重庆某区青春发动时相提前儿童生活质量及其影响因素的研究

发布时间：2018-07-27 20:22

【摘要】：目的编制《青春期儿童生活质量量表》,为青春期儿童生活质量测量工具的进一步开发提供依据;测定和比较青春发动时相提前儿童和非提前儿童生活质量,探讨青春发动时相提前儿童生活质量的影响因素,为其生活质量的干预提供依据。方法1.结合文献查阅和小组讨论形成量表初始条目池;选取5年级1个班学生进行小范围测试,确定初始量表;选取4-8年级共511人进行预调查,采取7种条目筛选方法和探索性因子分析对初始量表进行条目筛选,形成正式测试量表,并对其可行性、信度和效度进行初步考评。2.采用分层整群抽样方法,从重庆某区选取城乡的中小学各2所(共8所学校),包括4-9年级共3486名学生,运用《青春期儿童生活质量量表》、《青春期发育事件自评量表(PDS)》等进行现况调查,并懫用多元逐步回归分析影响青春发动时相提前儿童生活质量的因素。结果通过条目专业筛选和统计筛选后,形成包含生理、心理、社会和青春期4维度10个因子共39个条目组成的《青春期儿童生活质量量表》。初步考评结果显示,总量表和4个维度的Cronbach’sα系数分别为0.89、0.81、0.77、0.85和0.64;总量表和4个维度的重测相关系数(Pearson相关系数)分别为0.88、0.76、0.78、0.82和0.72;验证性因子分析表明模型拟合良好,χ2/df=4.24,CFI=0.95、NFI=0.94、NNFI=0.92、GFI=0.96、AGFI=0.92、RMSEA=0.08;以“儿少主观生活质量量表”为效标进行评价,量表总分与效标总分的相关系数为0.76。现况调查显示,在调查的3486名4-9年级学生中,青春发动时相提前、正常、延迟儿童检出率分别为20.0%、64.1%和15.9%;青春发动时相提前儿童生活质量总分(134.99±18.75)低于正常儿童(139.64±18.71)和延迟儿童(139.73±17.52)(P0.05),除青春期维度得分提前组(20.29±3.88)和正常组(20.07±3.76)高于延迟组(19.70±3.68)(P0.05),其余3个维度得分均是提前组低于正常组和延迟组(P值均0.05)。单因素分析结果表明,父母文化程度、家庭关系、学习成绩、学校环境、亲密朋友数量等15个因素对提前组儿童生活质量有影响。多元逐步回归分析显示,抑郁、家庭关系差、亲密朋友数量少和青春期态度得分低是影响青春发动时相提前儿童生活质量的主要因素。结论《青春期儿童生活质量量表》的初步考评具有较好的信效度,可以作为正式评价青春发育期儿童生活质量的测定工具。青春发动时相提前儿童生活质量低于正常和延迟儿童,在提高青春发动时相提前儿童生活质量的过程中,可以考虑从改善抑郁、家庭关系、亲密朋友数量和提高青春期态度得分等方面着手。
[Abstract]:Objective to develop the quality of Life scale for Adolescent Children (QOL), to provide the basis for the further development of quality of life measurement tools for adolescent children, and to measure and compare the quality of life of early and unadvanced children at the onset of adolescence. To explore the influencing factors of children's quality of life in early stage of youth initiation, and to provide basis for the intervention of quality of life. Method 1. Combined with literature review and group discussion to form the initial item pool of the scale; to select a class of grade 5 students for a small range test to determine the initial scale; 4-8 grades of a total of 511 people to carry out a pre-survey, In this paper, seven item screening methods and exploratory factor analysis were used to screen the initial scale, and the formal test scale was formed, and the feasibility, reliability and validity of the scale were preliminarily evaluated. 2. A stratified cluster sampling method was used to select 2 primary and rural primary and secondary schools (8 schools), including 3486 students in grades 4-9, from a certain district in Chongqing. The quality of life (QOL) of adolescent children was investigated by using the quality of Life scale (QOL) of Adolescent Children and the Self-Rating scale of Developmental events during adolescence (PDS), and the factors influencing the quality of life of children at the onset of adolescence were analyzed by multiple stepwise regression analysis. Results the quality of Life scale for Adolescent Children (QOL) composed of 10 factors including physiological psychological social and adolescent dimensions was formed after professional and statistical screening. Preliminary assessment results show that The Cronbach's 伪 coefficients of the total table and the four dimensions were 0.89 / 0.81 / 0.770.85 and 0.64, respectively; the Pearson correlation coefficients of the total table and the four dimensions were 0.880.760.780.82 and 0.72 respectively. The confirmatory factor analysis showed that the model fitted well, 蠂 ~ 2 / df4.24CFI0.95NFI0.94NNFI0.92GF-I0.902. The quality of Life scale was used to evaluate the quality of life. The correlation coefficient between the total score of the scale and the total score of the scale was 0.76. According to the survey, among the 3486 students in grades 4-9, the period of youth initiation was early and normal. The detection rate of delayed children was 20.041% and 15.9.The total score of quality of life (134.99 卤18.75) was lower than that of normal children (139.64 卤18.71) and retarded children (139.73 卤17.52) (P0.05), except that the scores of early puberty dimension (20.29 卤3.88) and normal subjects (20.07 卤3.76) were higher than those of delayed children (19.70 卤3.68) (P0.05). The dimension scores were lower in the early group than in the normal group and the delayed group (P < 0.05). The results of univariate analysis showed that 15 factors, such as parents' education level, family relationship, academic achievement, school environment and number of close friends, had an effect on the quality of life of children in advance group. Multiple stepwise regression analysis showed that depression, poor family relationship, low number of close friends and low score of puberty attitude were the main factors affecting children's quality of life. Conclusion the preliminary evaluation of the quality of Life scale for Adolescent Children has good reliability and validity and can be used as a tool for evaluating the quality of life of children in puberty. In the process of improving the quality of life of children in the early stage of youth initiation, we should consider improving depression, family relations, and family relations, in the process of improving the quality of life of children in the early stage of youth initiation, which is lower than that of normal and delayed children. The number of close friends and the improvement of adolescent attitude scores and so on.
【学位授予单位】：重庆医科大学
【学位级别】：硕士
【学位授予年份】：2017
【分类号】：R179

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