上海市入园儿童心理健康状况及影响因素研究

Study on mental health status and its influencing factors in kindergarten children in Shanghai

目的研究新入园儿童心理健康状况及影响因素,为后续儿童健康干预策略规划提供理论依据。方法采用多阶段分层整群随机抽样方法,于2017年在上海市16个区县抽取187所幼儿园共22 509名入园儿童,利用网络调查评估人口学特征、儿童养育环境(ICCE)得分及心理健康(SDQ),采用Logistic回归模型,分析各因素对儿童心理健康的影响。结果完成调查的22 067名儿童平均43.5月龄,SDQ困难总分评定结果18.29%异常;女童、社会经济状况好、非独生子女、父母家庭完整、睡眠充足、屏幕暴露少、无早期不良经历以及早期母乳喂养的儿童SDQ得分较低;SDQ困难总分及各因子高危风险随着ICCE总分及各维度得分升高而减小,呈负相关,其中避免打骂维度比值比最低(OR值分别为0.713、0.754、0.493、0.553、0.506、0.726,P<0.001)。结论儿童心理健康不仅与家庭社会经济因素及家庭结构有关,且与早期母乳喂养和无早期不良经历明显相关。养育环境越好,儿童发生社会心理问题的风险越小。

Objective To study the mental health status and its influencing factors of new children in kindergartens, so as to provide theoretical basis for the follow-up strategy planning of children′s health intervention. Methods Using multi-stage stratified cluster random sampling method, a total of 22 509 children from 187 kindergartens were selected from 16 districts and counties in Shanghai in 2017. Children′s demographic characteristics, rearing environment and mental health were assessed by Index of Child Rearing Environment(ICCE) and Strengths and Difficulties Questionnaire(SDQ) via an online survey. Results Totally 22 067 children completed the survey, with an average age of 43.5 months old. And 18.29% of the children were detected with abnormal SDQ results. Chidren who were girls, with better socio-economic condition, not-only child, a completed family, adequate sleep, less screen time, and had no early adverse experience breastfed early had a significantly higher score of SDQ. The total score of SDQ and the high risk of each dimension were negatively related to ICCE score, and the odds ratio of avoiding restriction was the lowest(OR=0.713, 0.754, 0.493, 0.553, 0.506, 0.726, P<0.001). Conclusions Parenting environment is not only related to family socioeconomic factors and family structure, but also related to the early breastfeeding experience. The nurturing environment plays an important role in promoting children′s early development.