留守流动儿童与城乡儿童的行为问题比较

目的比较留守儿童、流动儿童与城乡儿童行为问题的差异,为其干预研究提供参考依据。方法分层整群抽取广西8所农村小学和3所城郊结合部小学3~6年级学生2499人,采用自编问卷和Rutter儿童行为问卷(教师版)进行现场调查。结果儿童行为问题阳性率18.29%,"N行为""A行为""M行为",男童行为问题阳性率均显著高于女童(χ2=41.468,P0.05),男女儿童均以"N行为"为主。农村非留守组儿童行为问题阳性率最低(9.55%),且与农村留守组(18.45%)、城市流动组(22.82%)、城市非流动组(24.58%)差异显著(χ2=16.012,40.654,72.451;P0.001)。结论农村非留守儿童行为问题低于留守儿童,城市流动儿童与非流动儿童行为问题差异不显著;男童行为问题明显高于女童。     

单纯性肥胖儿童行为问题配对研究

儿童单纯性肥胖症近年来呈上升的趋势[1] ,已成为医学界和家长们关心的问题。肥胖不仅对身体健康构成威胁 ,且严重引起儿童心理损害[2 ] 。本研究对武汉市城区 4所小学和幼儿园 345 0名儿童进行了有关单纯性肥胖儿童心理行为调查 ,旨在了解肥胖儿童心理行为影响因素 ,为进一步制定干预措施提供依据。1　对象与方法1.1　对象按照ＷＨＯ身高标准体重制定肥胖标准 :超重—体重超过标准值的 15 %～ 19% ;轻度肥胖—体重超过标准值的 2 0 %～ 2 9% ;中度肥胖—体重超过标准值的 30 %～ 4 9% ;重度肥胖—体重超过标准值的5 0 %以上。除外内分泌、…     

十类特殊家庭子女心理卫生状况的研究

目的 :探讨特殊家庭子女心理卫生的状况。方法 :对上海市 2 0个区县中离异、丧偶、再婚、特困、分居、本人残疾、寄养、父母残疾、服刑和孤儿这 10类家庭中 2 0 5 5名 8-2 1岁的子女进行了心理卫生状况的调查。结果 :显示特殊家庭行为问题发生率为 8 1%,其中男性 9 6 %,女性 6 4 %,男性行为问题发生率明显高于女性 (P <0 0 5 ) ,十类家庭中 ,每个家庭类型中男女性别行为问题发生率分别为 :本人残疾家庭 18 2 %,离异家庭 10 2 %,再婚家庭 8 4 %,丧偶家庭 4 3%,分居家庭 6 9%,寄养家庭 4 1%,服刑家庭 10 1%,父母残疾家庭 2 3%,孤儿家庭 1 5 %和特困家庭 6 0 %。与正常儿童相比 ,特殊家庭子女的行为总是都与居住地的社会风气、父母亲的教育方式和教育态度有关。结论 :特殊家庭子女心理健康状况需要引起社会的重视。     

Psychological Problems and Clinical Outcomes of Children with Psychogenic Non-Epileptic Seizures

Purpose

Our purpose was to investigate psychological problems and clinical outcomes in children with psychogenic non-epileptic seizures (PNES).

Materials and Methods

We retrospectively reviewed the data of 25 patients who were diagnosed with PNES between 2006 and 2012.

Results

Twenty-five children with PNES, aged 8 to 19 years (mean 13.82), were referred to psychiatrists for psychiatric assessment. On their initial visit, 72% of patients had comorbid psychological problems, including depression, anxiety, conduct disorder, adjustment disorder, Attention Deficit Hyperactivity Disorder, schizophrenia, and bipolar disorder. Among these, depression was the most frequent (36%). Predisposing and triggering factors included familial distress (40%), social distress (24%), and specific events (20%). The following treatment was advised based on the results of the initial psychological assessment: 3 patients regularly visited psychiatric clinic to assess their clinical status without treatment, nine underwent psychotherapy, and 13 received a combination of psychotherapy and psychopharmacological therapy. At the mean follow-up of 31.5 months after diagnosis, 20 patients (80%) were event-free at follow-up, three (12%) showed reduced frequency, and two (8%) experienced persistent symptoms.

