Investigation on the epidemic characteristics of injuries among left-behind children in rural areas in Qingyuan city, Guangdong Province
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摘要:
目的 探讨农村留守儿童伤害的流行情况及危险因素,为制订预防伤害措施提供相应的证据支持。 方法 采用分层整群抽样,于广东省清远市清新区经济发展程度不同的2个层中各随机抽取一个镇,再从当地随机抽取3所小学、3所中学的3~9年级的留守青少年儿童为研究对象,以学生自填问卷方式调查近一年内的伤害发生情况、个人情况、家庭环境和学校情况。运用χ2检验和多因素Logistic回归模型分析伤害的影响因素。 结果 一年内当地的留守儿童伤害发生率为17.50%(440人)。单因素检验提示学段、独生情况、健康状况、焦虑状况、伤害知识水平、伤害行为水平、与同学的关系、老师对学生态度、老师强调安全问题的组间伤害发生率的差异有统计学意义(均有P<0.05),多因素Logistic回归模型结果提示中学、身体健康、行为水平合格、与同学关系融洽是保护因素(均有P<0.05),焦虑是危险因素(OR=1.262,95%CI:1.009~1.577,P=0.041)。 结论 农村留守儿童伤害情况受多因素影响,因此应采取综合干预措施,在营造安全健康的成长环境的同时,积极做好伤害教育工作,减少伤害的发生。 Abstract:Objective To investigate the epidemic character of injuries among rural left-behind children, so as to provide evidence for strategies and processes on preventing injuries. Methods Using stratified cluster sampling, a town was randomly selected from each of the two layers with different economic development levels in Qingxin district, Qingyuan city, Guangdong Province. The local left-behind children of 3-9 grades from 3 elementary schools and 3 middle schools were randomly selected from the local area. The student self-administered questionnaire was used to investigate the occurrence of injuries, personal circumstances, family environment and school situation in the past year. Data of injury situation, personal situation, family situation and school situation during last year were analysed by Chi-square and multiple logistic analysis. Results Injuries were reported to occur in 440 left-behind children, with an injury rate of 17.5%. Significant difference of injury rate was observed between groups divided by grades, being only-child in family, health conditions, anxiety, getting along with other students, teacher's attitude to students, emphasizing security by teachers, knowledge level about injury, and injury-relative behaviors (all P<0.05). Multivariate logistic regression model results suggested that middle school, physical health, behavioral level, and relationship with classmates are protective factors, anxiety is a risk factor (OR=1.262, 95%CI: 1.009~1.577, P=0.041). Conclusions We have to take some comprehensive methods to prevent injuries that are influenced by all kinds of factors. While constructing an advantage circumstance to left-behind children, their awareness of security should also be improved to reduce the occurrence of injuries. -
Key words:
- Countryside /
- Left-behind children /
- Injuries /
- Epidemic character
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表 1 影响农村留守儿童发生伤害的个人因素分析
Table 1. Analysis of personal factors affecting the injury of left-behind children in rural areas
类别 调查人数 伤害人数(n=440) 伤害率(%) χ2值 P值 学段 31.454 <0.001 小学 1 266 275 21.72 中学 1 248 165 13.22 性别a 1.378 0.240 男 1 256 230 18.31 女 1 199 198 16.51 寄宿情况 0.015 0.904 寄宿 1 022 180 17.61 非寄宿 1 492 260 17.43 独生情况 3.956 0.047 独生 545 111 20.37 非独生 1 969 329 16.71 身体状况 6.525 0.011 较差 655 136 20.76 健康 1 859 304 16.35 焦虑状况 3.874 0.049 有 825 162 19.64 无 1 689 278 16.46 伤害知识水平 4.050 0.044 合格 1 943 324 16.68 不合格 571 116 20.32 伤害行为水平 15.170 <0.001 合格 2 154 351 16.30 不合格 360 89 24.72 注:a性别缺失59例。 表 2 影响农村留守儿童发生伤害的学校因素分析
Table 2. Analysis of school factors affecting the injury of left-behind children in rural areas
类别 调查人数 伤害人数(n=440) 伤害率(%) χ2值 P值 与同学关系6 26.166 <0.001 融洽 1 507 216 14.33 一般或不融洽 1 007 224 22.24 老师对学生态度 16.379 <0.001 和善 1 338 210 15.70 严格 658 111 16.87 溺爱 52 16 30.77 一般 466 103 22.10 老师强调安全问题 4.915 0.027 较多a 2 266 384 16.95 较少b 248 56 22.58 学校开展安全教育 0.441 0.506 有 2 387 415 17.39 没有 127 25 19.69 学校开展安全演习 0.925 0.336 有 2 383 413 17.33 没有 131 27 20.61 注:a包含总是、经常;b包含偶尔、很少、从不。 表 3 影响农村留守儿童发生伤害的家庭因素分析
Table 3. Analysis of family factors affecting the injury of left-behind children in rural areas
类别 调查人数 伤害人数(n=440) 伤害率(%) χ2值 P值 父母离异a 1.1497 0.284 是 230 46 20.00 否 2 206 379 17.18 父亲文化程度bg 3.664 0.056 高 297 62 20.88 低 1 772 290 16.37 父亲关心程度c 5.713 0.058 经常 1 373 247 17.99 有时 642 92 14.33 很少 412 80 19.42 母亲文化程度dg 15.571 <0.001 高 283 72 25.44 低 1 803 287 15.92 母亲关心程度e 4.234 0.120 经常 1 740 285 16.38 有时 421 80 19.00 很少 253 53 20.95 父母感情f 5.374 0.068 好 1 879 310 16.50 一般 410 84 20.49 差 150 32 21.33 注:a父母离异缺失78例,b父亲文化程度缺失127例,c父亲关心程度缺失87例,d母亲文化程度缺失107例,e母亲关心程度缺失100例,f父母感情缺失75例;g文化程度:学历在高中中专及其以上的为高学历,初中及其以下为低学历。 表 4 农村留守儿童发生伤害的多因素分析
Table 4. Multi-factor analysis of injuries in rural left-behind children
因素 β sx Wald值 P值 OR(95% CI)值 学段 小学 1.000 中学 -0.584 0.119 24.303 <0.001 0.558(0.442~0.703) 独生情况 独生 1.000 非独生 -0.130 0.127 1.051 0.305 0.878(0.685~1.126) 身体状况 较差 1.000 健康 -0.258 0.118 4.791 0.029 0.772(0.613~0.973) 焦虑状况 无 1.000 有 0.232 0.114 4.166 0.041 1.262(1.009~1.577) 伤害知识水平 不合格 1.00 合格 -0.030 0.127 0.055 0.814 0.971(0.758~1.244) 伤害行为水平 不合格 1.000 合格 -0.566 0.144 15.397 <0.001 0.568(0.428~0.753) 与同学的关系 一般、不融洽 1.000 融洽 -0.173 0.056 9.709 0.002 0.707(0.568~0.879) 母亲文化程度 低 1.000 高 0.006 0.026 0.047 0.828 1.006(0.956~1.058) 老师对学生态度 一般 1.000 和善 -0.256 0.141 3.286 0.070 0.774(0.587~1.021) 严格 -0.294 0.156 3.543 0.060 0.745(0.548~1.012) 溺爱 0.277 0.329 0.707 0.401 1.319(0.692~2.512) 老师强调安全问题 较少 1.000 较多 0.044 0.172 0.065 0.799 1.045(0.746~1.464) -
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