儿童少年卫生发展

儿童少年卫生学（也称学校卫生）是保护和促进儿童青少年身心健康的科学,是预防医学的重要组成部分。我国学校卫生发展起始于二十世纪初,百年来取得显著发展,包括儿童少年卫生学科发展健全、学校卫生工作体系完善、学生健康监测及疾病防控机制建立等,为儿童青少年健康促进做出很大贡献。     

安徽省留守青少年生活满意度自评结果分析

目的描述安徽省不同类型留守青少年生活满意度的差异,为促进留守青少年身心健康发展提供参考依据。方法采用分层整群抽样的方法,抽取皖南、皖北城乡普通中学7所,获得样本3 421名,其中留守青少年682名。应用中文版多维学生生活满意度量表(MSLSS-CV)对研究对象的一般情况和生活满意度进行测评。结果 10～17岁青少年的留守率为19.94%;留守青少年对生活的满意度低于非留守青少年,差异有统计学意义(P值均<0.01)。留守女生对自己的满意度低于男生(P<0.05);留守高中生对朋友、学校、生活环境和自己的满意度均低于初中生(P值均<0.01);农村留守中学生对朋友、学校、生活环境和自己的满意度均低于城镇(P值均<0.01);非独生子女留守中学生对朋友、学校、生活环境和自己的满意度均低于独生子女(P值均<0.01);父母外出类型不同的留守青少年对生活的满意度差异无统计学意义(P值均>0.05)。结论安徽省留守青少年对生活的满意度低于非留守青少年,留守青少年中的女生、高年级学生、非独生子女以及家庭所在地为农村的留守青少年生活满意度相对较低。     

Productivity growth in outpatient child and adolescent mental health services: The impact of case-mix adjustment

The performance of health service providers may be monitored by measuring productivity. However, the policy value of such measures may depend crucially on the accuracy of input and output measures. In particular, an important question is how to adjust adequately for case-mix in the production of health care. In this study, we assess productivity growth in Norwegian outpatient child and adolescent mental health service units (CAMHS) over a period characterized by governmental utilization of simple productivity indices, a substantial increase in capacity and a concurrent change in case-mix. We analyze the sensitivity of the productivity growth estimates using different specifications of output to adjust for case-mix differences. Case-mix adjustment is achieved by distributing patients into eight groups depending on reason for referral, age and gender, as well as correcting for the number of consultations. We utilize the nonparametric Data Envelopment Analysis (DEA) method to implicitly calculate weights that maximize each unit's efficiency. Malmquist indices of technical productivity growth are estimated and bootstrap procedures are performed to calculate confidence intervals and to test alternative specifications of outputs. The dataset consist of an unbalanced panel of 48–60 CAMHS in the period 1998–2006. The mean productivity growth estimate from a simple unadjusted patient model (one single output) is 35%; adjusting for case-mix (eight outputs) reduces the growth estimate to 15%. Adding consultations increases the estimate to 28%. The latter reflects an increase in number of consultations per patient. We find that the governmental productivity indices strongly tend to overestimate productivity growth. Case-mix adjustment is of major importance and governmental utilization of performance indicators necessitates careful considerations of output specifications.     

青春期女性心理健康状况2523例调查分析

目的 :了解青春期女性心理需求及健康状况。方法 :采用自制问卷调查表对 2 5 2 3例青春期女性进行心理健康状况及其影响因素以及对青春期保健需求等情况的调查。结果 :青春期女性的心理健康状况表现为对月经的焦虑和恐惧 ,造成的主要因素依次为痛经、月经不规律、经期综合征 ,与年龄呈正相关 (P<0 .0 1) ,青春期女性对保健需求及青春期生理心理知识的了解亦与年龄呈正相关 (P<0 .0 1)。结论 :青春期女性的心理健康状况随年龄不同而有差异 ,青春期健康教育尚存在问题 ,需要我们有针对性地实施保健指导     

培养适应妇幼卫生事业发展的专业人才

本文从妇幼卫生事业的发展及其重要作用;妇幼卫生人才的构建及其社会需求;妇幼卫生专业的创建及其蓬勃发展三方面阐述了培养妇幼卫生专业人才的重要性、迫切性、专业性及其专业体系发展的过程.     

