留守经历对中等职业学校学生心理健康影响的倾向匹配得分分析

周全湘; 佘福强; 万雁; 何学华; 杨敬源; 曹显明; 许向阳

doi:10.16835/j.cnki.1000-9817.2025069

留守经历对中等职业学校学生心理健康影响的倾向匹配得分分析

doi: 10.16835/j.cnki.1000-9817.2025069

1.
黔南民族医学高等专科学校医学系，贵州都匀 558000
2.
贵州医科大学公共卫生学院流行病与卫生统计学系

基金项目:

2019年贵州省教育科学规划课题 2019C040

2020年贵州省教育科学规划课题 2020C008

民族地区健康乡村建设科研创新团队项目 QNYZ2024005

详细信息

作者简介:
周全湘(1987-)，女，贵州龙里人，硕士，副教授，主要研究方向为预防医学教育教学及人群健康状况

利益冲突声明 所有作者声明无利益冲突。
中图分类号: G179 G78 G444
计量
- 文章访问数: 64
- HTML全文浏览量: 31
- PDF下载量: 18
- 被引次数: 0
出版历程
- 收稿日期: 2024-09-25
- 修回日期: 2025-01-07
- 网络出版日期: 2025-04-03
- 刊出日期: 2025-03-25

Propensity score matching analysis of the impact of left behind experience on the mental health of secondary vocational school students

1.
Department of Medicine, Qiannan Medical College for Nationalities, Duyun (558000), Guizhou Province, China

摘要

摘要: 目的了解留守经历对中等职业学校(以下简称“中职”)学生心理健康的影响，以期为中职学生心理健康教育提供理论依据。方法 2019年9—12月，采用多阶段整群随机抽样方法，在黔南地区都匀市、贵定县和平塘县共抽取3 401名中职学生，采用自行设计问卷和症状自评量表(SCL-90)进行一般情况和心理健康状况调查，采用倾向匹配得分法(PSM)匹配是否有留守经历学生各1 415名，并对数据进行Wilcoxon检验及Logistic回归分析。结果倾向得分匹配前，家庭结构、母亲文化程度、家庭居住地、家庭和睦情况及子女过去健康状况在是否有留守经历的学生间分布差异均有统计学意义(χ²值分别为28.17，52.40，96.31，29.75，19.10，P值均＜0.05)；匹配后，以上变量在两者间分布差异均无统计学意义(χ²=0.02~4.32，P值均＞0.05)。倾向得分匹配前，有无留守经历的中职学生在SCL-90中躯体化(1.67，1.58)、人际关系敏感(2.00，1.89)、焦虑(1.90，1.70)、强迫症状(2.20，2.10)、抑郁(2.00，1.85)、敌对(1.83，1.67)、恐怖(1.85，1.71)、偏执(1.83，1.67)、精神病性(1.70，1.60)、其他(1.85，1.71)10个维度得分中位数差异均有统计学意义(Z=-5.15~-2.84，P值均＜0.05)。倾向得分匹配后，有无留守经历中职生仅在SCL-90中人际关系敏感[(2.00(1.56, 2.67)，2.00(1.44, 2.56)]、偏执[1.83(1.33, 2.50)，1.83(1.33, 2.33)]、精神病性[1.70(1.30, 2.30)，1.70(1.20, 2.20)]3个维度得分中位数差异有统计学意义(Z值分别为-2.45，-2.12，-2.23，P值均＜0.05)。结论留守经历对中职学生心理健康的影响主要在人际关系敏感、偏执、精神病性等方面，应将其作为留守经历中职学生心理教育的重点领域。
- 精神卫生 /
- 倾向评分分配 /
- 回归分析 /
- 学生
Abstract: Objective To understand the impact of left behind experience on the mental health of secondary vocational school students, so as to provide theoretical basis for the psychological health education of secondary vocational school students. Methods From September to December in 2019, a total of 3 401 students from Duyun, Guiding and Pingtang County were selected by multi-stage cluster random sampling method. Self-designed questionnaire and Symptom Check List-90(SCL-90) were used to investigate mental health status. A total of 1 415 left behind students and 1 415 non left behind students were matched by using propensity score matching (PSM). Wilcoxon test and Logistic regression analysis were conducted. Results Before the matching of propensity score, there were statistically significant differences in the distribution of family structure, mother's educational level, family residence, family harmony and children's past health among the students with or without left behind experience (χ²=28.17, 52.40, 96.31, 29.75, 19.10, P < 0.05). After the matching, there were no statistically significant differences in the distribution of the above variables among the students with or without left-behind experience (χ²=0.02-4.32, P>0.05). Before the matching of propensity scores, there were significant differences in the scores of 10 dimensions of SCL-90, including somatization (1.67, 1.58), interpersonal sensitivity (2.00, 1.89), anxiety (1.90, 1.70), obsessive-compulsive symptoms (2.20, 2.10), depression (2.00, 1.85), hostility (1.83, 1.67), terror (1.85, 1.71), paranoia (1.83, 1.67), psychotic (1.70, 1.60) and other (1.85, 1.71) dimensions among secondary vocational school students with or without left behind experience (Z=-5.15 to -2.84, P < 0.05). After propensity score matching, there were significant differences in scores remained only in three factors for interpersonal sensitivity [(2.00(1.56, 2.67), 2.00(1.44, 2.56)], paranoia [1.83(1.33, 2.50), 1.83(1.33, 2.33)] and psychoticism [1.70(1.30, 2.30), 1.70(1.20, 2.20)] in SCL-90 among secondary vocational students with or without left behind experience (Z=-2.45, -2.12, -2.23, P < 0.05). Conclusion The impact of left behind experience on the mental health of vocational school students is mainly reflected in interpersonal sensitivity, paranoia, and psychoticism, which should be identified as key areas of psychological education for secondary vocational school students.
- Mental health /
- Propensity score matching /
- Regression analysis /
- 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 匹配前黔南地区是否有留守经历中职学生SCL-90得分比较[M(P₂₅, P₇₅)]

