1～3岁儿童家庭养育环境与回应性照护的关系研究

doi:10.11852/zgetbjzz2024-0034

摘要/Abstract

摘要： 目的了解1～3岁儿童家庭养育环境与回应性照护的现况及相关性,为开展婴幼儿回应性照护指导服务提供理论依据。方法 2023年3—9月期间,采用横断面调查方式,对武汉市1～3岁儿童父母进行一般人口学资料及婴幼儿回应性照护调查,应用家庭养育环境量表、回应性照护评价量表评估婴幼儿的家庭养育环境及回应性照护状况,并分析相关影响因素。结果共纳入244例儿童,其中男126例(51.6%)、女118例(48.4%),婴幼儿平均年龄为(2.52±0.71)岁。主要照顾者(F=18.705)、喂养方式(F=6.248)、医疗保险(F=54.252)、母亲文化程度(F=18.834)、父亲文化程度(F=33.149)、家庭户籍(t=11.363)、母亲全职工作(t=-5.394)、父母平均月收入(F=16.067)、夫妻关系(F=10.299)、子女数量(F=7.114)、家庭养育环境(t=6.521)对婴幼儿回应性照护能力差异均有统计学意义(P＜0.05)。家庭养育环境与婴幼儿回应性照护能力呈显著正相关关系(r=0.422,P＜0.01)。线性回归分析显示,家庭养育环境中的语言认知(β=0.206,95%CI:0.06~1.20)和忽视惩罚维度(β=-0.117,95%CI:-0.86～-0.08)对婴幼儿回应性照护能力的影响差异有统计学意义(P＜0.05)。结论家庭养育环境和婴幼儿回应性照护之间密切相关,儿科医疗保健人员应提高婴幼儿主要照顾者的回应性照护知识与技能,为婴幼儿构建良好的家庭养育环境,助力婴幼儿早期的发展。

关键词: 1～3岁儿童, 家庭养育环境, 回应性照护

Abstract: Objective To understand the current status and correlation of family rearing environments and responsive caregiving for children aged 1 to 3 years, in order to provide theoretical basis for the implementation of responsive caregiving guidance services for infants and young children. Methods From March to September 2023, a cross-sectional survey was conducted among parents of children aged 1 - 3 years in Wuhan. General demographic information and responsive caregiving practices for infants and young children were collected. Child Home Nurture Environment Scale and the Responsive Caregiving Evaluation Scale were used to assess the family nurturing environments and responsive caregiving status of infants and young children. Relevant influencing factors were also analyzed. Results A total of 244 children were included, with 126 males (51.6%) and 118 females (48.4%). The mean age of the infants and young children was (2.52±0.71) years old. Statistically significant differences were found in responsive caregiving abilities across the following factors: Primary caregiver (F=18.705), feeding method (F=6.248), medical insurance status (F=54.252), maternal education level (F=18.834), paternal education level (F=33.149), family registration status (t=11.363), mother's full-time employment status (t=-5.394), average monthly income of parents (F=16.067), marital relationship (F=10.299), number of children (F=7.114), and family nurturing environment (t=6.521,P<0.05). A significant positive correlation was observed between family nurturing environments and responsive caregiving abilities for infants and young children (r=0.422, P<0.01). Linear regression analysis revealed that the language and cognition dimension (β=0.206, 95%CI: 0.06 to 1.20) and the neglect and punishment dimension (β=-0.117, 95%CI: -0.86 to -0.08) in the family nurturing environment had statistically significant effects on responsive caregiving abilities (P<0.05). Conclusions There is a close relationship between family nurturing environments and responsive caregiving for infants and young children. Pediatric healthcare providers should enhance the knowledge and skills of primary caregivers in responsive caregiving, fostering optimal family nurturing environments to support early childhood development.

