家庭环境与儿童心理健康

家庭环境与儿童心理健康南京市白下区卫生防疫站张淑霞家庭环境对儿童心理健康有重要的影响主要表现在：（１）．家庭自然条件对儿童的极大强制性。父母以及父母的社会，经济地位。家庭对儿童的影响是潜移默化的，这便是家庭影响的无意识性。虽然人们并未感觉到家庭的地理...     

发展生态学理论视角下困境家庭儿童健康水平影响因素研究

目的:探究困境家庭儿童健康水平影响因素,为困境家庭儿童制定健康相应政策提供理论依据。方法:基于发展生态学理论框架,利用2018年8—9月开展的困境家庭儿童全国抽样调查数据,采用卡方检验和两独立样本T检验,分析困境家庭儿童和对照家庭儿童各指标差异,采用有序多分类Logistic回归进行多因素分析,采用倾向值匹配法分析社会救助政策对困境家庭儿童健康的影响。结果:困境家庭儿童与对照组儿童自评健康水平间差异具有统计学意义(P0.01)。基于发展生态学系统观,困境家庭儿童和对照组儿童各指标间差异具有统计学意义(P0.05)。年龄、民族、家庭人均年收入、监护人生活照顾、监护人沟通交流、一周吃新鲜水果次数、家庭是否重视学习、监护人受教育程度、是否接受社会救助补贴、规定接受国家疫苗接种是影响困境家庭儿童健康的因素(P0.05)。接受社会救助补贴对困境家庭儿童自评健康水平有显著正向促进作用(t2.576,P0.01)。结论和建议:家庭因素是困境家庭儿童健康水平重要影响因素,政策干预应当促进落实"家庭责任",重视困境家庭儿童社会保障工作,完善困境家庭儿童社会救助体系。     

0～3岁儿童照顾模式与健康不平等关系

目的了解0～3岁儿童照顾模式与健康不平等的关系,为促进儿童健康发展提供参考依据。方法收集中国家庭追踪调查(CFPS)2018年全国数据,从中抽取1 837名0～3岁儿童,采用集中指数与分解的方法测量儿童健康不平等状况及相关贡献因素,重点分析照顾模式对儿童健康不平等的贡献。结果全国0～3岁儿童健康不平等指数为0.039,表明我国存在与社会经济地位相关的儿童健康不平等,来自高收入家庭的儿童普遍健康状况更好。儿童健康集中指数分解结果显示,隔代抚养与混合抚养对0～3岁儿童健康不平等的贡献率分别为4.99%和8.04%,一定程度造成了不平等。儿童的家庭规模(53.98%)、年均家庭收入(38.81%)和父亲的健康状况(23.63%)是对儿童健康不平等贡献最大的3个要素。医疗保险和母乳喂养时长对儿童健康不平等的贡献率分别为–6.36%和–7.56%,有助于缩小儿童健康不平等。结论儿童照顾模式及相关家庭因素均对0～3岁儿童的健康有重要影响,并会造成儿童健康的不平等,应注意规避相关危险因素。     

与收入相关的健康不平等及其分解

目的:测量与收入相关的自评健康不平等程度,并分析各因素的贡献。方法:利用家庭健康询问调查数据,采用集中指数法测量居民基于收入的自评健康不平等程度及各因素对自评健康不平等的贡献。结果:不同收入人群的自评健康有差异,集中指数为0.034,仍存在亲富人的健康不平等;各因素对自评健康不平等的贡献中,收入贡献率为46.30%,地区为22.00%,性别-年龄为13.80%,城乡类型为10.10%,文化程度为7.20%。结论:收入和地区因素对自评健康不平等贡献较大;改善收入分配、缩小地区间发展差距、加快城乡一体化建设、推进教育公平等有利于降低健康不平等。     

父母外出务工对农村留守儿童心理健康的影响研究

目的:了解贫困农村地区留守儿童与非留守儿童心理健康差异并探索其影响因素。方法:在宁夏固原市用分层整群抽样的方法对7所小学的2017名学生进行问卷调查,并通过家长调查获取1474名学生的家庭信息。结果:欠发达地区农村儿童自我意识水平整体偏低;留守儿童心理健康比非留守儿童差,具体表现为自我意识水平较低、孤独感较强、社交焦虑水平较高;父母外出务工是留守儿童心理健康的危险因素,家长对孩子的关心程度、同伴关系和师生关系是影响留守儿童心理健康的三个最主要因素。结论:加强留守儿童家庭中的亲子沟通,提高监护人对留守儿童心理健康的重视,以及老师帮助学生建立融洽的师生和同伴关系是改善留守儿童心理健康状况的有效途径。     

