目的 探索学龄前儿童夜醒问题的自然转归及其与情绪行为问题的关联,为全面促进学龄前儿童睡眠与心理健康提供理论依据。方法 采用分层整群随机抽样设计,于2016年11月从上海市16个区县选取新入园儿童进行基线调查,并于2019年4月在其将离园时进行随访。由主要养育人填写的儿童睡眠习惯问卷评估夜醒问题及自然转归情况,长处与困难问卷评估儿童情绪行为问题、内化问题及外化问题。采用logistic回归分析考察夜醒问题自然转归与情绪行为问题的相关性。结果 共17 194名儿童完成两次调查。入园和离园时夜醒问题的发生率分别为8.01%和4.26%。儿童夜醒的自然转归情况分为4组,无夜醒组88.63%,夜醒好转组7.11%,新发夜醒组3.36%,持续夜醒组0.90%。与无夜醒组相比,夜醒好转组(OR=1.43, 95%CI:1.21~1.69)、新发夜醒组(OR=3.98, 95%CI:3.29~4.82)和持续夜醒组(OR=2.66, 95%CI:1.82~3.88)出现情绪行为问题风险更高(P＜0.001)。结论 学龄前儿童持续或新发夜醒问题会增加情绪行为问题的发生风险,提示应当进行早期预防和综合干预,以促进学龄前儿童的心理健康和入学准备。
Abstract
Objective To explore the natural transition of night wakings(NWs) problems in preschoolers and their association with emotional and behavioral problems, in order to provide theoretical basis for comprehensively promoting the sleep and mental health of preschool children. Methods Using the stratified cluster random sample method, a sample of preschoolers from 16 districts in Shanghai was recruited for baseline investigation in November 2016, and follow-up visit was in April 2019 before graduation.Children′s Sleep Habits Questionnaire was used to assess NWs and the natural transition, and the Strengths and Difficulties Questionnaire was used to assess children′s emotional and behavioral problems(EBPs) reported by primary caregivers.Logistic regression analysis was used to investigate the correlation between natural transition of NWs and EBPs. Results A total of 17 194 children completed both surveys.The prevalence of frequent NWs at entry and graduation years was 8.01% and 4.26%, respectively.Children were categorized into four groups based on their natural transition of NWs, including 88.63% in the no NWs group, 7.11% in the disappeared NWs group, 3.36% in the incident NWs group, and 0.90% in the persistent NWs group.Compared with the no NWs group, the disappeared NWs group (OR=1.43, 95%CI:1.21-1.69), the incident NWs group (OR=3.98, 95%CI:3.29-4.82) and the persistent NWs group (OR=2.66, 95%CI:1.82-3.88) exhibited a higher risk of EBPs (P＜0.001). Conclusion Persistent or incident NWs problems, are associated with the increase risk of EBPs, suggesting that early and comprehensive intervention should be carried out to promote the sleep and mental health.
关键词
夜醒 /
睡眠 /
情绪行为问题 /
学龄前儿童
Key words
night wakings /
sleep /
emotional and behavioral problems /
preschoolers
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基金
国家自然科学基金(82201645;82073568;82071493);上海市教育委员会专项经费项目(2024幼1-1);上海市卫健委卫生健康学科带头人(2022XD056)
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