Key words: children aged 1-3 years old, family rearing environment, responsive caregiving

中图分类号:

R174

徐玉英, 郭晨鸣, 张玺, 王素青, 鲁亚平, 余立平. 1～3岁儿童家庭养育环境与回应性照护的关系研究[J]. 中国儿童保健杂志, 2024, 32(12): 1364-1368.

XU Yuying, GUO Chenming, ZHANG Xi, WANG Suqing, LU Yaping, YU Liping. Relationships between family rearing environment and responsivecaregiving for children aged 1 - 3 years[J]. Chinese Journal of Child Health Care, 2024, 32(12): 1364-1368.

参考文献

[1] 徐玉英, 王雪娜, 李佳, 等. 婴幼儿回应性照护的研究进展[J]. 中国儿童保健杂志, 2023, 31(1): 71-75.
Xu YY,Wang XN, Li J,et al. Research progress in responsive caregiving for infants and toddlers[J].Chin J Child Health Care, 2023, 31(1): 71-75.(in Chinese)
[2] Scherer E, Hagaman A, Chung E, et al. The relationship between responsive caregiving and child outcomes: Evidence from direct observations of mother-child dyads in Pakistan[J]. BMC public health, 2019, 19(1): 252.
[3] World Health Organization, United Nations Children's Found, World Bank Group. Nurturing care for early childhood development:A framework for helping children survive and thrive to transform health and human potential[R]. Geneva:WHO, 2018.
[4] Lucas JE, Richter LM, Daelmans B. Care for child development: An intervention in support of responsive caregiving and early child development[J]. Child Care Health Dev, 2018, 44(1): 41-49.
[5] Lu C, Black MM, Richter LM. Risk of poor development in young children in low-income and middle-income countries: An estimation and analysis at the global, regional, and country level[J]. The Lancet. Global Health, 2016, 4(12): e916-e922.
[6] 祁月, 张羽頔, 蒋子晗, 等. 2月龄时回应性照护对婴儿6个月内发育影响的出生队列研究[J]. 中国儿童保健杂志, 2020, 28(1): 23-27.
Qi Y, Zhang YD, Jiang ZH. Influence of responsive caregiving at 2 months of age on the development of infants during the first 6 months:A birth cohort study[J]. Chin J Child Health Care, 2020, 28(1): 23-27. (in Chinese)
[7] 许培斌, 奚翔云. 养育照护策略与行动——解读世界卫生组织《儿童早期发展养育照护框架》[J]. 中国妇幼健康研究, 2020, 31(7): 840-843.
Xu PB, Xi XY. Nurturing care strategies and actions——Interpretation of framework for nurturing care in early childhood development published by the World Health Organization[J]. Chinese Journal of Woman Child Health Research, 2020, 31(7): 840-843. (in Chinese)
[8] 倪雪菲, 樊利春. 儿童早期发展养育照护体系中的回应性照护[J]. 中国儿童保健杂志, 2023, 31(1): 62-65,70.
Ni XF, Fan LC. Responsive care in early childhood development nurturing care systems[J]. Chin J Child Health Care,2023, 31(1): 62-65,70. (in Chinese)
[9] Bourne SV, Korom M, Dozier M. Consequences of inadequate caregiving for children's attachment, neurobiological development, and adaptive functioning[J]. Clin Child Fam Psychol Rev, 2022, 25(1): 166-181.
[10] Trude ACB, Richter LM, Behrman JR, et al. Effects of responsive caregiving and learning opportunities during pre-school ages on the association of early adversities and adolescent human capital: An analysis of birth cohorts in two middle-income countries[J]. Lancet Child Adolesc Health, 2021, 5(1): 37-46.
