中国西部两省（市）岁儿童受忽视现状及影响因素研究

  本文关键词：中国西部两省（市）岁儿童受忽视现状及影响因素研究，由笔耕文化传播整理发布。

        目的:为了解西部两省（市）农村0-6岁儿童、城市6-17岁中小学生受忽视现状，找出其受忽视的影响因素，为有针对性地制定改善儿童忽视的工作措施提供科学依据。方法：1.对象的选择：（1）农村0-6岁儿童忽视现况调查：采用多阶段分层整群随机抽样的方法，先在西部地区陕西省和重庆市中分别随机抽取3个市（区），然后分别从每个市（区）抽取经济文化水平高、中、低各一个农村乡/镇，每个乡/镇随机抽取一个村，村中0-6岁每个年龄段随机调查10名健康儿童，男、女各半。（2）城市6-17岁中小学生忽视现况调查：采用多阶段分层整群随机抽样方法，先在西部地区陕西省和重庆市中分别随机抽取经济、文化水平中等的2个市（区），，每个市（区）随机抽取城市小学、中学（包括初中部和高中部）各1所，每所学校内每个年级（小学1～6年级、初中1～3年级、高中1～2年级）中各抽1个班级，班级内所有符合调查条件的学生全部作为调查对象。2．调查方法：自制调查问卷，0-6岁农村儿童、6-8岁小学生由其监护人填写，9-17岁中小学生有调查对象本人填写，于2010年12月-2011年3月期间对我国西部陕西省和重庆市农村0-6岁儿童、2008年11-12月期间对两省（市）城市6-17岁中小学生一般人口信息、受忽视现状及其影响因素进行调查。3.计分和评价方法：儿童忽视调查问卷评价量表包含儿童身体、情感、教育、安全、医疗、社会6个层面的测查题，正向计分题对每个备选答案分别赋1、2、3、4分，题前字母编码尾字母带“R”的反向计分题对每个备选答案分别赋分4、3、2、1分。根据调查对象的填答情况，计算出调查对象的忽视总分和6个忽视层面忽视得分。调查对象在任一层面上的得分超过该层面规定的界值点，即被认定在该层面上受到了忽视；调查对象在任一层面受到了忽视，都最终被认定为受到了忽视（总忽视）。儿童受忽视情况由忽视率和忽视度来反映，受到忽视的儿童数与调查儿童数的比值为忽视率，忽视率反映儿童受忽视的频率；调查对象忽视分值与忽视满分值的比值为忽视度，忽视度反映儿童受忽视的强度。结果：1.农村0-6岁儿童调查结果：（1）共调查1488名儿童，农村0-6岁儿童总忽视率和总忽视度分别为31.59%和48.32；男、女儿童总忽视率分别为32.63%和30.38%，组间差异无统计学意义（χ2=0.86,P>0.05），男、女儿童总忽视度分别为48.56和48.05，组间差异亦无统计学意义（U=1.51,P>0.05）；0-2岁组、3-6岁组儿童总忽视率分别为30.25%和32.75%，组间差异无统计学意义（χ2=1.07,P>0.05），两年龄组总忽视度分别为47.36和49.16，组间差异有统计学意义（U=-5.33，P<0.001）；三代同堂家庭和核心家庭儿童总忽视率、总忽视度均低于单亲家庭和再婚家庭儿童（χ2=10.03，F=2.83,P<0.05）；留守儿童总忽视率和总忽视度均高于非留守儿童（χ2=30.30，U=6.76,P<0.05）；陕西省儿童总忽视率和总忽视度均低于重庆市儿童（χ2=9.42，U=8.40,P<0.05）。（2）重庆市男、女儿童忽视率组间差异无统计学意义(χ2=2.22,P>0.05),但男童忽视度高于女童（U=2.34,P<0.05），重庆市0-2岁组、3-6岁组儿童忽视率和忽视度组间差异均无统计学意义（χ2=2.10,U=-0.56,P>0.05），重庆市不同家庭类型忽视率和忽视度组间差异均无统计学意义（χ2=2.22,F=1.09,P>0.05）；留守儿童忽视率和忽视度均高于非留守儿童（χ2=12.34，U=-5.12,P<0.01）。（3）陕西省男、女儿童忽视率和忽视度组间差异均无统计学意义(χ2=0.04, U=0.04,P>0.05),陕西省0-2岁组儿童忽视率高于3-6岁组儿童（χ2=5.15，P<0.05），忽视度低于3-6岁组儿童（U=-4.81, P<0.001），陕西省不同家庭类型儿童忽视率和忽视度组间差异均有统计学意义（χ2=11.70，F=5.64, P<0.05），陕西省留守儿童忽视率和忽视度均高于非留守儿童（χ2=17.10，F=-3.92,P<0.05）。多因素非条件logistic回归分析结果显示：留守儿童（OR=1.54；95%CI，1.20-1.97）、单亲或再婚家庭（OR=1.38；95%CI，1.16-1.65）、父亲职业为外出务工或在家务农（OR=0.87；95%CI，0.78-0.97）、母亲的文化程度较低（OR=1.27；95%CI，1.07-1.52）、冷淡疏远的父子关系（OR=1.43；95%CI，1.07-1.91）等5个因素是我国西部两省（市）农村0-6岁儿童忽视率升高的主要影响因素。2.城市6-17岁中小学调查结果：共调查1604名中小学生，城市中小学生忽视率和忽视度分别为30.30%和（45.27±8.71）；男、女生忽视率分别为34.88%、25.23%，男生忽视率高于女生（χ2=17.62，P<0.001）,男、女生忽视度分别为（46.50±8.79）、（43.92±8.42），男生忽视度高于女生（U=5.99, P<0.001）；6～8、9～11、12～17岁城市中小学生忽视率分别为30.69%、28.74%、31.71%，组间差异无统计学意义（χ2=1.41，P>0.05）,忽视度分别为（43.34±6.86）、（42.90±8.42）、（48.49±8.69），组间差异有统计学意义（F=84.49，P<0.001），12～17岁中学生忽视度最高；三代同堂家庭和核心家庭子女忽视率和忽视度均低于单亲家庭和再婚家庭子女（χ2=9.44，F=4.53, P<0.05）；独生子女忽视率和忽视度均低于非独生子女（χ2=11.27，U=-6.38,P<0.05）。多因素非条件logistic回归分析结果显示：男生（OR=0.63；95%CI，0.50-0.79）、低年龄组小学生（OR=0.84；95%CI，0.72-0.98）、居住在省会或直辖市（OR=0.79；95%CI，0.63-0.98）、父亲文化程度较低（OR=1.40；95%CI，1.25-1.56）、与父母关系不好或一般（OR=2.89；95%CI，2.27-3.67）等5个因素是我国西部两省（市）城市中小学生忽视率升高的主要影响因素。结论：1.中国西部陕西、重庆两省（市）农村0-6岁儿童忽视率低于同期全国农村0-6岁儿童受忽视水平，但忽视度高于全国农村0-6岁儿童受忽视水平，影响忽视率升高的主要因素是留守儿童、单亲或再婚家庭、父亲职业为外出务工或在家务农、母亲的文化程度较低、冷淡疏远的父子关系。2.中国西部陕西、重庆两省（市）城市6-17岁中小学生受忽视程度较严重，6-8岁和9-11岁小学生、12～17岁中学生受忽视频率和强度均高于同期全国城市6-17岁中小学生受忽视水平，影响忽视率升高的主要因素是男生、低年龄组小学生、居住在省会或直辖市、父亲文化程度较低、与父母关系不好或一般。

