Factors influencing utilization of the preventive health services among children aged 6-60 months in Bahrain. Part I

Two-hundred fifty-eight out of 2587 children aged 6-60 months were randomly selected from eight villages in western region of Bahrain. The data were collected by visiting and interviewing the mothers, and examining the birth certificates for immunizations. Age of the child, family structure, sickness of the child and mother's attitude toward the provided preventive services were significant determinants for the use of preventive care. However, no significant relationships were found between utilization of the preventive care and child sex, family size, mother's education, socioeconomic status and situational factors.     

Factors associated with haemoglobin concentration among Timor-Leste children aged 6-59 months

The study was conducted to assess the prevalence of and factors associated with haemoglobin (Hb) concentrations among children aged 6-59 months in Timor-Leste. The 2003 Demographic and Health Survey was a multi-stage cluster survey of 4,320 households from four different geographic regions in Timor-Leste. In total, 4,514 children aged 6-59 months were included in the analysis. The prevalence of anaemia (Hb concentration <11.0g/dL) was 38.2% (638/1,668) for children aged 6-23 months and 22.6% (644/2,846) for older children (p<0.001). Girls had a higher mean Hb concentration than boys (11.9g/dL vs 11.7g/ dL, p<0.006) and children who had diarrhoea in the previous two weeks had a lower Hb concentration than children without diarrhoea (11.5g/dL vs 11.9g/dL, p<0.001). Children from the richest and middle-class households had a lower average Hb concentration than those from the poorest households (11.8g/ dL, 11.7g/dL vs 12.0g/dL, p<0.001). Children of mothers with some secondary or more education had a lower mean Hb concentration than children of mothers with completed primary, some primary and no education (11.7 g/dL vs 11.9 g/dL, 11.8 g/dL, and 11.9 g/dL, p=0.002). Children from severely-anaemic mothers had a lower mean Hb concentration than children from moderately-, mild and not anaemic mothers (10.5 g/dL vs 11.1 g/dL, 11.6 g/dL, 12.0 g/dL, p<0.001). After backward stepwise hierarchical multiple regression, wasting, male sex, recent diarrhoea, household wealth index (richest and middle-class), maternal educational status (some secondary or more and some primary), and maternal anaemic status were significantly associated with a lower Hb concentration in children and increased age of child and duration of breastfeeding (6 months) with a higher Hb concentration. Anaemia-prevention programmes among children in Timor-Leste should focus on those children aged less than two years, children with recent diarrhoea, wasted children, high socioeconomic status, and anaemic mothers.     

3～7岁儿童气质的影响因素研究

目的了解3～7岁儿童气质的影响因素.方法对难养型、启动缓慢型及易养型儿童273例进行影响因素调查.结果出生时胎龄、窒息时间、离开父母异地抚养年龄、看护人性格态度、教育方式、老师教育态度、父学历及身体状况、父母饮酒量、孩子看电视时间等与儿童的气质维度有关;住房类型、平均每年患病次数、3岁前看护人、老师教育态度与气质类型有关.结论采取适合儿童气质特点的抚养和教育方式,加强围生期保健,可促使儿童气质向积极方向发展.     

Determinants of persistent underweight among children, aged 6-35 months, after huge economic development and improvements in health services in Oman

Over the last decades, health indicators have witnessed major improvements in the Sultanate of Oman. This study was aimed at factors associated with underweight among children in four regions of Oman, as, in 1998, underweight was prevalent among 17.9% of children aged less than five years. A case-control study was conducted in 2002: 190 cases were 6-35-month old children with weight-for-age < -2 z-scores. Controls were individually matched by village of residence, sex, and age. The questionnaire included anthropometry of children, child-feeding practices, morbidity, anthropometry of mothers, parity, birth-spacing, and socioeconomic characteristics. Conditional logistic regression was used for analyses. Birth-weight of < 2,500 g was strongly associated with underweight and also were height of mother, low level of education of mother, bad quality of water in households, diarrhoea of children in the last two weeks, and regular use of infant formula. Factors, such as birth-weight, height of mother, supply of safe water in household, and care for mothers and children were the determinants of persistent underweight after huge economic development and improvements in health services. Further research is also needed to investigate further specific determinants of low birth-weight in the Omani context and try to disentangle emaciation and determinants of linear growth retardation.     