Conclusion

The outcomes of PNES in children are much better than those in adults, despite a high rate of psychological comorbidities.     

行为问题儿童的生活质量及其影响因素调查

目的:探讨行为问题儿童的生活质量及影响因素.方法:采用Conners量表和儿少主观生活质量问卷调查2087例少年儿童的行为问题和生活质量,然后将问题儿童与正常儿童的结果做比较.结果:行为问题儿童的生活质量明显低于正常儿童,相关分析显示儿少主观生活质量问卷与Conners量表父母问卷和教师评定量表的部分因子存在不同程度的相关.逐步回归显示儿童的学业、行为问题、家庭经济、父亲性格、年龄、父母对不良行为的处理方式、独生共7个变量影响着儿童的生活质量.结论:行为问题儿童生活质量下降,需要得到学校、家庭、同伴、社会等多方面的关怀帮助.     

上海市区学龄儿童行为问题及相关因素研究

目的：研究学龄儿童的行为问题及相关因素。方法：用Ｒｕｔｔｅｒ儿童行为问卷及自编的相关调查表对上海市区小学一年组至初中二年级（７－１４岁）学生８６１名,男４４５名,女４１６名进行调查,结果：显示行为问题父母问检出率为６．３％,教师问检出率为１０．５％。相关分析表明,Ａ因子两问卷均与性别有关,父母问卷还与母孕期健康状况有关。Ｎ因子在教师问卷中有与儿童照料者,考试压力、课外读书环境有关;在父母问卷中与考     

Preferences for in-person disclosure: Patients declining telephone disclosure characteristics and outcomes in the multicenter Communication Of GENetic Test Results by Telephone study

Telephone disclosure of cancer genetic test results is noninferior to in-person disclosure. However, how patients who prefer in-person communication of results differ from those who agree to telephone disclosure is unclear but important when considering delivery models for genetic medicine. Patients undergoing cancer genetic testing were recruited to a multicenter, randomized, noninferiority trial (NCT01736345) comparing telephone to in-person disclosure of genetic test results. We evaluated preferences for in-person disclosure, factors associated with this preference and outcomes compared to those who agreed to randomization. Among 1178 enrolled patients, 208 (18%) declined randomization, largely given a preference for in-person disclosure. These patients were more likely to be older (P = 0.007) and to have had multigene panel testing (P < 0.001). General anxiety (P = 0.007), state anxiety (P = 0.008), depression (P = 0.011), cancer-specific distress (P = 0.021) and uncertainty (P = 0.03) were higher after pretest counseling. After disclosure of results, they also had higher general anxiety (P = 0.003), depression (P = 0.002) and cancer-specific distress (P = 0.043). While telephone disclosure is a reasonable alternative to in-person disclosure in most patients, some patients have a strong preference for in-person communication. Patient age, distress and complexity of testing are important factors to consider and requests for in-person disclosure should be honored when possible.     

行为问题儿童听觉事件相关电位P300对照研究

目的:探讨行为问题儿童听觉事件相关电位P300特点.方法:用Achenbach儿童行为问卷(CBCL)和中国联合型瑞文测验(CRT-C2)筛选行为问题儿童,并按同性别、同年龄进行1:2配对;采用odd模式测试听觉事件相关电位.结果:①问题组儿童的P300各项指标与对照组儿童无显著差异;②混合问题组P300潜伏期较单一问题组延迟(P<0.05),Pz点P300的基线波幅混合问题组与单一问题组的差异接近有统计学意义.③行为问题儿童Pz点P300基线波幅与行为问卷总分呈显著负相关(P<0.05).结论:行为问题较为严重的儿童可能有认知功能损害.     

