居家艾滋病致孤及脆弱儿童关怀支持项目结果分析

目的评价卧龙区第三轮全球基金艾滋病项目中,居家艾滋病脆弱儿童关怀支持项目工作开展5年后的效果,为下一步工作方案的制订提供依据。方法对卧龙区全部18岁以下居家艾滋病致孤和脆弱儿童进行问卷调查。结果2004年12月和2008年12月分别调查儿童199人和123人。2004年和2008年接受过关怀支持的艾滋病致孤和脆弱儿童分别占93.97%和100%,对关怀支持项目满意度为47.24%和87.00%,下一步关怀需求中,需要生活补助、技能培训、心理健康的分别为36.18%、49.25%、47.24%和20.33%、60.98%、60.98%;两次调查结果的差异有统计学意义(P0.05)。结论卧龙区第三轮艾滋病项目中,居家致孤及脆弱儿童关怀支持项目取得了一定的成效,但存在着生活技能、心理关爱等需进一步加强的问题。     

受艾滋病影响儿童关爱救助政策落实情况的实证分析

目的分析受艾滋病影响儿童相关政策的落实情况。方法采用问卷调查、个案访谈、深入访谈等方法,获得我国艾滋病流行较为严重的四个省份的相关数据,通过定量、定性分析相结合的方法分析。结果共得到有效抚养人问卷149份,涉及受艾滋病影响儿童323名;有效多部门工作人员问卷23份,多部门深入访谈35次。其中县/市级深入访谈30次(含多部门研讨会7次),省级深入访谈5次(含多部门研讨会3次)。调查家庭中有57.7%的家庭儿童获得了生活救助,20.1%的家庭儿童获得了教育救助,5.4%的家庭儿童获得了医疗救助,17.6%的家庭儿童参加过心理关怀活动。但现有政策在执行过程中,仍面临缺乏资金和人员等保障条件、信息收集和共享困难等问题。结论国家及地方都出台了一系列针对受艾滋病影响儿童的关怀救助政策,为减轻艾滋病对儿童的影响发挥了积极作用,但政策落实尚不均衡,阻碍政策有效实施的因素仍然存在。     

受艾滋病影响儿童的关怀需求及干预措施的研究现状

通过收集近年相关文献,综述了受艾滋病影响儿童所面临的生长发育、学习、生活、心理等诸多问题,以及针对这些问题所采取的政策、医疗、教育、生活、心理等干预措施。受艾滋病影响儿童主要存在生活、教育和心理关怀需求,应开展综合干预措施,特别是开展对受艾滋病影响儿童的心理关怀研究,以探讨适合不同关怀需求的干预模式。     

受HIV/AIDS影响儿童面临的问题及应对策略

受艾滋病病毒伎滋病（HIV／AIDS）影响儿童分为四类：（1）感染了HIV的儿童；（2）AIDS致孤儿童；（3）与HIV感染者或AIDS患者共同生活的儿童；（4）AIDS高发区中的儿童。受AIDS影响儿童面临许多问题，主要包括：家庭困难、社会歧视、教育问题、心理问题等。给予受艾滋病影响儿童生理、心理上的关怀是十分重要的，对儿童的成长发育起着积极作用。     

艾滋病对中国儿童影响的研究

目的了解和认识艾滋病对中国儿童的影响。方法利用方差分析等方法,提出一个多层次的分析框架,设计以儿童成长为核心的家庭调查表及儿童访谈提纲,并进行实地调查。结果受艾滋病影响儿童的家庭人均生产收入减少;救助活动对改善艾滋病孤儿家庭的经济状况起到了一定的作用;父母存活的受艾滋病影响儿童的缺课率最高;受艾滋病影响儿童感受到心理压力和忧伤。结论艾滋病对儿童的影响主要反映在儿童的生活环境、生存状况和身心健康三个层面。在这三个层面,受艾滋病影响儿童与非艾滋病家庭的儿童存在明显的差异。     

