目的 研究社区亲子关系干预措施对北京市城区祖辈-母共同养育质量的作用,为开发适宜社区应用的婴幼儿心理保健模式提供依据。方法 2013年12月-2014年3月选取北京市海淀、石景山区4所社区卫生服务中心管理的4~11月龄儿童203名,按1∶1随机分为研究组和对照组。研究组在常规儿童定期体检中对家长个体化技能指导和咨询,并每月1次对家长进行知识讲座。对照组儿童及家庭仅接受常规儿童健康检查与指导。1年后通过问卷调查比较两组儿童家庭祖辈-父母共同养育情况。结果 两组家庭祖辈与父母缺乏育儿沟通和养育冲突问题较为突出。研究组家庭中祖辈对母亲的情感支持程度(P<0.01)和配合度更高(P=0.046);研究组中祖辈和母亲存在养育分歧(P=0.046)、以及祖辈在儿童面前说母亲坏话的家庭比例均低于对照组(P=0.04)。结论 社区亲子关系干预措施对提高共同养育者在育儿过程中的配合度、减少养育分歧、减少损害亲子关系发展行为等方面具有积极作用,但对共同养育其他维度作用有限。建议进一步完善社区促进亲子关系干预策略。

Objective To observe the effect of community intervention of parent-child relationship on parents-grandparents coparenting in Beijing urban area,and provide a basis for appropriate community care model on children mental health care. Methods From December 2013 to March 2014,a total of 203 children aged from 4 to 11 months old and their families in 4 communities of two districts in Beijing were studied.4 communities were randomly divided into study group and control group.In the study group,children's caregivers were given personalized skills guidance and counseling,and were given lectures on children health care and parent-child relationship once a month.Children's caregivers of the control group were given routine child health examination and guidance.A self-designed questionnaire was used to investigate all participants after 1 year. Results The existing prominent problems of parents-grandparents coparenting in families of both groups were lack of communication and coparenting conflict.The proportions of families in which grandparents supported (P< 0.01) and cooperated (P=0.046) with children's parents in the study group were higher than that of the control group.The proportions of families in which grandparents had disagreements (P=0.046) with children's parents and disparaged (P=0.04) them in the study group were lower than that of the control group. Conclusion s Community intervention of parent-child relationship improves the cooperation of grandparents and parents,reduces the differences of child rearing,and the behavior undermining parent-child relationships.However,its effect on other dimensions of coparenting is not significantly.It is recommended to further improve the community intervention strategies of parent-child relationship.