as follows: exercise intervention (3.29±0.79), psychological monitoring (3.17±0.58), and health education and signing (2.81±0.73). The results of multiple linear regression analysis showed that parents' educational level (junior high school, high school/vocational school, college/undergraduate and above), living conditions (floating), and children's illness status (1, 2, >3 types) were the related factors of parents' health management service needs after the entrance examination for new students (B=2.16, 3.07, 3.68; -2.19; 3.14, 3.34, 3.11, P < 0.05). Conclusions The prevalence of common illness in primary schools in Guiyang is characterized by a heavy burden from single diseases, with a notable occurrence of multiple comorbidities. After the physical examination, parents have obvious demand for follow-up health management services. These health management services should integrate the concept of multi-disease prevention according to the needs of parents. -
Key words:
- Dental caries /
- Myopia /
- Obesity /
- Anemia /
- Regression analysis /
- Students /
- Legal guardians
1) 利益冲突声明 所有作者声明无利益冲突。 -
表 1 不同组别儿童常见疾病检出率比较
Table 1. Comparison of detection rates of common illness in children in different groups
组别 选项 人数 统计值 筛查性近视 肥胖 龋齿 脊柱侧弯 缺铁性贫血 性别 男 1 759 298(16.94) 133(7.56) 1 039(59.07) 21(1.19) 69(3.92) 女 1 451 255(17.57) 63(4.34) 894(61.61) 16(1.10) 55(3.79) χ2值 0.22 14.37 2.15 0.06 0.04 P值 0.64 < 0.01 0.14 0.81 0.85 年龄/岁 6 1 656 389(23.49) 101(6.10) 831(50.18) 26(1.57) 59(3.56) 7 1 130 108(9.56) 61(5.40) 841(74.42) 8(0.71) 34(3.01) 8 424 36(8.49) 34(8.02) 261(61.56) 3(0.71) 31(7.31) χ2值 96.98 3.69 165.16 5.23 16.20 P值 < 0.01 0.16 < 0.01 0.07 < 0.01 民族 汉族 2 200 368(16.73) 131(5.95) 1329(60.41) 20(0.91) 98(4.45) 布依族 299 63(21.07) 22(7.36) 181(60.54) 5(1.67) 8(2.68) 苗族 413 69(16.71) 24(5.81) 251(60.77) 7(1.69) 12(2.91) 其他民族 298 53(17.79) 19(6.38) 172(57.72) 5(1.68) 6(2.01) χ2值 3.63 1.01 0.88 3.42 6.97 P值 0.31 0.80 0.83 0.30 0.07 注： ()内数字为检出率/%。 
下载: 导出CSV
表 2 不同组别家长对新生入学体检后健康管理服务需求的单因素分析(x ± s)
Table 2. Univariate analysis of parents in different groups on their health management service needs after the freshmen physical examination(x ± s)
组别 人数 需求得分 t/F值 P值 组别 人数 需求得分 t/F值 P值 性别 家庭结构 男 783 3.02±0.53 4.63 < 0.01 核心家庭 1 321 3.35±0.53 2.63 0.05 女 2 350 3.24±0.85 直系家庭 922 3.17±0.45 年龄/岁 联合家庭 679 3.09±0.45 20~ < 30 137 3.18±0.73 1.75 0.09 单亲家庭 211 2.88±0.45 30~ < 40 1 986 3.23±0.74 家庭年均总收入/元 >40 1 010 3.05±0.56 < 10 000 222 2.95±0.71 8.34 < 0.01 居住情况 10 000~49 999 547 3.02±0.65 常住 2 543 3.46±0.85 7.75 < 0.01 50 000~99 999 1 385 3.32±0.73 流动 590 3.01±0.69 100 000~199 999 754 3.67±0.67 家中孩子个数 ≥200 000 225 3.75±0.88 1 1 268 3.31±0.82 1.22 0.10 父母文化程度 2 1 274 3.29±0.88 小学及以下 389 2.76±0.68 6.24 0.04 ≥3 591 3.13±0.76 初中 513 2.93±0.84 孩子患病情况/种 高中/中专 811 3.16±0.75 0 367 3.23±0.81 8.33 < 0.01 大专/本科及以上 1 420 3.38±0.78 1 1 999 3.51±0.69 户口性质 2 618 3.68±0.93 城市 2 341 3.42±0.87 7.21 < 0.01 ≥3 149 3.75±0.85 农村 792 3.11±0.77
