目的 探讨农村0～3岁儿童心理行为发育和主要养育人(简称养育人)回应性照护水平现况及其相关性,为促进农村儿童早期发展提供科学依据。方法 采用整群抽样法,于2023年8月—2024年6月选取云南省两个县的21个村开展调研,共纳入601名0～3岁农村儿童作为研究对象。使用婴幼儿回应性照护评价量表(RCRS)评估养育人回应性照护水平,年龄与发育进程问卷第3版(ASQ-3)评估儿童心理行为发育。采用t检验和χ2检验进行组间差异分析,采用logistic回归分析回应性照护与儿童心理行为发育的相关性。结果 601名农村儿童中有132例(21.96%)存在发育迟缓风险。分别有8.99%、8.65%、9.15%、8.15%和5.49%的儿童存在沟通、粗大动作、精细动作、解决问题和个人-社会能力发育迟缓风险。沟通(t=2.829)、粗大动作(t=4.528)、精细动作(t=2.393)、解决问题(t=2.885)和个人-社会(t=3.919)能力发育正常组的养育人回应性照护水平均高于对应的存在发育迟缓风险组(P<0.05)。养育人回应性照护平均得分(63.29±11.41)分,且回应性照护水平越高,儿童发生沟通(OR=0.970,95%CI:0.946~0.994)、粗大动作(OR=0.952,95%CI:0.929~0.976)、精细动作(OR=0.972,95%CI:0.948~0.996)、解决问题(OR=0.971,95%CI:0.947~0.995)和个人-社会(OR=0.953,95%CI:0.925~0.983)能力发育迟缓的风险越小(P<0.05)。母亲年龄越大,儿童发生个人-社会能力发育迟缓的风险越小(OR=0.470,95%CI:0.227~0.971,P<0.05)。结论 农村儿童早期心理行为发育与养育人回应性照护水平密切相关,提升农村养育人的回应性照护水平可有效促进农村儿童早期发展。
Abstract
Objective To explore the status of psychological-behavioral development in rural children aged 0 - 3 years and the responsive caregiving level of their primary caregivers, and to examine the association between them, so as to provide a scientific basis for early childhood development promotion strategies in rural areas. Methods Using cluster sampling, this study was conducted in 21 villages across two counties in Yunnan Province, from August 2023 to June 2024, involving 601 rural children aged 0 - 3 years.The Responsive Caregiving Rating Scale (RCRS) was used to assess caregivers' responsive caregiving levels, while the Ages & Stages Questionnaires, Third Edition (ASQ-3) was employed to evaluate children's psychobehavioral development.Group differences were analyzed using t-tests and χ2 tests, and associations were examined using multivariate logistic regression. Results Among the 601 children, 21.96% (132/601) were at risk of developmental delay in at least one domain.The prevalence rates of developmental delay risk were 8.99%, 8.65%, 9.15%, 8.15%, and 5.49% for communication, gross motor, fine motor, problem-solving, and personal-social domains, respectively.The caregivers of children with normal development in communication (t=2.829), gross motor (t=4.528), fine motor (t=2.393), problem-solving (t=2.885), and personal-social (t=3.919) skills demonstrated significantly higher levels of responsive caregiving compared to those in the corresponding at-risk group for developmental delay(P<0.05).Multivariate logistic regression analysis revealed that higher responsive caregiving levels were associated with lower risks of developmental delay in communication (OR=0.970, 95%CI: 0.946 - 0.994), gross motor skills (OR=0.952, 95%CI: 0.929 - 0.976), fine motor skills (OR=0.972, 95%CI: 0.948 - 0.996), problem-solving (OR=0.971, 95%CI: 0.947 - 0.995), and personal-social abilities (OR=0.953, 95%CI: 0.925 - 0.983) (P<0.05).Additionally, older maternal age was associated with lower risk of personal-social developmental delay (OR=0.470, 95%CI: 0.227 - 0.971, P<0.05). Conclusions Early psychobehavioral development of rural children is closely associated with caregivers' responsive caregiving levels.Enhancing responsive caregiving among rural caregivers may serve as an important entry point for promoting early childhood development in rural areas.
关键词
农村地区 /
儿童早期发展 /
回应性照护 /
心理行为发育 /
儿童
Key words
rural area /
early childhood development /
responsive caregiving /
psychological and behavioral development /
children
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