武汉市0～14岁儿童非致命意外伤害病例对照研究

随着公路交通和人们生活范围的扩大，意外死亡逐年增多，意外伤害使无数儿童死亡，但更多地还是造成大量的儿童青少年非致命性伤害。据统计，1986年美国0-19岁儿童因意外伤害致死者2．2万，住院病例60万，有1600万病例需要接受急诊室处理，同时3万多名儿童因意外伤害导致永久性功能残疾。意外伤害给儿童本人及其家人带来沉重的心理压力．也给社会带来巨大的经济负担。笔者采用1：2配比的病例对照研究，对儿童的行为特点与意外伤害发生之间的关系进行了探讨。     

山西省某三甲医院意外伤害住院儿童疾病经济负担分析

目的以山西省长治市某三甲医院为基点了解长治地区意外伤害住院儿童疾病经济负担,为确定本地区卫生工作重点提供科学依据。方法选取2012年8月1日—2013年7月31日首次住长治市某三甲医院的意外伤害儿童共70人作为研究对象,进行面对面调查,采用秩和检验。结果本组资料意外伤害的疾病负担,前5位的为交通事故439 192.72元,跌落217 833.73元,中毒61 508.93元,烫伤36 118.76元,昆虫/动物咬伤15 380.19元。总疾病负担为835 007.24元,直接经济负担占81.63%,间接经济负担占18.39%。其中直接经济负担中住院费用占80.05%。人均疾病经济负担11 928.67元。10~14岁的经济负担占总经济负担的51.87%。结论意外伤害造成的经济负担是严重的。不同意外伤害原因中交通事故的危害最重,其次为跌落。在各年龄段,10~14岁的经济负担最高。     

广州市海珠区托幼机构集体儿童意外伤害现状及分析

目的了解广州市海珠区托幼机构集体儿童意外伤害发生的流行病学特征,为预防和控制集体儿童意外伤害的发生提供理论依据。方法用自制的儿童意外伤害调查表,在海珠区整群抽取11所幼儿园的1 563名儿童作为样本,回顾性调查其一年间意外伤害发生情况。结果海珠区集体儿童外伤害发生率为13.18%。意外跌落是最常见的伤害(63.11%),家中(35.92%)和幼儿园(34.95%)是发生意外伤害的主要场所,伤害部位以头部为主(59.71%),61.17%的儿童发生伤害后送往医院就诊,伤害程度以轻度居多(79.13%),人均医疗支出459.36元。结论集体儿童意外伤害发生率较高,增加了家庭和社会的经济负担。控制儿童意外伤害应由全社会参与,采取综合防范措施     

2004-2015年北京市儿童意外伤害的系统评价

目的 通过系统分析北京市儿童意外伤害的研究现状,为儿童意外伤害的进一步防治提供参考。方法 对北京市2004-2015年发表的儿童意外伤害研究文献进行分析。结果 北京市儿童意外伤害发生率男生高于女生,致伤原因主要是跌倒坠落伤、碰撞钝器伤、烧烫伤和动物咬伤。性质多不严重,主要为浅表伤、扭伤脱臼和骨折。部位集中在四肢与头面部。学校和家中是伤害的多发地点。伤害导致的经济负担和时间负担较重。性别、年级、年龄、家庭类型、父母亲文化程度、学习成绩等是影响因素。结论 意外伤害是影响儿童健康的主要因素,是致死、致残的主要原因,应该引起社会各界的重点关注。     

儿童意外伤害社区干预策略方案的选择

意外伤害严重影响着儿童的生命质量 ,不仅给儿童和家庭带来身心痛苦 ,也造成严重的社会经济负担。儿童伤害的有效干预和控制过程是一项涉及多学科协作、多部门参与的社会系统工程 ,积极提倡和推行社区干预是一个有效、经济、符合我国国情的理想选择。结合对中国儿童意外伤害现状的统计分析 ,对儿童意外伤害社区干预的原则、策略的选择方案进行分析探讨。     

