中国部分城市3～6岁儿童忽视状况及影响因素分析

Study on the current situation and influential factors of child neglect among aged 3-6 year-olds in the urban areas of China

目的了解中国城市儿童忽视现状,明确影响儿童忽视的主要危险因素。方法采用“中国3～6岁城区儿童忽视常模”中规定的量表和评价方法,对全国25个城市采用多阶段分层整群抽样方法,共调查1163例3～6岁儿童,其中男童占49.6%,少数民族占4.5%。分别计算不同地区、年龄、性别、忽视类型(身体、情感、教育、医疗、安全等)的忽视分值、忽视率与忽视度。忽视危险因素的多因素分析分别采用Binarylogistic回归分析和多元线性逐步回归分析方法。结果(1)3～6岁城区儿童总忽视率为28.0%,各年龄组间差异无统计学意义(χ2=4.798,P>0.05);忽视度为42.2,各年龄组间差异无统计学意义(F=0.988,P>0.05);男、女儿童忽视率分别为32.6%和23.7%(χ2=6.585,P<0.05),忽视度分别为42.7和41.8(F=2.502,P>0.05);在儿童忽视的5种类型中,忽视度为39.4～43.4,忽视率为5.1%～12.9%,除身体忽视外,其他4种类型的发生率性别间差异均无统计学意义(P值均>0.05);所有儿童均以单项(即只在5种忽视类型的任何一种)受忽视为主(发生率16.5%,构成比58.9%)。在不同类型结构的家庭中,以单亲家庭中的儿童受忽视率最高(42.9%),核心家庭次之,而“三世同堂”家庭中儿童受忽视率最低(25.5%)。无论以年龄或性别分组,儿童均为在安全、医疗方面受到的忽视较轻。

Objective Children aged 3-6 years in the urban areas of China were surveyed for the first time to find out the state of child neglect (CN) as well as the major relevant risk factors so as to provide evidence for developing intervention measures. Methods 1163 children ( of whom 49.6 % were males and 4.5 % were minority nationality) were randomly sampled under multistage stratification, from 25 cities which representating 15 provinces of China. Based on the Child Neglect Norms used by China, prevalence of CN was idenfied and SPSS-Windows 11.0 was employed for statistical analysis. Scores, frequency/ degrees, age, sex and 5 types (physical, emotional, educational, medical and safety) of CN on every group of the regions, were calculated. Multifactorial analysis was conducted through Binary Logistic Regression and multiple linear regression to determine the relevant risk factors. Results (1)The average degree of CN for the 3-6 year-olds was 42.2 , with its prevalence as 28.0 %. Degrees of CN for the groups of 3,4,5, 6- year-olds were 41.7 , 42.2 , 42.1 and 43.1 ( F= 0.988 , P> 0.05 ), with frequencies of 25.0 %, 25.3 %, 27.9 % and 35.4 %( χ2= 4.798 , P> 0.05 ), respectively. Degrees for CN in males and females were 42.7 and 41.8 ( F= 2.502 , P> 0.05 ) with the frequencies as 32.6 % and 23.7 % ( χ2= 6.585 , P< 0.05 ), respectively. Degrees of CN for the five types were 39.4- 43.4 with the frequencies as 5.1%- 12.9 %, respectively. No significant difference was found in the frequency of the types (with an exception on 'physical neglect') between males and females ( P> 0.05 ).The highest frequency ( 42.9 %) of CN was seen in the single-parent families and the lowest in large family with three generations( 25.5 %). (2)According to monofactorial χ2 test, the possible risk factors of CN would include: educational background, occupation and decrease of income of the parents during last year, etc. (3)Binary Logistic regression analysis showed that the influential factors to the occurrence of CN would include: father's educational background, sex of the child and mother's occupation, etc. (4)Multiple linear regression showed that the influential factors to the degree of CN were: family structure, number of supporting family members, relationship between parents and children, etc. Conclusion The degree and frequency of CN among children aged 3 to 6 in the urban areas of China were high but similar among the four age groups. Male children had a higher frequency of neglect than females, but with similar degree. Children in single-parent families had the highest frequency. The major influential factors of CN would include: educational background, occupation, family structure, family income of the parents which were similar to the results reported from foreign literature.