嘉兴市新居民儿童心理发育行为问题及影响因素分析

目的调查嘉兴市新居民儿童心理发育行为问题及影响因素，为改善新居民儿童心理健康提供理论依据。方法随机抽取新居民儿童548例，本地儿童1248例，采用自编量表评估儿童家庭影响因素，长处与困难问卷评估儿童心理发育行为问题，心理痛苦温度计评估主观心理痛苦程度，儿童心理虐待与忽视量表评估家庭教养方式，社会支持量表评估社会支持程度。结果新居民儿童主观评定心理痛苦程度高于本地儿童（P=0.002）。新居民儿童亲社会化行为低于本地儿童（P=0.000），多动/注意缺陷问题高于本地儿童（P=0.011）。儿童忽视虐待量表本地儿童5个因子得分低于新居民儿童：责骂因子（P=0.000）、恐吓因子（P=0.000）、情感忽视因子（P=0.000）、教育忽视因子（P=0.000）、身体忽视因子（P=0.000）。社会支持量表本地儿童3个因子得分均高于新居民儿童：客观支持（P=0.032）、主观支持（P=0.000）、对支持的利用度（P=0.000）。新居民儿童在新居民儿童学校、混合学校、本地儿童学校的3类学校中亲社会化行为、忽视因子、虐待因子、社会支持均有统计学差异（均P＜0.05）。结论新居民儿童较本地儿童心理发育行为明显落后，良好的家庭教养方式和有效的社会支持系统能够更快更好地促进其身心发育。     

Mineurs non accompagnés accueillis au centre psychiatrique d’orientation et d’accueil de l’hôpital Sainte-Anne,Paris

Since its creation, the Psychiatric Guidance and Reception Centre (CPOA) has received and cared for patients aged 16 to 18. Among them, the rate of Unaccompanied Minor Refugees (UMR) has steadily increased, from 10% in 2016 to 12% in 2018. Meeting UMR patients most often occurs at the peak of their crisis, when their personal resources are overwhelmed and when they experience a severe state of psychological suffering. Our objective was to understand who UMR are concerning the particularities and the similarities they could share at clinical and therapeutic levels with other adolescents. We conducted a retrospective and observational cohort study of the 52 UMR received at the CPOA in 2018 in order to draw a portrait of them, to identify the specificities of their care, their guidance and their access to care, and to compare them with other young non UMR patients. UMR we met at CPOA in 2018 were most often boys aged 16 to 17, with limited resources and in great psychological distress. UMR had more suicidal behaviors (19%) than other minor patients (13%), and our results showed more prolonged consultations for UMR than non UMR at the CPOA (44% versus 41%), indicating that the isolated situation of UMRs complicates their ambulatory support. This study also allowed us to question the existence of emergency care specially dedicated to UMR. Although there are few recommendations to date, it seems important to reintroduce time into their care, in order to recreate a unit, which has sufficient place and time for these young patients whose lives are marked by many breakdowns.     

深圳市宝安区流动人口肺结核患者成功治疗情况及影响因素分析

目的 探讨流动人口肺结核患者成功治疗的影响因素,为制定干预措施、改善治疗效果提供理论依据.方法 以2009-2013年在深圳市宝安区接受治疗的流动人口肺结核患者为研究对象,比较成功与未成功治疗患者在人口学特征、诊断结果、管理方式等方面的差异,同时采用非条件logistic回归分析探讨成功治疗的影响因素.结果 2009-2013年深圳市宝安区流动人口结核病患者的成功治疗率为86.06％.成功治疗与未成功治疗患者在年龄、职业、来源、就诊时间、诊断结果、治疗分类、是否系统管理和有无空洞的构成方面存在显著差异;多因素非条件logistic回归分析显示,年龄为20～40岁.职业为家政、家务及待业,无空洞是成功治疗的保护因素,OR(95％ CI)分别为1.463(1.225～1.748)、1.229(1.037～1.455)和1.459(1.216～1.752);而转诊、诊断结果阳性和复治患者是成功治疗的危险因素,OR(95％ CI)分别为0.808(0.677～0.963)、0.567(0.461～0.698)和0.495(0.389～0.630).结论 各种因素导致的流动人口结核病患者未成功治疗是结核病防治工作中的重要问题,应当引起关注,采取针对性干预措施有利于提高流动人口结核病患者成功治疗率.     