医院门急诊就诊意外伤害儿童临床特征调查分析

目的:了解医院急诊就诊儿童意外伤害的临床特征和分布,探讨儿童意外伤害的危险因素。方法:采用现场问卷调查的方法,调查2009年7～10月来湖南省儿童医院门急诊就诊的意外伤害儿童,经筛选后收回资料完整问卷66份。结果:66例意外伤害儿童中,男童意外伤害发生构成比高于女童,比例为1.36∶1;医院急诊就诊意外伤害儿童病因顺位前3位为跌落、碰撞/硬物击伤、气管异物;常见的部位是头面部(62.1%);发生地点主要在家中(51.5%);意外伤害给家庭带来沉重的心理负担、经济负担和社会负担,其中心理负担最重。结论:充分了解儿童意外伤害的临床特征、相关危险因素、预防措施以优化医院急诊抢救措施,减少意外伤害后因抢救不力引起的致残、致死率。     

儿童意外伤害的流行病学研究进展

意外伤害是威胁儿童健康和安全的公共卫生问题，也是我国儿童的主要死因。阐述了儿童意外伤害流行分布特征、变化趋势、意外死因及干预措施，以期能为儿童意外伤害的研究提供参考。     

儿童意外伤害的家庭环境因素研究

儿童意外伤害的家庭环境因素研究徐勇，谭琪，曾广玉，陶芳标，张洪波近年我国的一些调查表明，儿童意外伤害也已成为儿童死亡的第一死因［１］。因此，研究儿童意外伤害发生的影响因素，对于保障儿童身心健康具有重要意义．我们在对儿童意外伤害调查的基础上，对一些家庭...     

长治地区意外伤害住院儿童疾病负担分析

了解长治地区伤害住院儿童的特点并对疾病经济负担和家庭负担进行评价,为有针对性地开展高危人群干预和降低疾病负担提供参考.方法 利用自制调查表及家庭负担量表(Family Burden Scale of disease,FBS)对长治地区医院2013年1月1日至2013年12月31日688名意外伤害住院儿童的疾病经济负担及家庭负担进行测量和分析,并对家庭负担的影响因素进行多元逐步回归分析.结果 意外伤害患儿平均总经济负担11 988.67元/人.从经济负担构成看,直接经济负担占81.45%,间接经济负担占18.55%.直接经济负担中住院费用占80.06%.伤害对患儿家庭造成多维度的影响,其中家庭娱乐活动阳性回答率为54.29%,家庭成员心理健康为52.86%,家庭经济负担为45.71%,家庭关系为42.86%,家庭日常活动为38.57%,家庭成员躯体健康为37.14%.疾病的转归、住院天数、伤害程度、患儿的年龄、直接经济负担、误工造成的经济损失、总经济负担与家庭负担呈正相关(R值分别为0.278,0.377,0.340,0.311,0.395,0.311,0.397,P值均<0.05).疾病家庭负担的主要影响因素有总经济负担和疾病转归(Beta值分别为0.365,0.226,P值均<0.05).结论 意外伤害造成长治地区住院儿童的经济负担较重.在家庭负担中,家庭娱乐活动、家庭成员心理健康和家庭经济负担造成的负担较大.疾病家庭负担的主要影响因素为总经济负担和疾病转归.     

国儿童意外伤害研究现状分析

意外伤害可以定义为由意想不到的原因造成的损害或死亡，它属于一类疾病，国际疾病分类（ＩＣＤ）中有其详细分类。近年来，随着传染性和营养不良性疾病得到控制，意外伤害越来越明显地成为影响我国儿童生命安全、生活质量和身体健康的重要因素。据不完全统计，我国每年有上万儿童死于意外伤害，更有上千万儿童因意外事故而受伤或致残，这给受害儿童及家庭造成的损失是难以估量的。自１９８９年９月第一次国际儿童意外伤害学术会议后，我国儿童意外伤害的研究开始起步，本文将从研究概况、研究分类、研究特点和研究方向等方面对中国儿童意外…     