Table 1. Comparison of SCL-90 scores of vocational school students with or without left behind experience in Qiannan Area before matching[M(P₂₅, P₇₅)]

留守经历	人数	躯体化	强迫症状	人际关系敏感	抑郁	焦虑
有	1 593	1.67(1.25, 2.25)	2.20(1.80, 2.70)	2.00(1.56, 2.67)	2.00(1.46, 2.69)	1.90(1.40, 2.50)
无	1 808	1.58(1.17, 2.08)	2.10(1.70, 2.60)	1.89(1.44, 2.44)	1.85(1.38, 2.54)	1.70(1.30, 2.40)
Z值		-2.84	-3.93	-5.15	-3.83	-4.08
P值		0.01	< 0.01	< 0.01	< 0.01	< 0.01

留守经历	人数	敌对	恐怖	偏执	精神病性	其他
有	1 593	1.83(1.33, 2.50)	1.85(1.29, 2.57)	1.83(1.33, 2.50)	1.70(1.30, 2.30)	1.85(1.14, 2.43)
无	1 808	1.67(1.33, 2.33)	1.71(1.14, 2.29)	1.67(1.33, 2.33)	1.60(1.20, 2.10)	1.71(1.29, 2.29)
Z值		-2.85	-4.13	-4.28	-4.90	-4.53
P值		< 0.01	< 0.01	< 0.01	< 0.01	< 0.01

下载: 导出CSV

表 2 中职学生留守经历混杂因素的Logistic回归分析(n=3 401)

Table 2. Logistic regressiojn analysis of mixed factors of left behind experience of vocational school students(n=3 401)

自变量与常数	β值	标准误	Wald χ²值	P值	OR值(95%CI)
家庭结构	0.09	0.03	8.07	0.01	1.09(1.03~1.16)
家庭居住地	0.62	0.08	53.65	< 0.01	1.85(1.57~2.18)
母亲文化程度	-0.22	0.06	12.59	< 0.01	0.80(0.71~0.91)
家庭和睦情况	-0.31	0.06	26.78	< 0.01	0.74(0.65~0.83)
子女过去健康情况	0.16	0.04	14.79	< 0.01	1.18(1.08~1.28)
常数	-0.30	0.28	1.15	0.28	0.74

下载: 导出CSV

表 3 匹配前后有无留守经历中职学生一般特征分布比较

Table 3. Comparison of distribution of general characteristics of vocational school students with or without left behind experience before and after matching

匹配前后	留守经历	人数	统计值	家庭结构					母亲文化程度
匹配前后	留守经历	人数	统计值	核心家庭	单亲家庭	主干家庭	联合家庭	其他	小学及以下	初中	高中及以上
匹配前	有	1 593		941(59.07)	198(12.43)	319(20.03)	73(4.58)	62(3.89)	1 111(69.74)	418(26.24)	64(4.12)
	无	1 808		1 190(65.82)	209(11.56)	246(13.61)	84(4.64)	79(4.37)	1 085(60.01)	556(30.75)	167(9.24)
			χ²值			28.17				52.40
			P值			< 0.01				< 0.01
匹配后	有	1 415		901(63.67)	166(11.73)	221(15.62)	70(4.95)	57(4.03)	941(66.50)	410(28.98)	64(4.52)
	无	1 415		927(65.51)	147(10.39)	205(14.49)	65(4.59)	71(5.02)	955(67.49)	376(26.57)	84(5.94)
			χ²值			3.84				4.28
			P值			0.43				0.12

