1 163例3～6岁城市儿童忽视调查分析

目的 建立中国3—6岁城市儿童忽视常模,并对其信度和效度进行检验。方法 复习文献,自行设计调查问卷;采用多阶段分层整群随机抽样方法,在全国25个城市采样1465例;对样本中的66例间隔2周重复测查——评价重测信度。调查问卷均由家长或看护人(和被测查儿童在一起生活1年以上)填写;采用项目分析、因素分析和信度分析等统计学方法重新建构量表并检验其信度和效度。结果 用统计学方法删除了不适宜题项,去除了社会忽视层面,排除了2岁组研究对象,最终确定了由91个题项组成的正式量表,它包括身体、情感、教育、安全和医疗等5个忽视层面,分别包含17、40、17,10、7个题项。采用身体、情感、教育、安全和医疗等各忽视层面及总量表得分的第90百分位数的分值作为划界分,分别为35、80、40、20、15、190分。总量表的内在信度是0．94,分半信度为0．88,重测信度为0．92。对于身体、情感、教育、安全和医疗等5个忽视层面,内部一致性α系数为0．60—0．88,分半信度为0．54—0．80,重测信度为0．77—0．94,P值均小于0．01;其结构效度、表面效度和外部效度也较为满意;结论 本常模符合中国国情,适用于在3—6岁城市儿童忽视状况的研究中作为一个评价标准,而且也可以作为一个测查工具用来衡量家长及与儿童有关的人员在养育和看护孩子时的行为和态度,值得推广和应用。

Investigation and analysis of child neglect in 1163 urban children aged 3 - 6 years

OBJECTIVE: Child abuse and neglect (CNS) increasingly have become a serious problem in modern society all over the world. Children neglected and abused are at risk for maladaptation in behavioral, emotional, social, cognitive, and physical functioning. The purpose of this investigation was to develop the Child Neglect Scale for children aged 3 - 6 years in Chinese urban areas and to test the reliability and validity of this norm. METHODS: According to the principle and procedure of developing scales, a child neglect questionnaire was designed. Multistage sampling was used in the study in accordance with sex, age, the levels of economy and kindergartens, a random sample of 1,465 children aged 2 - 6 years was selected from 25 cities. Of the 1,465 subjects who completed the Child Neglect Questionnaires again 2 weeks later, 66 had completed data on each of the two occasions. The Child Neglect Questionnaires were completed by parents and caregivers. The data were analyzed using items analysis, factor analysis, internal consistency analysis and the reliability and validity of the norm were tested. The factor structure of the Child Neglect Scale was determined using an oblique rotation. The internal consistency was reflected in Cronbach's alpha. Since no existing categorization scheme on child neglect could be found in the literature, one was formulated in an attempt to efficiently and meaningfully group similar types of caregiver behaviors. The initial pool of potentially neglecting caregiver behaviors was drawn from literature. The most common patterns of parental behaviors were grouped according to six neglect subscale schemes found in the literature, with modifications made to increase item specificity and reduce overlap. The initial Child Neglect Questionnaire contained a 25-item physical neglect subscale, a 59-item emotional neglect subscale, a 23-item educational neglect subscale, a 20-item safety neglect subscale, a 10-item medical neglect subscale, a 9-item social neglect subscale. RESULTS: Completed Child Neglect Questionnaires were obtained from 1,457 subjects, 726 males and 731 females. The overall findings of this study came from 1,163 subjects, because children aged 2 years (294 subjects) were removed from subjects by statistical method. The 91-item Child Neglect Scale was presented to the respondent as a child neglect questionnaire with a 9-item social neglect subscale and some items in other subscales were removed from the initial questionnaire by using statistical method. The questionnaire contained 17 physical neglect items, 40 emotional neglect items, 17 educational neglect items, a 10 safety neglect items, and 7 medical neglect items. The internal consistency of the overall Child Neglect Scale as reflected in Cronbach's alpha was 0.94, the split-half reliability was 0.88, the test-retest reliability was 0.92. For physical, emotional, educational, safety, medical neglect subscale, Cronbach's alpha, respectively was 0.80, 0.88, 0.84, 0.68, 0.60, the split-half reliability was 0.54 - 0.88, the test reliability was 0.89, 0.94, 0.87, 0.80, 0.77, respectively. The construct validity, face validity and exterior validity of the norm were good. For physical, emotional, educational, safety, medical neglect subscale and overall child neglect scale, the scores of percentiles 90 were used as cut-point. They were 35, 80, 40, 20, 15, 190, respectively. CONCLUSIONS: The norm was consistent with China's economic-cultural background and reality. It not only may be used for research purpose but also may be useful in assessing parent's and child-oriented individual's behaviors and attitude as a measuring instrument.