目的 探索生活方式对学龄期儿童心理行为状况的影响,为儿童行为问题干预提供科学依据。方法 采用分层整群抽样,于2023年5月8—20日在西安市5所小学抽取1 200名9~13岁学龄儿童进行纸质问卷调查,使用青少年自评量表(YSR)对其近半年内的行为和情绪问题进行评价,通过自行设计的调查问卷收集学龄儿童的家庭基本情况、生活方式等信息,采用χ2检验和二元Logistic回归模型对儿童生活方式和心理行为问题的关联进行统计分析。结果 本研究中学龄儿童情绪及行为问题检出率为22.4% (252/1 127),各因子中以思维问题最为突出(14.8%),其次为社交问题(10.6%)。儿童非常挑食(OR＝4.595,95%CI:1.593~13.249,P=0.005)、每天完成家庭作业时间超过3h(OR=3.644,95% CI:1.640~8.096,P=0.001)、每天视屏时间>2h(OR=2.691,95%CI:1.311~5.527,P=0.007)或>3h(OR=3.542,95%CI:1.848~6.789,P<0.001)、从来不做家务(OR=7.477,95%CI:1.372~40.733,P=0.020)是学龄儿童发生情绪及行为问题的危险因素,而偶尔(OR=0.530,95%CI:0.315~0.892,P=0.017)或经常(OR=0.447,95%CI:0.266~0.753,P=0.002)参加体育锻炼、身体不适时选择找卫生员(OR=0.205,95% CI:0.115~0.365,P<0.001)或看医生(OR=0.341,95%CI:0.150~0.772,P=0.010)、婴幼儿时期很少患病(OR=0.435,95%CI:0.219~0.866,P=0.018)、有4个及以上好朋友(OR=0.270,95%CI:0.093~0.783,P=0.016)将有助于降低学龄儿童情绪及行为问题的发生风险。结论 学龄儿童情绪及行为问题与其生活方式高度相关,应关注儿童思维和社交问题,提倡科学饮食、积极锻炼、鼓励儿童适当参与家务劳动、减少视屏时间,控制不良生活习惯将有助于其行为问题的改善。
Abstract
Objective To explore the association between lifestyle and psycho-behavioral problems in school-age children,in order to provide scientific basis for the prevention of Children's behavioral problems. Methods Using stratified whole-cluster sampling,1 200 school-age children aged 9 - 13 years in Xi'an were selected for a paper questionnaire survey in May 2023.Their behavioral and emotional problems in the past six months were evaluated using the Youth Self-Report (YSR).Information on basic family situation and lifestyles was collected through self-designed questionnaires on the demographic characteristics of their families and their lifestyles.The correlation between Children's lifestyles and psycho-behavioral problems was explored and validated using the χ2 test and binary logistic Logistic regression model. Results The detection rate of psychological and behavioral problems in school-age children in this study was 22.4% (252/1 127).Thinking problems were most prominent among the factors (14.8%),followed by social problems (10.6%).Multivariate Logistic regression analysis showed that picking eating (OR=4.595,95% CI:1.593 - 13.249),doing homework >3h/d (OR=3.644,95%CI:1.640 - 8.096),and screen time >2h/d (OR=2.691,95%CI:1.311 - 5.527) or >3h/d (OR=3.542,95%CI:1.848 - 6.789),and never doing housework (OR=7.477,95%CI:1.372 - 40.733) were risk factors for psychological and behavioral problems in school-age children.Occasional (OR=0.530,95%CI:0.315 - 0.892) or frequent (OR=0.447,95%CI:0.266 - 0.753) participation in physical activity,visiting a healthcare worker (OR=0.205,95%CI:0.115 - 0.365) or a doctor (OR=0.341,95%CI:0.150 - 0.772)in sick,having few illnesses in infancy and early childhood (OR=0.435,95%CI:0.219 - 0.866),and having 4 or more good friends (OR=0.270,95%CI:0.093 - 0.783) reduced the risk of developing psychological and behavioral problems in school-age children. Conclusions Lifestyle of school-age children is closely related to psycho-behavioral problems.Paying attention to Children's thinking and social problems,advocating scientific diet,active exercise,encouraging children to participate in household chores appropriately,reducing video screen time,and controlling undesirable habits will help improve their behavioral problems.
