父母管教方式与农村青少年自杀行为关系研究

发布时间：2018-05-12 00:03

本文选题：青少年 + 自杀　；参考：《山东大学》2017年硕士论文

【摘要】：1.研究背景自杀是日益受到关注的公共卫生问题之一。全球的自杀率是11.4/10万,是15-29年轻人群的第二死亡原因,中国的自杀人数约占世界的22%。根据我国的实际情况,自杀行为可分为自杀死亡、自杀未遂、自杀准备、自杀计划、自杀意念。青少年的自杀行为引起了广泛关注,虽然在10-14岁青少年中发生自杀死亡较为少见,但是自杀行为发生的频率在青少年阶段显著增长,且青少年自杀意念、自杀计划和自杀未遂是自杀死亡的危险因素。不同国家中青少年的自杀率变化和自杀方式都存在各自的特点。早期识别和筛查青少年自杀危险因素对预防青少年发生严重的自杀行为至关重要。目前对青少年自杀行为的相关因素调查大多来自于使用问卷的现况调查以及以医院为基础的随访调查。青少年自杀行为发生率存在性别、年龄上的差异,青少年自杀行为可能与精神障碍、情绪问题以及危害健康的行为相关。父母管教方式是指父母在教养孩子的过程中对待孩子的固有行为模式和行为倾向,有许多家长都采取了严格的纪律对孩子进行惩戒教育。父母管教方式的选择可能和父母以及孩子自身都存在关系,且父母严厉管教方式与孩子的心理健康和情绪问题相关。目前我国关于父母管教方式对孩子自杀行为的研究较少,尤其是缺乏基V较大样本量对这一关系进行分析。本研究利用山东省农村地区八所学校获得的调查资料进行分析,将对青少年自杀行为预防措施提供一定的科学依据。2.研究目的2.1探究青少年父母管教方式的特点以及对父母管教方式量表进行信效度评价;2.2探究农村青少年自杀行为的人口学特征和心理学特征;2.3分别探究父亲和母亲管教方式对青少年自杀行为的影响。3.研究方法3.1研究对象本研究于2015年11-12月在山东省邹城市、阳谷县和利津县开展。每个县(市)选取两到三所学校进行调查。最终这三个地区共调查了八所中学,包括了五所初中和三所高中,调查对象来自这八所高中的初一至高二的在校学生。五所初中的所有初一学生以及三所高中的所有高一学生均接受调查,初二、初三、高二的学生则以班级为单位进行整群随机抽样。目标班级中的所有学生都接受调查。在调查开始之前,取得了学校相关人员和目标班级学生的知情同意。3.2研究方法本研究使用青少年健康与行为问卷收集资料,采取了问卷自填的方式进行调查。学生在开始回答问卷前,接受过问卷使用培训且具有公共卫生背景的工作者会使用统一的引导语,告知被调查者需要认真阅读问卷开头的引导语并说明这是一个匿名调查,以保证问卷回答的准确性。问卷调查在常规上课时间进行,完成问卷平均需要四十五分钟。本研究取得山东大学公共卫生学院伦理委员会和目标学校相关人员的同意。阳谷县调查结束两周后,分别在阳谷县初一、初二、高一、高二每个年级随机抽取两个班进行重测调查,最后共有8个班进行重测,纳入统计分析的共有490人。研究内容:青少年健康与行为问卷共包括七个部分,分别是一般健康状况、青春期发育状况、日常活动和健康行为、性格和情绪、社会支持和家庭状况、生活应激事件、社区环境。本次分析中包括了基本信息(性别、出生年月、家庭经济状况、父母亲的教育水平、吸烟、饮酒情况)、心理状况(绝望、情绪和行为问题)、自杀行为(自杀意念、自杀计划和自杀未遂)以及父母严厉管教方式。3.3统计分析使用SPSS 18.0和AMOS 17.0软件进行统计分析。单因素比较分析使用分类变量采用t检验、检验或者Fisher精确概率法;采用Logistic回归进行单因素以及多因素分析,并使用结构方程模型分析父母严厉管教方式与自杀行为之间的关系。4.研究结果4.1调查对象基本情况目标班级中的调查人数为12301,最终共有11836个学生参与了调查,应答率为96.22%。11836份问卷中其中5份为空白问卷,最终有11831份问卷纳入统计分析,其中男性共6018(50.9%)。调查对象的平均年龄为14.97± 1.46。父亲和母亲的教育水平多集中在初中,比例分别是54.4%和46.9%,但是母亲在小学或以下教育水平的比例要高于父亲,而父亲高中及以上学历的比例要高于母亲。大部分孩子的自我评定的家庭经济情况都处于一般(68.5%)。4.2父母管教方式量表信效度评价分别对父亲和母亲管教方式量表进行探索性因子分析。探索性因子分析采用主成分法,以特征值1进行因子提取,两个量表都提取了 5个公因子,分别是体罚、敌意、缺乏照料、专制、忽略。分别对父亲和母亲管教方式量表进行验证性因子分析。父亲和母亲管教方式量表的验证性因子分析模型中,拟合优度指数(GFI)、调整的拟合优度指数(AGFI)、规范拟合指数(NFI)、不规范拟合指数(NNFI)、比较拟合指数(CFI)、增值拟合指数(IFI)均在0.9以上,RMSEA在父亲管教方式量表中是0.060,在母亲中是0.066。分别对父亲和母亲管教方式进行调查的管教方式量表进行信度检验。父亲管教方式量表的Cronbach's α系数是0.847,分半信度系数是0.683,重测信度系数是0.652。母亲管教方式Cronbach's α系数的是0.845,分半相关系数是0.704,重测信度为0.637。4.3青少年自杀行为情况报告终生曾有自杀意念的学生数有2400(20.3%),自杀计划者1131(9.6%),自杀未遂者461(3.9%)人。青少年自杀意念、自杀计划、自杀未遂中,女性报告率均高于男性,16岁年龄组的自杀意念报告率最高(25.2%),17岁年龄组的自杀计划报告率最高(11.7%),15岁年龄组的自杀未遂报告率最高(4.7%)。情绪与行为问题得分最高组的报告率均高于其他组,绝望得分越高报告率越大,吸烟、饮酒的报告率高,且都具有统计学意义(P0.05)。单因素logistic回归发现,女性(OR=1.43,95%CI:1.31-1.57)、年龄大于等于15岁(OR=3.30,95%CI:2.41-4.53)、吸烟(OR=2.42,95%CI:2.19-2.67)、饮酒(OR=2.43,95%CI:2.22-2.67)、内向性问题(OR=7.69,95%CI:6.82-8.67)、外向性问题(OR=6.23,95%CI:5.53-7.02)、绝望(OR=2.61,95%CI:2.33-2.91)是自杀意念的危险因素;女性(OR=1.22,95%CI:1.08-1.38)、年龄大于等于15岁(OR=2.21,95%CI:1.49-3.27)、吸烟(OR=2.63,95%CI:2.31-2.99)、饮酒(OR=2.39,95%CI:.11-2.71)、内向性问题(OR=7.18,95%CI:6.08-8.48)、外向性问题(OR=6.86,95%CI:5.81-8.11)、绝望(OR=3.19,95%CI:2.75-3.71)是自杀计划的危险因素;女性(OR=1.34,95%CI:1.11-1.62)、年龄大于等于15岁(OR=2.38,95%CI:1.28-4.45)、吸烟((OR=2.87,95%CI:2.37-3.47)、饮酒(OR=2.70,95%CI:2.23-3.27)、内向性问题(OR=6.81,95%CI:5.29-8.75)、外向性问题(OR=6.48,95%CI:5.04-8.33)、绝望(OR=3.04,95%CI:2.41-3.82)是自杀未遂的危险因素。4.4中国父母管教方式情况父亲管教方式量表总得分为32.13±8.82,母亲管教方式量表总得分为31.75±8.73。