The impact of inclusive education which integrated home, school and health care institutions on the injury outcome of students in Guangming District, Shenzhen
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摘要:
目的 了解“家校卫融合”模式对中小学生伤害发生和结果的影响，为制定中小学生伤害预防与干预政策提供科学依据。 方法 采用分层整群抽样方法，抽取深圳市光明区已采用“家校卫融合”模式运作的3所哨点学校2019学年(2019年9月1日-2020年8月31日)11 439名中小学生，与干预模式实施前的2014学年(2014年9月1日-2015年8月31日)3所学校8 056名中小学生的伤害数据作为对照进行比较，采用SPSS 21.0软件进行统计分析，定性资料采用频率描述，组间比较使用χ2检验，等级资料组间比较使用非参数检验。 结果 2019学年光明区学校报告年平均伤害发生率为19.86%，男生伤害发生率为24.54%，女生伤害发生率为13.89%;小学伤害发生率最高，为35.01%;伤害发生时最主要的状态是活动娱乐/玩耍/休闲，占比60.40%;伤害类型主要表现为跌倒/坠落伤、钝器伤，分别占比57.39%、30.85%;伤害部位以膝部、头部为主，分别占比19.76%、15.76%;挫伤、擦伤是最主要的伤害后果，占比64.13%;与2014学年相比，2019学年学生轻度伤害比例提升，中度和重度比例下降，差异具有统计学意义(Z=-51.88, P < 0.001)。 结论 “家校卫融合”模式促进了家庭、学校、医疗卫生机构的在学校卫生工作各方面的有效协同，提高了中小学生伤害监测的敏感度。 Abstract:Objective To understand the impact of inclusive education which integrated home, school and health care institutions on the occurrence and outcome of injuries among primary and middle school students, and to provide a scientific basis for the development of student injury prevention and intervention policies. Methods A stratified cluster sampling was used to select 11 439 primary and secondary school students who had adopted the inclusive education model in 2019 from 3 sentinel schools in Guangming District of Shenzhen City. The injury data of 8 056 students from 3 schools in 2014 before the implementation of the intervention model were used for comparison. Qualitative data are described by frequency, and the chi-square test was used for comparison between groups. The nonparametric test was used for the comparison of hierarchical data between groups. SPSS 21.0 software was used for statistical analysis. Results In 2019, the average incidence of injuries reported by schools in Guangming District was 19.86%. The incidence of injuries in boys (24.54%) was higher than in girls (13.89%). The primary school had the highest injury rate (35.01%). The most common injuries were recreation/play/leisure (60.40%). The main injury types were fall/fall injury (57.39%) and blunt injury (30.85%). The main injury sites were the knee (19.76%) and head (15.76%). Contusions and abrasions (64.13%) were the main injury consequences. Compared with 2014, the proportion of students with mild injuries increased in 2019, while the proportion of moderate and severe injuries decreased, with statistical significance (Z=-51.88, P < 0.001). Conclusions The inclusive education model promotes effective coordination among families, schools and health institutions in school health work, and improves the sensitivity and response of injury monitoring for primary and secondary school students. -
Key words:
- Wounds and injuries /
- Population surveillance /
- Student
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表 1 2014学年“家校卫融合”模式实施前与2019学年“家校卫融合”模式实施后不同组别中小学生伤害发生率比较
Table 1. Comparison of injury rates of primary and middle school students in different groups before and after the implementation of inclusive education which integrated home, school and health care in 2014 and 2019