下载: 导出CSV
表 3 家长对新生入学体检后健康管理服务需求的多重线性回归分析(n=3 133)
Table 3. Multiple linear regression analysis of parents' health management service demand after freshmen entrance physical examination(n=3 133)
自变量 B值 标准误 β值 t值 P值 父母文化程度 初中 2.16 0.69 0.23 3.06 < 0.01 高中/中专 3.07 0.72 0.30 4.28 < 0.01 大专/本科及以上 3.68 0.69 0.42 5.34 < 0.01 居住情况 -2.19 0.53 -0.24 4.01 < 0.01 孩子患病情况/种 3.13 0.68 0.36 4.15 < 0.01 1 3.14 0.52 0.36 4.23 < 0.01 2 3.34 0.68 0.40 5.08 < 0.01 ≥3 3.11 0.66 0.35 4.19 < 0.01
下载: 导出CSV
-
[1] CHEN T J, DONG B, DONG Y, et al. Matching actions to needs: shift-ing policy responses to the changing health needs of Chinese children and adolescents[J]. Lancet, 2024, 403: 1808-1820. doi: 10.1016/S0140-6736(23)02894-5 [2] 中共中央国务院印发《"健康中国2030"规划纲要》[EB/OL]. (2016-10-25)[2024-11-08]. https://www.gov.cn/zhengce/2016-10/25/content_5124174.htm .[3] 国家疾病预防控制局. 学生健康管理技术规范: WS/T 10021—2024[EB/OL]. (2024-10-18)[2024-11-08]. https://www.ndcpa.gov.cn/jbkzzx/c100202/common/content/content_1846467554702110720.html .[4] 郭欣. 加强儿童青少年健康管理促进学校卫生工作高质量发展[J]. 中国学校卫生, 2024, 45(6): 761-765, 769. doi: 10.16835/j.cnki.1000-9817.2024174GUO X. Strengthening the health management of children and adolescents to promote high-quality development of school health work[J]. Chin J Sch Health, 2024, 45(6): 761-765, 769. (in Chinese) doi: 10.16835/j.cnki.1000-9817.2024174 [5] 聂颖, 蔡菁晖, 朱焱. 基层儿童健康管理服务技术评价指标体系研究[J]. 现代预防医学, 2024, 51(11): 2001-2007.NIE Y, CAI J H, ZHU Y. Study on technical evaluation index system of primary children's health management service[J]. Mod Prev Med, 2024, 51(11): 2001-2007. (in Chinese) [6] 郭清. 健康管理学[M]. 北京: 人民卫生出版社, 2015.GUO Q. Health management science[M]. Beijing: People's Medical Publishing House, 2015. (in Chinese) [7] 中华人民共和国卫生部. 国家学生健康检查技术规范GB/T 26343—2010)[EB/OL]. (2011-06-07)[2024-11-08]. http://www.nhc.gov.cn/cms-search/xxgk/getManuscriptXxgk.htm?id=51939 .[8] 陶芳标. 儿童少年卫生学[M]. 8版. 北京: 人民卫生出版社, 2018.TAO F B. Child and adolescent health science[M]. 8th ed. Beijing: People's Medical Publishing House, 2018. (in Chinese) [9] 刘志浩, 张京舒, 孙冰洁, 等. 中国六省市低年级小学生近视与父母近视和学龄前文化课学习的关联[J]. 中国学校卫生, 2024, 45(9): 1345-1348, 1353. doi: 10.16835/j.cnki.1000-9817.2024275LIU Z H, ZHANG J S, SUN B J, et al. Association between parental myopia and extracurricular activities before school age with myopia among lower grade students in 6 provinces and cities in China[J]. Chin J Sch Health, 2024, 45(9): 1345-1348, 1353. (in Chinese) doi: 10.16835/j.cnki.1000-9817.2024275 [10] 郁莹, 易芳羽, 张皓, 等. 上海市小学一年级学生患龋状况调查及影响因素分析[J]. 海军军医大学学报, 2024, 45(10): 1310-1315.YU Y, YI F Y, ZHANG H, et al. Caries status and its influencing factors among first-grade primary school students in Shanghai[J]. Acad J Naval Med Univ, 2024, 45(10): 1310-1315. (in Chinese) [11] WHO. Global oral health status report: towards universal health coverage for oral health by 2030[EB/OL]. (2022-11-18)[2024-11-08]. https://www.who.int/publications/i/item/9789240061484 .