上海地区学龄前儿童心理卫生状况及相关影响因素的研究

目的 探讨上海地区学龄前儿童心理卫生健康状况, 同时对影响心理卫生健康状况的高危因素进行评估, 以全面了解上海地区儿童早期的心理健康状况。方法 采用分层整群随机抽样方法, 抽取上海市7个区县23个幼儿园的2 073名学龄前儿童进行调查。本研究采用国际上广泛使用的长处和困难问卷(Strength and Difficulty Questionnaire, SDQ)儿童个人及家庭社会环境问卷, 收集儿童心理卫生状况与个人家庭社会环境等信息。结果 进入分析的儿童有1 682人(有效应答率为81.1%), 平均年龄(5.42±0.92)岁, 男童占53.2% 。此次调查结果发现:心理卫生状况问题处于临界水平占11%, 异常占10%, 与其它发达国家水平相类似。但在同伴问题上, 上海地区学龄前儿童的临界以及异常的发生率分别为20% 和21%, 两者总体为41%, 大大超过发达国家。多因素分析后发现, 亲子关系差及父母亲教育收入水平低等是最终影响学龄前儿童心理健康的因素。结论 上海地区学龄前儿童的心理卫生问题发生率, 与发达国家相类似, 唯独同伴关系问题发生率相对较高, 而亲子关系等家庭环境因素是影响学龄前儿童心理问题发生的重要因素。     

Tourette综合征儿童的行为问题与家庭环境

目的:评估Tourette综合征(TS)儿童的行为和家庭情况,探讨家庭因素对TS儿童行为问题的影响.方法:采用定式问卷、家庭环境量表(FES)、儿童行为量表(CBCL)对60名TS儿童和60名正常儿童的行为问题、家庭背景和家庭环境进行调查评定,并对数据进行相关分析和多重线性回归分析.结果:TS组CBCL总分及各因子得分均高于对照组(均P＜0.05).TS组家庭-亲密度得分低于对照组,家庭-矛盾性得分高于对照组(P＜0.001).相关分析显示家庭-亲密度与社会退缩、躯体主诉、行为问题总分负相关;情感表达与躯体主诉负相关;家庭-矛盾性与社会退缩、焦虑/抑郁、违纪行为、外化性问题、行为问题总分正相关.多因素分析显示TS儿童行为问题与家庭-矛盾性正相关,与母亲文化程度负相关.结论:TS儿童存在广泛和明显的行为问题并有着相对不良的家庭环境,TS儿童的家庭环境和行为问题相互影响,家庭矛盾性和母亲文化程度是TS儿童行为问题的主要家庭影响因素.     

三～五年级儿童家长健康知识影响因素分析

国外研究报道 ,家庭环境是影响健康的重要因素。家庭是教育儿童的重要场所 ,良好的家庭环境对儿童的健康成长有着重要的意义〔1〕。如何创造良好的家庭环境越来越受到人们的关注。为了了解儿童家长健康知识水平及主要影响因素 ,我们于 1999年 5月对太原市某小学三～五年级儿童家长进行了问卷调查。现将结果报告如下。对象与方法　 (1)对象 :太原市某小学三～五年级 895名儿童家长。共发放调查表 895份 ,删除项目填写不全者 71名 ,收回有效调查表 82 4份 ,有效率为 92 %。在基线测查 1月后 ,随机抽取 1班 48名 (约占 5 8% )复测 ,健康知识复…     

儿童心理卫生问题及健康教育策略分析

通过案例及文献资料呈现我国儿童心理卫生问题的现状,论述心理问题影响儿童的健康成长,且会延及成年后生活,阐述儿童心理健康教育的重要.探讨了我国儿童主要心理卫生问题,如学习相关问题、情绪问题、人际关系问题、行为问题及性心理问题;分析其存在的家庭、学校及社会的影响因素,如父母教养方式不良、家庭不和睦,过重的学习压力、教师不科学教育方式、同伴矛盾,社会媒体低俗、不良信息的传播等,并提出建设性的干预策略.     

1309名学龄前儿童心理行为问题调查

目的:了解银川市城区学龄前儿童心理行为问题发生情况及相关因素。方法:设置学龄前儿童心理行为问题筛查表,以问卷形式对1309名2～6岁儿童进行调查分析。结果:儿童心理行为问题检出率36.97%,性格缺陷检出率15.35%。心理行为问题、性格缺陷检出率各年龄组间比较差异有显著性(P<0.05),男女间有显著性差异(P<0.05),家庭经济状况、父母文化程度、不良家庭环境、不同教育方法对儿童行为影响有显著性差异(P<0.05)。结论:儿童心理行为问题发生率较高,是家长、教育工作者不容忽视的问题,在家庭教育中独生子女教育问题更为重要,应重视家庭教育方法对儿童时期个性形成与行为习惯培养的影响,加强家庭教育智能培训,以促进儿童身心健康的发展。     