武汉市儿童脑外伤患者家庭负担的前瞻性研究

目的了解武汉市儿童脑外伤后家庭负担变化的基本状况.方法以0～17岁脑外伤患者作为研究对象进行前瞻性研究,分别于儿童住院期间及出院6个月后,利用以上经过检验的家庭负担测量工具,测量儿童家庭所承受的压力和负担及其变化,并利用儿童行为量表（CBCL）对脑外伤后儿童的社会行为能力进行评估.结果113例儿童在脑外伤发生前、住院期间及出院6个月后随访时家庭功能评价问卷（APGAR）平均得分分别为7.96、6.94、7.60分,配对t检验显示,家庭功能在外伤发生后发生障碍,6个月后恢复到外伤发生前的水平,但重度脑外伤对家庭功能的影响在出院6 个月后仍未得到恢复.住院期间疾病家庭负担会谈量表（FBS）得分最高的3个维度分别为家庭经济负担、家庭日常生活、家庭娱乐活动.出院6个月后FBS量表总得分下降,家庭成员心理健康维度得分最高,其次为家庭经济负担维度和家庭关系维度,配对t检验结果表明脑外伤对家庭成员心理健康的影响在儿童出院6个月后尚未得到消除.113例儿童出院6个月后CBCL得分均在正常范围内.结论脑外伤发生后家庭APGAR得分降低,FBS得分提高,表明脑外伤儿童的家庭受到伤害事件的影响,其家庭负担加重,家庭功能发生障碍.随着疾病的康复,除重度脑外伤组以外,脑外伤儿童的家庭功能均可恢复正常.     

The burden of injuries in Iranian children in 2005

Background  

Child injury is recognized as a global health problem. Injuries caused the highest burden of disease among the total population of Iran in 2003. We aimed to estimate the morbidity, mortality, and disease burden caused by child injuries in the 0- to 14-year-old population of Iran in 2005.     

Preventing child unintentional injury deaths: prioritising the response to the New Zealand Child and Adolescent Injury Report Card

Objective: To develop recommendations for child unintentional injury prevention by comparing New Zealand's child unintentional injury mortality and injury prevention policies with those of European countries. Methods: Unintentional child injury death rates based on external cause of injury were calculated and ranked. NZ's score for each of the 12 domains (based on external causes of injury) from the New Zealand Child and Adolescent Report Card was compared to European scoring. Policy priorities are identified by domains where mortality makes up a high proportion of overall child unintentional injury mortality (high burden of injury) and where report card score for that domain is low in comparison to other countries (under‐utilisation of effective interventions). Results: Death as a motor vehicle occupant accounts for 49% of all child unintentional injury deaths, followed by pedestrian (10%) and drowning deaths (8%). The overall score for the 12 policy domains of the NZ Report Card ranks NZ as 15^th among the 25 European countries. There are important policy and legislative actions which NZ has not implemented. Conclusions: A number of evidence‐based injury prevention policy and legislative actions are available that could target areas of greatest childhood injury mortality in NZ. Implications: A set of injury prevention policy and legislation priorities are presented which, if implemented, would result in a significant reduction in the injury mortality and morbidity rates of NZ children.     

苍南县中小学生伤害现状调查及负担分析

目的了解苍南县中小学生伤害发生情况,分析影响因素和伤害负担。方法采用比例分层随机整群抽样方法,抽取4926名中小学生。采用自制问卷,调查过去一年伤害发生与处置情况。结果伤害和伤害事件发生率分别为25.94%(1278/4926)和40.84%(2012/4926)。跌倒、扭伤、刀割伤、交通伤、环境和自然因素受害居前5位。民办学校、农村学校、好动、视力异常、非独生子女和单亲家庭的学生伤害发生率高于公办学校、城镇学校、文静、视力正常、独生子女和双亲家庭的学生;初中组发生率最高,小学1～3年级组最低;做家务和高月花费是伤害的危险因素。平均每例伤者治疗/休息2.47 d,缺课1.17 d,家人陪护1.93 d,误工1.01 d,年人均费用337.85元。结论苍南县中小学生伤害发生率较高,负担重,伤害发生与个人、家庭、环境等因素有关;建立监测系统,开展健康教育,加强多部门合作,开展科研和干预十分必要。     

Social deprivation and the prevention of unintentional injury in childhood: a systematic review

There is a known association between social deprivation and risk of death from unintentional injury in childhood. In the UK context, these inequalities do not appear to be decreasing. This paper reports on the findings of a systematic review of the world literature between 1975 and 2000 on the prevention of childhood injuries, with particular reference to social deprivation. Literature was identified via electronic databases, key journals and informants. All papers were read independently by at least two reviewers and information was extracted using a standardized form. Results indicate that of 155 studies identified in the systematic review, 32 addressed the issue of social deprivation. The way social deprivation was defined in different studies varied considerably. The literature was not evenly spread across different injury types and did not reflect the burden of injury. There is a paucity of evidence relating to the prevention of child pedestrian injury. Very few studies examined the impact of interventions in different social groups. Without such evidence, it remains difficult for those involved in health promotion to know how to design and target interventions to address inequalities in child injury rates.     

