教育工作者对艾滋病致孤儿童认知调查

目的了解教育工作者对我国艾滋病流行以及致孤儿童的认知程度,为探索经济、有效、可持续的干预策略提供依据.方法自行设计问卷,对103名来自艾滋病项目省的教育行政官员和教师进行调查.结果被调查者对艾滋病流行态势以及国家有关政策了解不足,且对艾滋病的流行尚未引起足够重视.行政官员与一线教育者认知差异无统计学意义;超过80%的人认为艾滋病致孤儿童问题比较严重,100%均认为应优先投入资源,采取措施予以应对.结论针对艾滋病致孤儿童开展基于社区与学校的关爱与支持工作十分必要;应对开展关爱工作的核心人群即教育工作者进行培训与教育.     

毒品及艾滋病致孤儿童行为问题及健康状况

目的了解云南省某地区毒品及9～15岁艾滋病致孤儿童的行为问题、健康状况及其关系,为做好遗孤儿童的心理辅导和心理健康教育提供依据。方法采用Achenbach儿童行为量表、自测健康评定量表(SRHMS)和访谈对60名毒品、艾滋病致孤儿童行为问题、健康状况进行调查,并进行统计学分析。结果毒品及艾滋病致孤儿童行为问题检出率为53.3%,其中男童检出率为55.26%,女童检出率为50%,男女童差异无统计学意义(χ2=0.155,P=0.694);遗孤儿童生理健康总体状况相对较好(111.55±21.24),优于心理健康(97.22±19.47)和社会健康(86.33±15.03);男女童行为问题组的SRHMS各项得分普遍低于非行为问题组;男女童行为问题总分对SRHMS各项目(除社会支持)均有明显的负向预测作用。结论毒品及艾滋病致孤儿童行为问题较为突出,健康状况不容乐观,学校应及时对其进行心理干预和辅导。     

艾滋病致孤儿童学习现状分析

目的了解艾滋病致孤儿童的学习现状，为进一步加强以家庭和学校为基础的支持提供线索。方法选取5个中国政府和联合国儿童基金会合作艾滋病致孤儿童关怀项目县，对251名6-14岁艾滋病致孤儿童进行问卷调查，并对其中10人进行个人深入访谈。结果23.1％的儿童没有上学，其中31.0％在父／母去世前辍学，主要原因是经济困难、给家里干活、照顾生病父母、跟不上学习等。上学儿童中，29．5％的儿童学习成绩在父母去世后下降，主要原因有父母生病去世期间缺课、担心父／母病情、生活困难导致家庭作业条件差，无人管教、家务活多、上课不能集中注意力等。结论父／母患艾滋病或死于艾滋病后儿童的学习情况发生了变化，他们在父母生病期间和父母去世后需要经济和社会心理支持。     

受艾滋病影响儿童社会心理关怀长效机制的构建

受艾滋病影响的儿童（OVC）系指其家庭中有艾滋病病毒（HIV）感染者或艾滋病病人,或社区中HIV感染者达到一定数量,生活在艾滋病阴影下的儿童（《联合国儿童权利公约》定义为18周岁以下的任何人）,但他们中的大多数人并未受到HIV感染。可分为以下四类：（1）感染了HIV的儿童;（2）艾滋病致孤儿童,即父母一方或双方死于艾滋病的儿童;（3）与HIV感染者／艾滋病病人共同生活的儿童,这部分儿童本身并未感染HIV,但他们与感染了HIV或患艾滋病病的父母或其他家庭成员共同生活;（4）艾滋病高发区的儿童,即家庭中没有HIV感染者,但生活在艾滋病高发社区中的儿童。     

农村受艾滋病影响的儿童和家庭需求的定性研究

目的了解艾滋病对儿童和家庭的影响,为开展干预活动提供基线资料。方法:采用专题小组讨论方法,在某艾滋病流行重点地区组织感染者/病人及受艾滋病影响的儿童的监护人进行访谈。结果受访人员都知道当地有艾滋病,且流行很严重;艾滋病防治信息的来源主要是疾控人员的宣传;都说家庭经济状况较困难;绝大多数都认为对儿童健康没影响,但在儿童营养饮食方面受到一定限制。偏见和歧视导致了对儿童心理的影响。儿童都能免费上学,在学校和老师、同学相处都很好,但有的学习成绩受到家庭一定的影响。都能得到政府的关爱和生活救助。希望有钱能让孩子们有好的生活条件,能上大学。结论:本次调查显示,艾滋病对儿童及其家庭具有明显影响,受影响的儿童和家庭的需求高。     