除了母亲对孩子的缺乏管教不具有男女差异外,其他维度以及总分在两个量表中均具有统计学意义(P0.05),男孩各个分量表得分以及总分均高于女孩。4.5父母管教方式与自杀行为关系多因素分析发现,父亲严重严厉管教方式与自杀意念(OR=1.57,95%CI:1.39-1.78)、自杀计划(OR=2.00,95%CI:1.70-2.35)和自杀未遂(OR=2.23,95%CI:1.74-2.86)相关;母亲中等(OR=1.15,95%CI:1.02-1.30)、严重严厉管教方式(OR=1.16,95%CI:1.43-1.86)与自杀意念相关,母亲严重严厉管教方式与自杀计划(OR=1.97,95%CI:1.67-2.33)、自杀未遂(OR=1.95,95%CI:1.51-2.50)相关。父母管教方式与自杀行为的结构方程模型中发现,(1)父母管教方式直接对自杀行为起作用;(2)行为和情绪问题在父母管教方式对自杀行为影响中起调节作用,父母严厉管教方式会增加发生行为和情绪问题,情绪和行为问题会直接对自杀行为发生作用,也会通过物质滥用间接对自杀行为发挥作用;(3)物质滥用受到父母管教方式以及情绪和行为问题影响,直接对自杀行为起作用。5.结论和建议5.1研究结论(1)父母严厉管教方式量表可分为体罚、敌意、缺乏照料、专制、忽略五个因子,总量表信效度较好。(2)相对于女孩,男孩更容易受到父母的严厉管教。父母各自的教育程度、家庭经济状况不同,采用严厉管教方式总分存在差异。(3)青少年的自杀行为与性别、年龄、吸烟、饮酒、内向性和外向性问题以及绝望相关;父亲严重严厉管教方式与自杀意念、自杀计划和自杀未遂相关;母亲中等、严重严厉管教方式与自杀意念相关,母亲严重严厉管教方式与自杀计划、自杀未遂相关。(4)父母严厉管教方式和青少年情绪和行为问题与物质滥用成正相关,严厉管教方式对青少年自杀行为起直接作用,也通过情绪和行为问题以及物质滥用的中介效应对自杀行为起作用。5.2预防建议(1)提高父母对管教方式的认识,避免采取体罚、口头责备等严厉管教方式。(2)青春期的自杀行为应当受到重视,切实关注孩子的心理和情绪问题。(3)重视受到严重严厉管教方式孩子的精神和行为健康,对他们给与更多的关注和社会支持。
[Abstract]:1. research background suicide is one of the increasingly popular public health problems. The global suicide rate is 11.4/10 million, which is the second cause of death in 15-29 young people. The number of Chinese suicide accounts for about the world's 22%. according to the actual situation of our country, suicidal behavior can be divided into suicide death, suicide attempt, suicide preparation, suicidal plan, suicidal ideation. Suicide behavior in adolescents has aroused widespread concern, although suicide deaths in 10-14 year olds are rare, but the frequency of suicide is significantly increased in adolescents, and adolescents' suicidal ideation, suicide plans and attempted suicide are risk factors for suicide deaths. Early identification and screening of young suicide risk factors are essential to prevent young people from committing serious suicides. The current survey of adolescent suicides mostly comes from the current survey of using the questionnaire and the follow-up survey based on the hospital. There are gender, age differences, and teenage suicides may be related to mental disorders, emotional problems, and health hazards. Parental discipline means parents' behavior patterns and behavior tendencies to treat their children during the process of nurturing their children, and many parents have taken strict discipline to punish their children. Education. The choice of parental management may be related to both parents and children themselves, and the strict management of parents is related to the mental health and emotional problems of the children. At present, there is little research on the behavior of children's suicidal behavior by parental discipline in our country, especially the lack of basic V. Based on the investigation data obtained by eight schools in rural areas of Shandong Province, this paper provides a scientific basis for the prevention measures of adolescent suicidal behavior. 