目的 了解贵阳市学龄前儿童心理行为发育预警征筛查现状及其影响因素,为促进儿童健康发展,为制定防控措施提供依据。方法 于2024年5—7月采用分层整群随机抽样方法对贵阳市3个区县11家社区卫生服务中心/卫生院1 668名3~6岁儿童及主要照顾人进行调查,主要照顾人填写一般情况、中文版亲子互动问卷、父母养育和家庭适应量表、3~6岁幼儿家庭养育环境量表,采用儿童心理行为发育问题预警征象对儿童进行筛查,χ2检验和Wilcoxon秩和检验进行差异性比较,多因素分析采用Logistic回归分析法。结果 贵阳市3~6岁儿童预警征阳性检出率5.6%,精细动作发育问题较突出,在3、4、5、6岁年龄段中占比分别为6.2%、3.5%、2.5%、1.7%。年龄(χ2=13.675)、母亲文化程度(χ2=6.743)、父母养育技能(Z=2.266)、鼓励性养育(Z=2.171)、父母适应(Z=2.690)、忽视/惩罚/干涉(Z=-2.322)与儿童预警征阳性检出率有关(P<0.05)。多因素分析显示,3岁(OR=3.441)、4岁(OR=2.362)、母亲高中及大专文化(OR=3.113)、母亲初中及以下文化(OR=2.623)、早产(OR=2.241)与儿童预警征阳性呈正相关(P<0.05),高、中水平养育技能(OR=0.515、0.537)与儿童预警征阳性呈负相关(P<0.05)。结论 贵阳市学龄前儿童心理行为发育问题仍需关注,儿保医生需结合各年龄阶段特点对照护人进行针对性健康教育和养育技能的提升,以改善家庭养育环境,促进儿童健康发展。
Abstract
Objective To investigate the current status of early warning signs screening for psychobehavioral development among preschool children in Guiyang and its influencing factors, in order to provide a basis for promoting healthy child development and formulating preventive and control measures. Methods From May to July 2024, a stratified cluster random sampling method was used to investigate 1 668 children aged 3 to 6 years and their primary caregivers in 11 community health service centers/township hospitals in three districts and counties of Guiyang. The primary caregivers completed questionnaires on general information, the Chinese version of the Parent-Child Interaction Questionnaire, the Parenting and Family Adaptation Scale, and the Home Nurture Environment Scale for Children aged 3 - 6. Children were screened for psychobehavioral development problems using early warning signs. The χ2 test and Wilcoxon rank-sum test were used for comparison of differences, and multivariate analysis was conducted using logistic regression analysis. Results The positive detection rate of early warning signs among children aged 3 to 6 years was 5.6%, with fine motor development issues being prominent, accounting for 6.2%, 3.5%, 2.5%, and 1.7% at 3、4、5、6 age groups, respectively. Age (χ2=13.675), maternal education level (χ2=6.743), parenting skills (Z=2.266), encouraging parenting (Z=2.171), parental adaptation (Z=2.690), neglect/punishment/interference (Z=-2.322) were associated with the positive detection rate of early warning signs in children (P<0.05). Multivariate analysis showed that being 3 years old (OR=3.441) and 4 years old (OR=2.362), maternal education(high school or college OR=3.113, junior high school education or below OR=2.623), and premature (OR=2.241) were positively correlated with positive early warning signs in children (P<0.05). High and medium levels of parenting skills (OR=0.515, 0.537) were negatively correlated with positive early warning signs in children (P<0.05). Conclusions The issue of psychobehavioral development among preschool children in Guiyang still requires attention. Child health professionals should provide targeted health education to caregivers based on the characteristics of each age group and enhance their parenting skills, thereby improving the family rearing environment and promoting healthy child development.
关键词
学龄前儿童 /
心理行为发育 /
预警征 /
发育筛查
Key words
preschooler /
psychological and behavioral development /
early warning signs /
developmental screening
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参考文献
[1] 姚星,肖琛嫦,燕虹,等.武汉市学龄前儿童发育迟缓现状[J].中国学校卫生,2019,40(3): 466-469.
Yao X, Xiao CC, Yan H, et al. Current situation of stunting in preschool children in Wuhan[J]. Chin J Sch Health, 2019, 40(3): 466-469. (in Chinese)
[2] 王飞英,倪钰飞,倪勇,等.南通市10 177名婴幼儿神经心理行为发育检查结果分析[J].中国儿童保健杂志,2016,24(03): 315-317.
Wang FY, Ni YF, Ni Y, et al. Analysis on the results of neuropsychological development of 10 177 children in Nantong[J]. Chin J Child Health Care, 2016, 24(03): 315-317. (in Chinese)
[3] 金星明. 重视儿童发育监测和筛查在儿童保健中的应用[J].中国实用儿科杂志,2016,31(10): 726-729.
