嘉兴市0~3岁儿童养育风险现状分析

目的 了解嘉兴市0~3岁婴幼儿养育风险现状及家庭养育中存在的问题,为婴幼儿家庭养育提供针对性的家庭养育建议。 方法 采用横断面调查方法,2020年6月1日-7月31日期间在嘉兴地区所有儿童保健门诊体检的0~3岁儿童为研究对象,家长现场用手机填写0~6、6~12、12~36月龄段《养育风险问卷》以及自拟的《家庭基本情况调查问卷》问卷星,根据风险因素给予家庭干预指导。 结果 共调查9 384例0~3岁婴幼儿家庭,养育风险筛查阳性率0~6月龄为30.48%,6~12月龄为39.11%,12~36月龄为45.63%。小于6月龄婴幼儿养育风险因素前三位的是儿童不吃母乳(10.61%)、家中玩具少于3个(8.34%)、儿童至少有2周新生儿期住院史(7.93%);6~12月龄婴幼儿养育风险因素前三位的为没有给儿童吃富含铁的食物 (23.73%)、儿童有营养性疾病(9.64%)、儿童每天吃奶少于3次(6.53%);12~36月龄婴幼儿养育风险因素前三位的为儿童很少每天吃瘦肉或鸡蛋(22.46%)、家中没有图画书(14.85%)、每天很少跟儿童一起玩耍(9.87%)。多因素Logistic回归分析显示父亲学历为高中大专、本科及以上(OR=0.784,95%CI:0.697~0.881;OR=0.701,95%CI:0.599~0.820); 母亲学历为高中大专、本科及以上(OR=0.815,95%CI:0.724~0.917;OR=0.628,95%CI:0.539~0.732)是保护因素;性别男性为危险因素(OR=1.160,95%CI:1.066~1.262)。 结论 现阶段0~3岁婴幼儿普遍存在养育风险,各级专业人员亟需加强健康教育,指导家庭科学养育,规避家庭养育中可避免的风险,保障婴幼儿身心健康。     

婴幼儿家庭养育照护指导需求分析

目的 调查婴幼儿家庭养育照护指导需求情况及其影响因素,为推进医育结合照护服务提供参考。方法 2020年9—11月在我国9省12市选取3 439名婴幼儿家庭进行问卷调查。由照护者填写一般资料和家庭养育问卷,收集婴幼儿家庭对照护指导的需求情况。结果 在3 439名婴幼儿家庭中,有1 022个(29.7%)家庭有照护指导需求,其中对回应性照护和早期学习机会的指导需求尤为突出。Logistics回归分析显示：主要照护者是父亲(OR=0.476,95%CI:0.361～0.629)和(外)祖父母(OR=0.455,95%CI:0.304～0.681)、工作状态为务农(OR=0.395,95%CI:0.240～0.649)、退休(OR=0.612,95%CI:0.500～0.750)是婴幼儿家庭养育照护指导需求的保护因素;家庭结构为主干家庭(OR=1.295,95%CI:1.101～1.523)、单亲家庭(OR=2.631,95%CI:1.405～4.927),文化程度为大专/本科(OR=2.180,95%CI:1.600～2.971)、研究生及以上(OR=3.116,95%CI:2.109～4....     

婴幼儿养育照护专家共识

正联合国儿童基金会(United Nations International Children′s Emergency Fund,UNICEF)及世界卫生组织(World Health Organization,WHO)在儿童发展目标中均提及,促进儿童早期发展最直接、有效的方法就是养育照护~([1-2])。2018年,WHO等国际组织联合发布养育照护促进儿童早期发展框架(Nurturing Care Framework,NCF),将养育照护定义     

婴幼儿养育照护的框架和策略

儿童早期发展对个体的身体发展、大脑发展、心理健康有着长远影响,甚至影响下一代的健康和福祉。但是仍有相当一部分的儿童还处在发育不良的风险中。养育照护的实施能有效提高婴幼儿的早期发展潜能,促进儿童的健康和营养,保护儿童免受威胁,并为其提供早期学习的机会,这种照护可以影响终身甚至下一代。因此,本文将系统地介绍婴幼儿养育照护的框架和策略,以期为进一步的临床和科研工作提供参考。     

婴幼儿养育照护的框架和策略

儿童早期发展对个体的身体发展、大脑发展、心理健康有着长远影响,甚至影响下一代的健康和福祉。但是仍有相当一部分的儿童还处在发育不良的风险中。养育照护的实施能有效提高婴幼儿的早期发展潜能,促进儿童的健康和营养,保护儿童免受威胁,并为其提供早期学习的机会,这种照护可以影响终身甚至下一代。因此,本文将系统地介绍婴幼儿养育照护的框架和策略,以期为进一步的临床和科研工作提供参考。     

