西藏农牧区藏族中学生非自杀性自伤行为与求助行为的关联

Non-suicidal self-injurious behaviors and associations with help-seeking behaviors among Tibetan middle school students in agricultural and pastoral areas of Tibet

目的了解西藏农牧区藏族中学生非自杀性自伤行为(NSSI)状况及与求助行为之间的关联关系,为农牧区藏族中学生预防NSSI和干预提供帮助。方法2023年4—5月选取西藏农牧区的那曲和阿里地区4204名农牧区藏族中学生进行NSSI和求助行为的自评问卷调查,并采用χ^(2)检验、t检验、Logistic回归分析等方法进行统计分析。结果西藏农牧区藏族中学生NSSI检出率为33.33%(1401/4204),其中初中学生检出率为36.00%(878/2439),高中学生为29.63%(523/1765),差异有统计学意义(χ^(2)=18.68,P<0.01)。高中生存在NSSI的学生求助意愿、求助对象(家人、教师、朋友)和求助方式(面对面交流、电话交流、微信QQ)得分均显著低于非NSSI者,差异均有统计学意义(P<0.01)。Logistic回归分析显示,初中女生(OR=1.46)、班干部(OR=1.28)、城市学生(OR=1.47)、亲子关系一般(OR=1.46)、亲子关系较差(OR=2.01)、教养方式一般(OR=1.44)、教养方式较差(OR=2.11)、常被训斥(OR=1.99)、学习压力较重(OR=1.42)与NSSI发生呈正相关(P<0.05)。高中生求助意愿(OR=0.85)、求助家人(OR=0.96)、求助教师(OR=0.98)与NSSI发生呈负相关(P<0.05)。结论西藏农牧区藏族中学生NSSI不容忽视,与求助行为之间存在密切关联。应鼓励农牧区藏族中学生积极主动寻求帮助,缓解学业压力和减少训斥,保持良好的亲子关系和教养方式,以降低NSSI的发生。

Objective To investigate the status of non-suicidal self-injury(NSSI)among Tibetan middle school students in agricultural and pastoral areas of Tibet and its association with help-seeking behaviors,in order to provide reference for the prevention and intervention of NSSI in this demographic.Methods A self-report questionnaire survey on NSSI and help-seeking behaviors was conducted among 4204 Tibetan middle school students in the rural and pastoral areas of Nagqu and Ali regions of Tibet from April to May 2023.Chi-square tests,t test,and Logistic regression analysis were employed to analyze the data.Results The detection rate of NSSI among Tibetan middle school students in agricultural and pastoral areas of Tibet was 33.33%(1401/4204),with junior high school students having a significantly higher rate of 36.00%(878/2439)compared to 29.63%(523/1765)for senior high school students(χ^(2)=18.68,P<0.01).Senior high school students with NSSI had a significantly lower score on help-seeking intentions,help-seeking targets(family,teachers,friends),and help-seeking methods(face-to-face communication,telephone conversations,WeChat/QQ)than those without NSSI(P<0.01).Logistic regression analysis revealed that female junior high school students(OR=1.46),class leaders(OR=1.28),urban students(OR=1.47),average parent-child relationships(OR=1.46),poor parent-child relationships(OR=2.01),average parenting styles(OR=1.44),poor parenting styles(OR=2.11),frequent scolding(OR=1.99),and heavy academic pressure(OR=1.42)were positively associated with the occurrence of NSSI(P<0.05).Among senior high school students,help-seeking intentions(OR=0.85),seeking help from family members(OR=0.96),and seeking help from teachers(OR=0.98)were negatively associated with the occurrence of NSSI(P<0.05).Conclusions NSSI among Tibetan secondary school students in agricultural and pastoral areas of Tibet should not be ignored,and there is a close association between NSSI and help-seeking behaviors.Tibetan secondary school students in agricultural and pastoral areas should be encouraged to proactively seek help,reduce academic stress and reprimands,and maintain good parent-child relationships and parenting styles in order to reduce the incidence of NSSI.