Mechanisms of Communicating Health Information Through Facebook: Implications for Consumer Health Information Technology Design

BackgroundConsumer health information technology (IT) solutions are designed to support patient health management and have the ability to facilitate patients’ health information communication with their social networks. However, there is a need for consumer health IT solutions to align with patients’ health management preferences for increased adoption of the technology. It may be possible to gain an understanding of patients’ needs for consumer health IT supporting their health information communication with social networks by explicating how they have adopted and adapted social networking sites, such as Facebook, for this purpose.ObjectiveOur aim was to characterize patients’ use of all communication mechanisms within Facebook for health information communication to provide insight into how consumer health IT solutions may be better designed to meet patients’ communication needs and preferences.MethodsThis study analyzed data about Facebook communication mechanisms use from a larger, three-phase, sequential, mixed-methods study. We report here on the results of the study’s first phase: qualitative interviews (N=25). Participants were over 18, used Facebook, were residents or citizens of the United States, spoke English, and had a diagnosis consistent with type 2 diabetes. Participants were recruited through Facebook groups and pages. Participant interviews were conducted via Skype or telephone between July and September 2014. Data analysis was grounded in qualitative content analysis and the initial coding framework was informed by the findings of a previous study.ResultsParticipants’ rationales for the use or disuse of a particular Facebook mechanism to communicate health information reflected six broad themes: (1) characteristics and circumstances of the person, (2) characteristics and circumstances of the relationship, (3) structure and composition of the social network, (4) content of the information, (5) communication purpose, and (6) attributes of the technology.ConclusionsThe results of this study showed that participants consider multiple factors when choosing a Facebook mechanism for health information communication. Factors included what information they intended to share, what they were trying to accomplish, attributes of technology, and attributes and communication practices of their social networks. There is a need for consumer health IT that allows for a range of choices to suit the intersectionality of participants’ rationales. Technology that better meets patients’ needs may lead to better self-management of health conditions, and therefore, improve overall health outcomes.     

学龄前儿童行为问题与家庭功能的相关性分析

目的探讨学龄前儿童行为问题的特点及其与家庭功能的关系,为学龄前儿童行为问题的家庭干预措施提供依据。方法选用家庭功能评定量表(FAD)、Conners儿童行为问卷和自设问卷对148例学龄前儿童进行调查。结果学龄前儿童行为问题总检出率为18.24,其家庭功能除问题解决功能较好以外,家庭沟通、角色、情感反应、情感介入、行为控制和家庭总功能方面均存在一定问题;除问题解决功能外,家庭其余各方面功能与行为问题呈现低度正相关,其中行为控制和家庭总功能对行为问题的影响较大。结论学龄前儿童存在较多的行为问题,并与其家庭功能状况有关,家长应积极致力于家庭功能的完善,为学龄前儿童创造一个良好的家庭环境。     

不同时期北京市城区儿童行为问题比较研究

目的：比较不同时期北京城区儿童行为问题的检出率。方法：对两个时期的北京市城区儿童行为问题的调查结果进行了比较，两次调查均选用Ｒｏｔｔｅｒ行为评定量表进行评定。结果：１９９３年儿童行为问题的检出率为１０．９％，显著高于１９８５年的检出率（８．３％，Ｐ〈０．０５）；其中，Ｎ行为、ＡＮ行为的检出率也均明显高于１９８５年；而Ａ行为的检出率则是１９９３年（５．５％）明显低于１９８５年，男孩行为问题检出率２次     

Some Considerations About Sexual Abuse and Children with Sexual Behavior Problems

SUMMARY

In the mid 1980s treatment programs for children twelve years and younger who molested other children began to appear. There was little known about these children and there were numerous misconceptions about this population. It was believed that the primary etiological factor in the development of this behavior was previous hands-on sexual abuse to the child. It was also believed that a majority of sexually abused children would engage in problematic sexual behaviors and that it was quite likely that they would go on to molest others. In the intervening years a great deal has been learned about children who molest. The diversity of reasons for the development of problematic sexual behavior has been researched. Another important finding is that there is a range of disturbed sexual behaviors in children. This is important as there has been an overidentification of children who engage in problematic sexual behaviors as children who are molesting. A continuum of sexual behaviors in children is described which delineates three groups of children who engage in problematic sexual behavior, only one of which is molesting other children. With this understanding professionals can distinguish between children who engage in natural and healthy sexual behaviors, sexually-reactive behaviors, extensive but mutual sexual behaviors, and children who molest. This assists in more accurate assessment and treatment planning in an era in which children can be placed on sex offender registries and potentially be subject to community notification.     