2.1 to explore the characteristics of the mode of parental management for young people and to evaluate the reliability and validity of the parental management style scale, and 2.2 to explore the suicidal behavior of rural adolescents. Oral and psychological characteristics; 2.3 the study of the influence of father and mother's management on adolescent suicidal behavior (.3. research method 3.1) was conducted in 11-12 months of 2015 in Zoucheng, Yanggu and Lijin, Shandong province. Each county (city) selected two to three schools to investigate. Finally, the three areas were investigated. Eight middle schools, including five junior high schools and three high schools, were investigated from the first first to senior two students in the eight high schools. All the junior middle school students in five junior middle schools and all the senior high school students in three high school were investigated. All the students received the investigation. Before the start of the investigation, the study method of informed consent.3.2 of the school related and target class students was obtained. The study used the questionnaire of adolescent health and behavior to collect data. Public health workers will use a unified guide to inform the respondents that the respondents need to read the beginning of the questionnaire carefully and show that this is an anonymous survey to ensure the accuracy of the questionnaire. The questionnaire survey was carried out in regular class time and the average of the completion of the questionnaire was forty-five minutes. This study obtained the public of Shandong University public. The ethics committee of the Institute of health and the relevant staff of the target school have agreed. After two weeks of the completion of the survey in Yanggu County, two classes were randomly selected for retest in the first, second, high, and second grades of Yanggu County, and 8 classes were retested in a total of 8 classes. The research content: adolescent health and behavior questions The volume consisted of seven parts: general health status, puberty development, daily activity and health behavior, personality and emotion, social support and family status, life stress events, and community environment. This analysis included basic information (sex, birth year, family economic condition, educational level of parents, smoking, drinking). Psychological status (despair, emotional and behavioral problems), suicidal behavior (suicidal ideation, suicide plan and suicide attempt) and.3.3 statistical analysis of parental strict control methods using SPSS 18 and AMOS 17 software for statistical analysis. Single factor comparative analysis used classified variables to use t test, test or Fisher precision probability method; use Logistic Single factor and multi factor analysis were carried out, and structural equation model was used to analyze the relationship between strict management of parents and suicidal behavior. Results 4.1 the total number of subjects in the basic target class was 12301, and 11836 students participated in the investigation, and the response rate was 5 of them. 4.1 For the blank questionnaire, 11831 questionnaires were finally included in the statistical analysis, among which men were 6018 (50.9%). The average age of the respondents was 14.97 + 1.46. and the education level of fathers and mothers was mostly concentrated in junior middle school. The proportion of the parents was 54.4% and 46.9% respectively, but the proportion of the mother at primary school or below was higher than that of the father, while the father was high school and above. The proportion of educational background is higher than that of the mother. Most of the children's self-assessment of family economic situation is in the general (68.5%).4.2 parents' management style scale. 