组别 2014学年 2019学年 监测学生人数 伤害发生率(%) 监测学生人数 伤害发生率(%) 性别 男 4 490 19.46(874/4 490) 6 415 24.54(1 574/6 415) 女 3 566 11.83(422/3 566) 5 024 13.89(698/5 024) 学段 小学 3 826 23.81(911/3 826) 5 096 35.01(1 784/5 096) 初中 2 114 11.21(237/2 114) 2 788 12.34(344/2 788) 高中 2 116 6.99(148/2 116) 3 555 4.05(144/3 555) 合计 8 056 16.09(1 296/8 056) 11 439 19.86(2 272/11 439) 
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表 2 2014学年“家校卫融合”模式实施前与2019学年“家校卫融合”模式实施后中小学生伤害发生时活动分布[n (%)]
Table 2. Activity distribution of primary and middle school students before the implementation of inclusive education which integrated home, school and health care in 2014 and after the implementation of inclusive education which integrated home, school and health care in 2019 [n (%)]
学年 例数(n) 伤害发生时活动 家庭活动 交通 其他 体育活动/运动 学习 娱乐/玩耍/休闲 2014 1 296 22(1.70) 16(1.23) 30(2.31) 433(33.41) 12(0.93) 783(60.42) 2019 2 272 12(0.53) 13(0.57) 58(2.55) 717(31.56) 77(3.39) 1 395(61.40) 合计 3 568 34(0.95) 29(0.81) 88(2.47) 1150(32.23) 89(2.49) 2 178(61.04)
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表 3 2014学年“家校卫融合”模式实施前与2019学年“家校卫融合”模式实施后中小学生伤害类型分布[n (%)]
Table 3. Distribution of injury types of primary and middle school students before and after the implementation of inclusive education which integrated home, school and health care in 2014 and 2019 [n (%)]
学年 例数(n) 伤害类型 刀或锐器伤 跌倒/坠落伤 动物伤 钝器伤 交通伤 其他 烧烫伤 2014 1 296 47(3.63) 781(60.26) 4(0.31) 387(29.86) 6(0.46) 51(3.94) 20(1.54) 2019 2 272 75(3.30) 1304(57.39) 9(0.40) 701(30.85) 10(0.44) 149(6.56) 24(1.06) 合计 3 568 122(3.42) 2 085(58.44) 13(0.36) 1 088(30.49) 16(0.45) 200(5.61) 44(1.23)
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表 4 2014学年“家校卫融合”模式实施前与2019学年“家校卫融合”模式实施后中小学生伤害主要部位分布[n (%)]
Table 4. Distribution of main injury parts of primary and middle school students before and after the implementation of inclusive education which integrated home, school and health care in 2014 and 2019 [n (%)]
学年 例数(n) 伤害类型 膝部 头颈部 胳臂 手指 踝部 2014 956 315(24.31) 190(14.66) 175(13.50) 155(11.96) 121(9.36) 2019 1 523 449(19.76) 358(15.76) 296(13.03) 237(10.43) 183(8.05) 合计 2 479 764(30.82) 548(22.11) 471(19.00) 392(15.81) 304(12.26)
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表 5 2014学年“家校卫融合”模式实施前与2019学年“家校卫融合”模式实施后中小学生伤害后果分布[n (%)]
Table 5. Distribution of injury consequences of primary and middle school students before and after the implementation of inclusive education which integrated home, school and health care in 2014 and 2019 [n (%)]
学年 例数(n) 伤害后果 挫伤、擦伤 骨折 脑震荡、脑挫裂伤 扭伤、拉伤 其他 锐器伤、开放伤 烧烫伤 咬伤 2014 1 296 901(69.52) 48(3.71) 1(0.08) 116(8.95) 102(7.87) 77(5.94) 32(2.47) 9(0.70) 2019 2 272 1 457(64.13) 57(2.51) 2(0.09) 339(14.92) 292(12.85) 79(3.48) 22(0.97) 24(1.06) 合计 3 568 2 358(66.27) 105(2.95) 3(0.08) 455(12.79) 394(11.07) 156(4.38) 54(1.52) 33(0.93)
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表 6 2014学年“家校卫融合”模式实施前与2019学年“家校卫融合”模式实施后中小学生伤害程度分布[n (%)]
Table 6. Distribution of injury degree of primary and middle school students before and after the implementation of inclusive education which integrated home, school and health care in 2014 and 2019 [n (%)]
学年 例数(n) 伤害程度 轻度 中度 重度 2014 1 296 1 105(85.26) 182(14.04) 9(0.70) 2019 2 272 2 160(95.07) 110(4.84) 2(0.09) 合计 3 568 3 265(91.51) 292(8.18) 11(0.31)
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