温州地区托养儿童行为问题调查

目的：了解温州市6-16岁托养儿童行为问题发生情况。方法：根据分层整群抽样的原则,对温州地区8340名6-16岁学生采用自制问卷和Achenbach儿童行为量表（CBCL）进行调查。结果：温州市6-16岁的儿童行为问题检出率为14.4%（1202/8340）略高于中国常模13.0%,但无统计学意义（P〉0.05）。2520名为托养儿童,占30.2%（2520/8340）,6-11岁托养儿童840位,行为问题检出率18.6%（156/840）高于非托养普通儿童检出率13.4%（396/2960,χ2=14.2,P〈0.05）;12-16岁托养儿童1680位,行为问题检出率19.2%（322/1680）高于非托养普通儿童检出率11.5%（328/2860,χ2=51.1,P〈0.05）。托养儿童行为问题的危险因素有出生时患病、学前所处环境（单亲）、性别（男）、托养家庭结构（矛盾）、托养方式（全天）、托养人受教育程度（小学）及教育方式（专制、放任）（OR=1.287～2.582）,保护因素有托养人数（3人以上）、居住地（城镇）,（0R=0.412～0.499）。结论：6-16岁托养儿童行为问题检出率较高,心理健康状况应引起关注。     

唇腭裂患儿心理行为问题的临床研究

目的：探讨唇腭裂患儿心理行为问题发生的相关因素,方法：对唇腭裂患者组45例和正常对照组93例,采用Achenbach儿童行为量表（CBCL）、抑郁自评量表（SDS）及焦虑自评量表（SAS）进行评定分析。结果：CBCL患儿家长用表异常率为42．2％,高于对照组的8．6％（P＜0．01）,学生用表患儿组异常率为20．2％,明显高于正常对照的2．1％（P＜0．05）。SDS、SAS量表评定,无论年龄、性别手术前和手术后和组均明显高于正常对照,但患儿术后得分较手术前明显降低。结论：唇腭裂患儿存在明显的心理和行为问题。     

农村留守与非留守儿童心理虐待与忽视及情绪和行为问题对比研究

目的:了解留守儿童与非留守儿童的心理虐待与忽视现状以及有关的情绪和行为问题。方法:采用分层整群抽样法抽取江西省上饶市横峰县某小学和中学的三到七年级学生共306人,采用儿童心理虐待与忽视量表,长处和困难问卷儿童版(SDQ),以及自编一般情况问卷进行调查。结果:留守儿童的心理虐待与忽视总分、忽视分量表得分显著高于非留守儿童(P0.05)。留守儿童在干涉维度、情感忽视维度、身体/监督忽视维度上得分显著高于非留守儿童(P0.05)。留守儿童在SDQ的同伴交往问题、品行问题得分及困难总分上显著高于非留守儿童(P0.05或P0.01)。虐待与忽视总分与长处和困难问卷的情绪症状、品行问题、多动/注意不能和困难总分呈显著相关,均P0.01。结论:农村留守儿童存在一定程度的心理虐待与忽视以及情绪和行为问题。     

低出生体重儿童的气质特征和行为问题

目的：探讨低出生体重对2～3岁儿童气质特征和行为发育的影响。方法：采用1～3岁婴幼儿气质问卷(TTQ)、2～3岁Aehenbaeh儿童行为量表(CBCL)和自编的家庭一般环境问卷，对50名2～3岁低出生体重(LBW)儿童和380名正常出生体重（NBW)儿童进行气质和行为问题的调查。结果：①在九个气质维度中，只有活动水平，LBW组儿童低于NBW组，差异有统计学显著性(t=-2．192，P=0．029)，而两组儿童气质类型的分布无统计学显著差异，均以中间型和易养型为主。②LBW组社交退缩的发生率高于NBW儿童差异有显著性(x^2=5．427，P=0．02)，而NBW儿童的睡眠障碍高于LBW组，差异有统计学显著性(t=2．20,P=0．031)。结论：2～3岁LBW儿童的活动水平低，社交退缩的发生率高，需通过养育方式适当干预。     