婴幼儿养育照护中的回应性喂养

除了食物的数量和种类外,研究人员越来越认识到,缺乏回应的喂养方式是健康与营养的一个重要障碍。为此,世界卫生组织(WHO)和联合国儿童基金会(UNICEF)在其喂养指南中提倡回应性喂养。本文围绕回应性喂养(RF)的范畴、面临的挑战、实施方案、促进策略及效果监测五个方面进行阐述,旨在促进婴幼儿养育照护中回应性喂养的开展。     

婴幼儿养育照护中的回应性喂养

除了食物的数量和种类外,研究人员越来越认识到,缺乏回应的喂养方式是健康与营养的一个重要障碍。为此,世界卫生组织(WHO)和联合国儿童基金会(UNICEF)在其喂养指南中提倡回应性喂养。本文围绕回应性喂养(RF)的范畴、面临的挑战、实施方案、促进策略及效果监测五个方面进行阐述,旨在促进婴幼儿养育照护中回应性喂养的开展。     

温岭市1～35月龄婴幼儿家庭养育风险因素研究

目的 分析浙江省温岭市1～35月龄婴幼儿家庭养育风险及影响因素.方法 2019年12月-2020年5月,在温岭市随机抽取8个镇(街道)1～35月龄婴幼儿2066名,采用问卷方式调查家庭养育可能存在的风险因素及影响因素.结果 2066名婴幼儿存在养育风险307名,阳性率14.86％,其中男性174名,阳性率8.42％ (...     

杭州市萧山区社区责任医生现状调查

目的：了解萧山区责任医生的工作现状和需求状况。方法：采用横断面调查方法,设计问卷对责任医生的个人基本情况、工作情况和需求情况进行调查。结果：萧山区责任医生队伍稳定、工作得到认可,但也存在年龄结构老化、专业素质低、岗位结构不合理、工作任务重压力大等问题。结论：萧山区需进一步加大公共卫生投入、完善责任医生培训、提高信息化管理水平,以提高责任医生队伍整体素质。     

Attrition among adolescents and infants involved in a parenting intervention

Attrition was assessed in a randomized trial of a parenting intervention programme for adolescent mothers and their infants. Infants who were admitted to the neonatal intensive care unit, mothers who had partner difficulties, and mothers and infants who were visited for less than 60 min a week on average (typically in the control group) were more likely to miss one of the two follow-up visits.     

Parenting concepts and experiences of adults abandoned as infants

Parental concepts are crucial in understanding family, relationships and psychological functioning of parents. How these evolve and manifest may vary according to family and personal experience. This study of adults who were abandoned as infants explores three perspectives—their concepts of their biological parents who have abandoned them, their concepts of their adoptive parents who have raised them and finally their concepts of themselves as parents on the birth of their own children. Qualitative interviews with 16 adult survivors of infant abandonment were conducted and thematically analysed to explore parenting. The interviews revealed that although some justified and felt forgiveness for their biological mothers, others sustained feelings of anger and resentment. Participants reported a desire for further knowledge regarding their biological mother, with some reporting a desire for a reunion and others highlighting concerns regarding their genetic health. The majority had no views or thoughts on their biological father. Relationships with adoptive parents were mixed—some were supportive and loved yet others were distant and troubled. For most who had children of their own, such births represented the first moment of true biological and genetic continuity and were reported as precious. Others, however, were challenged or avoided parenting altogether. This study is the one of the first steps to understanding the long-term effects of abandoned infants in terms of the parenting they receive and the intergenerational effects on the parenting they provide in turn to the next generation. Such insight should inform parenting preparation for adoptive parents in the case of those abandoned and subsequently adopted as well as support for survivors of infant abandonment when they reach adulthood and become parents themselves.     

Family discipline practices with infants at six months of age

ABSTRACT

Objectives: To determine the frequency of 14 discipline strategies used by mothers (n?=?564) and fathers (n?=?335) in caring for their six-month old infant. Methods: Data on discipline practices were obtained from families participating in an obesity prevention trial (Prevention of Overweight in Infancy). Each parent was asked to indicate the frequency of using 14 different discipline strategies during the previous week with their infant. Associations between the use of these strategies and parity, deprivation, parental ethnicity, depression symptoms and infant sex were investigated. Results: Parents reported using both positive (mean: 8.8 for mothers and 7.9 for partners) and negative (0.7 for mothers and 0.7 for partners) strategies over the past week. At six months, positive strategies such as smiling, praising and distraction were most commonly reported (≥87% for both mothers and partners), negative strategies such as smacking, time out and shouting being reported infrequently (≤8% for all). Discipline requiring a level of cognitive understanding not developed at six months was reasonably common, including reasoning (17.7% for mothers, 23.4% for partners), negotiation (6.2%, 11.7%) and ignoring (26%, 19%). Multivariate analysis demonstrated that mothers with more than one child had a lower positive discipline index than those with only one child (difference, 95% C.I.: 1.05 (0.57, 1.54). An increase of one point on the 10-point hostile parenting scale was associated with an increase of 0.18 (0.04, 0.31) for the mothers and 0.47 (0.23, 0.70) for partners on the negative strategy index. Conclusions: Discipline strategies emerge early in infancy and are associated with family size and parental hostility.     