[12] 马庆祥. 济宁市兖州区2~7岁儿童缺铁性贫血情况及其危险因素[J]. 济宁医学院学报, 2023, 46(4): 270-273.MA Q X. Analysis of iron-deficient anemia and risk factors in children aged 2-7 years in Yanzhou District, Jining[J]. J Jining Med Univ, 2023, 46(4): 270-273. (in Chinese) [13] 国家疾病预防控制局. 中国居民营养与慢性病状况报告(2020年)[M]. 北京: 人民卫生出版社, 2020.National Disease Control and Prevention Administration. Report on nutrition and chronic diseases of Chinese residents(2020)[M]. Beijing: People's Medical Publishing House, 2020. (in Chinese) [14] 陈玉娟, 李立, 杨惠玲, 等. 石家庄儿童脊柱侧弯现状及影响因素分析[J]. 中国学校卫生, 2021, 42(11): 1674-1678. doi: 10.16835/j.cnki.1000-9817.2021.11.017CHEN Y J, LI L, YANG H L, et al. Current status and influencing factors of scoliosis of children in Shijiazhuang[J]. Chin J Sch Health, 2021, 42(11): 1674-1678. (in Chinese) doi: 10.16835/j.cnki.1000-9817.2021.11.017 [15] 陶舒曼, 伍晓艳, 陶芳标. 《学生常见病多病共防技术指南》专题解读[J]. 中国学校卫生, 2024, 45(10): 1372-1377. doi: 10.16835/j.cnki.1000-9817.2024305TAO S M, WU X Y, TAO F B. Expert interpretation on the Technical Guidelines for the Joint Prevention of Common Disease Multimorbidity among Students[J]. Chin J Sch Health, 2024, 45(10): 1372-1377. (in Chinese) doi: 10.16835/j.cnki.1000-9817.2024305 [16] 董彦会, 陈璐, 马军, 等. 构建高水平学校卫生体系促进学生常见病共防行动[J]. 中国学校卫生, 2024, 45(5): 609-614. doi: 10.16835/j.cnki.1000-9817.2024160DONG Y H, CHEN L, MA J, et al. Constructing a high-level school health system to facilitate joint prevention practice of common diseases among students[J]. Chin J Sch Health, 2024, 45(5): 609-614. (in Chinese) doi: 10.16835/j.cnki.1000-9817.2024160 [17] 黄生垒, 张凤云, 曲爽笑, 等. 上海市2021年中小学生常见病共患现状及相关因素[J]. 中国学校卫生, 2024, 45(5): 635-639. doi: 10.16835/j.cnki.1000-9817.2024135HUANG S L, ZHANG F Y, QU S X, et al. Comorbidity of common illnesses and associated factors among primary and middle school students in Shanghai in 2021[J]. Chin J Sch Health, 2024, 45(5): 635-639. (in Chinese) doi: 10.16835/j.cnki.1000-9817.2024135 [18] 李云, 张裕民, 张越, 等. 0~3岁儿童家长养育的健康素养调查研究[J]. 中国妇幼健康研究, 2021, 32(11): 1622-1627.LI Y, ZHANG Y M, ZHANG Y, et al. Parental health literacy among caregivers of children aged 0-3 years old[J]. Chin J Woman Child, 2021, 32(11): 1622-1627. (in Chinese) [19] 宋逸, 张秀红, 马军. 儿童青少年主要健康问题"共病-共因-共防"机制建立与探索[J]. 中国学校卫生, 2023, 44(9): 1281-1285. doi: 10.16835/j.cnki.1000-9817.2023.09.001SONG Y, ZHANG X H, MA J. Establishment and exploration of the mechanism of Co-morbidity, Shared Etiology, and Shared Prevention of major health problems of children and adolescents[J]. Chin J Sch Health, 2023, 44(9): 1281-1285. (in Chinese) doi: 10.16835/j.cnki.1000-9817.2023.09.001 -
点击查看大图
表(3)
计量
- 文章访问数: 68
- HTML全文浏览量: 36
- PDF下载量: 14
- 被引次数: 0