Depression Among Children with Chronic Medical Problems: A Meta-Analysis

Reviewed 60 studies of depressive symptoms among children andadolescents with chronic medical problems. Findings indicatethat children with a chronic medical problem are at slightlyelevated risk for depressive symptoms but that most are notclinically depressed. Although great variability in depressivesymptoms was found across children with the same disorder, childrenwith certain disorders (e.g., asthma, recurrent abdominal pain,sickle cell anemia) may be at greater risk than children withother disorders (e.g., cancer, cystic fibrosis, diabetes mellitus).Disorder severity was inconsistently related to depressive symptoms,while time since diagnosis, gender, and age were generally unrelatedto symptoms. Parent (vs. child) ratings and the use of community(vs. normative) control groups were associated with higher ratingsof depressive symptoms among children with a chronic medicalproblem     

Shedding light on the dark side of doctor-patient interactions: verbal and nonverbal messages physicians communicate during error disclosures

Objective

Existing investigations on medical error disclosures have neglected the fact that a disproportionately large amount of the meaning in messages is derived from nonverbal cues. This study provides an empirical assessment of the verbal and nonverbal messages physicians communicate when disclosing medical errors to standardized patients.

Methods

Sixty hypothetical error disclosures by a volunteer sample of attending physicians were videotaped, coded, and statistically analyzed.

Results

Physicians used friendly, smooth, approaching and invested nonverbal styles as they disclosed medical errors to standardized patients. Female physicians smiled more and were more attentive to patients than male physicians, and physicians tended to exhibit more positive affect in the form of facial pleasantness toward angry female patients than toward angry male patients. Furthermore, physicians touched and smiled at patients more frequently at the beginning and at the end of their error disclosures, and displayed decreased attentiveness and interactional fluency.

Conclusion

Future research needs to examine which disclosure styles patients perceive as competent, and to assess their causal impacts on objective and relational disclosure outcomes.

Practice implications

This study provides an important baseline understanding of medical error disclosures that is essential for the successful implementation of empirically based training programs.     

6～11岁肥胖儿童行为问题调查

目的：调查6～11岁肥胖儿章行为问题。方法：采用Achenbach’s儿童行为量表（CBCL），对安徽省安庆市与铜陵市111名调查对象进行问卷调查。结果：肥胖儿童行为问题发生率为36．94％，男、女分别为40．38％和33．90％，性别间差异无统计学意义（P〉0．05）。4～16岁正常儿童青少年行为问题总发生率为12．97％（男童13．44％、女童12．52％），肥胖儿童整体及按性别比较，行为问题发生率均较高（u分别为7．52、5．70和4．96，P均〈0．01）。男童行为问题各因子发生率由高到低依次为：强迫行为34．62％、分裂焦虑23．08％、抑郁19．23％、体诉15．39％、交往不良13．46％、社交退缩9．62％、多动9．62％、攻击性9．62％和违纪表现5．77％，各因子发生率差异有统计学意义（X^2=25．25，P〈0．05）；女童行为问题各因子发生率依次为：分裂强迫23．73％、抑郁11．86％、多动10．17％、性问题10．17％、体诉848％、攻击性8．48％、社交退缩6．78％、残忍表现6．78％和违纪表现5．09％，差别有统计学意义（X^2=15．59，P〈0．05）。男、女童共有的6个行为问题因子：社交退缩、多动、体诉、违纪表现、攻击性、抑郁，无性别差异（P均〉0．05）。结论：肥胖儿童行为问题发生率远远高于全国4～16岁儿童青少年，肥胖男童主要表现在强迫行为、分裂焦虑、抑郁、体诉、交件不良，女童主要表现在分裂强迫、抑郁、多动、性问题。     

Children, biobanks and the scope of parental consent

The use of stored tissue samples from children for genetic research raises specific ethical questions that are not all analogous to those raised when adult participants are concerned. These include issues with regard to consent, as it is typically a parent who consents to the use of samples from children. In this paper, we discuss the scope of parental consent. This scope has a temporal dimension and one related to the content of consent. It is not questioned that the temporal scope of parental consent is limited and that young adults have the right to decide on the fate of their samples when they reach the age of maturity. With regard to the content of consent, the question remains whether parents are allowed to give full broad consent to any possible future research on the samples of their children. We argue that they should not be allowed to do so, based on two premises. First, it is generally acknowledged that children have a right to express their own values and that they should be given the opportunity to develop their own autonomy as they grow older. Second, research and science are not completely value-free and some types of research may be more sensitive than other types. Children should be given the opportunity to express their values also in this respect.