中国人口较少民族中小学生自杀意念流行现况及危险因素研究

Research on epidemic situation and risk factors for suicide ideation among primary and junior school students in less populated ethnic areas,China

目的了解中国人口较少民族中小学生自杀意念的发生现况,探究其发生的影响因素,为制定人口较少民族自杀意念干预策略及相关卫生政策提供科学依据。方法采用整群抽样方法,随机抽取人口数较少民族的9~16岁中小学生作为调查对象。利用自行编制的《人口数较少民族中小学生健康相关/危险行为调查问卷》,分析人口较少民族中小学生自报告的自杀意念发生情况及其影响因素;采用单因素和多因素Logistic回归模型对数据进行分析。结果本次调查显示,2016年中国人口较少民族的中小学生过去12个月里自杀意念自报告发生率为16.38%(430/2 625)。其中,男生为17.39%,女生为15.44%;布朗族自报告发生率为16.80%,阿昌族为13.43%,普米族为14.64%,怒族为33.52%,德昂族为11.70%,独龙族为11.71%,基诺族为13.44%。经多因素Logistic回归分析显示,怒族,过去12个月有过自伤事件、意外伤害、自觉有孤独感,曾连续两周或更长时间因为伤心绝望而停止平常的活动,过去30 d里有过校园暴力,留守儿童母亲从事非农业工作,母亲受教育程度低的学生,发生自杀意念的风险性越高。结论中国人口较少民族中小学生的自杀意念问题不容忽视,今后应加强对人口较少民族中小学生的自杀相关行为的预防与综合干预,采用重点干预和分类指导的方法。

Objective To understand the epidemic of suicide ideation among less-populated ethnic students in primary and junior schools of China,to identify the risk factors of suicide ideation,and to provide scientific evidence for developing strategy and health policies to intervene their suicide-related behavior among ethnic minorities. Methods Lesspopulated ethnic students,aging between 9 and 16 years old,were recruited. Randomized cluster sampling was adopted. A self-designed questionnaire was used to collect data. Risk factors for suicide ideation were assessed by univariate analysis and Logistic regression analysis. Results In 2016,16. 38%( 430/2 625) of the less populated ethnic students in primary and junior school students of China had suicide ideation during the past 12-month period prior to the study,of which,the incidence was 17. 39% in boys and 15. 44% in girls. When stratified by ethnic groups,the self-reported incidence of suicide ideation among students in different ethnic groups was significantly different. The incidence rate was 16. 80% among Bulang people,13. 43% among Achang people,14. 64% among Pumi people,33. 52% among Nu people,11. 70% among De’ang people,11. 71% among Dulong people,and 13. 44% among Jinuo people. The multi-variates logistic regression analysis showed that students who had self-injury events,and unintentional injury over the past 12 months,felt lonely,stopped their daily activities continuously for two weeks or longer due to depression,suffered school violence over the past30 days,were left-behind children,had mothers engaged in non-agricultural work,or had lower educational level in parents were more likely to have the idea of suicide. Conclusions The problem of suicide ideation cannot be ignored among the less-populated ethnic students in primary and junior school students of China. In the future,we should strengthen the prevention and comprehensive intervention against suicide related behavior in primary and middle school with more ethnic students.