农村儿童家庭及住宅附近环境安全隐患现状调查

[目的]了解农村儿童家庭及住宅附近环境安全隐患现状,为制定伤害干预措施提供依据. [方法]整群抽取崇仁县3个乡(镇),对所抽取乡(镇)的2 918户儿童家庭环境及住宅附近环境安全现状进行问卷调查及现场观察. [结果]0～6岁儿童伤害发生率为21.86%,伤害发生在家中占50.48%,住宅附近的占38.25%,幼托机构的占11.27%.13项儿童家庭及住宅附近环境安全隐患调查指标,有10项安全隐患百分率高于60%. [结论]农村儿童家庭及住宅附近环境安全隐患严重,加强儿童伤害家庭危险因素排查及对儿童及看护人进行儿童安全相关知识的健康教育很有必要.     

农村儿童伤害综合性干预效果评价

目的评价农村儿童伤害综合性干预效果。方法整群抽取干预县3个乡(镇)3 834名学龄前儿童、2946名儿童看护人和667名学龄儿童,于2007年9月—2010年8月实施为期3年的综合性干预,包括发展政策、伤害监测、安全宣传、知识培训、村医入户安全隐患排查等,并对干预过程和结果进行评估。结果 0～6岁儿童非致死性伤害发生率从干预前的21.86%下降到干预后的9.58%;在伤害相关知识的12个指标中,干预后儿童看护人对其中9个指标正确认知的比例较干预前有明显提高;幼龄儿童住所附近有防护的水源比例从干预前的26.69%增加到干预后的75.88%;学校、儿童家庭及住宅附近环境安全隐患状况有效改善;以上差异均有统计学意义(P<0.01)。结论综合性干预是预防社区儿童伤害的重要措施和有效途径。     

江西省崇仁县儿童伤害发生现状与认知情况

目的 了解江西省崇仁县儿童伤害发生现状及儿童看护人对伤害的认知情况,为制定伤害干预措施提供依据.方法 整群抽取崇仁县3个乡(镇),对所抽取乡(镇)3 784名0～6岁儿童伤害发生现状及2946名儿童看护人伤害认知情况进行调查.结果 0～6岁儿童非致死性伤害发生率为21.86%,男性发生率高于女性,伤害类型构成排在前3位的依次为跌伤(9.70%)、锐器伤(3.46%)和动物致伤(3.09%);7例致死性伤害中,溺水死亡5例,且均发生在村里的池塘和沟渠.被调查的儿童看护人只有24.30%听说过伤害.结论 农村6岁以下儿童伤害发生情况较为严重,看护人对伤害预防的相关知识非常缺乏.加强对儿童及看护人开展与儿童安全相关知识的健康教育与宣传很有必要.     

陕西省商洛市山区留守儿童看护人麻疹相关知识行为影响因素分析北大核心

目的了解山区留守儿童看护人麻疹相关知识掌握情况及影响因素,为麻疹相关健康知识宣传策略提供依据。方法在陕西省商洛市镇安县随机抽取10个镇,每个镇按照距镇政府所在地近、中、远距离随机抽取3个村,每个村连续调查10户7岁以下留守儿童看护人,由统一培训的调查员入户对儿童看护人及接种人员进行面对面问卷调查。结果共调查300名儿童看护人,看护人麻疹相关知识知晓率为74.6%,儿童含麻疹成分疫苗首剂及时接种率为73.5%,看护人信息获取途径以接种医生为主（95.7%）。低学历是影响看护人麻疹相关知识知晓的危险因素（OR=0.26,95%CI：0.11-0.76）,看护人为汉族系保护因素（OR=2.27,95%CI：1.34-3.84）。结论留守儿童看护人麻疹相关知识知晓率低,需加强对接种医生麻疹相关知识、宣传技能的培训,以及留守儿童看护人特别是低学历、少数民族者的麻疹相关健康教育。     

肥胖儿童生活环境控制和心理干预效果评价

目的探讨肥胖儿童生活环境控制和心理干预方法，为及早控制肥胖儿童的体重提供科学依据。方法随机抽取扬州市2所学校。在1个学年期内，建立可操作性的“学校-家庭-社区”、“三级预防”、“知-信-行”3个三位一体的健康教育实践模式，实施生活环境控制和心理干预的综合措施。结果干预后，儿童、家长健康知识、态度和行为都有明显提高（P〈0．01）；肥胖儿童BMI和血压都降低（P＜0．01），饮食行为有所改普，社会心理功能、生理心理健康、生活环境、总体评价均高于干预前（P＜0．01），生活质量呈上升趋势（P＜0．01）。结论以家庭、学校和社区为平台，通过对肥胖儿童生活环境控制和心理干预的综合措施，可有效降低肥胖的发生。     

甘肃省会宁县贫困家庭和非贫困家庭0~6岁儿童看护人儿童保健知识水平现况调查

目的了解甘肃省会宁县贫困家庭和非贫困家庭0~6岁儿童看护人儿童保健知识水平,为制定本地区儿童保健相关健康教育策略提供依据。方法在会宁县随机抽取6个乡镇作为调查地区,选取0~6岁的贫困家庭儿童看护人作为调查对象,同时选取同样数量的非贫困家庭儿童看护人作为对照,通过问卷调查和访谈的方式获得调查对象儿童保健知识知晓率和健康行为形成率。结果分别调查了会宁县贫困和非贫困家庭儿童看护人533人,两类家庭儿童看护人对国家基本公共卫生服务政策知晓率较高,对国家免费提供儿童保健服务和预防接种服务的知晓率均高于88.7%。两类家庭儿童看护人至少能识别3种以上儿童疾病/危险信号的比例分别为51.0%和50.3%。儿童看护人为儿童添加的辅食的时间分别是7.0和6.7月龄,儿童看护人关键节点(为孩子准备食物前和上厕所后)的洗手率为13.1%和17.8%,差异有统计学意义,使用肥皂加流水洗手的儿童看护人分别占1.1%和1.9%。结论会宁县应充分利用宣传资料、广播和电视等形式进行健康教育,提高贫困和非贫困家庭儿童看护人对妇幼保健核心知识的掌握,达到提高儿童健康水平的目的。     