乡村医生对艾滋病致孤儿童问题的认识与支持现状调查

目的了解我国部分艾滋病致孤儿童所在村医生对相关问题的认识和解决能力。方法采用问卷调查方法,调查艾滋病致孤儿童所在村医生320名,了解其对相关问题的认识和解决能力。结果乡村医生(村医)对艾滋病致孤儿童可能面临问题的认识低于31.0%。9.7%的村医不愿给艾滋病病毒感染者的子女看病,19.4%的人曾向村民介绍过艾滋病预防关怀知识,12.2%的人曾到感染者家中引导其积极地生活,9.7%的人曾组织过感染者生产自救。有72.2%的村医对蚊虫叮咬不传播艾滋病有正确认识,57.2%的村医对医疗注射会增加艾滋病的传播风险有正确认识,48.1%的人对只与一个忠诚的未感染艾滋病病毒的人发生性行为可以降低艾滋病的传播风险有正确认识,77.8%的人对使用避孕套可以降低艾滋病的传播风险有正确认识。结论村医对艾滋病致孤儿童可能面临的问题普遍认识不足,并有少数村医不愿意给艾滋病致孤儿童看病。在村民中开展艾滋病健康教育、引导感染者积极生活、组织感染者生产自救的村医也很少。动员村医在农村开展艾滋病致孤儿童关怀工作,仍需给予其正确信息。     

商水县受艾滋病影响儿童关爱体系调查分析

目的了解商水县受艾滋病影响儿童的生活质量和社会支持现状,分析其相关的影响因素。同时了解受艾滋病影响的儿童及其家庭需求。方法通过整群抽样法对全县受艾滋病影响的164名儿童及受艾滋病影响的124户儿童家庭进行普查。结果 164名受艾滋病影响儿童特别是29名致孤儿童造成的社会影响已经明显显现;农村救助体系虽已建立,帮扶工作还存在很多缺陷。结论建立并完善涵盖受艾滋病影响儿童的农村社区关爱体系,是农村艾滋病防控工作的当务之急。     

贺州市86例14岁以下艾滋病致孤儿童生活现状调查分析

目的了解贺州市两区三县14岁以下艾滋病致孤儿童的生活、社会救助、健康保障等现状。方法采用自制自评量表以及访谈的方式获得86名艾滋病致孤儿童的主观满意度评价。通过民政部门获得他们所在家庭的领取救助情况。结果贺州市大部分艾滋病孤儿是以家庭寄养的方式生活在有血缘关系的亲戚家,但是这样的抚养方式还是让24.42%的调查对象称生活不够稳定,并有20.93%的调查对象不满意现在的生活。在政府救助和医疗保障方面,政府救助覆盖了所有接受调查的对象家庭。91.86%的调查对象参加了医疗保险,参加接种国家免费疫苗达到100%。96.51%的调查对象接受过1次以上健康体检,76.74%的调查对象还每年接受1次体检。调查对象除1例患"肌萎缩"、1例患"皮痒"、2例"鼻炎"外,其他儿童未有常见疾病及传染病。结论贺州市艾滋病致孤儿童在当地政府、社会组织的关心扶持下,艾滋病致孤儿童生活、教育得到了有力保障,身心都保持健康。综合抚养模式可能有利于艾滋病致孤儿童生活更稳定、更有保障。     

2008年西华县艾滋病专题调查评估指标分析

目的了解西华县全球基金艾滋病项目目标完成情况,为下一步制定计划提供科学依据。方法自愿咨询检测(VCT)服务、HIV/AIDS疫情及治疗状况的调查采用艾滋病综合防治信息系统显示的数据进行填报;在知情同意情况下,对中学生、村民、HIV/AIDS、受艾滋病影响儿童、暗娼等5类人群采用普查、整群抽样、PPS二阶段抽样的调查方法 ,以问卷访谈的形式了解知识、行为和受关爱救助状况。结果在HIV/AIDS人群中艾滋病防治知晓率为88.33%,正确使用安全套的比例为83.05%;在暗娼人群中艾滋病防治知晓率为83.75%,最近1次商业性性行为中正确使用安全套的比例为85.00%,艾滋病预防服务在暗娼人群的覆盖率为90.00%;在中学生人群中艾滋病防治知晓率为66.06%;在15～24岁村民人群中艾滋病防治知晓率为60.66%,在25～49岁村民人群中艾滋病防治知晓率为63.32%,15～49岁村民中艾滋病预防信息的知晓率为95.12%因家庭获得外部援助而得到关怀的居家艾滋病致孤和脆弱儿童的比例为99.02%。结论全球基金艾滋病项目实施以来,对艾滋病高危人群和大众人群的知识、行为、态度干预取得了一定效果,但尚应不断扩大覆盖面,并值得在流行状况类似的地区加以推广。     