广州市流动儿童卫生服务需求与利用状况及其相关因素的调查研究

目的 描述广州市流动儿童的卫生服务需求与利用状况及其相关因素。方法 对广州市4所民办小学585名五、六年级学生的卫生服务需求与利用状况进行问卷调查。结果 1)流动儿童两周就诊率为54.8%,影响流动儿童两周就诊的因素是流动儿童的性别、父母的宗教信仰情况。2)流动儿童过去1年内住院率为4.8%,住院原因主要为创伤和感冒。3)流动儿童定期体检率为75.4%,建档率仅为17.3%,影响流动儿童建档的因素是父母在广州的情况。4)过去一年内有10.5%的流动儿童返乡就医。返乡就医的原因,主要是“父母探亲时顺便带孩子看病”(41.2%)和 “城市医疗费用太高”(23.5%)。结论 流动儿童两周就诊率较低、住院率低,预防保健利用不足。     

孕前保健服务利用及影响因素调查分析

目的:了解我国孕前保健服务需求和利用现状,探讨影响孕前保健服务利用的关键因素。方法:随机选择2009年7～12月在山东、河南、甘肃分娩的产后妇女并应用自行设计的调查问卷进行调查,利用统计学方法对孕前保健服务利用的影响因素进行分析。结果:多因素logistic回归分析结果显示,年龄、民族、居住地、文化程度以及对孕前优生健康检查的重视程度等是影响孕前保健服务利用的重要因素。结论:应该加大对育龄人群的宣传力度,完善基层医疗条件和合作医疗制度,提高群众对服务的可及性,有针对性地开展孕前保健服务工作。     

Psychosocial care and nutritional status of children aged 6-36 months among patrilineal (Karo) and matrilineal (Minangkabau) households in Jakarta

A study on psychosocial care among Karo (patrilineal kinship) and Minangkabau (matrilineal kinship) households who lived in Jakarta, Indonesia was aimed at investigating psychosocial care practices of mothers and the relation of psychosocial care to the nutritional status of children aged 6-36 months as indicated by Weight-for-Age (WFA), Weight-for-Height (WFH), and Height-for-Age (HFA) Z-scores. The study was a cross sectional study. The tool used to assess the psychosocial care was the Home Observation for Measurement of the Environment (HOME) inventory scale for infants and toddlers. Psychosocial care of 52 respondents from Karo and 87 from Minangkabau were generally good. Out of the total 45 items of the six sub-scales HOME inventory, 1 item in sub-scale I (Emotional and verbal responsiveness), 4 items in sub-scale II (Acceptance of child's behavior), 1 item in sub-scale IV (Provision of play materials), 1 item in sub-scale V (Parental involvement with child), and 3 items in sub-scale VI (Opportunities for variety in daily stimulation) were statistically different between the two ethnic groups. More Minangkabau children were underweight and wasting compared to Karo children. Within the Karo group, well-nourished children in terms of WFA and WHA tended to have greater total HOME scores than their underweight and wasting counterparts. Among Minangkabau group, well-nourished children in terms of WFA, WHA, and HFA tended to have greater total HOME scores than their underweight, wasting, and stunting counterparts. The total HOME score of well-nourished Karo children in terms of WFA, WFH and HFA were greater than that of well-nourished Minangkabau children.     

Factors associated with Hb concentration in children aged 6-59 months in the State of Pernambuco, Brazil

In 1997, the prevalence of anaemia was 40.9 % among children aged 6-59 months in the State of Pernambuco, north-east Brazil. Using the same sample of children, we have investigated possible reasons for this high prevalence. A representative sample was selected through a three-stage process: proportional systematic random sampling of municipalities in the State, systematic random sampling of census sectors within these municipalities, and finally, simple random sampling of households with children aged 6-59 months to obtain the sample of 650 children. Data collection included demographic, environmental, socio-economic and maternal variables, and nutritional status and dietary intakes of the children. Multiple linear regression analysis was based on a hierarchical model of factors associated with Hb concentration. The mean Hb concentration of children aged 6-23 months was 10 g/l lower than that of older children. In the regression analysis, child age explained 8.3 % of the variance in Hb concentration. The intake of bioavailable Fe explained a further 3.3, serum retinol 2.7, diarrhoea 2.4, water treatment 1.7, sanitation 1.3 and low birth-weight 0.5 %. The final model explained 23.4 % of the variance in Hb concentration. We conclude that child age, bioavailable-Fe intake, serum retinol concentration, diarrhoea, water treatment, sanitation and low birth-weight are independently associated with Hb concentration. In north-east Brazil, anaemia prevention programmes among children should focus on those aged <2 years and should consider feasible strategies to improve intakes of bioavailable Fe and vitamin A, and reduce infection. Supplemental Fe should be given to low birth-weight infants.     