开展妇幼保健保偿服务应注意的宏观关系

随着妇幼保健保偿服务的迅速发展,一些宏观关系如何处理显得越来越重要了.本文认为,开展妇幼保健保偿服务与实现妇幼卫生工作总体目标之间的关系、与巩固和加强基层卫生组织建设之间的关系、与妇幼卫生其它工作任务之间的关系、与非保偿以及其它卫生工作保偿之间的关系,是直接关系妇幼保健保偿服务能否健康地生存和发展的主要宏观关系问题,只有处理好这些关系,才能保证其沿着正确的轨道健康地发展.     

发展中国社区精神卫生服务体系的思考

中国社区精神卫生的发展必须基于中国人口众多、精神疾病人数庞大的现状,结合我国已经开展的精神疾病三级防治模式,取国外先进经验之长,将先进的管理模式和中国国情有机结合起来,重点是发展多专业合作的精神卫生服务团队、健全相关法律条文、整合社区社会资源、规范社区康复机构运作、加强综合性家庭干预等。通过社区精神卫生服务体系建设,降低精神疾病发病率、减少肇事率,促进社区居民精神卫生健康水平。     

Place and provision: mapping mental health advocacy services in London

The National Health Service (NHS) Executive for London carried out an investigation in 2002 as part of their wider mental health strategy to establish whether existing mental health advocacy provision in the city was meeting need. The project took a two-part approach, with an emphasis on, (a) mapping the provision of advocacy services and, (b) cartographic mapping of service location and catchments. Data were collected through a detailed questionnaire with service providers in collaboration with the Greater London Mental Health Advocacy Network (GLMHAN) and additional health and government sources. The service mapping identified some key statistics on funding, caseloads and models of service provision with an additional emphasis on coverage, capacity, and funding stability. The questionnaire was augmented by interviews and focus groups with commissioners, service providers and service users and identified differing perspectives and problems, which informed the different perspectives of each of these groups. The cartographic mapping exercise demonstrated a spatially-even provision of mental health advocacy services across the city with each borough being served by at least one local service as well as by London wide specialist schemes. However, at local level, no one borough had the full range of specialist provision to match local demographic need. Ultimately the research assisted the Advisory Group in providing commissioning agencies with clear information on the current status of city-wide mental health advocacy services, and on gaps in existing advocacy provision alongside previously unconsidered geographical and service dimensions of that provision.     

An investigation of the mental health needs of children looked after by craigavon and banbridge health and social services trust

Rates of mental health difficulties were investigated among children in substitute care across five childcare teams in Craigavon and Banbridge H+SS Trust. A total of 64 children were assessed using a behavioural screening instrument. Results indicate that more than 60% of 4-10 year olds assessed may have a diagnosable psychiatric disorder. The presence of such a disorder is probable in almost 50%. Among the 11-16 year olds assessed, the proportion likely to have a diagnosable disorder is slightly higher at almost two-thirds of the sample group. A significant number of children appeared in more than one diagnostic category, indicating the complexity of their presentation and probable co-morbid diagnoses. The implications of these results for further research and for the provision of mental health services to young people in substitute care are discussed.     

同伴教育对青春期中小学生心理健康干预效果评价

了解同伴教育干预方式对改善青春期中小学生心理健康状况的效果,为促进青春期中小学生心理健康发展提供依据.方法 采用非随机对照试验的方法,在重庆某区选取2所小学和2所初中学校,将1所小学(四至五年级)和1所中学(七至八年级)作为同伴教育干预组,由接受培训的同伴教育者对学生进行干预;另1所小学和1所中学相同年级作为对照组,不采取任何干预措施.用《中学生心理健康自评量表》(Mental Health Inventroy of Middle-SchoolStudents,MMHI-60)和一般情况调查问卷进行基线调查和随访调查.结果 同伴教育干预校学生总心理健康状况、强迫症状、偏执、敌对、人际关系紧张与敏感、抑郁、焦虑、学习压力、情绪不平衡和心理不平衡问题检出率由干预前的39.9%,55.3%,38.8%,37.9%,43.9%,40.5%,42.7%,48.0%,52.5%,32.1%降低到干预后的36.8%,46.1%,36.6%,33.3%,37.2%,38.8%,40.9%,45.7%,49.2%,30.3%,干预后适应不良的检出率(39.8%)高于干预前(37.7%),差异均有统计学意义(P值均<0.05).二元Logistic回归分析结果显示,干预后干预校青春期中小学生的总心理健康、强迫症状、偏执、敌对、人际关系紧张与敏感、抑郁、焦虑和学习压力检出率分别是对照校学生的0.63(95%CI=0.49~0.81)、0.73(95% CI=0.58~ 0.91)、0.75(95%CI=0.60~0.95)、0.60(95%CI=0.47~0.76)、0.67(95%CI=0.53~ 0.86)、0.72(95% CI=0.56~0.91)、0.68(95%CI=0.54~0.86)和0.71 (95%CI=0.56~ 0.91)倍(P值均<0.05).结论 同伴教育能有效改善青春期中小学生的强迫症状、偏执、敌对、人际关系紧张与敏感、抑郁、焦虑和学习压力.     