低流行区艾滋病致孤儿童救助现状分析

目的探索建立艾滋病致孤儿童救助长效机制，以保障他们的合法权利及权益，为他们提供和谐的生存及社会环境。方法对低流行区艾滋病致孤儿童救助现状进行分析，针对目前工作中存在的问题，探讨切实可行的救助策略。结果目前艾滋病致孤儿童的救助工作中尚存在着救助金发放不够合理、抚养方式有待改进、致孤儿童的受保护权及发展权等合法权利未得到有效的保障、这部分儿童的心理问题也不容忽视。结论国家急需建立一套整体综合的方案及适应其身心健康的安置模式，来满足这一特殊群体对关爱和保护的多种需求。     

黔南少数民族地区受艾滋病影响儿童现况调查

摘要:目的　了解黔南布依族、苗族自治州受艾滋病影响儿童生活现况,掌握其生活、就学和教育情况及健康状况,找出影响他们生活质量的主要因素,为进一步干预提供科学依据。方法　采用贵州省统一设计的调查问卷,对未满18岁的受艾滋病影响儿童及其监护人进行访谈,内容包括生活、教育、医疗、社会救助等四方面情况。结果　调查HIV感染者子女314人,252个家庭,分布在我州12个县（市）;HIV/AIDS 18人,占5.73%,非HIV/AIDS 296人,占94.27%,儿童平均年龄8.72岁。抚养人90%以上为初中以下文化程度,农民占69.75%;人年人均收入3 868元,低于我州农民人均纯收入,且40个家庭年人均收入低于1 000元（250～20 000）。学校给孩子减免学杂费或学费的仅占27.40%。孩子生病在乡镇以下医疗机构就诊的占71.87%;有基本医疗保险的占83.76%,有一定困难但能承受的占27.39%,很困难但能承受的为29.94%,不能承担的占24.84%。结论　黔南州社会对儿童关注程度较弱,对儿童的支持缺乏全面性和可持续性,政府主导,多部门协作、社会参与,建立并完善涵盖依靠农村、社区、学校建立对受AIDS影响儿童长效的支持体系是艾滋病防控当务之急。     

Care and secrecy: Being a mother of children living with HIV in Burkina Faso

Home care has become a central component of the response to the HIV/AIDS epidemic, displacing caregiving work onto women. While increasing interest has been paid to HIV/AIDS care with a focus on ailing adults and orphan foster care, the issue of caring for children living with HIV has received little attention in the social sciences. Based on ethnographic material gathered in Burkina Faso between November 2005 and December 2006, the aim of this paper was to gain understanding of women who mother and care for children living with HIV in resource-limited countries. The study involved participant observation in community-based organizations in Burkina Faso and semi-structured interviews with 20 women mothering HIV-positive children as well as 15 children infected with HIV, aged between 8 and 18 years. In daily care mothers face many great challenges, ranging from the routine of pill-taking to disturbing discussions with children asking questions about their health or treatment. The results also show how HIV/AIDS-related stigma adds an additional layer to the burden of care, compelling mothers to deal with the tension between secrecy surrounding the disease and the openness required in providing care and receiving social support. As mothers live in fear of disclosure, they have to develop concealment strategies around children's treatment and the nature of the disease. Conversely, some mothers may share their secret with kin members, close relatives or their children to gain social support. As HIV/AIDS care is shaped by secrecy, these findings shed light on mothers' isolation in child care within a context of changing patterns of family bonds and lack of formal psychosocial support addressing child-related issues. Finally, women's engagement in child care invites us to look beyond the essentialist approach of women's vulnerability conveyed by international discourse to characterise the situation of women facing the HIV/AIDS impact.     