江苏省3~6岁幼儿体质健康水平分析

  目的  了解江苏省3~6岁幼儿体质健康现状, 为幼儿体质健康促进的理论与实践工作提供依据和参考。  方法  依据《国民体质测定标准手册(幼儿部分)》中规定的方法和标准, 对随机整群抽取的江苏省5 951名3~6岁幼儿的身体形态与身体素质指标进行测量与分析。  结果  江苏省幼儿体质综合评价总体合格率为79.8%, 低于2020年全国平均水平(94.4%), 其中男童综合评价的优秀率(4.3%)、良好率(15.7%)和达标率(80.3%)高于女童(3.6%, 15.3%, 79.2%); 幼儿身高、体重指标普遍高于2020年全国水平; 各年龄组幼儿协调性低于全国水平(t=11.56, P < 0.01);江苏省5~6岁幼儿的柔韧性和身体平衡能力等方面素质相对较好。  结论  江苏省3~6岁幼儿体质健康水平稳步增长, 其中身体柔韧性和身体平衡能力发展较好, 但下肢力量和爆发力、协调性等相关素质有待提高。建议科学推进幼儿体质监测、管理及其后续干预促进等工作。     

Factors associated with sunburn in white children aged 6 months to 11 years

OBJECTIVE: To determine the sunburn experience and factors associated with sunburn among white children aged 6 months to 11 years. METHODS: Telephone interviews were conducted with parents and primary caretakers of children, selected by random, stratified sampling, in the contiguous United States in the summer of 1998. Information was gathered on demographic characteristics of parents and children, and children's sunburn experience during the past year, protection from sun exposure, and hours per week spent outdoors. The proportion of children experiencing sunburn in the past year was calculated. Multivariate logistic regression analyses were conducted to determine factors associated with sunburn. Information for 1052 white children was available for the analyses. RESULTS: An estimated 42.6% of U.S. white children experienced one or more sunburns within the past year (95% CI 38.2-47.0). Sunburn was less common among children who ever wore hats (adjusted OR 0.59, 95% CI 0.40-0.87) and more common among children who did not always wear sunscreen (OR for using sunscreen sometimes compared with always, 2.25; 95% CI 1.31-3. 86). Sunburn was also more common among children with sun-sensitive skin and older children. CONCLUSIONS: A large proportion of U.S. white children experience sunburns. Parents and children may benefit from education about protection from sun exposure.     

信阳市3～6岁儿童忽视现状及其影响因素

目的 了解河南省信阳市3～6岁儿童忽视状况及影响因素.方法 采用“中国3～6岁城区儿童忽视常模”中制定的量表和评价方法,调查1 005名3～6岁儿童忽视状况,采用多因素logistic回归分析方法分析忽视的相关影响因素.结果 调查对象总忽视率为31.7％,男童总忽视率和身体忽视率高于女童(均P＜0.05);不同年龄组总忽视率和安全忽视率差异有统计学意义(均P＜0.05);三代同堂、核心家庭儿童在总忽视率、情感忽视率、医疗忽视率层面低于单亲家庭和再婚家庭儿童(均P＜0.05);调查儿童忽视度为(45.7±6.8),男女童总忽视度差异无统计学意义(u=1.35,P=0.172),但男童身体忽视度高于女童(u =2.95,P=0.002);不同年龄组总忽视度、身体、教育及安全忽视度差异有统计学意义(均P =0.000),三代同堂、核心家庭儿童总忽视度、情感、教育、安全和医疗忽视度低于单亲家庭和再婚家庭儿童(均P =0.000);多因素非条件logistic回归分析结果显示,家庭类型(OR=4.689,P=0.009)、父母亲职业(OR =0.064;P =0.001)、父母亲文化程度(OR=0.130,P=0.000)、父母的关系(OR =4.578,P=0.000)4个因素是儿童受忽视的主要影响因素.结论 信阳市3～6岁儿童受忽视程度比较严重,影响儿童受忽视的主要因素为家庭类型、父母亲文化程度、父母亲职业、父母的关系.     

