黑龙江省农村儿童伤害累积效应分析

目的探讨农村儿童伤害的危险因素和保护因素的累积效应,为农村伤害的早期干预提供参考。方法采用多阶段整群抽样抽取黑龙江省8所农村中小学2 109名5~15岁学生的监护人为调查对象,调查中小学生伤害发生情况及严重程度,以长处与困难量表(Strengths and Difficulties Questionnaire,SDQ)、伤害行为检查表(Injury Behaivor Checklist,IBC)、危险和风险感知问卷(Perceptions of Risks and Hatards,PRH)得分作为危险因素,以家长监督属性概况问卷(Parent Supervision Attribules Profile Questionnaire,PSAPQ)、家庭环境评定量表-物理环境评定量表(Home Observation for Measurement of the Environment,HOME)、儿童意外伤害知识态度行为问卷(Knowledge,Attitude and Practice for Children Unintentional Injury,KAP)得分作为保护因素,将各变量得分进行二分类转化,相加后得危险因素指数(risk factor inder,RFI)和保护因素指数(protective factor index,PFI)。结果儿童伤害严重程度与SDQ总分、IBC总分和伤害感知均呈正相关(r值分别为0.15,0.29,0.12,P值均<0.01);与HOME家庭物理环境维度得分、PSAPQ总分和KAP总分均呈负相关(r值分别为-0.25,-0.14,-0.09,P值均<0.01);分层回归结果,伤害严重程度与SDQ总分、IBC总分、HOME物理环境维度得分相关均有统计学意义,可解释伤害程度总变异的34%;伤害严重程度与RFI呈正相关(β=0.21)、与PFI呈负相关(β=-0.18)、RFI与PFI存在交互作用(β=-0.11,R2=0.31)(P值均<0.01)。结论农村儿童伤害,危险因素和保护因素均与伤害严重程度呈累积效应关系,其中保护因素可以调节危险因素与伤害的关系。

Cumulative effects of unintentional injury among rural children of Heilongjiang Province

Objective To explore the cumulative effects of unintentional injury among children in rural area, in order to provide information for early intervention of unintentional injury. Methods Through multistage clustering sampling method, 2 109 primary caregivers of students from 8 rural primary and elementary schools of Heilongjiang Province were recruited. Strengths and Difficulties Questionnaire( SDQ), Injury Behavior Checklist( IBC), Perceptions of Risks and Hazards were used to collect as the risk factors, while Perceptions of Risks and Hazards( PSAPQ), Home Observation for Measurement of the Environment( HOME)and Knowledge, Attitude and Practice for Children Unintentional Injury( KAP) were also used as the protective factors. Risk factors index( RFI) and protective factors index( PFI) were computed in the study. Results The severity of unintentional injury were positively correlated with SDQ, IBC and perceptions of risks and hazards( r = 0.15, 0.23, 0.12, P<0.01), and were negatively correlated with HOME, PSAPQ and KAP( r =-0.25,-0.14,-0.09, P<0.01). Hierarchical linear regression showed that the total scores of SDQ, IBC and environmental of HOME predicted the severity of unintentional injury which could explain 34% variant of unintentional injury. It also indicated that the severity of unintentional injury were positively correlated with RFI( β = 0.21) and negatively correlated with PFI( β =-0.18), the interaction was significant( β =-0.11,R2= 0.31)( P<0.01). Conclusion Both risk and protective factors of unintentional injury have cumulative effects on the severity of injury among rural children. The relationship between risk factors and injury could be mediated by protective factors.