Jin XM. Pay attention to the application of child development monitoring and screening in children's health care[J].Chin J Pract Pediatr, 2016,31(10): 726-729. (in Chinese)
[4] 张悦,黄小娜,王惠珊,等. 中国儿童心理行为发育问题预警征编制及释义[J].中国儿童保健杂志,2018,26(1): 112-114.
Zhang Y, Huang XN, Wang HS, et al. Establishment and interpretation of warning signs checklist for screening psychological, behavioral and developmental problems of children[J]. Chin J Child Health Care, 2018, 26(1): 112-114. (in Chinese)
[5] 史倩萍,黄爱群,潘晓平. 24月龄幼儿心理行为预警征筛查现状及影响因素分析[J].中国儿童保健杂志,2020,28(9): 1017-1020.
Shi QP, Huang AQ, Pan XP. Analysis of the status quo and influencing factors of early warning screening of psychological behavior in infants aged 24 months[J]. Chin J Child Health Care, 2020, 28(9): 1017-1020. (in Chinese)
[6] 彭仰华,周海山,沈宴玲,等. 坪山区3～6岁儿童心理发育问题预警征筛查现状及影响因素[J].中国医药科学,2022,12(16): 130-133.
Peng YH, Zhou HS, Shen YL, et al. Current situation and influencing factors of early warning signs of psychological development problems in children aged 3~6 years in Pingshan District[J]. China Medicine and Pharmacy, 2022, 12(16): 130-133. (in Chinese)
[7] 鲍筝,常新蕾,王曼丽,等.北京市通州区6岁以下儿童心理行为发育问题预警征筛查现状[J].中国生育健康杂志,2018,29(6): 501-505,601.
Bao Z, Chang XL, Wang ML, et al. The status quo of early warning screening for psychological and behavioral development problems in children under 6 years of age in Tongzhou District, Beijing[J].Chin J Reproductive Health, 2018, 29(6): 501-505,601. (in Chinese)
[8] Sanders MR, Morawska A, Haslam DM, et al. Parenting and family adjustment scales (PAFAS): Validation of a brief parent-report measure for use in assessment of parenting skills and family relationships[J]. Child Psychiat Human Dev, 2013, 45(3): 255-272.
[9] Guo MC, Morawska A, Filus A. Validation of the parenting and family adjustment scales to measure parenting skills and family adjustment in Chinese parents[J]. Meas Eval Couns Dev, 2017, 50(3): 139-154.
[10] 何守森,刘一霞,倪晨曦,等.城市3～6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,2009,17(2): 134-136,139.
He SS, Liu YX, Ni CX, et al. The compilation and reliability validity of the family parenting environment scale for urban children aged 3~6 years[J]. Chin J Child Health Care, 2009, 17(2): 134-136,139. (in Chinese)
[11] Ip P, Tso W, Rao N, et al. Rasch validation of the Chinese Parent-Child Interaction Scale (CPCIS)[J]. World J Pediatr, 2018, 14(3): 238-246.
[12] 吴岩,林桐,李文,等.上海市新入幼儿园儿童亲子互动水平与儿童早期发展横断面调查[J].中国循证儿科杂志,2020,15(6): 406-410.
Wu Y, Lin T, Li W, et al. A cross-sectional survey on the level of parent-child interaction and early childhood development of new kindergarten children in Shanghai[J]. Chin J Evid Based Pediatr, 2020, 15(6): 406-410. (in Chinese)
[13] 黄小娜,张悦,冯围围,等.儿童心理行为发育问题预警征象筛查表的信度效度评估[J].中华儿科杂志,2017,55(6):445-450.
Huang XN, Zhang Y, Feng WW, et al. Evaluation of the reliability and validity of the screening form for early warning signs of children's psychological and behavioral developmental problems[J].Chin J Pediatr, 2017, 55(6): 445-450. (in Chinese)
[14] 梁颖,李楠,姚燕滨,等.天津市18～34个月儿童预警征筛查阳性结果追踪评估[J].中国医药科学,2019,9(12): 189-191,211.
Liang Y, Li N, Yao YB, et al. Follow-up evaluation of positive screening results for early warning signs in children aged 18 to 34 months in Tianjin[J]. China Medicine and Pharmacy, 2019,9(12): 189-191,211. (in Chinese)
[15] 农雪艳,刘玥,邵紫贤,等. 2021年佛山市顺德区学龄前儿童心理行为发育现状及影响因素分析[J].实用预防医学,2024,31(6): 700-703.
Nong XY, Liu Y, Shao ZX, et al. Analysis of the current situation and influencing factors of psychological and behavioral development of preschool children in Shunde District, Foshan City in 2021[J]. Pract Prevent Med, 2024, 31(6): 700-703. (in Chinese)
[16] 缪琼,柴臻,Jane S,等.基于《年龄与发育进程问卷-第3版》调查的中国和美国1～66个月儿童发育状况的比较[J].中国循证儿科杂志,2017,12(2): 111-115.