云南少数民族贫困地区农村6～23月龄儿童缺铁性贫血患病水平及影响因素

目的 了解云南省少数民族贫困地区6～23月龄儿童缺铁性贫血现状,为制定儿童贫血干预措施提供参考依据。方法 采用多阶段分层整群抽样的方法抽取云南省不同程度贫困地区1 226名6～23月龄儿童进行血常规、血清铁蛋白测定及体格检查,同时对其看护人进行问卷调查。结果 研究对象中,儿童贫血患病率为47.15%,其中,缺铁性贫血患病率为32.87%;不同程度贫困地区儿童缺铁性贫血率差异有统计学意义(P均<0.05)。缺铁性贫血的多因素Logistic回归分析显示男童比女童患缺铁性贫血的危险性增加;随着儿童年龄增大,患缺铁性贫血的危险性降低;母亲职业为农民、家庭年收入越低、未给儿童补充营养包是6～23月龄儿童贫血的危险因素。结论 云南省少数民族贫困地区6～23月龄儿童缺铁性贫血患病率较高,贫困、健康服务可及性差、未补充营养包是缺铁性贫血患病危险因素。应开展多种形式的健康教育,加强儿童家长的喂养指导,合理添加辅食,同时建议扩大贫困地区6～23月龄儿童营养包补充范围及多种防治方法。     

Factors influencing the utilization of visiting nursing and home-help services

PURPOSE: To identify the respective characteristics of clients using visiting nursing service and home-help service. Since the past, research on the utilization of in-home care services has usually focused on different services collectively. METHODS: Interviews using structured questionnaires were carried out with 134 elderly individuals who were selected in October 1997 from the list for home visit of public health nurses in a town with a population of 36,000. With regard to the utilization of visiting nursing as well as home-help service, the relationship with three factors of the conceptual Andersen's model (predisposing factor, needs factor, enabling factor) were examined. RESULTS AND DISCUSSION: Of the 134 subjects, 38.1% utilized visiting nursing service and 36.6% used home-help services. Use of visiting nursing service was significantly associated with variables such as declining ADL in the elderly, hospitalization within the past two years, less caregiving by family members, and less resistance to service-use by caregivers. On the other hand, use of home help service was related to less caregiving by family members and resources of visiting nursing. The clients who used both visiting nursing and home-help service had more difficulty with caregiving by family members compared to those who used only nursing service, and the latter were inferior in them of physical conditions, including ADL, to those who employed only home-helpers. CONCLUSION: The factors promoting the use of visiting nursing are different to some extent from those for home-help service. Clients using both are characterized by the presence of a broader variety needs.     

Factors influencing the use of community health and social services by those aged 65 and over

Interview data collected in a 1990/91 health and life-style survey is used to investigate in those aged 65 years and over the relationship to the use of community health and social services of age, health status and social and economic factors. One thousand eight hundred and forty-one respondents were included in the study. Contacts with general practitioners (GPs), district nurses and home helps and use of “meals on wheels”, day centres for elderly people and lunch clubs were related to age, chronic illnesses, gender, mental well-being, living alone, income and social class. Age and chronic illness were strongly related to the use of all services. A distinctive pattern of service use was found for particular chronic illnesses. Musculoskeletal conditions were most strongly related. Significant relationships between mental well-being, living alone, gender, income and social class remained after the effects of age and chronic illness were removed. Consideration is given to the implications for those who plan community health and social services.     