5 common factors were extracted, which were corporal punishment, hostility, lack of care, despotism, neglect. The confirmatory factor analysis was carried out on the father and mother's management style scale respectively. In the confirmatory factor analysis model of father and mother's management style scale, the goodness of fit index (GFI), the adjusted goodness of fit index (AGFI), and the standard fitting index (NFI) were used. The non standard fitting index (NNFI), the comparison fitting index (CFI), the value added fitting index (IFI) were above 0.9, and the RMSEA was 0.060 in the father's management style scale. In the mother, the degree of trust was tested by 0.066. for the father and the mother's management mode respectively. The Cronbach's alpha coefficient of the father's management style scale was 0.847, The coefficient of split half reliability was 0.683. The retest reliability coefficient was 0.845 for 0.652. mother tube Cronbach's alpha coefficient and 0.704 in half correlation coefficient. The retest reliability was 2400 (20.3%), 1131 (9.6%) of suicide planners and 461 (3.9%) in suicide attempt. In the year of suicidal ideation, suicide plan and suicide attempt, the rate of female reporting was higher than that of men. The rate of suicidal ideation was the highest (25.2%) in the age group of 16 years (25.2%). The rate of suicidal planning was the highest (11.7%) in the age group of 17 years, and the highest rate of attempted suicide in the group of 15 years (4.7%). The reporting rate of the highest group of emotional and behavioral problems was higher than that of the other groups. The higher the reporting rate of despair, the higher the reporting rate, the high reporting rate of smoking, drinking, and statistically significant (P0.05). Single factor Logistic regression found that women (OR=1.43,95%CI:1.31-1.57), age greater than 15 years (OR=3.30,95%CI:2.41-4.53), smoking (OR=2.42,95%CI:2.19-2.67), drinking (OR=2.43,95%CI:2.22-2.67), introverted problems (OR=7.69,95) %CI:6.82-8.67), extroversion (OR=6.23,95%CI:5.53-7.02), OR=2.61,95%CI:2.33-2.91 is a risk factor for suicidal ideation; women (OR=1.22,95%CI:1.08-1.38), age greater than 15 years (OR=2.21,95%CI:1.49-3.27), smoking (OR=2.63,95%CI: 2.31-2.99), alcohol (OR=2.39,95%CI:.11-2.71), and introverted problems (OR=7.18,95%CI:6.08-8.) 48), extroversion (OR=6.86,95%CI:5.81-8.11), OR=3.19,95%CI:2.75-3.71 is a risk factor for suicidal plans; women (OR=1.34,95%CI:1.11-1.62), age greater than 15 years (OR=2.38,95%CI:1.28-4.45), smoking (OR=2.87,95%CI:2.37-3.47), drinking (OR=2.70,95%CI:2.23-3.27), introversion (OR=6.81,95%CI:5.29-8.75), and extroversion (OR=6.81,95%CI:5.29-8.75). OR=6.48,95%CI:5.04-8.33, OR=3.04,95%CI:2.41-3.82 is the risk factor for suicide attempt.4.4 Chinese parents' teaching method of parental discipline, the