匹配前后	留守经历	人数	统计值	家庭居住地		子女过去健康情况			家庭和睦情况
匹配前后	留守经历	人数	统计值	城镇	农村	较好	一般	较差	和睦	比较和睦	不和睦
匹配前	有	1 593		369(23.16)	1 224(76.84)	696(43.69)	409(25.67)	488(30.64)	974(61.14)	493(30.95)	126(7.91)
	无	1 808		702(38.83)	1 106(61.17)	896(49.56)	474(26.22)	438(24.22)	1 244(68.81)	484(26.77)	80(4.42)
			χ²值	96.31		19.10			29.75
			P值	< 0.01		< 0.01			< 0.01
匹配后	有	1 415		369(26.08)	1 046(73.92)	613(43.32)	370(26.15)	432(30.53)	963(68.06)	375(26.50)	77(5.44)
	无	1 415		372(26.29)	1 043(73.71)	646(45.65)	387(27.35)	382(27.00)	921(65.09)	420(29.68)	74(5.23)
			χ²值	0.02		4.32			3.54
			P值	0.90		0.12			0.17
注：()内数字为构成比/%。

下载: 导出CSV

表 4 匹配后黔南地区是否有留守经历中职学生SCL-90得分比较[M(P₂₅, P₇₅)]

Table 4. Comparison of SCL-90 scores of vocational school students with or without left behind experience in Qiannan Area after matching[M(P₂₅, P₇₅)]

留守经历	人数	躯体化	强迫症状	人际关系敏感	抑郁	焦虑
有	1 415	1.67(1.25, 2.25)	2.20(1.80, 2.70)	2.00(1.56, 2.67)	2.00(1.46, 2.62)	1.90(1.40, 2.50)
无	1 415	1.58(1.25, 2.08)	2.20(1.70, 2.70)	2.00(1.44, 2.56)	1.92(1.46, 2.54)	1.80(1.30, 2.50)
Z值		-1.13	-1.88	-2.45	-1.22	-1.68
P值		0.26	0.06	0.01	0.22	0.09

留守经历	人数	敌对	恐怖	偏执	精神病性	其他
有	1 415	1.83(1.33, 2.50)	1.86(1.29, 2.43)	1.83(1.33, 2.50)	1.70(1.30, 2.30)	1.85(1.43, 2.43)
无	1 415	1.67(1.33, 2.33)	1.71(1.29, 2.43)	1.83(1.33, 2.33)	1.70(1.20, 2.20)	1.85(1.43, 2.29)
Z值		-1.26	-1.54	-2.12	-2.23	-2.29
P值		0.21	0.12	0.03	0.03	0.02

下载: 导出CSV

参考文献(16)