    Objective To learn the current neglected situation and impact factors ofchildren aged0-17years old in two provinces in western China; findimpact factors and provide scientific evidences for effective interventions.Methods The participants of this study:(1) The investigation of ruralchildren aged0-6years old was conducted by using multistage stratifiedcluster sampling method. Three cities or districts were randomly chosenfrom Chongqing and Shanxi province, and the countries or towns werechosen by the three levels (set as high, middle and low) of economy andculture. One village was included in the present study from each country ortown respectively, and5boys and5girls of every range, from0to6yearsold,60in total, were randomly chosen from each village.(2) Theinvestigation of urban children aged from6to17years old was conductedby using multistage stratified cluster sampling method. Two cities ordistricts were randomly chosen from Chongqing and Shanxi province bythe level of economy and culture. One primary school and one seniormiddle school (included both senior and junior) were chosen in each city ordistrict. In each school, one class was randomly chose from every grade (primary school: from one to six grade; junior middle school: from one tothree grade; senior high school: from one to three grade), and the allstudents in that class were participated in this study.The method of investigation: the rural participants aged from0-6andthe primary students aged from6to8, the questionnaire was filled by theirguardian; and the participants aged from9-17, the questionnaire wasanswered by themselves. The investigation of rural children in theChongqing and Shanxi province was conducted during Dec2010to Mar2011, and the investigation of primary and high school students was takenduring Nov2008to Dec2008.The standard and the method of evaluation: the scale of questionaireabout neglected children contains the question of the child’s physical,emotional, education, security, medical and social aspects.For each alternative answers, forward questions was set the score of1,2,3and4, respectively. The reverse question before the letter coding andend the letter with "R" was set as the score of4,3,2and1respectively, foreach alternative answers. According to the survey, we calculate the totalscore of neglected and six level of score of neglected. Once survey in anylayer of the surface of the score exceed the level prescribed cutoff point, weshould identify that it is the neglected level; and the survey at any one levelhas been neglected, then that will be eventually identified as being ignored,the total neglect. The neglected situation of children was determined by the neglect rate and degree of neglect; the neglect rate was calculated by thenumber of neglected children and the