Injuries among children--some cost considerations in USA

Unintentional and intentional injuries are a major cause of morbidity and mortality among children under the age of 19. The large number of premature death and disabilities due to injury and accompanying high economic cost, including public sector expenditures, emphasize the need to reduce the burden of injury. Productivity losses are greater from injury than from the three other leading causes of death--heart disease, stroke and cancer. Implementation of known injury-control interventions can substantially reduce the incidence, severity, and accompanying cost of injury. Because financial resources are limited, decision-makers need to consider the cost and effectiveness of alternative prevention strategies. Injury causes with the highest cost per injury could make a priority, especially within maternal and child health programs; as an alternative, projected total injury cost could determine program priority.     

社区居民伤害经济负担的评价框架研究

目的 探讨适合于社区居民伤害经济负担的评价框架。方法 用现场流行病学方法调查的北京居民伤害经济损失资料对所构建的伤害经济负担评价模型进行验证和评价。结果 构建评价社区居民伤害经济负担的模型(总伤害经济负担=二步法直接经济负担 人力资本法间接经济负担 支付意愿法无形经济负担)，用该方法评价3083名居民的全年伤害经济负担为744877元，其中直接经济负担299770元，间接经济负担为331382元，无形经济负担为113725元。结论 构建的模型在评价社区居民伤害经济负担上有较好的应用价值，居民的伤害直接经济负担和间接经济负担相差不大。     

Predictors of burden in mothers of physically disabled children

The impact a physically disabled child has on the family, particularly the impact of the child on the mother's burden, is a relatively unexplored area of study in the literature. The purpose of the present study was to identify which factors are significantly associated with the burden perceived by mothers of a disabled child. Seventy-four mothers who had a child with a physical disability, living in Québec, Canada, completed four self-administered questionnaires which examined certain characteristics of the mother, the child and the environment in relation to burden. The statistical analysis of the data revealed four predictors of burden in mothers of a physically disabled child: the amount of time the mother spent on caregiving, the secondary health problems of the child, the number of years of marriage and the mother's use of specific coping strategies. The findings are discussed in terms of their clinical implications for occupational therapists and recommendations for future studies are proposed.     

进一步推动我国儿童伤害预防控制工作

伤害是危害我国儿童健康的重要公共卫生问题。我国已开展了大量预防儿童伤害的实践和科学研究，儿童伤害疾病负担已有所减轻，但伤害仍是造成儿童死亡的第1位原因，预防儿童伤害应被列为促进儿童健康的优先工作领域。健全和完善以政府为主导、多部门合作的儿童伤害预防机制，开展系统、全面、科学的儿童伤害预防控制工作，是降低我国儿童伤害疾病负担的重要策略。建议依托《"健康中国2030"规划纲要》完善伤害预防相关政策法规，制定和颁布实施儿童伤害预防行动计划，深入开展预防儿童伤害的实践和科学研究，加强儿童伤害防控的队伍建设和人才培养，以达到减少儿童伤害，促进儿童健康的目的。     

Perceived parental burden and service use for child and adolescent psychiatric disorders.

OBJECTIVES: Pediatric chronic physical illness and adult psychiatric disorders are substantial sources of burden for family care-takers, but little attention has been paid to parental burden resulting from children's or adolescents' psychiatric disorders. This paper describes the predictors of perceived parental burden and its impact on the use of specialty mental health and school services. METHODS: A representative general population sample of 1015 9-, 11-, and 13-year-olds and their parents completed structured psychiatric diagnostic interviews and the Child and Adolescent Burden Assessment. RESULTS: Weighted estimates indicated that 10.7% of parents in the general population perceived burden resulting from their children's symptomatology. Significant predictors of perceived burden were levels of child symptomatology and impairment and parental mental health problems. Children's depressive and anxiety disorders were associated with less burden than other diagnoses. The effects of child disorder severity on specialty mental health service use appeared to be mediated by the level of burden induced. CONCLUSIONS: Substantial levels of parental burden resulted from child psychiatric disorders and were a major reason for specialist mental health service use.