家庭健康生产视角下儿童健康的影响因素及其相对贡献度研究

目的：基于家庭健康生产视角,探究家庭客观因素及监护人的主观能动性对儿童健康的影响以及各维度因素的相对贡献度,为促进儿童健康提供依据。方法：基于2015年中国健康与营养调查数据,使用线性回归模型、Logistic模型分别探究家庭健康生产相关因素对0~18岁儿童年龄别身高Z评分、超重/肥胖以及自评健康的影响,并使用Shapley分解法计算各因素对儿童健康影响的相对贡献度。结果：家庭系统客观因素、母亲健康遗传、对儿童的健康管理均影响子代HAZ、超重/肥胖以及自评健康;Shapley分解显示,除去亲代对儿童的健康遗传,家庭居住区域、家庭健康生产客观因素以及监护人的健康管理对儿童健康的影响贡献度较高。结论：建议关注家庭健康生产客观因素与监护人的主观能动性对儿童健康的影响,尤其加强对母亲的健康教育,提升其健康管理能力。     

童年家庭功能障碍对老年人抑郁倾向的影响贡献、累积效应与作用机制

目的:探讨童年家庭功能障碍与老年人抑郁倾向的关系及相对贡献,累积效应、作用机制.方法:依据中国健康与养老追踪调查2014、2018年数据,使用Shapley值分解方法,分析老年人抑郁倾向在生命早期阶段的重要影响因素,利用中介和调节效应分析,研究成年期社会经济地位、童年期家庭功能障碍与老年期抑郁倾向之间的关系.结果:童年...     

Pediatric mental health problems and associated burden on families

Approximately 20% of children in the United States have mental health problems. The factors associated with childhood mental health problems and the associated burdens on families are not well understood. Therefore, our goals were to profile mental health problems in children to identify disparities, and to quantify and identify correlates of family burden. We used the National Survey of Children's Health, 2003 (n?=?85,116 children aged 3–17 years) for this analysis. The prevalence, unadjusted and adjusted odds ratios (AOR) of mental health problems and family burden were calculated for children by child-, family- and health systems-level characteristics. The prevalence of mental health problems among children aged 3–17 years was 18%. The odds of mental health problems were higher for boys, older children, children living in or near relative poverty, those covered by public insurance, children of mothers with fair or poor mental health, children living in homes without two parents, children without a personal doctor or nurse and children with unmet health care needs. Among families with children with mental health problems, 28% reported family burden. Correlates of family burden included white race, severity, older age, higher income, non-two-parent family structure and having a mother with mental health problems. In conclusion, childhood mental health problems are common, and disproportionally affect children with fewer family and health care resources. Families frequently report burden, especially if the mental health problem is moderate to severe, but the correlates of family burden are not the same correlates associated with mental health problems. Understanding those highest at risk for mental health problems and family burden will help assist clinicians and policy makers to ensure appropriate support systems for children and families.     

Psychosocial Components of Asthma Management in Children

Asthma is a growing health problem that affects 4.8 million children in the US alone. This paper considers empirical studies from the past 20 years examining the relationship between psychosocial factors and asthma management and morbidity. Research indicates that psychosocial factors, including risk and protective factors in the social environment, and knowledge, attitudes and skills pertaining to asthma management, can play an important role in asthma management, adherence and morbidity. Caregiver and child mental health problems have been linked to increased asthma symptoms and poorer functional status. Family functioning, chronic stresses and social support have also been identified as potential risks and/or protective factors in the social environment.Of the asthma self-management skills, practical problem-solving skills have received increasing attention as an important, and potentially modifiable, psychosocial component. Families may also fail to adhere to medical recommendations because of concerns regarding their utility. Results from a recent individualised asthma intervention protocol provide a strategy for successfully addressing both environmental risk factors and asthma self-management skills to reduce asthma morbidity. Recommendations for healthcare providers include: (i) screening families for psychosocial risk and protective factors on an ongoing basis, including mental health concerns; (ii) engaging family members in dialogue to identify potential areas of confusion or disagreement with the treatment plan; and (iii) including non-medical specialists such as health educators and mental health practitioners as part of the treatment team.     

