中国儿童性虐待的流行病学研究现状：测量工具、流行现状及危险因素分析

目的初步掌握中国0-17岁儿童性虐待的流行病学研究现状。方法通过对近20年（1992-2012年）的国内外文献进行检索,获取较全面的、有代表性的中国儿童性虐待流行病学研究资料,对儿童性虐待研究的测量工具、发生率现状及危险因素等进行系统分析。结果 1测量工具：现有研究比较多的是调查16岁前发生的性虐待,多采用成年人回顾的方式进行调查。常用的测量方法是采用不记名自填式问卷对接触性和非接触性性行为的发生情况进行回顾性调查,也有研究者使用标准化的儿童虐待量表。2发生率现状：男性遭受性虐待的发生率为10.2%-23.0%,女性遭受性虐待的发生率为14.2%-25.5%;在性虐待发生的性别差异方面,尽管不同研究结果存在不一致性,但总体上女性遭受性虐待的发生率高于男性。3危险因素：城市地区儿童遭受性虐待的比例高于农村地区,生活在重组家庭中的儿童性虐待的报告率高于核心家庭,父、母亲经常在家庭中使用暴力、有不良嗜好、体弱多病、家庭关系紧张等是儿童性虐待发生的危险因素。结论有关儿童性虐待问题的测量方法不一致,现有研究多为成人回顾性调查,有必要在测量工具标准化、全国流行现状等方面开展深入研究。     

86例被虐待儿童临床及流行病学研究

目的 研究被虐待儿童的临床特征及流行病学特征，寻注预防干预措施。方法 采用统一表格及方法和判断标准，回顾性调查和分析１９９８年１月～１９９９年１２月期间８６例被虐待儿童的临床资料和流行病学资料。结果 受虐待儿童男女之比为０．７６：１，女孩多于男孩。年龄以３～１６岁居多，占６０．４６％。发病季节以春冬季为主，分别占３２．６％和３３．７２％，虐待方式以身体虐待为主，占４５．３４％，损伤类型以皮肤软组织     

国内儿童虐待的流行病学研究

目的:儿童虐待作为造成儿童意外伤亡的重要因素,需要了解近年来国内的流行病学研究进展.主要内容:该文章围烧以下方面进行了综述:儿童虐待的定义、诊断标准、调查方法、正常及特殊人群的流行情况;儿童虐待发生的可能病因和后果,干预原则与效果.结论:目前国内的相关研究还有待深入,需要共同努力,不断推进本学科的健康发展.     

儿童虐待与忽视研究的相关问题

由于人类文明的进步和医学模式的转变，儿童虐待与忽视((CNA)成为国际上普遍关注的公共卫生领域研究的热点问题。它是一个复杂的、涉及多方面的、全世界普遍存在的现象。近年来许多国家致力于儿童虐待与忽视问题的探讨和干预，该文概述了CAN问题的产生背景和“国际防止CAN协会”的作用，介绍了CAN的基本概念和危害，旨在强调开展CAN研究及提高公众认识的必要性和紧迫性。     

儿童虐待与忽视研究的相关问题

由于人类文明的进步和医学模式的转变 ,儿童虐待与忽视 (CNA)成为国际上普遍关注的公共卫生领域研究的热点问题。它是一个复杂的、涉及多方面的、全世界普遍存在的现象。近年来许多国家致力于儿童虐待与忽视问题的探讨和干预 ,该文概述了CAN问题的产生背景和“国际防止CAN协会”的作用 ,介绍了CAN的基本概念和危害 ,旨在强调开展CAN研究及提高公众认识的必要性和紧迫性。     

儿童性虐待流行病学研究进展

既往研究表明,儿童性虐待(childhood and adolescent abuse,CSA)是一种较为普遍的社会现象.CSA史不仅对受害者的心理健康有不利影响[1-9],且与受害者之后的高危行为和不良的健康结果有关[1,5,7-23].本文旨在通过文献回顾分析CSA史对受害者的影响,并为之后的相关研究提供线索.     

儿童的虐待与忽视及其干预对策

本文从儿童虐待和忽视的定义、分类及其危害进行了阐述,指出虐待和忽视儿童权利已成为造成儿童意外伤亡的第一杀手,并对其干预对策进行了简单的介绍,以引起儿童保健工作者的关注.     