武汉市6~10岁儿童磨牙-切牙矿化不全的现状及影响因素分析

目的 探究武汉市6~10岁儿童磨牙-切牙矿化不全(molar-incisor hypomineralization, MIH)的现状及相关影响因素分析。方法 应用分层整群随机抽样调查方法,选择2016年6月—2019年3月期间933例6~10岁儿童作为研究对象,根据口腔筛查结果,将研究对象分成MIH组(n=47)和正常组(n=886)。多因素回归分析发生MIH的影响因素并建立其预测模型。结果 在933例6~10岁儿童调查对象中,MIH发病率为5.04%(47/933)。logistic回归分析表明喜欢碳酸饮料(OR=2.782, 95%CI:1.142~6.772)、每日刷牙次数(0~1次)(OR=2.721, 95%CI:1.245~5.948)、出生低体质量(OR=1.842, 95%CI:1.149~2.955)、抗生素频繁使用(OR=2.392, 95%CI:1.331~4.298)及主要抚养人了解口腔疾病(OR=0.371, 95%CI:0.206~0.669)等5项指标是发生MIH的独立影响因素(均P<0.05)。结论 武汉市933例6~10岁儿童MIH患病率为5.04%,喜欢碳酸饮料、每日刷牙次数、出生低体质量、抗生素频繁使用和主要抚养人了解口腔疾病等因素是MIH发生的独立影响因素。     

湖南省贫困农村地区6~24月龄婴幼儿营养包有效服用相关因素

目的了解贫困农村地区6~24月龄婴幼儿营养包有效服用情况及相关因素。方法 2015年8月在湖南省辖区内武陵山区和罗霄山区25个贫困县采用概率比例规模抽样(PPS抽样)方法抽取7481名农村6~24月龄婴幼儿作为研究对象,采用问卷调查婴幼儿的基本信息、家庭基本情况以及营养包服用情况等;采用多因素非条件Logistic回归模型分析6~24月龄婴幼儿营养包有效服用相关因素。结果营养包发放率为90.4%(6762/7481);营养包有效服用率为69.2%(4677/6762),营养包有效服用的婴幼儿占总调查人数的62.5%(4677/7481)。多因素Logistic回归分析结果显示,相对于6~11月龄,12~17月龄和18~24月龄是婴幼儿营养包有效服用的保护因素(OR=0.839,95%CI 0.735~0.959;OR=0.854,95%CI 0.748~0.974);相对于汉族,苗族、土家族、侗族以及其他少数民族是婴幼儿营养包有效服用的保护因素(OR=1.243,95%CI 1.070~1.443;OR=2.352,95%CI 2.008~2.755;OR=1.801,95%CI 1.453~2.233;OR=1.675,95%CI 1.192~2.355);相对于父亲小学及以下学历,父亲高中以及大学及以上学历是婴幼儿营养包有效服用的保护因素(OR=0.774,95%CI 0.618~0.970;OR=0.570,95%CI 0.428~0.760);相对于父亲职业为农民,父亲职业为工人/干部是婴幼儿营养包有效服用的危险因素(OR=1.279,95%CI 1.104~1.482);相对于看护人为父母,看护人为祖父母是婴幼儿营养包有效服用的保护因素(OR=0.651,95%CI 0.581~0.729);相对于营养包服用无不适反应,营养包服用有不适反应是婴幼儿营养包有效服用的危险因素(OR=2.759,95%CI 2.346~3.245)。结论贫困农村地区婴幼儿营养包有效服用率较低;低月龄、少数民族、父亲低学历、父亲职业为工人/干部、看护人为父母以及营养包服用不适反应是婴幼儿营养包有效服用的危险因素。     

上海地区6~8岁儿童近视前期流行病学调查

  目的  了解上海市6~8岁儿童近视前期的分布现状及进展规律, 并分析相关影响因素, 为中国儿童青少年近视防控工作的开展提供理论依据。  方法  采用随机整群抽样方法, 选取上海市8个区8所小学一、二年级2 037名学生开展2年随访调查研究, 基线及每年随访时进行视力、睫状肌麻痹电脑验光和眼轴长度等眼科检查, 收集相关因素问卷信息, 分析近视前期流行病学特征, 运用多元Logistic回归分析近视前期和远视儿童发生近视的影响因素。  结果  基线、第1年和第2年随访的总体近视前期检出率分别为26.2%, 37.3%, 41.3%, 其中基线时6, 7, 8岁儿童近视前期检出率分别为20.7%, 37.0%, 42.6%, 2年随访时8, 9, 10岁儿童为31.5%, 38.3%, 41.4%, 性别间差异无统计学意义(χ2=0.01~2.66, P值均>0.05)。基线近视前期儿童随访1年后近视发病率为31.5%, 随访2年后累计近视发病率为62.0%, 远高于远视儿童(0.6%和9.0%)。多因素分析结果显示, 基线近视前期、女生、父母均近视、基线AL与随访2年新发近视呈正相关(P值均 < 0.05)。  结论  近视前期低龄儿童2年内近视发生风险大, 是开展监测与近视预防干预的重点人群。     