number of children who recruited; theneglect rate reflected the frequency of children being neglected, the degreeof neglect was calculated by the neglected score of children and the totalscore of neglected; the degree of neglect reflected the degree of childrenneglected.Results:(1) The results of the rural children investigation:①1488subjects, aged from0to6, were recruited in the present study. Resultsshowed that the total prevalence of neglected rural children were31.59%,48.32%respectively. No significant was found on the prevalence ofneglected for boys (32.63%) and girls (30.38%)(χ2=0.86, U=1.51, P>0.05).The total neglected rate of children aged0-2and3-6years old was30.25%and32.75%respectively. The degree of neglected was47.36and49.16,and showed no significant difference as well (U=-5.33, P<0.05). The totalneglected rate and the degree of neglected in Shanxi province were lowerthan that of Chongqing (χ2=9.42, U=8.40, P<0.05). Total neglected rate anddegree of neglected in three generations and the core families were lowerthan that of single and remarried families (χ2=10.03, F=2.83, P<0.05).Further, the total neglected rate and the degree of neglected in left-behindchildren was higher than that of non left-behind children.(2) There was nosignificant difference at the rate of neglected between boys and girls(χ2=2.22, P>0.05). However, the degree of neglected of boys was higher than that of girls in Chongqing (U=2.34, P<0.05). The neglected rate anddegree of0-2and3-6years old children showed no significant difference(χ2=2.10, U=-0.56, P>0.05). There were no significant difference amongdifferent type of families on the rate and degree of neglected (χ2=2.22,F=1.09, P>0.05). The neglected rate and degree of left behind childrenwere higher than that of non-left behind children (χ2=12.34, U=-5.12,P<0.01).(3) There was no significant difference at the rate and degree ofneglected between boys and girls (χ2=0.04, U=0.04, P>0.05). However, therate of neglected of children aged from0-2was higher than that of childrenaged from3-6in Shanxi province (χ2=5.15, P<0.05), and the degree ofneglected of children aged from0-2was lower than that of children agedfrom3-6(U=-4.81, P<0.001). There were significant among different typeof families on the neglected rate and degree (χ2=17.10, F=-3.92, P<0.05),and the neglected rate and degree of left behind children were all higherthan that of non-left behind children (χ2=11.70, F=5.64, P<0.05).Based on multivariate non-conditional logistic regression analysis, thedeterminants of stunting among the strand children were: left-behind(OR=1.54;95%CI,1.20-1.97); the style of family(OR=1.38;95%CI,1.16-1.65); father’s occupation (OR=0.87;95%CI,0.78-0.97); the educationof children’s mother (OR=1.27;95%CI,1.07-1.52); relationship betweenchildren and their fathers (OR=1.43;95%CI,1.07-1.91).