A case-control study on the risk factors of unintentional injuries among internal-migrant children
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摘要:
目的 探讨外来民工子弟学校儿童非故意伤害的危险因素。 方法 采用1：1匹配的病例对照研究，以同班级、同性别和年龄相差不超过两岁为原则，对外来民工子弟学校发生非故意伤害的的332例儿童进行1：1的匹配。调查以问卷为基础，采用EpiData 3.1软件建立数据库，SPSS 23.0软件进行单因素、多因素条件Logistic回归模型分析。 结果 多因素Logistic回归分析模型结果表明，看护人在儿童考试前施加压力、看护人的性格为外向型和中间型、看护人的文化程度为文盲和小学、儿童的神经症行为是外来民工子弟学校儿童发生非故意伤害的危险因素。其调整后的比值比（odd ratio，OR）和95%的置信区间（confidence interval，CI）分别为2.086（95%CI：1.263~3.444）、2.074（95%CI：1.275~3.372）、1.796（95%CI：1.158~2.784）、1.867（95%CI：1.280~2.722）、2.458（95%CI：1.169~5.168）、1.466（95%CI：1.012~2.124）。 结论 外来民工子弟学校儿童非故意伤害与其看护人以及儿童自身的危险行为有关，应及时采取有效措施降低非故意伤害的发生。 -
关键词:
- 外来民工子弟学校儿童 /
- 非故意伤害 /
- 病例对照研究
Abstract:Objective To explore risk factors of unintentional injuries among internal-migrant children. Methods A 1:1 matched case-control study was conducted between 332 internal-migrant children with unintentional injuries, based on the principle that same class, same gender and age was no more than two years old. The survey was based on the unified questionnaire. Epi Data 3.1 was used to establish database and SPSS 23.0 was used for univariate analysis and multi-conditional Logistic regression analysis. Results Multi-conditional Logistic regression analysis model indicated that caregiver put pressure on children before exam and the adjusted odd ratio (OR) was 2.086 and 95% confidence interval (CI) was 1.263-3.444, caregiver's character was extravert type (OR=2.074, 95% CI: 1.275-3.372) or middle type (OR=1.796, 95% CI: 1.158-2.784), caregiver's educational background was illiteracy (OR=1.867, 95% CI: 1.280-2.722) or primary school (OR=2.458, 95% CI: 1.169-5.168), the neurotic behaviors of children (OR=1.466, 95% CI: 1.012-2.124) were risk factors of unintentional injuries among internal-migrant children. Conclusions The characteristics related to internal-migrant children's caregiver and children's neurotic behaviors are associated with the occurrence of unintentional injuries. Immediate and effective measures should be taken to ease the high injury prevalence and prevent the unintentional injuries among internal-migrant children. -
Key words:
- Internal-migrant children /
- Unintentional injury /
- Case-control study
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表 1 外来民工子弟学校儿童人口学特征基本情况
Table 1. General demographic characteristics of internal-migrant children
特征 人数[n(%)] 病例组[n(%)] 对照组[n(%)] 儿童性别 男 400(57.23) 200(60.24) 200(60.24) 女 264(42.77) 132(39.76) 132(39.76) 看护人 父亲 238(36.90) 106(32.92) 132(40.87) 母亲 241(37.36) 137(42.55) 104(32.20) 祖父母 26(4.03) 12(3.73) 14(4.33) 其他 140(21.71) 67(20.81) 73(22.6) 看护人文化程度 文盲 41(6.51) 25(7.89) 16(5.11) 小学 310(49.21) 171(53.94) 139(44.41) 初中 231(36.67) 99(31.23) 132(42.17) 高中及以上 48(7.62) 22(6.94) 26(8.31) 学校距家距离(米) ＜500 77(12.94) 33(11.00) 44(14.92) 500~ 126(21.18) 63(21.00) 63(21.36) 1 000~ 149(25.04) 78(26.00) 71(24.07) ≥2 000 243(40.84) 126(42.00) 117(39.66) 上学接送 有人接送 294(44.68) 129(39.21) 165(50.15) 自行车上下学 7(1.06) 5(1.52) 2(0.61) 校车接送 217(32.98) 125(37.99) 92(27.96) 步行上下学 123(18.69) 61(18.54) 62(18.84) 其他 17(2.58) 9(2.74) 8(2.43) 家庭年收入(万元) ＜5 31(10.54) 11(7.69) 20(13.25) 5~ 216(73.47) 104(72.73) 112(74.17) ≥10 47(15.99) 28(19.58) 19(12.58) 
