目的 了解北京市城区婴儿养育现状及其影响因素,为制定适合社区应用的促进依恋关系发展的保健模式提供依据。方法 采用自编儿童养育现状调查问卷对北京市2个城区4家社区卫生服务中心的270名4~11月龄婴儿家庭进行基线研究,分析养育行为与养育态度的影响因素。结果 1)婴儿母亲平均生育年龄为(30.46±3.56)岁;父母文化程度以大学及以上者为主(父88.52%、母89.63%);婴儿主要带养人以祖辈为主(57.99%)。2)68.20%和35.34%的家庭不能满足婴儿接触大自然和与他人交往的需求;53.76%的家庭很少陪婴儿看书;51.36%很少鼓励子女做稍有难度的活动;84.82%急于帮子女解决问题。3)母亲文化程度越高,陪伴子女时间越少(P=0.003),但养育敏感性和一致性(OR=3.51,95%CI:1.55~7.94)越高;生育年龄越大的母亲对婴儿哭闹更敏感(趋势χ²=7.42,P=0.010)、更为关注婴儿健康(χ²=6.94,P=0.008)和饮食(χ²=4.23,P=0.039);核心家庭经常带婴儿接触大自然(OR=1.95,95%CI:1.10~3.46)和家庭养育态度一致(OR=3.91,95%CI:1.26~12.14)的比例更高;主要带养人为祖辈的家庭经常与婴儿亲密接触(χ²=5.14,P=0.023)、定期带婴儿体检(χ²=5.17,P=0.026)的比例更高,而经常带子女接触大自然的比例低(OR=0.46,95%CI:0.26~0.83)。结论 目前北京市城区婴儿家庭存在不利于亲子关系发展的养育态度及行为,表现为给婴儿提供接触大自然和同伴交往的机会较少、陪伴婴儿阅读少、过度保护与过分限制等问题。应针对不同家庭类型、母亲生育年龄、文化程度特点和主要带养人等因素进行咨询指导,摸索适宜的促进婴儿期良好亲子关系发展的保健模式。

Objective To explore the status and influencing factors of infants' parenting in Beijing urban area,and to provide evidence for appropriate community care model on promoting parent-child attachment. Methods A total of 270 infants' families were investigated by a self-designed questionnaire to explore the current situation and influencing factors of parenting behavior and attitude. Results 1)The mothers' average childbearing age was (30.46±3.56) years old.Most of the parents graduated from college or above (father:88.52%,mother:89.63%);57.99% of the infants were reared by their grandparents as the main caregivers.2)68.20% and 35.34% of the infants lacked opportunity to get in touch with nature and communicate with others;53.76% of the parents rarely read with their babies;51.36% rarely encouraged their babies to do a little more difficult activities;84.82% offered help first when their babies encountered problems.3)Mothers with different education background showed significant differences in the time spending with their babies (P=0.003),parenting sensitivity and consistency (OR=3.51,95%CI:1.55~7.94); Mothers whose child birth age older than 25 years old responded more sensitively with the crying of infants (trend χ²=7.42,P=0.010),paid more attention to their babies' health (χ²=6.94,P=0.008) and diet (χ²=4.23,P=0.039).Nuclear families offered their babies more chance to get in touch with nature (OR=1.95,95%CI:1.10~3.46),were more likely to have consistent parenting attitude (OR=3.91,95%CI:1.26~ 12.14),and limit their babies playtime (χ²=5.21,P=0.034).Infants reared mainly by their grandparents had more close contact with their caregivers (χ²=5.14,P=0.023),and were more likely to have regular health checks (χ²=5.17,P=0.026),but had less chance to get in touch with nature (OR=0.46,95%CI:0.26~0.83). Conclusions Families with infants in Beijing urban area exist improper parenting behavior and attitude,which manifested themselves as overprotection,excessive restriction,less chance of getting in touch with nature,communicating with others and reading books.Exploring appropriate community care model to promote good parent-child attachment should take the infant's family pattern,its mother's childbearing age and education background,and its main caregiver into account.