婴幼儿超重肥胖的危险因素研究

目的 了解婴幼儿超重肥胖的现状,对其危险因素进行分析,为早期预防儿童超重肥胖提供依据.方法 选取2018年9-12月出生于首都医科大学附属北京妇产医院的儿童为研究对象,调查母亲孕产期和儿童0～12月龄生长发育相关信息.以世界卫生组织(WHO)性别月龄别体重指数(BMI)为超重肥胖的评价标准,采用x2检验、t检验、多因素...     

湖州市三级医院护理人力资源配置现状及对策研究

目的：了解湖州市市级医院护理人力资源配置现状,探讨管理对策。方法：对湖州市5家市级医院护理部进行问卷调查,内容包括护理人力基本配置、队伍结构、编外护士情况三部分。结果：5家医院实际开放床位与护士数之比为1∶0.55,普通病房实际开放床位与护士数之比为1∶0.35,ICU实际开放床位与护士数之比为1∶1.14,手术台与护士数之比为1∶2.26;大专学历占50.4%,本科学历占19.8%,在读研究生0.4%;高级职称护士占5.8%,高职称护士转岗到非护理岗位率达19.8%;30岁以下护士占52.9%;编外聘用护士占34.5%。结论：湖州市5家市级医院护理人力资源总量相对不足,队伍结构欠合理,人力配置中资源紧张与浪费现象并存;高学历高学位人才紧缺,解决编外聘用护士队伍稳定问题迫在眉睫。建议强化医疗机构责任,确保从数量、质量上合理配置护士;进一步规范编外聘用护士的准入管理,以确保护理队伍稳定。     

郑州市农村妇幼卫生工作现状研究

文章主要分析郑州市1996年至1999年农村妇幼卫生工作现状,结果：农村的妇幼卫生资源：每千人的医生数（2．79／千人）、床位数（1．81／千人）;妇幼保健服务对象的专职妇幼保健医生数（0．21／千人）。均明显低于城市（P＜0．01）;农村的孕产妇保健管理率（76．41％）和高危检出率（7．92％）均明显低于城市（P＜0．01）;7岁以下儿童保健管理率（71．22％）和体弱儿检出率（4．03％）均明显低于城市（P＜0．01）,农村的孕产妇死亡率（67．28／10万）和5岁以下儿童死亡率（29．29／10万）均明显高于城市,而死亡的孕产妇农村可避免死亡占的比例是城市（P＜0．01）的1．7倍;农村的婚前医学检查率（51．51％）和疾病检出率（1．47％）均明显低于城市（P＜0．01）;承担保健工作的单位中,农村以技术,设施相对较差的乡级卫生院为主,农村的人群居住分散,因此,为改善农村妇幼卫生工作现状,应切实把妇幼卫生工作重点放在农村去,尤其是乡村两级,应增加农村卫生资源投入,加强农村的妇幼保健机构的建设,充实,加强基层保健队伍,提高基层的医疗诊治水平及危、急、重症的抢救能力,做好健康教育工作,完善管理机制,满足广大农村妇幼保健服务人群的医疗保健需求,改善家村妇幼卫生现状。     

家庭培养干预方法在新生儿重症监护室早期干预中的研究进展

本文综述了将家庭培养干预方法(FNI)应用于新生儿重症监护室(NICU)中对患儿进行早期干预从而达到促进患儿神经发育、缓解母亲的压力、焦虑、抑郁等不良情绪作用的研究情况,为在NICU中开展FNI治疗以及相关研究提供参考和借鉴。     

家庭督导睡眠卫生习惯培养对婴儿生长发育的影响

目的 研究家庭督导睡眠卫生习惯培养对婴儿生长发育的影响,为促进婴儿健康生长提供指导意见。方法 以68例在儿童保健科门诊进行定期体检的婴儿为研究对象,分为干预组和对照组,前者给予家庭督导睡眠卫生习惯培养指导,后者仅对其睡眠行为进行常规询问并登记,定期对婴儿身长、体重进行测量,随访至12月龄,比较两组儿童睡眠情况及体格发育情况。结果 两组儿童的体重和身长增长情况差异均有统计学意义(P<0.001);不同时间点组间比较显示干预组儿童6、9、12月龄的体重和身长均优于对照组(P<0.05)。两组婴儿在入睡困难、频繁夜醒、睡眠节律紊乱和6月起维持整晚睡眠等方面比较,差异均有统计学意义(P<0.05)。结论 家庭督导睡眠卫生习惯培养能明显促进婴儿的体格发育。