Categorical ethnicity and mental health literacy in New Zealand

Objective. Public social policies in New Zealand assume that there are fundamental differences between Maori views of health phenomena and non‐Maori perceptions. The biomedical model and a Maori model known as Te Whare Tapa Wha are commonly employed to characterise these differences. Using the categorical ethnicity demarcation ‘Maori/non‐Maori’ we investigate this claim with respect to mental health literacy about depression.

Design. Participants were randomly selected from the General and Maori Electoral Rolls and recruited by post (N=205). A vignette methodology was employed and involved the development of a fictional character as a target stimulus who exhibited the minimum DSM‐IV‐R criteria for a major depressive disorder. Participants responded to items regarding problem recognition, well‐being, causal attributions, treatment preferences, and likely prognosis.

Results. The majority of Maori and non‐Maori participants correctly identified the problem the vignette character was experiencing and nominated congruent attributions for the causes of the problem. In relation to treatment strategies and likely prognosis, independent of self‐assigned ethnicity, participants rated professional treatments above alternative options. Overall the categorical ethnicity distinction ‘Maori and non‐Maori’ produced no systematic variation with regards to individual evaluative responses about a major depressive disorder.

Conclusions. Contrary to the embedded assumption within New Zealand's public health strategies that there are essential differences between the way Maori and non‐Maori view health problems, and that the categorical ethnicity demarcation reliably reflects these differences, we found no evidence for the veracity of this claim using a major depressive disorder as a target for judgements. Alternative explanations are canvassed as to why this assumption about fundamental differences based on categorical ethnicity has gained ascendancy and prominence within the sphere of New Zealand health.     

不同性别职业人员促进健康行为及健康教育策略

目的了解职业人员健康知识和促进健康行为形成的状况,为制定有效的健康教育策略提供依据。方法采用整群抽样的方法,对557名职业人员进行自编统一问卷调查,将所有的数据运用SPSS 13.0软件包进行统计学处理。结果 WHO健康定义女性知晓率为77.5%,高于男性的67.4%（P〈0.05）,无论男女对健康四大基石的知晓率〈15%。日常基本健康行为只有运动和休息的形成率在60%左右,每天吃早餐、三餐规律及通风换气健康行为方面均超过80%,保健行为上给孩子接种疫苗〉90%,女性认同婚前检查行为为89.9%,明显高于男性的75.2%（P〈0.01）,男性定期进行前列腺液、女性宫颈脱落细胞涂片检查〈15%;有意识进行生殖器官自我检查的女性为52.4%,明显高于男性的19.0%（P〈0.01）;有近40%的男性过马路有危险行为,明显比女性的20.6%高（P〈0.01）、有超过40%的男女人不走红绿灯,但对孩子的交通安全教育却达到80%;在公共场所劝阻吸烟的行为〈30%,女性劝阻亲人和朋友吸烟的明显比男性高,达到80%。结论从健康知识知晓上,职业女性好于男性;从健康行为所处阶段上,需要激发动机,提供方法,鼓励环境支持。因此,从健康教育策略上,针对他们的工作特点开展灵活多样的健康干预措施,以强化他们的健康行为,提高职业人员的健康素质和生活质量,促进社会经济的发展。     

中国儿童健康状况及服务利用地区差异分析

目的了解我国不同地区儿童健康状况及卫生服务利用的地区差异,为确定我国儿童保健工作重点及制定相应措施提供依据。方法以2008年中国卫生服务调查研究资料为基础,采用差异指数和地理分布图方法,分析儿童2周腹泻发病率、2周患病率、2周就诊率和住院率4项指标在不同地区的差异。结果儿童健康状况及卫生服务利用的4项统计指标均呈现农村高于城市。按照行政区域划分,儿童2周腹泻发病率较高的是西南(8.5%)和东北(8.0%),最低的是中南(5.1%);2周患病率和2周就诊率最高的都是中南(14.1%和20.9%),最低的均为西北(7.2%和6.9%);住院率最高的是中南(4.6%),最低的是华北(3.1%)。差异指数无论是在行政区域内部还是在全国范围基本都大于0.20,说明地区差异较为显著。结论我国儿童健康状况及卫生服务利用存在较大地区差异。     