中原部分农村地区受AIDS影响儿童生活质量的现况

目的了解中原部分农村地区受艾滋病(AIDS)影响儿童主观生活质量的现况,为进一步开展关怀和干预提供依据。方法使用《儿少主观生活质量量表》,对中原地区3个县117名受AIDS影响儿童进行调查。结果49%的儿童对目前的生活状况不满意;22%的儿童认知成分低于一般水平;情感成分极不满意和不太满意的儿童占39%;在情感成分和一些维度水平上受AIDS影响儿童低于一般农村儿童;受AIDS影响儿童的主观生活质量在不同的地区和年龄组之间存在一些差异。结论在社区、学校、家庭对受AIDS影响儿童的支持中,以儿童为中心,了解儿童的需求,关注儿童的心理健康,重视青春期教育和职业培训,尊重儿童的意见,提高儿童参与社会事务的程度,使受AIDS影响儿童生活质量得到全面的提高。     

三省受艾滋病影响儿童救助政策落实现状分析

目的分析受艾滋病影响儿童的救助政策落实情况,为制定和推动政策落实提供参考。方法采取文献回顾、深入访谈和专题小组讨论等方式,在3个省(自治区)开展调查研究,并对资料进行了定性分析。结果共调查243名受访者,其中深入访谈81人,与162名来自多部门的人员开展了专题小组讨论。调查发现,目前各地各部门针对受艾滋病影响儿童均制定了相关救助政策,开展了关怀救助活动,活动形式多样,内容涉及生活救助、教育支持、卫生保健、心理和职业发展等5方面,基本涵盖了儿童成长相关的各个方面。发现存在非义务教育阶段儿童教育缺乏政策保障、生活救助覆盖人数仍有限、对父母一方或双方存活的受艾滋病影响儿童关注度不够、心理关怀仍十分薄弱等问题。结论各地应针对现有政策制定实施细则或指导方案,进一步完善信息收集、交流和利用机制,提高有关部门和相关人员的政策认知程度,不断加大资源保障力度。     

贵州省1823例受艾滋病影响儿童基本情况的分析北大核心

目的了解贵州省受艾滋病影响儿童的基本情况,为防治工作提供依据。方法对艾滋病病毒（HIV）感染儿童、HIV感染者和病人的未成年子女进行问卷调查,内容包括生活、学习、就医和就业支持等情况。结果共计调查受艾滋病影响儿童1823名,≤14岁者占85.0%（1550名）,其父母中至少一方死亡占28.6%（453/1585）,父母中至少一方感染HIV的占97.7%（1546/1582）。112例HIV感染儿童中,母婴传播感染的占83.0%（93例）,年龄均≤14岁;经性途径传播13例,占11.6%,年龄在15~17岁间。24.1%（434/1802）儿童的家庭为低收入户,最近一年仅有12.7%（230/1807）儿童获得过生活救助金,学龄儿童中未上学者占7.1%（69/970）。受艾滋病影响儿童最近一次生病未看医生的占26.1%（455/1746）。48.6%（53/109）HIV感染儿童未接受抗病毒治疗,未治疗的原因主要是自认为身体好没必要治疗,担心药物不良反应,分别占39.2%（20/51）、23.5%（12/51）。结论受艾滋病影响儿童生活、学习、医疗和就业指导需要得到关注和支持,应继续加大资源投入保障力度。     

我国小额贷款在受艾滋病影响家庭中的应用

受艾滋病影响的家庭通常受到经济困难和社会歧视的双重打击。小额贷款作为一种特殊形式的生产自救,有助于改善感染者家庭的经济状况,提高生活质量并重返社会。文章综述了小额贷款的分类及实施模式,在受艾滋病影响人群中的应用,对其和家庭产生的影响,存在的问题,并对进一步实施小额贷款提出了建议,对受艾滋病影响人群开展关怀救助具有重要意义。     

乌鲁木齐市学龄前儿童生长发育调查

目的 了解新疆乌鲁木齐市学龄前儿童生长发育状况及影响因素,为促进儿童保健工作提供参考依据.方法 2019年4月-2020年1月,采用分层整群抽样方法,选取乌鲁木齐市7个区14所幼儿园1 153名儿童开展问卷调查并测量体格,参照WHO标准评价营养状况.结果 乌鲁木齐市7个区学龄前儿童,3～7岁同年龄组男女童身高差异无统计学意义(t=1.442,1.286,1.183,1.106,1.387,P＞0.05),6岁～组不同性别儿童体重差异有统计学意义(t=2.953,P＜0.05),其他年龄组差异均无统计学意义(t=1.324,1.217,1.709,1.355,P＞0.05).经济开发区儿童低体重(20.0％)和生长迟缓(21.4％)检出率最高,沙依巴克区儿童消瘦检出率最高(20.2％),高新区儿童超重(18.9％)和肥胖(15.0％)检出率最高.年龄(t=23.668,15.045)、性别(t=-2.415,-3.516)和家庭月平均收入水平(t=-4.495,-2.996)影响儿童的身高和体重,差异有统计学意义(P＜0.05).结论 乌鲁木齐市学龄前儿童面临肥胖与营养不良双重问题;应因势利导,针对不同区域儿童生长发育状况开展个体化营养干预,改善儿童营养状况.     