江门市学龄前儿童心理健康状况及影响因素分析

[目的]调查江门市学龄前儿童的心理健康问题,探讨影响因素,为儿童教育提供依据。[方法]采用两级整群抽样法,从江门市3区10所幼儿园抽取1 054名儿童,用3~6岁幼儿心理健康问卷和一般情况表调查,对影响因素进行分析。[结果]有26.5%的儿童存在心理健康问题。其中,社会性、情感与意志、生活习惯和认知能力问题的检出率分别为23.1%、11.3%、16.9%和16.0%。儿童年龄、性别、健康状况、学习成绩、营养状况、居住地、父母的教育方法、教育态度、母亲文化水平、父母关系、家庭结构和经济状况等因素与儿童心理问题的发生密切相关。[结论]目前江门市学龄前儿童的心理健康问题较普遍,预防和矫治要综合考虑儿童、家庭、社会3方面因素。     

PEDIATRIC MENTAL HEALTH PROBLEMS AND ASSOCIATED BURDEN ON FAMILIES

Approximately 20% of children in the United States have mental health problems. The factors associated with childhood mental health problems and the associated burdens on families are not well understood. Therefore, our goals were to profile mental health problems in children to identify disparities, and to quantify and identify correlates of family burden. We used the National Survey of Children's Health, 2003 (N=85,116 children aged 3-17 years) for this analysis. The prevalence, unadjusted and adjusted odds ratios of mental health problems and family burden were calculated for children by child-, family- and health systems- level characteristics. The prevalence of mental health problems among children aged 3-17 years was 18%. The odds of mental health problems were higher for boys, older children, children living in or near relative poverty, those covered by public insurance, children of mothers with fair or poor mental health, children living in homes without two parents, children without a personal doctor or nurse, and children with unmet health care needs. Among families with children with mental health problems, 28% reported family burden. Correlates of family burden included White race, severity, older age, higher income, non-two parent family structure, and having a mother with mental health problems. In conclusion, childhood mental health problems are common and disproportionally affect children with fewer family and health care resources. Families frequently report burden, especially if the mental health problem is moderate to severe, but the correlates of family burden are not the same correlates associated with mental health problems. Understanding those highest at risk for mental health problems and family burden will help assist clinicians and policy makers to ensure appropriate support systems for children and families.     

军校独生子女学员心理健康状况研究

目的 评定军校独生子女学员心理健康状况,为军校心理健康教育提供依据。方法 用SCL－90量表对军队高校学员12616人（其中独生子女2051人）进行测试。结果 军校独生子女学员心理健康水平低于普通高校独生子女,军校独生子女学员心理健康水平高于非独生子女,男性的这种差异更明显,在军校独生子女学员中,女生比男生更容易出现焦虚和恐怖倾向,农村生比城镇生更容易出现强迫,人际敏感和精神生倾向,男生的这种倾向更明显。农村女生比城镇女生更容易出现躯体化倾向。影响军校独生子女心理健康的主要因素是学员任务导致的心理压力,家庭教育,性别角色社会化和城乡环境。结论 军校应重视心理健康教育,在教育中必须考虑到不同学员的心理健康状况。     

Understanding differences in income-related health inequality between geographic regions in Taiwan using the SF-36

This paper measures and decomposes socio-economic inequality in general and mental health of Taiwan residents using concentration indices. The data from the 2001 Taiwanese National Health Interview Survey is based on multi-stage systematic sampling: 18,142 subjects aged 12 and above provided answers to questions on general and mental health domains of SF-36 Taiwan version. Significant inequalities favouring higher income groups emerge in both general and mental health, but these are particularly high for residents in remote areas. The decomposition analysis shows that in both areas income itself accounts for a significant and sizeable contribution (40-73%) of general and mental health inequality. The second largest contribution comes from inequality in education (15-22%) for general health and from employment status (17-18%) for mental health. Apart from these factors, age, and lifestyles are also important contributors for both general and mental health. We also find important regional disparities in income-related inequalities.     

Starting early: promoting the mental health of women and girls throughout the life span

The importance of mental health in the promotion of lifelong health among men and women alike cannot be overstated. However, mental health remains under-addressed within general public health and community health programs. In this report, we focus primarily on the mental health of women and discuss risk factors that can affect the well-being of women throughout the life span. The literature reviewed demonstrates a strong relationship between social and environmental risk factors, such as abuse and family dysfunction in childhood, to health risk behaviors and poor mental health in adulthood. We concluded that adverse childhood experiences (ACEs) and poor adult mental health could contribute to cycles of intergenerational transmission of risks leading to poor mental and physical health in children of ACEexposed parents. Also, we argue that public health communities can make a difference in women's lifelong health by improving early recognition and treatment of mental health concerns, seeking opportunities to prevent exposures to known risk factors in childhood, and developing targeted parenting interventions. Promoting healthy psychological states and coping mechanisms before, during, and after exposure to adverse events throughout life is also critical. Perhaps such efforts will help to reduce or even break cycles of risk exposure specifically for women and their children. Finally, existing prevention activities and opportunities for promoting the mental health of girls and women are discussed. Ultimately, this report challenges the women's health and public health communities to take action because mental health can have a serious impact on lifelong well-being.