上海市闵行区5~6月龄及11~12月龄儿童家庭养育环境现状及其影响因素

Status quo and risk factors of infant home nurture environment for children aged 5-6 and 11-12 months in Minhang district,Shanghai

目的了解上海市闵行区5~6及11~12月龄儿童家庭养育环境的现况及其影响因素,为制定有针对性的婴幼儿家庭养育环境干预策略和指导服务提供依据。方法2021年6—10月,在闵行区所有13家社区儿童保健门诊中,使用分层随机抽样方法选取5~6和11~12月龄儿童为研究对象,基于《0~6岁儿童家庭养育环境量表》了解其家庭养育环境,描述量表评价结果(良好、中等及不良的检出率)的分布及其在不同月龄的组间差异,采用有序Logistic回归分析家庭养育环境的影响因素。结果共纳入1152例儿童,其中男女分别为573例(49.74%)和579例(50.26%),5~6和11~12月龄分别为589例(51.13%)和563例(48.87%);家庭养育环境量表的总体及4个维度(感知/认知、情感温暖、忽视/限制、人际互动/喂养)的不良检出率分别为3.47%、4.60%、6.42%、8.07%、7.20%。“忽视/限制”维度5~6月龄良好检出率高于11~12月龄、中等检出率低于11~12月龄(χ^(2)=11.17,P=0.004),其余量表评价结果在不同月龄组间差异均无统计学意义(P>0.05)。家庭人均居住面积<30.58m2(2020年上海城市家庭人均水平)、人均月收入<1万元、家庭总体关系不良、有屏幕暴露、过去1个月每日亲子互动时间<2h、过去1个月儿童存在身体活动受限>1h/次是家庭总体养育环境的危险因素(OR分别为1.51、1.55、2.68、1.42、1.35、2.25)。结论闵行区5~6及11~12月龄儿童家庭养育环境的不良检出率总体较低,不同月龄组间存在差异,以11~12月龄的“忽视/限制”维度较为欠佳;针对多种危险因素,应制定有效的干预策略,营造良好的养育环境,助力儿童早期健康发展。

Objective To analyze the status and its influencing factors of home nurture environment(HNE)for children aged 5-6 and 11-12 months in Minhang district,Shanghai,in order to provide evidence for formulating targeted intervention strategies.Methods From June to October 2021,caregivers of children aged 5-6 and 11-12 months in the clinic of child health care were asked to conduct a questionnaire survey on their basic social demography and parenting behavior,and the 0-6 Years Child Home Nurture Environment Questionnaire(CHNEQ)for children aged 0-1 year was used to evaluate the parenting environment.The results of CHNEQ were compared in different age groups.The influencing factors of the CHNEQ were analyzed by ordered Logistic regression.Results A total of 1152 children were included,including 573(49.74%)boys and 579(50.26%)girls,589(51.13%)infants aged 5-6 months and 563(48.87%)infants aged 5-6 months.The detection rates of poor nurture environment in CHNEQ and its four dimensions,including perception/cognition,emotional warmth,neglect/restriction,interpersonal interaction/feeding were 3.47%,4.60%,6.42%,8.07%and 7.20%,respectively.The detection rate of good nurture environment in neglect/restriction dimension was higher in 5-to 6-month-old infants than that in 11-to 12-month-old infants and moderate detection ratewas lower than that in11-to 12-month-old infants(χ^(2)=11.17,P=0.004),but the differences in other dimensions between 5-to 6-month-old infants and 11-to 12-month-old infants were not significant(P>0.05).Children with per capita living area<30.58m2(the per capita level of urban households in Shanghai in 2020)and per capita monthly income<10000RMB,poor family relations,screen exposure,parent-child interaction time<2h/d and physical activity restriction>1h/time in the past month,had a higher risk of poor HNE(OR=1.51,1.55,2.68,1.42,1.35,2.25,P<0.05).Conclusions In Minhang district,the detection rate of poor HNE in children aged 5-6 months and 11-12 months is generally low.The detection rate of poor nurture environment in infants varies in different age groups,and the home nurture environment in 11-to 12-month-old infants is poor.In a word,HNE is affected by many risk factors,so targeted intervention strategies should be adopted to improve parents′parenting skills,avoid risk factors,create a good environment,and promote healthy development in early childhood.