四川省凉山州受艾滋病影响儿童焦虑情况及影响因素分析

目的 了解凉山州彝族受艾滋病影响儿童(简称受艾影响儿童)焦虑现状及其影响因素.方法 采用问卷调查法对凉山州某两所学校223名受艾影响儿童的焦虑情绪现状进行调查并分析其影响因素.结果 223名受艾影响儿童平均年龄为(15.24±2.79)岁,其中男童120名(53.8％),女童103名(46.2％),使用儿童焦虑性情绪障...     

Social environment in families of children with juvenile arthritis

The Family Environment Scale (FES) was used to study 50 families of children with juvenile arthritis (JA). The FES was administered to all family members over age 10. Interpersonal relationships among family members were evaluated by the cohesion, expressiveness, and conflict subscales of the FES, and personal development was indexed by the FES independence subscale. The family scores in each subscale were compared with normative data from 1,125 families from the San Francisco Bay Area comparable with study families in age, education, number of children, and socio-economic status. No significant differences (t tests) were found in family cohesion, expressiveness, conflict, or independence in families of children with JA compared with control families when using the FES. These data do not support the hypothesis that psychosocial distress in families precedes or inevitably results from development of arthritis in a child.     

广东省6188名3至14岁儿童血脂水平及影响因素分析

目的了解广东省3～14岁儿童血清胆固醇、甘油三酯、高密度脂蛋白胆固醇的水平及相关影响因素。方法运用多阶段整群随机抽样方法,抽取广东省大城市、中小城市、2类农村各3个区（县）,1类农村4个县,每个县（区）抽取3个街道（乡）、6个居委会;共对3～14岁6188名儿童检测了血脂。用面对面询问调查获得儿童个人及家庭基本情况,体检获取体重、身高数据;血脂采用酶法进行检测,使用Saturno 300生化分析仪和日立7060自动生化分析仪进行测定。结果经过标准人口年龄构成及地区人口权重处理后,广东省3～14岁儿童甘油三酯（TG）、胆固醇（TC）、高密度脂蛋白胆固醇（HDL—C）均值分别为0．80mmol／L,3．50mmol／L,1．28mmol／L。TG均值大城市与1类农村,中小城市与2类农村之间差异无统计学意义（P〉0．05）。TC均值中小城市最高（4．00mmol／L）,其次是大城市（3．72mmol／L）,1类农村与2类农村之间差异无统计学意义（P〉0．05）。四类地区HDL—C均值两两之间均有统计学意义。儿童高TG、高TC和低HDL—C的百分率分别为2．2％,2．1％和8．0％。城市、1类农村、男性、低体重及7．0～9．9岁为高TG的保护因素;对于高TC,家庭人口数3～4人,年龄7．0—9．9岁,大城市、中小城市和1类农村都是危险因素;男性,家庭经济收入800～9999元,中小城市,1类农村是低HDL—C的保护因素。结论广东省儿童血脂仍然处于较低的水平,居住地区、家庭人口数、年龄和性别是血脂的主要影响因素,但对TG、TC和HDL—C水平的影响是不同的。     

中国艾滋病致孤儿童生长发育与营养水平及心理健康研究

目的调研中国艾滋病致孤儿童生长发育、营养水平与心理健康状况,为政策制定提供依据。方法按性别、年龄1：1匹配,调查96对艾滋病致孤儿童与非孤儿的身心健康水平,并进行差异比较。结果孤儿组BMIz评分与肩胛下皮褶厚度显著低于非孤儿（P〈0．01）,消瘦明显。孤儿组自尊量表（SES）总分更低,而抑郁问卷（BDI）总分更高（P〈0．05）。男性孤儿身心健康弱势明显,女性组间未见显著性差异。结论中国艾滋病致孤儿童的身心健康脆弱性显著,需探索可持续性更强的孤儿抚养策略,并进行以心理支持为核心的综合健康干预,而且对男性孤儿应给予更多关注。     