关键词
学龄儿童 /
行为问题 /
生活方式
Key words
school-age children /
behavioral problems /
lifestyle
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参考文献
[1] 健康中国行动推进委员会.健康中国行动(2019—2030年):总体要求,重大行动及主要指标[J].中国循环杂志,2019,34(9):846-858.
Health China Action Promotion Committee.Healthy China Action (2019-2030):Overall requirements,major actions and key indicators[J].Chin J Circ,2019,34(9):846-858.(in Chinese)
[2] Gillian ZK.A proposed model of psychodynamic psychotherapy linked to Erik Erikson′s eight stages of psychosocial development[J].Clin psychol Psychother,2017,24(5):1047-1058.
[3] Gustafsson BM,Gustafsson PA,Granlund M,et al.Longitudinal pathways of engagement,social interaction skills,hyperactivity and conduct problems in preschool children[J].Scand J Psychol.2021,62(2):170-184.
[4] 宁曼,何海燕,余敏.儿童心理行为问题及影响因素概述[J].中国妇幼卫生杂志,2017,8(3):4-6,11.
Ning M,He HY,Yu M.Review of children mental health problem and influencing factors[J].Chin J Women Child Health,2017,8(3):4-6,11.(in Chinese)
[5] Greene CA,Haisley L,Wallace C,et al.Intergenerational effects of childhood maltreatment:A systematic review of the parenting practices of adult survivors of childhood abuse,neglect,and violence[J].Clin Psychol Rev,2020,80:101891.
[6] La MC,Maruyama JM,Munhoz TN,et al.Continuity of psychiatric disorders between 6 and 11 years of age in the 2004 Pelotas Birth Cohort[J].Braz J Psychiatry.2020,42(5):496-502.
[7] Goto M,Yamamoto,Y,Saito R,et al.The effect of environmental factors in childcare facilities and individual lifestyle on obesity among Japanese preschool children:A multivariate multilevel analysis[J].Medicine(Baltimore),2019,98(41):e17490.
[8] 阿尔孜古丽·喀喀尔,章舒心,黄思哲,等.新冠肺炎疫情期间广东省中小学生情绪行为问题及影响因素[J].中国学校卫生,2021,42(8):1129-1134.
Kakaer A,Zhang SX,Huang SZ,et al.Emotional and behavioral problems and determinants among primary and middle school students aged 6 to 17-year-old in Guangdong Province during the COVID-19 pandemic[J].Chin J Sch Health,2021,42(8):1129-1134.(in Chinese)
[9] Hinkley T,Brown H,Carson V,et al.Cross sectional associations of screen time and outdoor play with social skills in preschool children[J].PloS One,2018,13(4):e0193700.
[10] Luqman A,He M,Hassan A,et al.Mood and microbes:A comprehensive review of intestinal microbiota′s impact on depression[J].Front Psychiatry.2024,15:1295766.
[11] Achenbach TM.Manual for the YSR and 1991 profile[M].Burlington,VT:University of Vermont,Department of Psychiatry.1991b.
[12] 王润程,王孟成,高一点,等.Achenbach青少年自评量表(2001年版)中文版的信度和效度[J].中国临床心理学杂志,2013,21(6):977-980.
Wang RC,Wang MC,Gao YD,et al.Reliability and validity of the Chinese version of Achenbach Youth Self-Report (2001Version)[J].Chin J Clin Psychol,2013,21(6):977-980.(in Chinese).
[13] 邱田.重庆市主城区小学生行为问题状况的调查研究[D].重庆:重庆医科大学,2009.
Qiu T.A study on childhood behavior disorders of Chongqing urban area[D].Chongqing:Chongqing Med Univ,2009.(in Chinese)
[14] 余晓敏.小学生行为问题及影响因素研究[D].武汉:华中科技大学,2010.
YU XM.A study on behavior problems and influencing factors among primary school students [D].Wuhan:Huazhong Univ Scien and Technol,2010.(in Chinese)
[15] 刘秀军,张本娜,李园园,等.北京市通州区6～16岁儿童行为问题调查[J].首都公共卫生,2021,15(1):8-12.