儿童虐待与忽视问题的国际研究进展

儿童虐待与忽视是一个非常复杂的、涉及多方面的现象，包括有各种各样的虐待与忽视形式。它可以发生在家庭内外孩子成长的任何地方。而又，因为社会和文化价值观的不同，不同的民族关于儿童虐待与忽视的界定标准有很大的差异。该文介绍了各国关于儿童虐待与忽视的概念、判断标准、相关理论、危险因食及常用量表。旨在为中国开展儿童虐待与忽视问题的研究提供有用的信息。     

中国儿童虐待发生率的Meta分析

采用Meta分析评价中国儿童虐待发生率,为减少儿童受虐提供参考依据.方法 采用系统检索中国期刊全文数据库(CNKI)、维普中文科技期刊全文数据库和万方数据资源1989-2013年发表的有关儿童受虐率的文章,用R软件采用率值合并法进行分析.结果 符合入选标准的文献共10篇,涉及受虐监测样本量11 077人,其中发生受虐5 895人,随机效应模型显示儿童受虐率为54%(95%CI=42% ~67%).异质性分析显示I2 =99.5%,Tau-squared=0.038 8,P<0.01.结论 儿童受虐在我国一定程度上存在,需予以关注.应进一步提高对儿童受虐的识别,确保儿童健康成长.     

中国学龄初期儿童血压的流行病学研究

本研究为分析我国学龄初儿童血压偏高的发生率、地区分布特点及影响因素．抽选了29个省会市7～8岁男女学童23434人．作人群流行病学分析。按血压百分位数的P95筛检出8．5%的收缩压和4．0%的舒张压偏高儿童。检出率华北最高，华东最低。相关分析和组间方差分析提示体重、身高和BMI指数与儿童血压间有显著正相关；提示高血压一级预防应从学龄初儿童开始。     

Abuse of the disabled child: a systematic review of population-based studies

OBJECTIVE: To ascertain the strength of the association between childhood disability and abuse and neglect. METHODS: Systematic review of population-based studies published between 1966 and January 2006. Medline, Embase, Cinahl, Cochrane library, National Research Register, Social Sciences database and PsychInfo databases were searched for potentially relevant studies. Inclusion criteria: population-based cohort, case-control or cross-sectional studies of children <18 years of age that reported empirical data on the association of abuse with disability. Risk estimates were expressed as odds ratios with 95% confidence intervals (CI) where possible. Meta-analysis was not undertaken because of heterogeneity of studies. RESULTS: Four studies met the inclusion criteria. Two were longitudinal studies, one was a retrospective birth cohort and the remaining study was a cross-sectional survey. Types of disability studied varied widely as did methods used to ascertain abuse and neglect. Two studies accounted for potential confounding. Three studies reported an association between psychological and emotional disabilities and abuse. Two studies reported an association of learning disability with abuse. Only one study examined the association of physical disability (cerebral palsy) with abuse reporting an adjusted odds ratio for all forms of abuse of 1.79 (95% CI 0.96, 3.36) and for physical abuse of 3.00 (95% CI 1.29, 6.78). CONCLUSIONS: The evidence base for an association of disability with abuse and neglect is weak. Psychological and emotional problems, and learning difficulties appear to be associated with abuse but this association might arise because these conditions share a common aetiological pathway with abuse. There is limited evidence that physical disability predisposes to abuse.     

Public perceptions of child abuse and neglect in a midwestern urban community

This study found that the majority of urban adults did not believe that any of the characteristics of children posed to them predisposed a child to abuse. In contrast, 40% of respondents claimed child abuse could not occur in a family like the one in which they grew up. The majority perceived only one characteristic, alcohol abuse, as a characteristic of child abusers. Few respondents (10%) believed that child abusers could not be helped, and 25% were not sure. Adults' perceptions of child abuse and abusers varied by sex, age, socioeconomic status, and whether the respondents had children. The data indicate that there are significant deficits in the respondents' knowledge of child abuse and neglect.     

