家庭支持环境对3~4月龄婴儿ASQ粗大运动得分的影响研究

目的 探讨婴儿粗大运动发育水平和迟缓的影响因素,为促进婴儿运动能力和障碍的预防和干预提供理论依据。方法 以 2015年5—9月儿保门诊体检的653名健康婴儿作为研究对象。用年龄与发育进程问卷第三版中文版(ASQ-C)评估婴儿粗大运动发育水平,分为可疑组和正常组。用婴儿发育家庭环境支持量表中文版(AHEMD-IS)评估婴儿家庭支持环境。结果 纳入本研究的653例婴儿中,平均粗大运动得分为49.16±11.41,可疑粗大运动发育迟缓者93例(14.2%)。控制所在城市、母亲文化程度婚姻状态、家庭结构等变量后,活动空间适量(β=4.255,95%CI 2.013~6.492)、充足(β=3.010,95%CI 0.845~5.171)与不足相比,对粗大运动的影响具有统计学意义(P均<0.05)。控制所在城市、婚姻状态等变量后,活动空间适量(OR=0.357,95%CI 0.195~0.653)、活动空间充足(OR=0.476,95%CI 0.272~0.783)、活动多样性适量(OR=0.507,95%CI 0.288~0.893) 与可疑发育迟缓(ASQ筛查结果)存在关联,差异有统计学意义(P均<0.05)。结论 活动空间适量或充足、活动多样性适量可促进粗大运动的发育,儿童保健工作者需加强健康教育,指导家长改善家庭支持环境促进儿童早期发育。

Effect of home support environment on gross motor sub-score of Ages & Stages Questionnaires in infants aged 3~4 months

Objective To explore the influencing factors for developmental level and delay of the infant's gross motor, in order to provide reference for targeted prevention and intervention approaches. Methods A total of 653 healthy infants aged 3~4 months were selected as participants from May to September in 2015. The Ages & Stages Questionnaires Third Edition (Chinese Version) was used to assess gross motor development of infants, and the participants were divided into suspected abnormalities group and normal developing group according to results of assessment .The affordances in the Home Environment for Motor Development-Infant Scale instrument was adopted to assess the home support environment. Results The mean score of gross motor in 653 infants was 49.16±11.41, and 93 cases(14.2%) were identified with suspected developmental delays. After adjusting variables including city, maternal education, marital status and family structure,the appropriate level(β=4.255,95%CI:2.013~6.492) and sufficient level(β=3.010,95%CI:0.845~5.171)of activity space affected the gross motor significantly(both P＜0.05). After adjusting variables like city and marital status, the adequate activity space(OR=0.357, 95%CI: 0.195~0.653),appropriate activity space(OR=0.476, 95%CI: 0.272~0.783),and appropriate variety of stimulation(OR=0.507, 95%CI: 0.288~0.893) were related to suspected gross motor developmental delays. Conclusions Adequate or appropriate activity space, appropriate variety of activities could promote the development of gross motor. Child healthcare providers need to strengthen healthy education and guide parents to improve their home support environment so as to promote early childhood development.