外出务工妇女与户籍妇女孕前保健知识知晓及服务获得情况比较分析

目的:调查外出务工育龄妇女对出生缺陷预防和孕前优生健康检查的知晓和服务获得状况,为建立适宜高效的一级预防干预模式提供技术支持和依据。方法:对2013年3~8月在广东部分地区计划生育技术服务机构接受孕前优生健康检查服务的育龄妇女进行出生缺陷预防知识和孕前优生健康检查服务相关问卷调查。结果:调查对象外出务工组378名,户籍地常住组401名。779名对象年龄25.19±3.34岁。两组对象年龄、受教育程度和职业构成均无统计学差异(P均0.05)。调查对象对于出生缺陷的原因和预防措施及孕前优生服务项目等了解不全面。户籍地常住组对象对于如何获取这些免费服务的认知程度以及对孕前优生健康检查中地中海贫血筛查的意义知晓度明显高于外出务工组(P均0.05)。户籍地常住组对象出生缺陷预防知识得分高于外出务工组,且得分与对象受教育程度明显相关。结论:加强流动人口流入地出生缺陷相关知识科普宣传和孕前保健服务的提供,有利于提高目标人群出生缺陷一级预防效果。     

The generational gap: Mental disorder prevalence and disability amongst first and second generation immigrants in Australia

Despite unprecedented numbers of migrants internationally, little is known about the mental health needs of immigrant groups residing in common countries of resettlement. The majority of studies support the ‘healthy migrant hypothesis’, but few studies have examined: 1) shifts in prevalence patterns across generations; 2) how prevalence relates to disability in immigrant groups. Our study examined the prevalence of common mental disorders and disability in first and second generation migrants to Australia. Twelve-month and lifetime prevalence rates of affective, anxiety, and substance use disorders were obtained from the Australian National Survey of Mental Health and Wellbeing (N = 8841). First generation immigrants (born overseas) and second generation immigrants (both parents overseas) from non-English and English speaking backgrounds were compared to an Australian-born cohort. Disability was indexed by days out of role and the WHO Disability Assessment Schedule (WHODAS12). First generation immigrants with non-English speaking (1G-NE) backgrounds evidenced reduced prevalence of common mental disorders relative to the Australian-born population (adjusted odds ratio 0.5 [95% CI 0.38–0.66]). This lower prevalence was not observed in second generation immigrant cohorts. While overall levels of disability were equal between all groups (p > 0.05), mental health-related disability was elevated in the 1G-NE group relative to the Australian-born group (p = 0.012). The findings challenge the overarching notion of the “healthy migrant” and suggest a dissociation between reduced prevalence and elevated mental health-related disability amongst first generation immigrants with non-English speaking backgrounds. These findings highlight the heterogeneous psychiatric needs of first and second generation immigrants.     

Patterns of abuse amongst Sri Lankan women returning home after working as domestic maids in the Middle East: An exploratory study of medico-legal referrals

ObjectiveMigrant worker abuse is well recognised, but poorly characterised within the scientific literature. This study aimed to explore patterns of abuse amongst Sri Lankan women returning home after working as domestic maids.MethodsSri Lanka has over 2 million of its citizens employed overseas as international labor migrants. A cross-sectional study was conducted on Sri Lankan female domestic maids returning from the Middle East region who were referred for medico-legal opinion.ResultsA total of 20 women were included in the study. Average length of their employment overseas was 14 months. Complaints of physical violence directed mainly through their employers were made by 60% of women. Upon physical examination, two-thirds had evidence of injuries, with a third being subjected to repetitive/systematic violence. Eighty percent suffered some form of psychological trauma. Personal identity papers and travel documents had been confiscated by the employer in 85% of cases, with two thirds indicating they were prevented and/or restricted from leaving their place of work/residence.ConclusionsOur study demonstrates that female domestic maid abuse manifests through multiple pathways. Violence against such workers span the full spectrum of physical, financial, verbal, emotional abuse and neglect, as defined by the World Health Organization. Findings from this exploratory study cannot be generalized to the large volume of migrant worker outflows. Further research is needed to determine incidence and define patterns in other migrant worker categories such as low-skilled male workers.     