A cross-national exploration of societal-level factors associated with child physical abuse and neglect

Children around the world experience violence at the hands of their caregivers at alarming rates. A recent review estimates that a minimum of 50% of children in Asia, Africa, and North America experienced severe physical violence by caregivers in the past year, with large variations between countries. Identifying modifiable country-level factors driving these geographic variations has great potential for achieving population-level reductions in rates of child maltreatment. This study builds on previous research by focusing on caregiver-reported physical abuse and neglect victimisation, examining 22 societal factors representing 11 different constructs among 42 countries from 5 continents at different stages of development. Our findings suggest that gender inequity may be important for both child physical abuse and neglect. Indicators of literacy and development may also be important for child neglect. Given the limitations of the correlational findings and measurement issues, it is critical to continue to investigate societal-level factors of child maltreatment so that interventions and prevention efforts can incorporate strategies that have the greatest potential for population-level impact.     

美国儿童保护介绍

该文介绍了美国在儿童保护方面所作的努力,儿童虐待的预防系统,儿童保护系统,《儿童虐待预防和处理法》的产生和功能等,使读者能较全面的了解美国的儿童保护法律及其产生背景.对学校健康教育在儿童虐待预防中的作用和儿童保护的服务系统作了较详细的介绍,希望能对建立国内儿童保护系统有所启示.     

Effects of child abuse and neglect on adult survivors

Child abuse has profound immediate and long-term effects on a child's development. The long-term impact of abuse of a child can be seen in higher rates of psychiatric disorders, increased rates of substance abuse and relationship difficulties [Springer, K. W., Sheridan, J., Kuo, D., & Carnes, M. (2003). The long-term health outcomes of childhood abuse: An overview and a call to action. Journal of General Internal Medicine, 18(10), 864–870. doi:10.1046/j.1525-1497.2003.20918]. Child abuse is an intergenerational problem. Most frequently, the perpetrators of abuse are profoundly damaged people who have been abused and neglected themselves. This article attempts to bring out the psychosocial aspects of a case through Systems Theory and Cognitive Behavioural Therapy. Furthermore, it focuses on the psychological implications of an abused adult in early childhood and its impact on his development. Social work intervention plans highlight the importance of treatment and evaluation. The article suggests the role of social work profession to deal with this issue.     

The burden of child maltreatment in China: a systematic review

Objective

To estimate the health and economic burdens of child maltreatment in China.

Methods

We did a systematic review for studies on child maltreatment in China using PubMed, Embase, PsycInfo, CINAHL-EBSCO, ERIC and the Chinese National Knowledge Infrastructure databases. We did meta-analyses of studies that met inclusion criteria to estimate the prevalence of child neglect and child physical, emotional and sexual abuse. We used data from the 2010 global burden of disease estimates to calculate disability-adjusted life-years (DALYs) lost as a result of child maltreatment.

Findings

From 68 studies we estimated that 26.6% of children under 18 years of age have suffered physical abuse, 19.6% emotional abuse, 8.7% sexual abuse and 26.0% neglect. We estimate that emotional abuse in childhood accounts for 26.3% of the DALYs lost because of mental disorders and 18.0% of those lost because of self-harm. Physical abuse in childhood accounts for 12.2% of DALYs lost because of depression, 17.0% of those lost to anxiety, 20.7% of those lost to problem drinking, 18.8% of those lost to illicit drug use and 18.3% of those lost to self-harm. The consequences of physical abuse of children costs China an estimated 0.84% of its gross domestic product – i.e. 50 billion United States dollars – in 2010. The corresponding losses attributable to emotional and sexual abuse in childhood were 0.47% and 0.39% of the gross domestic product, respectively.

Conclusion

In China, child maltreatment is common and associated with large economic losses because many maltreated children suffer substantial psychological distress and might adopt behaviours that increase their risk of chronic disease.     

Measuring health-related quality of life for child maltreatment: a systematic literature review

Background  

Child maltreatment causes substantial morbidity and mortality in the U.S. Morbidity associated with child maltreatment can reduce health-related quality of life. Accurately measuring the reduction in quality of life associated with child maltreatment is essential to the economic evaluation of educational programs and interventions to reduce the incidence of child maltreatment. The objective of this study was to review the literature for existing approaches and instruments for measuring quality-of-life for child maltreatment outcomes.