Liu XJ,Zhang BN,Li YY,et al.Investigation on behavioral problems of children aged 6-16 inTongzhou district of Beijing[J].Cap J Pub Health[J],2021,15(1):8-12.(in Chinese)
[16] 王亿兰,骆艳,朱焱,等.新型冠状病毒疫情期间贵州地区学龄期儿童心理行为问题及影响因素研究[J].中国预防医学杂志,2021,22(1):53-58.
Wang YL,Luo Y,Zhu Y,et al.Psychological and behavioral problems of school-age children in Guizhou during COVID-19 pandemic[J].Chin Prev Med,2021,22(1):53-58.(in Chinese)
[17] 赵蓓,章皎洁,姚洪秀,等.镇江市6～16岁儿童青少年行为问题检出率及社会能力调查[J].四川精神卫生,2018,31(4):324-327.
Zhao B,Zhang JJ,Yao HX,et al.Investigation on the incidence of behavioral problems and social competence characteristics of children and adolescents aged 6～16 in Zhenjiang[J].Sichuan Mental Health,2018,31(4):324-327.(in Chinese)
[18] Mahmoodi Z,Rostami M,Bahrami G,et al.Predictor factors affecting emotional and behavioral problems in school-aged (6-12 years) children during the COVID-19 pandemic:A cross-sectional study[J].BMC Psychiatry,2023,23(1):633.
[19] Duan L,Shao X,Wang Y,et al.An investigation of mental health status of children and adolescents in china during the outbreak of COVID-19[J].J Affect Disord,2020,275:112-118.
[20] 程宇,孙要武,钞虹.学龄儿童行为问题与营养素摄入状况相关性分析[J].中国学校卫生,2018,39 (6):832-835.
Cheng Y,Sun YW,Chao H.Correlation between behavioral problems and nutrient intake in school-age children[J].Chin J Sch Health,2018,39 (6):832-835.(in Chinese)
[21] 张娜,朱文丽,张曼,等.《中国学龄儿童膳食指南(2022)》解读[J].中国学校卫生,2022,43(6):805-808.
Zhang N,Zhu WL,Zhang M,et al.Interpretation on dietary guidelines for Chinese school-aged children (2022)[J].Chin J Sch Health,2022,43(6):805-808.(in Chinese)
[22] Zhao J,Zhang Y,Jiang F,et al.Excessive screen time and psychosocial well-being:The mediating role of body mass index,sleep duration,and parent-child interaction[J].J Pediatr,2018,202:157-162.
[23] Lissak G.Adverse physiological and psychological effects of screen time on children and adolescents-Literature review and case study[J].Environ Res,2018,164:149-157.
[24] Stiglic N,Viner RM.Effects of screentime on the health and well-being of children and adolescents:A systematic review of reviews[J].BMJ Open,2019,9(1):e023191.
[25] 冯俊鹏,严翊.国内外儿童青少年体力活动现状分析:基于2018年《全球儿童、青少年体力活动报告》[J].中国运动医学杂志,2019,12:1094-1100.
Feng JP,Yan Y.Analysis of the current situation of physical activity in children and adolescents both domestically and internationally:Based on the 2018 global physical activity report for children and adolescents[J].Chin J Sports Med,2019,12:1094-1100.(in Chinese)
[26] Hirooka N,Kusano T,Kinoshita S,et al.Association between healthy lifestyle practices and life purpose among a highly health-literate cohort:A cross-sectional study[J].BMC Public Health,2021,21(1):820.
[27] Andrade LF,Saba G,Ricard JD,et al.Health related quality of life in patients with community-acquired pneumococcal pneumonia in France[J].Health Qual Life Outcomes,2018,16 (1):28.
[28] 王琳,周波,贾飞勇,等.居家隔离/线上学习期间儿童青少年心理行为问题预防和心理支持专家建议(第二版)[J].中国儿童保健杂志,2023,31(2):117-122.
Wang L,Zhou B,Jia FY,et al.Expert recommendations for prevention and coping strategies on psychological and behavioral problems of children and adolescents during home quarantine/ online learning (the 2nd Version)[J].Chin J Child Health Care,2023,31(2):117-122.(in Chinese)
基金
国家自然科学基金(81872633);西安市科技计划项目(22YXYJ0091)
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