已婚流动人口避孕节育服务利用情况分析

目的:了解近年来流动人口避孕节育服务利用情况及变化趋势,以期为提升流动人口避孕节育服务质量提供依据。方法:从2013年全国流动人口动态监测数据中选取年龄在16～49岁且首次外出时间在2007年以前、现用避孕方法始于2008年1月～2013年5月的已婚女性共17429人,分析其避孕节育措施利用状况及相关影响因素。结果:宫内节育器、避孕套、绝育术是该人群最主要的3种避孕措施,从2008年～2012年,在流入地获得服务的比例从49.24%上升到了69.21%,选择避孕套避孕的比例从37.14%上升到了52.11%。多因素logistic分析显示,现居住在城镇、非农业户口、低年龄、文化程度较高、亲生子女数量少、未持婚育证明和未报告避孕节育状况、跨省流动的已婚育龄妇女更可能选择避孕套避孕。结论:越来越多的流动人口在流入地获得避孕节育服务,避孕套成为流动人口首选方式;应提升流入地避孕节育手术服务的可及性,并加强生殖健康宣传教育,促进避孕套的正确使用。     

深圳市宝安区劳务工心理卫生知识调查分析

目的通过调查深圳市宝安区劳务工对心理卫生知识的掌握情况,为开展劳务工心理卫生工作提供参考。方法自编心理卫生知识调查问卷,在深圳市宝安区劳务工中开展调查并进行分析。结果宝安区劳务工最熟知的3种精神障碍依次是精神分裂症、抑郁症和焦虑症（88.8%、71.0%和43.6%）;总体来讲,受教育程度越高,对精神障碍名称的认知程度越高（χ2=57.859,P〈0.001）。对于抑郁症和精神分裂症常见表现,学历越高,认知程度越高,差异有统计学意义（χ2=58.199,P〈0.001;χ2=18.902,P〈0.001）。对心理问题或精神疾病的首选建议是精神科/心理科专科治疗（75.3%）;然而知晓在该市或该区＂到哪里看心理医生＂的比例分别为15.2%和5.3%。结论有必要对劳务工群体（尤其是学历较低者）加强有针对性的心理健康知识普及教育。     

丹阳市2009—2012年外来人口肺结核监测结果分析

目的通过外来人口肺结核随访监测,了解外来人口肺结核流行特征和诊治延误现状,为探寻降低肺结核患病率的有效措施提供依据。方法 2009—2012年每年对外来人口集中场所和村卫生室开展一次随访监测和健康教育,了解有无肺结核可疑症状者和患者。对辖区内管理的肺结核患者进行户籍地调查,掌握外来人口发病情况。做好疑似病例诊断,收集肺结核专报数据和确诊患者诊疗信息,进行患病率和诊疗延误分析评估,计数资料采用χ2检验,P0.05为差异有统计学意义。结果 4年监测外来人口586 342人,登记肺结核患者383例,其中新涂阳肺结核157例。外来人口肺结核、新涂阳肺结核年均标化患病率分别为84.86/10万、36.50/10万,其中男性肺结核、新涂阳肺结核患病率(分别为:82.59/10万、34.36/10万)均明显高于女性(分别为:42.81/10万、16.89/10万)。农民工为主要患病人群,15~24岁组与≥65岁组患病率相对较高,患者诊疗延误主要发生在就诊阶段,就诊延误率达57.70%,出现可疑症状到就诊平均34.63 d。结论目前外来人口肺结核防控仍不容忽视,年轻民工和老年人应是防治重点对象,需加强针对性宣传教育、主动监测和归口诊治,做到早发现、早诊断、早治疗。     

团体心理辅导对流动儿童的影响效果

目的 讨论团体心理辅导对流动儿童心理状况的影响.方法 采用中学生心理健康评定量表、青少年心理韧性量表、青少年社会支持评定量表、Rosenberg自尊量表,对北京市某流动儿童学校的41人进行干预,并以46人为对照.结果 ①干预组在中学生心理健康评定量表的症状总分上有了显著降低(t=-2.31,P＜0.05),具体表现在敌对(t=-3.24,P＜0.01)、适应不良(t=-2.10,P＜0.05)、情绪不稳定(t=-2.33,P＜0.05)3个因子上;②干预组在青少年心理韧性总分(t＝2.77,P＜0.01)和社会支持总分(t=2.56,P＜0.05)上有了显著性提高;③干预组在自尊量表得分上没有显著性变化.结论 团体心理辅导能加快流动儿童心理状况好转的进程,从整体上提高流动儿童的心理健康水平.