[11] Smith J, Chetcuti L, Kennedy L, et al. Caregiver sensitivity predicts infant language use, and infant language complexity predicts caregiver language complexity, in the context of possible emerging autism[J]. Autism Res, 2023, 16(4): 745-756.
[12] Laurin E, Guss SS, Horm D. Caregiver-infant and toddler interactions during diapering: Caregiver responsiveness and child well-being and involvement[J]. Infant Ment Health J, 2021, 42(4): 546-559.
[13] 沈施芳, 邵洁. 家庭养育与儿童早期语言发展[J]. 中国儿童保健杂志, 2022, 30(8): 865-868,873.
Shen SF, Shao J. Family parenting and early childhood language development[J]. Chin J Child Health Care, 2022, 30(8): 865-868,873. (in Chinese)
[14] 许培斌, 尹凤岚. 婴幼儿养育照护中的回应性喂养[J]. 中国儿童保健杂志, 2020, 28(9): 955-957.
Xu PB,Yin FL.Responsive feeding in infant and young child nurturing care[J]. Chin J Child Health Care, 2020, 28(9): 955-957. (in Chinese)
[15] 李佳, 王雪娜, 杜雯雯, 等. 家庭养育环境对儿童早期发展影响的研究进展[J]. 中国儿童保健杂志, 2021, 29(10): 1096-1099,1104.
Li J, Wang XN, Du WW, et al. Research progress on the influence of family nurturing environment on early childhood development[J]. Chin J Child Health Care,2021, 29(10): 1096-1099,1104. (in Chinese)
[16] 倪平, 陈京立, 刘娜. 护理研究中量性研究的样本量估计[J]. 中华护理杂志, 2010, 45(4): 378-380.
Ni P,Chen JL, Liu N. The sample size estimation in quantitative nursing research[J]. Chin J Nurs, 2010, 45(4): 378-380.
[17] 黄楹, 张海峰, 童连. 婴幼儿回应性照护评价量表的初步编制与评价[J]. 中国儿童保健杂志, 2022, 30(4): 386-391.
Huang Y, Zhang HF, Tong L. Preliminary development and evaluation of the Responsive Caregiving Rating Scale for children aged 0 to 4 years[J]. Chin J Child Health Care, 2022, 30(4): 386-391. (in Chinese)
[18] 何守森, 汪翼, 关春荣, 等. 城市1～3岁儿童家庭养育环境量表的编制及其信度效度研究[J]. 中国儿童保健杂志, 2008, 16(6): 650-652.
He SS, Wang Y, Guan CR,et al. 1-3 years Child Home Nurture Environment Scales:Development,reliability and validity[J].Chin J Child Health Care,2008, 16(6): 650-652. (in Chinese)
[19] 杨洁, 蒋琪, 岳爱, 等. 中国农村贫困地区照养人抑郁风险现状及其对养育行为的影响[J]. 华东师范大学学报(教育科学版), 2019, 37(3): 97-106.
Yang J, Jiang Q, Yue A, et al. Effects of caregiver depression on parenting behaviors in poor rural China[J]. Journal of East China Normal University (Educational Sciences), 2019, 37(3): 97-106. (in Chinese)
[20] 田园, 于广军. 儿童早期发展:为父母提供支持,迎接挑战[J]. 上海医学, 2021, 44(6): 384-387.
Tian Y, Yu GJ. Early childhood development:Provide support for parents to meet challenges[J]. Shanghai Medical, 2021, 44(6): 384-387. (in Chinese)
[21] McFadden KE, Tamis-emonda CS. Maternal responsiveness, intrusiveness, and negativity during play with infants: Contextual associations and infant cognitive status in a low-income sample[J]. Infant Ment Health J, 2013, 34(1): 80-92.
[22] Fernandez Rao S, Bentley ME, Balakrishna N, et al. A complementary feeding and play intervention improves the home environment and mental development among toddlers in rural India[J]. Matern Child Nutr, 2020, 16(Suppl 3): e13066.
[23] Page M, Wilhelm MS, Gamble WC, et al. A comparison of maternal sensitivity and verbal stimulation as unique predictors of infant social-emotional and cognitive development[J]. Infant Behav Dev, 2010, 33(1): 101-110.