Miao Q, Chai Z, Squires J, et al. Comparison in development of young children aged 1 to 66 months between China and U.S based on Ages and Stages Questionnaires (the third edition) [J].Chin J Evid Based Pediatr, 2017, 12(2): 111-115. (in Chinese)
[17] 桑田,王颖,胡秀丽,等.极低出生体重儿体格发育与神经发育关系的研究[J].中国新生儿科杂志,2016,31(3): 161-167.
Sang T, Wang Y, Hu XL, et al. A study of the relationship between physical development and neurodevelopment in very low birth weight infants[J]. Chin J Neonatol, 2016,31(3):161-167. (in Chinese)
[18] 王丹,戴宏伟.北京市东城区2009—2016年0～1岁儿童神经心理发育监测结果分析[J].中国儿童保健杂志,2019,27(7): 800-802.
Wang D, Dai HW. Analysis of monitoring results of neuropsychological development in children aged 0-1 years in Beijing Dongcheng district from 2009 to 2016[J]. Chin J Child Health Care, 2019, 27(7): 800-802. (in Chinese)
[19] 周穗赞,张敬旭,王晓莉.农村3岁以下儿童心理行为发育问题预警征象筛查发育偏异及影响因素[J].中国儿童保健杂志,2020,28(9): 967-970.
Zhou SZ, Zhang JX, Wang XL, et al.Prevalence and determinants of suspect developmental delay in warning sign for children mental and behavioral development screening among children under 3 years old in rural China[J]. Chin J Child Health Care, 2020, 28(9): 967-970. (in Chinese)
[20] 吴颖.永定门外社区0～3岁儿童心理行为发育问题现状及影响因素[J].中国社区医师,2023,39(4): 148-150.
Wu Y. Current situation and influencing factors of psychological behavior development in children aged 0-3 years old in Yongding Menwai community[J].Chin Comm Doc, 2023,39(4): 148-150. (in Chinese)
[21] 许琪,李瑞莉,金春华,等.北京市0～3岁儿童神经心理发育现状及影响因素分析[J].中国妇幼保健,2015,30(20): 3404-3406.
Xu Q, Li RL, Jin CH, et al. Analysis on the current situation of neuropsychological development and influencing factors of 0-3-year-old children in Beijing[J].Chin J Mater Child Health Care, 2015,30(20): 3404-3406. (in Chinese)
[22] Haslam DM, Poniman C, Filus A, et al. Parenting style, child emotion regulation and behavioral problems: The moderating role of cultural values in Australia and Indonesia[J]. Marriage & Family Review, 2020, 56(4): 320-342.
[23] Bhide S, Sciberras E, Anderson V, et al. Association between parenting style and socio-emotional and academic functioning in children with and without ADHD: A community-based study[J]. J Atten Disord, 2016, 23(5): 463-474.
[24] World Health Organization. Nurturing care for early childhood development: A framework for helping children survive and thrive to transform health and human potential: Executive summary[EB/OL]. (2018-05-18)[2024-08-19]. https://iris.who.int/handle/10665/272604.
[25] Daelmans B, Darmstadt GL, Lombardi J, et al. Early childhood development: The foundation of sustainable development[J]. Lancet, 2017, 389(10064): 9-11.
[26] 何海燕,余敏,宁曼,等.母子关系在母亲养育压力与学龄前儿童情绪行为问题关联中的作用[J].中国当代儿科杂志,2023,25(4): 394-400.
He HY, Yu M, Ning M, et al. The role of mother-child relationship in the association between maternal parenting stress and emotional and behavioral problems in preschool children[J]. Chin J Contemp Pediatr, 2023, 25(4): 394-400. (in Chinese)
[27] 邓成,顾莉萍,何婉懿,等.中山市2～3岁儿童的家庭养育环境与其气质相关性的调查分析[J].中国儿童保健杂志,2012,20(7): 651-653.
Deng C, Gu LP, He WY, et al. Relations research between temperament and home rearing environment of 2~3 years old children in Zhongshan[J]. Chin J Child Health Care, 2012, 20(7): 651-653. (in Chinese)
[28] 宫艳慧,郭玲玲,车超,等.发育性语言障碍儿童的亲子互动特征及影响因素分析[J].中国儿童保健杂志,2022,30(3): 259-263.
Gong YH, Guo LL, Che C, et al.Characteristics and influencing factors of parent-child interaction in children with developmental language disorder[J]. Chin J Child Health Care, 2022, 30(3): 259-263. (in Chinese)
基金
贵州省卫生健康委科学技术基金项目(gzwkj2022-199);贵州省第八批高层次创新型人才项目(筑科合同-GCC-〔2024〕024)
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