某校高职类医学生艾滋病相关知识、态度及行为调查

目的：了解高职类医学生艾滋病相关知识、态度及性观念，为学校开展健康教育提供依据。方法：随机整群抽取某校4个专业16个班共710名学生进行AIDS问卷调查。结果：高职类医学生对艾滋病认知全面性较低，对一般非传播途径是否传播艾滋病的应答正确率在30．1％～71．4％之间。对我国艾滋病的严重性认识不足，存在着一定的恐惧感，40．9％的学生认为其不会在我国蔓延，17．8％的学生担心自己已感染HIV，对AIDS病人或其病毒感染者不应当保密（38．6％），应将其集中管理（61．5％），隔离至痊愈或死亡（40．9％）；62．4％的学生认为应该关心艾滋病病人，51．4％的学生认为应允许感染艾滋病的儿童同其他孩子一起上学。29．6％的学生认为偶尔的婚外性行为可以理解，13．5％的学生认为多个性伴侣无可指责。83．0％以上的学生希望了解更多有关艾滋病知识。结论：在高职类医学生中开展艾滋病健康知识教育和自我保护技能教育是十分必要的。     

Nutritional Knowledge, Attitudes, and Practices of Women Living with HIV in Eastern Uganda

HIV and AIDS have posed various medical, nutritional, social and economic problems, female-headed households being the most affected. Poor nutritional knowledge and dietary practices common among the most affected households significantly contribute to the rapid progression of HIV. However, very little data exist concerning these aspects of nutrition among women living with HIV and AIDS in resource-limited settings, such as Uganda. The aim of the study was to investigate the gaps in nutritional knowledge, attitudes, and practices and their relationship with sociodemographic characteristics in an urban population of women living with HIV and AIDS in Uganda. In total, 133 women living with HIV were interviewed using a pretested questionnaire. Most (89.5%) women reported being trained on the importance of nutrition for people living with HIV and AIDS (PLWHA) and believed that it is very important to consume a balanced diet (99.5%). On the contrary, only 21.8% consumed at least three meals per day and 39.8% at least six food-groups. They also reported higher dependency on starchy staples while foods of animal origin and fruits that play vital immunity and protective roles were inadequately consumed. Results of bivariate analysis indicated that consumption of a diversified diet was significantly associated with access to food-aid (p=0.006), possibly because access to food-aid reportedly enhances the ability of the household to access other food items. However, much is still needed to understand the drug-food interaction and dietary diversification and enhance proper dietary practices through sustainable projects that ensure increased access to food. Support groups of the PLWHA are a good vehicle for communication of nutrition information and implementation of nutrition-related projects.Key words: Acquired immunodeficiency syndrome, Cross-sectional studies, Diet, Human immunodeficiency virus, Knowledge, attitudes, practices, Nutrition, Uganda     

Association of parental and children behaviors with the health status of preschool children

BACKGROUND: Parental and children behaviors can be associated with health promotion and illness prevention in preschool children. METHODS: We interviewed mothers of 804 out of 1000 households with children aged 3 to 5 years randomly sampled in Tokyo, in 1997. Child health status was categorized as: "good", that is, good general health with no sick days; "poor", that is, fair to poor with frequent sick days; or "moderate". RESULTS.: Good health status was associated with playing outside (OR=1.19, 95% CI: 1.03, 1.37) and family income (OR=1.38-1.78, depending on family income). Mothers of children with poor health were less likely to have good health behavior themselves (OR=0.76, 95% CI: 0.64, 0.90) and were more often sick (OR=1.55, 95% CI: 1.24, 1.94). CONCLUSION: Outdoor playing, good health practice of the mother and high income are associated with a better health status of urban preschool children.     

Children caring for their ill parents with HIV/AIDS

Abstract

Children orphaned by HIV/AIDS experience not only the trauma of a parent's death, but the stress of living with and often caring for an ill and dying parent. We interviewed 50 mothers ill from HIV/AIDS in both Mutare, Zimbabwe and New York, USA, and one child of each aged 8–16 about personal assistive care the child provided; other household responsibilities; hours/day children spent on chores; and parental/child mental health. Children provided substantial amounts of personal care; took responsibility for cooking, cleaning, shopping and other household tasks; and some were their parents' confidants. The amount of care provided was related to maternal disability, not child age, gender, or presence of other adults/siblings. Children reported performing more tasks than their mothers reported. Almost half of New York and 80% of Mutare children said they had too much responsibility, and most reported reduced after-school and peer activities. Both children and parents felt children were more capable because of their responsibilities. Depression rates in New York and Mutare children were high but Mutare children were extremely vulnerable; two-thirds had depression scores in the clinically significant range. However, child caregiving was unrelated to depression. Research to better understand the role of child caregivers is still needed.     