total score of the father management style scale is 32.13 + 8.82, the total score of the mother management style scale is 31.75 + 8.73. except that the mother's lack of control on the children does not have the difference between men and women, and other dimensions The degree and total score were statistically significant in the two scales (P0.05). The scores of each subscale and total score of boys were higher than that of the girls'.4.5 parental management and suicidal behavior. The father's severe severe discipline and suicide ideation (OR=1.57,95%CI: 1.39-1.78), suicide plan (OR=2.00,95%CI:1.70-2.35) and self OR=2.23,95%CI:1.74-2.86 related; mother medium (OR=1.15,95%CI:1.02-1.30), severe severe discipline (OR=1.16,95%CI:1.43-1.86) related to suicidal ideation. Mother's severe severe discipline was associated with suicide plan (OR=1.97,95%CI:1.67-2.33), suicide attempt (OR=1.95,95%CI:1.51-2.50). Parental discipline and suicide behavior In the structural equation model, it was found that (1) parental management played a direct role in suicidal behavior; (2) behavioral and emotional problems played a regulatory role in the effect of parental discipline on suicidal behavior, and parents' strict discipline would increase behavioral and emotional problems, emotional and behavioral problems would directly affect suicide and also pass through the action. Substance abuse exerts an indirect effect on suicidal behavior; (3) substance abuse is affected by parental discipline and emotional and behavioral problems, and it plays a direct role in suicidal behavior.5. conclusion and 5.1 research conclusions (1) parental strict management forms can be divided into corporal punishment, hostility, lack of care, autocracy, five factors, and total aggregate reliability and validity. (2) relative to girls, boys are more likely to be disciplined by their parents. Their parents' educational level, their family economic conditions, and the total score of strict management are different. (3) the suicide behavior of young people is related to sex, age, smoking, drinking, introversion and extroversion and despair. Suicidal ideation, suicide plan and suicide attempt; mother medium, severe severe discipline and suicidal ideation, mother's severe severe discipline and suicide plan, suicide attempt. (4) severe parental control and adolescent emotional and behavioral problems are positively related to substance abuse, and strict disciplining ways for adolescents to commit suicide In order to play a direct role, it also plays the role of.5.2 prevention for suicide by emotional and behavioral problems and the mediating effect of substance abuse (1) improving parents' understanding of the way of management, avoiding corporal punishment, oral reproach and other severe ways of management. (2) adolescent suicide should be paid attention to and pay attention to the psychology and emotion of the child. Problems: (3) attach importance to the mental and behavioral health of children who are severely disciplined, giving them more attention and social support.

【学位授予单位】：山东大学
【学位级别】：硕士
【学位授予年份】：2017
【分类号】：D669.9

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