[1]	朱颖. 农村留守儿童心理健康问题的表现、成因及对策[J]. 心理学进展, 2024, 14(11): 570-576. ZHU Y. Causes and countermeasures of mental health problems in rural left-behind children[J]. Adv Psychol, 2024, 14(11): 570-576. (in Chinese)
[2]	卢芸, 余应筠, 朱焱, 等. 贵州农村留守初中生心理健康状况及家庭影响因素[J]. 中国学校卫生, 2014, 35(9): 1413-1415. http://www.cjsh.org.cn/article/id/zgxxws201409047 LU Y, YU Y J, ZHU Y, et al. Psychological health status and family influence factors of left-behind middle school students in rural Guizhou[J]. Chin J Sch Health, 2014, 35(9): 1413-1415. (in Chinese) http://www.cjsh.org.cn/article/id/zgxxws201409047
[3]	王文, 陈丹丹, 张新卉. 留守儿童生存质量与心理健康的相关性及影响因素分析[J]. 中国儿童保健杂志, 2021, 29(11): 1245-1248. doi: 10.11852/zgetbjzz2021-0612 WANG W, CHEN D D, ZHANG X H. Correlation between quality of life and mental health of left-behind children and influencing factors of their quality of life[J]. Chin J Child Health Care, 2021, 29(11): 1245-1248. (in Chinese) doi: 10.11852/zgetbjzz2021-0612
[4]	赵晨晓, 董志勇. 父母外出务工与农村留守儿童健康: 基于CFPS微观证据的考察[J]. 湖北社会科学, 2021(2): 59-65. ZHAO C X, DONG Z Y. The impact of parental migration on the health of left-behind children in rural areas: evidence from CFPS microdata[J]. Hubei Soc Sci, 2021(2): 59-65. (in Chinese)
[5]	ANTÓN J I. The impact of remittances on nutritional status of children in ecuador[J]. Inter Migrat Rev, 2010, 44(2): 269-299.
[6]	刘珂言. 留守儿童心理健康问题的争论及网络心理咨询的适用性[J]. 心理学进展, 2023, 13(2): 545-551. LIU K Y. Debate on mental health problems in left-behind children and the applicability of online psychological counseling[J]. Adv Psychol, 2023, 13(2): 545-551. (in Chinese)
[7]	孙承媛, 王玫, 蒋梦巧, 等. 基于倾向得分匹配的老年人接种流感疫苗对流感就诊的保护效果研究[J]. 现代预防医学, 2021, 48(1): 1-4. SUN C Y, WANG M, JIANG M Q, et al. Influenza vaccine effectiveness against influenza-related outpatient and inpatient visits among the elderly based on propensity score matching[J]. Mod Prev Med, 2021, 48(1): 1-4. (in Chinese)
[8]	郭申阳, 马克·W·弗雷泽. 倾向值分析: 统计方法与应用[M]. 2版. 重庆: 重庆大学出版社, 2016: 84-139. GUO S Y, MARK ·W·FRAZIER. Propensity score analysis: statistical methods and applications[M]. 2th ed, Chongqing: Chongqing University Press, 2016: 84-139. (in Chinese)
[9]	汪向东, 王希林, 马弘, 等. 心理卫生评定量表手册(增订版)[M]. 北京: 中国心理卫生杂志社, 1999: 241-244. WANG X D, WANG X L, MA H, et al. Manual of Psychological Health Assessment Scales(Revised and Enlarged edit)[M]. Beijing: Chinese Mental Health Journal Office, 1999: 241-244. (in Chinese)
[10]	陈雄, 汪俊华, 汪小斌, 等. 网络游戏对贵州省中学生自杀态度的影响[J]. 中国学校卫生, 2018, 39(2): 226-228. doi: 10.16835/j.cnki.1000-9817.2018.02.020 CHEN X, WANG J H, WANG X B, et al. Research on the influence of online game on suicide attitude of middle school students in Guizhou Province[J]. Chin J Sch Health, 2018, 39(2): 226-228. (in Chinese) doi: 10.16835/j.cnki.1000-9817.2018.02.020
[11]	马文燕, 陆超祥, 余洋, 等. 农村留守中学生心理韧性在一般疏离感与主观幸福感间的作用[J]. 中国学校卫生, 2018, 39(4): 619-622. doi: 10.16835/j.cnki.1000-9817.2018.04.042 MA W Y, LU C X, YU Y, et al. The role of psychological resilience of rural left behind middle school students in the relationship between general alienation and subjective well-being[J]. Chin J Sch Health, 2018, 39(4): 619-622. (in Chinese) doi: 10.16835/j.cnki.1000-9817.2018.04.042
[12]	胡皓杰, 吴基右, 文韬, 等. 青少年运动员心理弹性对心理疲劳的影响: 应对方式的中介作用[J]. 湖北体育科技, 2024, 43(2): 65-69. HU H J, WU J Y, WEN T, et al. Influence of psychological resilience on psychological fatigue of teenage athletes: the mediating role of coping styles[J]. Hubei Sports Sci, 2024, 43(2): 65-69. (in Chinese)
[13]	周全湘, 佘福强, 杨敬源, 等. 黔南民族地区有留守经历中职学生心理健康状况及影响因素分析[J]. 中国预防医学杂志, 2021, 22(4): 269-273. ZHOU Q X, SHE F Q, YANG J Y, et al. The impact of left-behind experience on psychological health of students in secondary vocational schools in Qiannan Rural Minority Area[J]. Chin Prev Med, 2021, 22(4): 269-273. (in Chinese)
[14]	张俊杰, 刘婷, 陈艳玲, 等. 留守经历农村大学生人际关系敏感对心理健康的影响: 自我效能感和情绪的多重中介作用[J]. 华北理工大学学报(医学版), 2021, 23(4): 303-308. ZHANG J J, LIU T, CHEN Y L, et al. Effect of inter personal sensitivity on mental health of rural college students with left-behind experience: multiple mediating effects of self-efficacy and emotion[J]. J North China Univ Sci Technol (Health Sci Edit), 2021, 23(4): 303-308. (in Chinese)
[15]	龙燕满, 彭磊义, 罗建基. 留守经历中职生自杀意念机制研究: 社会支持和心理健康的多重中介[J]. 中小学心理健康教育, 2023, 24: 11-17. LONG Y M, PEN L Y, LUO J J. The mechanism of suicidal ideation among left-behind secondary vocational students: multiple mediations of social support and mental health[J]. Ment Health Educ Prim Second Sch, 2023, 24: 11-17. (in Chinese)
[16]	左静, 王东方, 陈曦, 等. 有留守经历大学生社会支持与精神病性体验的关系及乐观和自尊的链式中介效应[J]. 中国临床心理学杂志, 2020, 28(4): 705-712. ZUO J, WANG D F, CHEN X, et al. Effect of optimism and self-esteem between social support and psychotic-like experiences college students with left-behind experiences[J]. Chin J Clin Psychol, 2020, 28(4): 705-712. (in Chinese)