儿童诈病的原因分析及护理对策

目的探讨学龄儿童的诈病原因,提高识别的技巧。方法对诈病儿童实施细致的临床体查,相关实验室检查,院外心理专科会诊,细心对谈方式结合临床经验等措施。结果确诊为诈病的儿童共有10例,其中8例以"发热﹑腹痛﹑胸痛"患儿因学习压力大﹑厌学而诈病;1例因自觉好玩想"挑战"医生而诈病;1例因缺乏家庭的关爱以"气促﹑双下肢无力"而诈病;最后均以"治愈"而出院。结论提高对儿童诈病的识别技巧,及早给予有效干预,对儿童的健康成长以及促进家庭与社会和谐有着非常重要的临床意义。     

艾滋病对贫困农村地区儿童监护人及家庭的影响研究

目的了解安徽省农村地区受艾滋病影响儿童监护人的情况,为今后开展干预活动提供基线资料。方法采用整群抽样方法,在安徽省阜南县抽取两个艾滋病流行重点村,招募所有符合条件的受艾滋病影响儿童的监护人,用半结构式问卷和面对面访谈方法进行调查。结果在154名调查对象中,女性占58%,年龄在36～45岁占70%,未上过学占48%,已婚占77%,全部是农民,家庭收入≤2500元的占54%。有53%的人将自己或家人的感染状况告诉了别人,81%的人告知了孩子。有54%的人认为自己的生活状况“差”或“很差”,45%的人对自己的健康状况不太满意,世界卫生组织生命质量指数平均为66.70,该指数同家庭艾滋病感染状况有关（F=9.40,P〈0.01）。女性Zung抑郁分值是25.61,男性23.14,女性明显高于男性（F=9.40,P〈0.01）;抑郁分值同家庭艾滋病感染情况有关（F=5.82,P〈0.01）。有14%的人认为艾滋病使得他们的家庭关系变差了,9%的人认为艾滋病使得他们的家庭关系变好了;有39%的人说曾遇到过歧视。所有监护人都赞同调查表中提出的干预活动,补充的建议中只涉及帮助改善经济状况和孩子的教育两个方面。结论在安徽省阜南县贫困农村地区,对受艾滋病影响儿童的监护人的影响主要包括：经济状况、健康状况、生活质量、家庭生活等方面,存在的需求是多方面的,但他们的主观要求并不高。     

Listening and facilitating all forms of communication: disabled children and young people in residential care in England

ABSTRACT

Little research has been undertaken into how children with complex communication needs living in residential care are encouraged to express their views, be involved in decision-making, and importantly, make it known when they are unhappy. This group are often placed a long distance from home and can be some of the most vulnerable children in the care system. Ensuring they have access to a communication method, people who understand their communication and support to empower them to grow their capacity is not only a right and a safeguarding mechanism, it is also important in preparation for adulthood and for leaving care. This unique paper reports on the English arm of a European project, which aimed to devise the first international monitoring system to prevent abuse of disabled children in residential settings. Trained professionals examined how disabled children were heard, and encouraged to be involved in decision-making within 10 case-study residential settings. To aid international development of good practice, this paper focuses on positive aspects of practice. Examples are used to illustrate how all forms of communication can be encouraged and used positively to both protect and empower disabled children in residential care. Implications for practice are presented to support practitioners to create positive communication environments.     

7岁以下流动和常住儿童卫生服务现状及需求调查

目的:了解7岁以下流动和常住儿童卫生服务现状及需求。方法:采取多阶段抽样方法,抽取武汉市江岸和硚口区的两个社区内7岁以下儿童作为对象,用自拟“7岁以下儿童卫生服务现状及需求调查”问卷对其父母进行调查。结果:共调查509名流动儿童和500名常住儿童,其中:①流动儿童免疫接种建卡率(88.62%)低于常住儿童(98.76%);25.40%的流动儿童未接受过体检,体检者其体检次数较常住儿童少;家长对其身体健康关心程度亦低于常住儿童,主要就诊机构也较常住儿童差(P<0.01)。②流动儿童父母对儿童保健知识的总体需求低于常住儿童父母,近1/2的流动儿童父母不了解儿童保健知识,了解者其了解程度亦低于常住儿童父母(P<0.01)。③影响儿童保健服务的主要因素有是否为流动人口家庭、父母文化程度和职业、家庭经济状况等。结论:流动儿童卫生服务状况及需求均较常住儿童差,应采取多种措施提高其保健水平。