Willingness to care for children orphaned by HIV/AIDS: a study of foster and adoptive parents

There is substantial evidence to indicate that South Africa is facing the prospect of a large number of children, now and in the future, who will be orphaned as a result of the HIV/AIDS pandemic. Following the incapacitation and/or death of their parents, many of these children will be cared for by the safety net provided by members of their extended families. However, there is evidence to suggest that this safety net is fast becoming overwhelmed and possibly reaching saturation point. The ideal would be for as many of these children as possible to experience some type of family life in which to grow and mature into responsible adults. The present study explores adoptive and foster parents' (n = 175) willingness to care for a child orphaned by HIV/AIDS. Although some differences were noted depending on the HIV status of the child and whether the respondent was an adoptive or foster parent, results indicate an overall willingness in these populations to care for children orphaned by HIV/AIDS. The evidence also suggests that HIV-negative female orphans who are younger than 6 years, and who are family members, or from the same cultural background as the potential caregivers and do not have surviving relatives or siblings, have the best chance of being taken into foster or adoptive care.     

Psychosocial intervention in the process of empowering families with children living with HIV/AIDS-a descriptive study

The notion of 'family empowerment' is of crucial importance in any kind of psychosocial intervention directed to families with children living with HIV/AIDS. The goal is to restore self-efficacy and self-esteem, encourage positive coping and help family members make their own choices. Two settings for psychosocial intervention are described: an outpatient clinic within a larger medical institution and a therapeutic camp for families with children. Different psychotherapeutic and counselling strategies and approaches are briefly presented. Preliminary results based on work with families with children infected and/or affected by HIV/AIDS are described. The conclusion is that interventions that involve different settings seem to be most effective, especially for the most vulnerable families. The important issue is also collaboration between different service providers and NGOs.     

Nutritional status of young children in AIDS-affected households and controls in Uganda

This study conducted in Uganda assessed the nutritional status of young children and their disease history in the 3-month period before the study. Two groups of children were randomly selected: the first group consisted of 105 children living in homes where a family member fell sick of AIDS, whereas the second group consisted of 100 children who were living in homes where nobody was affected by AIDS. Acute malnutrition (wasting) was rare. There was no difference in the severity of stunting in the two groups (Z scores, -2.1 versus -2.2, P = 0.70). In those children living in AIDS-affected homes, disease episodes were longer (15.7 versus 11.3 days, P = 0.014), but the frequency of disease occurrence was similar in both groups. Fifty-five percent of all children suffered from moderate to severe malnutrition (stunting). The high stunting rate in early childhood suggests a public nutritional intervention program is recommended.     

Acquisition of cytomegaloviral infections in families with young children: a serological study

Acquisition of cytomegalovirus (CMV) infection in families with young children was investigated with serial serological tests for antibody to CMV by using ELISA and anti-complement immunoflourescence. Members of 68 Houston families were studied for a mean of 3.5 years. Seroconversion occurred in one or more members of 37 (53%) of 68 families studied. The mean annual seroconversion rate was 10% for fathers, 10.6% for mothers, and 10.3% for children. The attack rate for susceptible family members (including the index case) was 54%. The index case was the child in 10 instances, the father in 2, and the mother in 2. The index case could not be identified in 23 families. This Houston study indicates that the family with young children is a high-risk setting for CMV infection. This is an important concern regarding risks for mothers in their childbearing and child-rearing years.     

Young AIDS migrants in Southern Africa: policy implications for empowering children

Many AIDS-affected children in southern Africa engage in migration when household members fall sick or die from AIDS, or because they are sent to assist relatives. Despite this, little attention has been paid to the consequences of these movements for children's lives. Multi-method research, conducted in Lesotho and Malawi, revealed that children sent to live with kin commonly move over long distances and between urban and rural areas. They are generally not consulted or informed about these migrations and face a range of associated difficulties, particularly with integrating into new families and communities. Severed family ties exacerbate the difficulties faced by children who end up in institutions or on the streets. This paper advocates that policy approaches for those affected by AIDS should be children-centred and take into account the implications of migration at three levels. First, many of the difficulties children face could be overcome if they were familiar with the place and people they were moving to Second, children would be better able to cope with new situations if they were included in family discussions with decision-makers regarding their migration preferences. Third, maintaining ties with kin would ensure that children do not become distanced from their family and cultural heritage, which is essential for post-institutional support.