上海市小学生近视相关读写姿势现况及影响因素分析

Reading and writing postures of primary school students in Shanghai and associated factors

目的了解上海市小学生的读写姿势现状,探索读写姿势的影响因素。方法采用整群抽样法抽取上海市某区7所学校的1~5年级小学生,对同意进行睫状肌麻痹验光检查的2680名小学生家长进行问卷调查,内容包括基本情况、读写姿势、用眼强度/时间、用眼行为等。结果 79.6%的小学生读写姿势不良,近视学生高于不近视学生。在三项读写姿势中,胸桌距离的不良率最高,为64.6%;其次为眼书距离(42.5%);不良率最低的为手笔尖距离(29.8%)。高年级、持续用眼后休息眼睛、饮食平衡不挑食、阅读环境良好、读写时照明充足的小学生读写姿势不良率相对较低,OR值分别为0.683(0.545~0.857)、0.461(0.375~0.566)、0.749(0.608~0.922)、0.326(0.241~0.442)、0.300(0.217~0.416);近视、学习成绩差、上学日每天做作业超过3 h、双休日每天屏前时间超过5 h的小学生,读写姿势不良率相对较高,OR值分别为1.334(1.017~1.750)、1.670(1.150~2.426)、1.330(1.031~1.715)、1.424(1.067~1.901)。结论研究人群读写姿势不良情况严重,需政府相关部门、学校和家庭合作,采取干预措施、改善影响读写姿势的用眼时间和用眼行为,帮助预防近视的发生。

Objective To investigate the reading and writing postures of primary school students in Shanghai,and to explore the associated factors that affect the postures. Methods A total of 2680 primary school students from 7 schools were selected by cluster sampling in one district in Shanghai. Demographic information,reading and writing postures,daily time of near work and visual activities were analyzed. Results 79. 6% of the primary school students had unhealthy reading and writing postures. Inappropriate chest-to-desk distance was the most common finding（ 64. 6%）,followed by inappropriate distance between eyes and book（ 42. 5%）,and distance between finger and nib（ 29. 8%）. Students who were in higher grades,allowed intermittent visual rest in long-lasting near distance works,had been on a balanced diet,had good reading environment,and had adequate lighting were less likely to have unhealthy postures. OR values for those factors were 0. 683（ 0. 545 - 0. 857）,0. 461（ 0. 375 - 0. 566）,0. 749（ 0. 608 - 0. 922）,0. 326（ 0. 241 - 0. 442）,and0. 300（ 0. 217 - 0. 416） respectively. Unhealthy postures were more common in students who were myopic,had poor academic performance,had more than 3 hours of homework on school days,and used digital screens over 5 hours during weekends. OR values for these factors were 1. 334（ 1. 017 - 1. 750）,1. 670（ 1. 150 - 2. 426）,1. 330（ 1. 031 - 1. 715）,and1. 424（ 1. 067 - 1. 901）. Conclusions Myopia was associated with reading and writing postures. Government,school and family should collaborate to improve near distance work time and habits in order to help students to develop healthy reading and writing postures.