(2) The results of the rural children investigation:1604subjects, aged from6to17, were recruited in the present study. Results showed that thetotal prevalence of neglected primary and secondary school students were30.30%, and the total neglected degrees were45.27±8.71; also, theprevalence of neglected of boys and girls were34.88%and25.23%respectively (χ2=17.62, P<0.001), and the neglected rate of boys werehigher than that of girls (χ2=17.62, P<0.001). The neglected degrees were46.50±8.79and43.92±8.42, and the neglected degree of boys were higherthan that of girls (U=5.99, P<0.001). The prevalence of neglected on6-8,9-11and12-17years age groups were30.69%,28.74%,31.71%(χ2=1.41,P>0.05) respectively, and the neglected degrees were43.34±6.86,42.90±8.42,48.49±8.69(F=84.49, P<0.001) respectively. Our datademonstrated the neglected degrees in12-17years age group were highest;further, both the prevalence and degree of neglected in three generationsfamilies were lowest, however, they were highest in single-parent families(χ2=9.44, F=4.53, P<0.05); the one child families were significantly lowerthan non-one child families both in the prevalence and degree of neglected(χ2=11.27, U=-6.38, P<0.05).Based on multivariate non-conditional logistic regression analysis, thedeterminants of stunting among the children were: boys (OR=0.63;95%CI,0.50-0.79); young primary students’ group (OR=0.84;95%CI,0.72-0.98);living in the capital cities or municipalities (OR=0.79;95%CI,0.63-0.98);the low education of children’s father (OR=1.40;95%CI,1.25-1.56); relationship between children and their parents (OR=2.89;95%CI,2.27-3.67).Conclusions:(1) The neglected situation of rural children was seriousin the Shanxi and Chongqing provinces. The frequencies of neglected ofrural children from aged0-6in these places were lower than that of thenation at the same period, however, the degree of neglected was higherthan that of the nation. The main impact factors were the left-behindchildren, single parent or remarried family, the migrant work or homefarming of father, the low level of maternal education and the estrangedfather-child relationships.(2) The neglected situation of urban primary and secondary schoolstudents were serious in the western China. The frequencies and degree ofneglected of children who aged from6-8,9-11and12-17in these placeswas higher than that of the nation at the same period. The main impactfactors were: boys, younger primary students, live in the capital cities ormunicipalities, the low level of paternal education, the bad relationshipamong parents.

        中国西部两省（市）岁儿童受忽视现状及影响因素研究

英汉缩略语名词对照5-6摘要6-11ABSTRACT11-16前言17-19第一部分 中国西部两省（市）农村 0-6 岁儿童受忽视现状及影响因素分析19-34    1 对象与方法19-23    2 结果23-31    3 讨论31-34第二部分 中国西部两省（市）城市 6-17 岁中小学生受忽视现状及影响因素研究34-46    1 对象与方法34-37    2 结果37-43    3 讨论43-46全文总结46-47创新与不足47-48参考文献48-52附表 152-56附表 256-59文献综述59-69    参考文献65-69致谢69-70攻读硕士期间发表的论文70-71

  本文关键词：中国西部两省（市）岁儿童受忽视现状及影响因素研究，由笔耕文化传播整理发布。