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表 2 外来民工子弟学校儿童一般人口学特征的单因素分析
Table 2. Univariate conditional Logistic regression analysis of general demographic characteristics of internal-migrant children
因素 β Wald值 P值 OR(95% CI)值 上学接送 有人接送 1.000 自行车上下学 1.162 1.893 0.169 3.198(0.610~16.749) 校车接送 0.553 9.346 0.002 1.738(1.219~2.477) 步行上下学 0.230 1.140 0.286 1.258(0.825~1.919) 其他 0.364 0.530 0.467 1.439(0.540~3.833) 年收入(万元) ＜5 1.000 5~ 0.524 0.399 0.190 1.688(0.772~3.693) ≥10 0.986 0.479 0.040 2.679(1.048~6.849) 看护人 父亲 1.000 母亲 0.495 7.221 0.007 1.640(1.143~2.354) 祖父母 0.065 0.025 0.875 1.067(0.474~2.405) 其他 0.134 0.391 0.532 1.143(0.752~1.737) 文化程度 初中 1.000 文盲 0.734 4.483 0.034 2.083(1.056~4.110) 小学 0.495 7.972 0.005 1.640(1.163~2.323) 高中及以上 0.121 0.143 0.705 1.128(0.604~2.107) 职业 办事人员和有关人员 1.000 待业 0.105 0.149 0.699 1.110(0.653~1.888) 专业技术人员 0.213 0.575 0.448 1.237(0.713~2.147) 商业服务业人员 0.031 0.009 0.924 1.031(0.546~1.948) 农牧渔水利生产人员 1.216 4.714 0.030 3.375(1.126~10.120) 军人及其他 0.243 0.816 0.366 1.275(0.753~2.160) 健康状况 良好 1.000 一般 0.599 8.720 0.003 1.820(1.223~2.709) 有慢性病 0.134 0.044 0.834 1.143(0.327~3.998) 性格 内向型 1.000 外向型 0.517 5.215 0.022 1.678(1.076~2.615) 中间型 0.406 3.932 0.047 1.500(1.005~2.241) 教育方式 惩罚与教育相结合 1.000 以惩罚为主 0.708 4.818 0.028 2.031(1.079~3.823) 以说服教育为主 0.039 0.053 0.819 1.039(0.748~1.445) 其他 0.268 0.300 0.584 1.308(0.501~3.416) 儿童考试前父母态度 不管不问 1.000 施加压力 0.756 10.136 0.001 2.130(1.337~3.394) 谆谆教诲 -0.150 0.209 0.648 0.860(0.452~1.639) 其他 0.095 0.108 0.742 1.100(0.625~1.935)
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表 3 外来民工子弟学校儿童危险行为特征的单因素分析
Table 3. Univariate conditional logistic regression of risk behavioral problems of internal-migrant children
行为分类 赋值方法 β Wald χ2值 P值 OR(95% CI)值 反社会行为 1=是，0=否 0.205 16.038 ＜0.001 1.227(1.110~1.357) 经常破坏东西 1=是，0=否 0.387 4.656 0.031 1.472(1.036~2.091) 不听管教 1=是，0=否 0.481 17.143 ＜0.001 1.618(1.289~2.032) 时常说谎 1=是，0=否 0.322 5.922 0.015 1.381(1.065~1.790) 欺负别的孩子 1=是，0=否 0.605 5.746 0.017 1.832(1.117~3.005) 偷东西 1=是，0=否 0.595 2.457 0.117 1.812(0.862~3.811) 神经症行为 1=是，0=否 0.432 45.452 ＜0.001 1.541(1.359~1.747) 肚子痛或者呕吐 1=是，0=否 0.323 6.576 0.010 1.382(1.079~1.769) 到学校就哭或拒绝上学 1=是，0=否 0.322 0.893 0.345 1.381(0.707~2.695) 烦恼，对许多事心烦 1=是，0=否 0.678 27.681 ＜0.001 1.970(1.530~2.535) 害怕新事物新环境 1=是，0=否 0.563 12.460 ＜0.001 1.756(1.285~2.400) 睡眠困难 1=是，0=否 0.732 19.440 ＜0.001 2.079(1.501~2.878)
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表 4 外来民工子弟学校儿童非故意伤害的危险因素的多因素Logistic回归分析
Table 4. Multivariate Logistic regression analysis for risk factors of unintentional injuries among internal-migrant children
危险因素 β sx Wald χ2值 P值 OR (95% CI)值 儿童考试前父母态度 不管不问 1.000 施加压力 0.735 0.256 8.255 0.004 2.086(1.263~3.444) 谆谆教诲 -0.195 0.371 0.277 0.599 0.823(0.397~1.702) 其他 0.325 0.319 1.041 0.308 1.384(0.741~2.584) 看护人性格 内向型 1.000 外向型 0.729 0.248 8.647 0.003 2.074(1.275~3.372) 中间型 0.585 0.224 6.845 0.009 1.796(1.158~2.784) 看护人文化程度 初中 1.000 小学 0.624 0.192 10.515 0.001 1.867(1.280~2.722) 文盲 0.899 0.379 5.628 0.018 2.458(1.169~5.168) 高中及以上 0.065 0.338 0.037 0.848 1.067(0.551~2.068) 儿童行为问题 不具有神经症行为 1.000 具有神经症行为 0.383 0.189 4.103 0.043 1.466(1.012~2.124) 常数 -1.109 0.242 21.045 0.000
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