矿工子女生活事件与心理健康的关系

目的为了探讨淮北地区煤炭工人子女生活事件与心理健康的关系。方法以271名中学生为被试,采用刘贤臣等人编制的生活事件量表和由60项可能给青少年带来心理反应事件构成的中学生心理健康量表对其进行了问卷调查。结果对生活事件的各个因子进行研究表明,中学生在丧失因子上差异有统计学意义,中学生的心理健康水平在年级上差异有统计学意义,生活事件是影响中学生心理健康的主要因素。结论生活事件各个因子及总均分与心理健康各个因子及总均分有十分显著正相关。     

Supporting family engagement with child and adolescent mental health services: A scoping review

A key challenge facing the mental health field is connecting children and families to services when symptoms first appear. Multiple barriers inhibit timely access to treatment, and interventions to resolve barriers to care are not common among health and social care organisations. To address this research‐to‐practice gap this study undertook a scoping review of the empirical literature aimed at identifying key factors in the social ecology of families which influence family engagement with child and adolescent mental health services, then identifying and describing models of intervention designed to help facilitate access to care. Forty studies published between 1 January 2000 and 28 February 2019 were reviewed. Key factors associated with child and adolescent mental health service engagement included family attitudes towards mental illness and help seeking, the flexibility and availability of needed services, community attitudes and stigma surrounding mental illness and mental health treatment, and the degree of coordination and integration across systems of health and social care. Models of intervention to facilitate engagement with mental health services included family outreach, telephone and digital health strategies, and integrated care approaches. Empirical support is strongest for family outreach and integrated care, although telephone and digital health strategies are underexplored with children and families and a potentially promising avenue for future research. To support family engagement with child and adolescent mental health services health and social care organisations should be prepared to identify barriers in their local practice settings and integrate efficacious engagement approaches into their continuum of available services.     

应用LQAS方法快速评价上海县妇幼卫生服务

本文首次用批量质量控制抽样(LQAS)技术,快速评价了上海县有关妇幼卫生服务覆盖情况,如孕12周建卡率、产后访视率等,结果显示纯母乳喂养率有待进一步提高,须加强病案管理,特别在浦东片.同时,对现场使用LQAS的方法也作了提示.     

超重学生的行为和脑力工作能力特征

目的 探讨超重(含肥胖)与A型行为及脑力工作能力的关系。方法 现场测量扬州市442名中小学生的身高和体质量，并以身高标准体质量指标判定超重和肥胖。采用调查问卷的形式对该群体的A型行为倾向、学习等级、学习时间、学习自主性和脑力工作能力等进行调查分析。结果 A型行为特征及其TH倾向。超重组与正常体质量组无明显差别。CH倾向。男生超重组高于正常体质量组。学习时间，女性超重组少于正常体质量组。脑力工作能力的3个指标(阅读数、错误数和．IMC)。女性超重组均低于正常体质量组。学习自主性和学习等级方面两组均无明显的区别。结论 A型行为中的CH因子与超重有一定的关联。超重学生无明显的学习落后。女性超重学生脑力工作能力具有一定的特点，学习状态下。表现出大脑皮层的兴奋性相对较低。内抑制相对较高。     

合肥市青少年学生对肥胖态度及其与心理健康关系

目的 了解合肥市某区青少年学生对肥胖的态度与其自身生活满意度等心理状况间的关联情况.方法 通过调查问卷,对合肥市某区初中、高职及大学青少年对肥胖态度及心理状况进行现况调查.结果 共调查2 838名青少年学生,肥胖态度得分在不同性别、学历、体质指数及心理健康水平问差异均有统计学意义.肥胖态度与自尊、生活满意度、积极应对方式呈负相关,与抑郁、消极应对方式呈正相关.逐步回归分析显示,性别、学历、自尊、抑郁、消极应对方式、生活满意度、体质指数与肥胖态度存在关联,可能是青少年对肥胖产生歧视的影响因素.结论 合肥市青少年对肥胖存在不同程度的偏见,可通过培养积极健康的心态,减少对肥胖的歧视,从而更好的控制肥胖人群增多的趋势.