农村1～4岁留守儿童喂养状况与发育偏离的关系研究

Study on the relationship between children＇s feeding and development deviation among left behind children aged 1-4 years old with both parents working out

目的 调查农村1～4岁双亲均外出的留守儿童监护人的喂养知识、态度、行为评分与儿童发育偏离的关系.方法 在安徽省2个县、12个行政村,各选取212名双亲均外出的留守儿童和双亲均未外出儿童,使用自编喂养知识、态度、行为问卷对儿童监护人进行调查,对研究对象进行体格发育测量与评价,对其外周血血红蛋白、锌元素进行测量,检测尿碘,检查神经精神发育情况.结果 在儿童健康的理解、部分重要食品（如奶及其制品）对儿童健康的重要性、以及烹饪方法 对食物营养成份影响方面的知识,对儿童膳食结构、健康状况和进食行为方面的态度,为儿童提供多种食物、经常查找喂养孩子知识方面的行为,农村留守儿童监护人的正确率均低于对照组（均P〈0.05）.留守儿童营养不良检出率（4.7%）、营养性贫血检出率（19.8%）、锌缺乏率（46.2%）、碘缺乏率（21.7%）均高于对照组（0.9%、8.5%、34.4%、12.7%）,差异均有统计学意义（χ2值分别为5.489、11.182、6.125、5.974,均P〈0.05）.留守儿童智力低下和边缘智力的检出率（3.8%、20.8%）高于对照组（1.9%、10.4%）,差异有统计学意义（χ2＝13.476,P〈0.05）.农村留守儿童监护人喂养知识、态度、行为得分为＂低分组＂的儿童,其营养不良和营养性贫血检出率较高（χ2值分别为12.211,6.921,均P〈0.05）.结论 农村儿童监护人喂养知识、态度、行为与儿童营养状况关系密切,我国农村儿童监护人的喂养知识、态度、行为存在较多问题,祖父辈监护人更为缺乏.

Objective To investigate the relationship between scores on rural children guardians＇ feeding knowledge, attitude and practices and children development deviation among left-behind children aged 1-4 years old with both parents working out. Methods A total of 424 children aged I-4 years old were selected from 12 villages in 2 counties of Anhui province, half of them with both parents working out and half of them without. Their guardians＇ feeding knowledge, attitude and practices were evaluated with self-designed questionnaires, and the physical development of the children was measured and evaluated. The peripheral blood hemoglobin, trace element of zinc, urinary iodine, and children neuropsychological development were evaluated. Results The rates of correct understanding of some children feeding knowledge, such as knowledge of children health, importance of some important foods （milk and milk products）, effects of cooking methods on food nutrition, of left-behind children＇ s guardians were lower than those of control group （ all P 〈 0.05 ）. The rates of correct attitude on food structure, health status and eating habit and of correct practices on providing various foods and looking for knowledge about children feeding of left-behind children＇ s guardians were also lower （ all P 〈 0.05 ）. The prevalence of malnutrition, nutritional anemia, zinc deficiency and iodine deficiency in left-behind children were higher than those of control group （4.7% vs 0.9% , 19.8% vs 8.5%, 46.2% vs 34.4% and 21.7% vs 12.7%, respectively）, and the differences were statistically significant （X2 value was 5. 489, 11. 182, 6. 125 and 5. 974, respectively, all P 〈 0.05 ）. The prevalence of mental retardation and edge intelligence in left-behind children were higher than those of control group （3.8% vs 1.9%, 20.8% vs 10.4%, respectively）, and the differences had statistical significance （X2 = 13. 476, P 〈 0.05 ）. The prevalence of malnutrition and nutritional anemia was higher in left-behind children with low scores on guardians＇ feeding knowledge, attitude and practices （X2 value was 12.211 and 6. 921, respectively, both P 〈 0.05 ）. Conclusion Rural children＇s nutritional status is closely associated with their guardians＇ knowledge, attitude and practices. There are more problems in feeding knowledge, attitude and practices of rural children guardians＇ , especially in grandparents.