健康素养对妇女儿童基本公共卫生服务利用的 影响研究

摘要:目的　了解城市妇女儿童的基本公共卫生服务利用情况和儿童母亲的健康素养状况,探索儿童母亲的健康素养对其基本公共卫生服务利用的影响。方法　采用多阶段整群随机抽样方法,对北京、宁波和厦门三城市的1 048名0～6岁儿童母亲进行问卷调查。使用卡方检验和多因素Logistic回归分析健康素养与基本公共卫生服务利用之间的关系。结果　所调查的母亲健康素养水平为低、中、高的比例分别为38.27%、29.00%和32.73%。34.26%的母亲建立了健康档案,36.27%的能够利用健康教育服务,孕12周参加免费体检者为47.10%,进行产前筛查者占85.24%;能按时接受产前检查者占92.94%,分别有81.01%和97.52%的儿童规范参加了健康管理和疫苗接种;Logistic回归结果显示,健康素养与建立健康档案（OR＝0.446,95%CI:0.329～0.604）、接受健康教育（OR＝1.451,95%CI:1.100～1.914）、产前检查（OR＝2.094,95%CI:1.089～4.026）、儿童健康管理（OR＝1.891,95%CI:1.246～2.872）存在关联。结论　健康素养水平能够影响到妇女儿童基本公共卫生服务的利用,建议针对儿童母亲开展更多旨在提高其健康素养水平的活动,进而促进妇女和儿童对基本公共卫生服务的利用。     

北京300例0～6岁儿童缺铁性贫血调查及影响因素

目的 调查北京市取部分0～6岁儿童缺铁性贫血现状并分析其影响因素.方法 随机选择北京市2013年6月至2014年1月的300例0～6岁儿童进行问卷调查及血常规、血清铁、血清铁蛋白含量、总铁结合力等检测,观察儿童缺铁性贫血分布现状,并对相关因素进行分析.结果 ①300例儿童缺铁性贫血96例,发病率为32.00％,轻度、中度、重度贫血分别为22.00％、8.33％、1.67％,7～12个月儿童缺铁性贫血发病率最高,为42.14％,≤6个月儿童发病率最低,为16.00％;②喂养方式、辅食添加时间、饮食情况、消化功能、母亲妊娠期贫血、早产均是影响北京市0～6岁儿童缺铁性贫血的关键因素(OR值分别为0.668、0.861、5.447、5.316、1.969、5.668,均P＜0.05).结论 北京市0～6岁儿童缺铁性贫血发病率有所降低,以轻度多见,应加强孕期保健,积极母乳喂养,改善饮食,6个月前给予积极地预防措施.     

广州市残疾儿童卫生服务利用现状及相关因素的调查分析

目的 了解广州市残疾儿童的卫生服务利用现状并探讨其影响因素,为有关部门改善残疾儿童卫生服务利用提供依据。方法 采用研究者自行设计的“残疾儿童卫生服务利用调查表”对广州市残疾人康复中心及4所特殊学校的残疾儿童家长进行问卷调查。结果 共回收有效问卷511份。1)残疾儿童的两周就诊率为25.2%,影响因素为儿童年龄、就读方式、家长健康状况及家庭接受最低生活保障救助情况(P<0.05);2)残疾儿童的年住院率为17.2%,影响因素为儿童年龄、残疾等级、家长了解早期干预情况(P＜0.05);3)疫苗全程接种率为61.1%,定期体检率为21.5%,影响因素为儿童就读方式及家庭接受最低生活保障救助情况(P<0.05);4)残疾儿童康复利用率为58.9%,影响因素为儿童年龄、残疾类型、独生子女、就读方式及家长了解早期干预情况等(P＜0.05),随访复查率为19.2%。结论 残疾儿童卫生服务利用相对不足,卫生服务可及性与利用服务的主动性有待改善;相关部门应建立合理、有效的卫生服务保障体系,优化卫生资源可及性;同时加强残疾儿童的预防保健及早期干预,提高家长利用服务的主动性,以促进残疾儿童健康成长。