目的 初步掌握中国0~17岁儿童虐待问题的流行现状,为制定和实施预防儿童虐待策略提供建议。方法 通过对近20年(1992-2012年)的国内外文献进行检索,获取较全面的、有代表性的中国儿童虐待流行病学研究资料,参考证据质量分级和推荐强度系统(GRADE)方法编制了文献质量评价体系,对文献质量和内容进行系统分析。结果 筛选出84篇文献综合分析中国儿童虐待的流行现状的文献,其中仅研究躯体虐待的文献有11篇,仅研究情感虐待的有3篇,仅研究性虐待的15篇,仅研究忽视的12篇,其余均为多种虐待同时研究。1)躯体虐待:城市地区儿童遭受躯体虐待的发生率为41.2%~67.3%,农村地区为32.4%~39.4%。不同研究对躯体虐待的测量方法不一致。2)情感虐待:目前尚没有统一的情感虐待测量方法,不同研究显示的儿童情感虐待发生率存在较大差异,发生率在10.6%~67.1%之间。3)性虐待:现有研究比较多的是调查16岁前发生的性虐待,多采用成年人回顾的方式进行调查。男性遭受性虐待的发生率为10.2%~23.0%,女性遭受性虐待的发生率为14.2%~25.5%。4)忽视:国内研究者从1999年开始进行忽视评价工具和标准的研究,形成了适用于城乡人群、针对不同年龄阶段儿童的中国忽视评价量表。城市3~17岁儿童的被忽视发生率为22.4%~32.8%,农村0~6岁儿童的被忽视发生率为53.7%~54.9%,暂无农村6岁以上儿童被忽视发生率的数据。结论 中国儿童虐待问题不容忽视,需要在儿童虐待定义、调查工具编制、全国流行现状等方面开展深入研究。

Objective To recognize the epidemiology situation of child maltreatment among 0~17 year-old children in China,and provide advices and potential solutions for child maltreatment prevention policies. Methods Domestic and internatiaonl literatures about child maltreatment from 1992 to 2012 were searched to collect comprehensive valuable and representative data in China.Evaluation tools were developed according to GRADE method to assess the quality and content of the literatures. Results 84 related literatures were screened out.11 focusd on physical abuse,3 focused on emotional abuse,15 focused on sex abuse and 12 focusd on neglect.The others reported different kinds of abuse at the same time.1)Physical abuse:Incidences of physical abuse were 41.2% to 67.3% in urban areas and 32.4% to 39.4% in rural areas.Measuring instruments of physical abuse used in different studies were inconsistent.2)Emotional abuse:Since there was no unified measurement of emotional abuse,results showed variety of emotional abuse incidences (10.6%-67.1%).3)Sexual abuse:Most researches focusd on sexual abuse before 16 years old used a retrospective survey method.The incidences of sexual abuse were around 10.2% to 23.0% among boys,and around 14.2% to 25.5% among girls.4)Neglect:Chinese researchers had already developed a set of urban and rural applicably Chinese Neglect Scales for different age groups since 1999.The neglect incidences were 22.4% to 32.8% among 3~17 year-old urban children,and 53.7% to 54.9% among 0~6 year-old rural children; incidence of neglect among rural children age 6 and older was not available so far. Conclusion The issue of child maltreatment in China can not be neglected.Research on definition of child maltreatment,survey instruments,and the national level epidemiology are needed.