儿童步行安全健康教育干预效果评估

目的探索儿童伤害预防教育材料的内容和教学方法,提高儿童伤害预防意识和自我保护能力,评估健康教育的干预效果。方法在2所小学抽取500名儿童为干预对象,对其进行儿童步行安全知识的健康教育,干预前及干预后1个月,分别采用自行设计的认知问卷进行相关知识掌握情况与安全行为遵循情况的调查。结果干预后学生认识黄色交通信号灯起警示作用、下车后正确过马路、正确掌握十字路口遇上红灯时过马路方法的知晓率均有显著提高（P〈0.05）;在马路上追逐玩闹、在红灯亮起时穿越马路、跨越马路中间护栏过马路等危险行为显著减少（P〈0.05）;与机动车或非机动车碰撞的情况也显著减少（P〈0.05）。结论对儿童开展步行安全健康教育干预效果显著,建议在健康教育形式和内容方面要不断创新,营造伤害预防教育的良好氛围,调动儿童参与的积极性,不断增强干预效果。     

陕西省商洛市山区留守儿童看护人麻疹相关知识行为影响因素分析

目的了解山区留守儿童看护人麻疹相关知识掌握情况及影响因素,为麻疹相关健康知识宣传策略提供依据。方法在陕西省商洛市镇安县随机抽取10个镇,每个镇按照距镇政府所在地近、中、远距离随机抽取3个村,每个村连续调查10户7岁以下留守儿童看护人,由统一培训的调查员入户对儿童看护人及接种人员进行面对面问卷调查。结果共调查300名儿童看护人,看护人麻疹相关知识知晓率为74.6%,儿童含麻疹成分疫苗首剂及时接种率为73.5%,看护人信息获取途径以接种医生为主(95.7%)。低学历是影响看护人麻疹相关知识知晓的危险因素(OR=0.26,95%CI:0.11~0.76),看护人为汉族系保护因素(OR=2.27,95%CI:1.34~3.84)。结论留守儿童看护人麻疹相关知识知晓率低,需加强对接种医生麻疹相关知识、宣传技能的培训,以及留守儿童看护人特别是低学历、少数民族者的麻疹相关健康教育。     

北京市海淀区幼儿家长伤害认知状况分析

目的 了解幼儿家长对预防儿童伤害知识态度行为情况,为制定有针对性健康教育干预措施提供依据.方法 分层整群抽取10个托幼园所中2 122名儿童家长,采用自行设计的问卷进行伤害知识态度行为问卷调查.结果 儿童家长伤害知识知晓率在6.3%～86.0%;伤害知识来源途径前3位为电视宣传、阅读报刊及网络,而更希望获得途径为医生健康教育、专题宣传材料和电视宣传;大部分家长对儿童学习安全知识持支持态度并采取一定的措施阻止伤害的发生,儿童父母在保护儿童避免伤害认知及伤害防护方面明显高于其他看护人.结论 家长应接受预防儿童伤害知识的全面健康教育,儿童父母外的其他看护人是重点人群.园所保健医生在预防儿童伤害中的作用亟待加强.     

肥胖儿童生活质量及健康干预研究

目的探讨肥胖儿童生活质量及健康干预的方法和效果，为儿童肥胖的控制提供科学依据。方法随机抽取2所学校吧胖儿童82名及其相应对照组进行配对研究，对肥胖儿童进行儿童少年生活质量量表的评定、生活指标检测和1学年的健康教育及生活质量的干预。结果干预前肥胖儿童与正常儿童比较，除了亲子关系、活动机会性、生活便利性3个维度没有显著差异（P〉0．05）以外，在自我满意度、师生关系、同伴关系、学习能力与态度、自我概念、躯体感受、负性情绪、作业态度、运动能力、其他共10个维度均有差异（P〈0．01），社会心理功能、生理心理健康、生活环境、总体评分差异显著（P〈0．01），肥胖儿童低于正常儿童。肥胖儿童干预前后比较，自我满意度、师生关系、同伴关系、学习能力与态度、自我概念、躯体感受、负性情绪、作业态度、运动能力、其他共10个维度差异显著（P〈0．01），社会心理功能、生理心理健康、生活环境、总体评分有显著差异（P〈0．01），干预后高于干预前。干预后肥胖儿童与正常体重比较，同伴关系、自我概念、负性情绪、作业态度、运动能力、其他以及社会心理功能、生理心理健康、生活环境、总体评分均有显著意义（P〈0．01）。结论以家庭、学校和社区为平台，采取综合措施，对肥胖儿童生活质量干预效果显著。     

Child injury in a changing world

Abstract

The importance of child injuries has now been recognised as a significant public health problem internationally. The World Health Organisation (WHO) and United Nations Children's Fund (UNICEF) have recently published the first world report on child injury prevention. As infectious diseases decline, the relative importance of injury has increased, but the pace of change of global processes means that absolute increases in injury may occur over the next 20–30 years. This paper examines child injury in a changing world by outlining the ways in which the forces of globalisation, urbanisation, motorisation and environmental change could have an impact on injury epidemiology and policy.

We consider how those in public health and those in the injury field should respond to the changing world of injury. Child injury prevention needs to be incorporated into planning for the rapidly changing urban environments of low-income countries and strategies devised for the large numbers of people displaced by environmental change.     

小学生家长伤害预防监护能力情况

  目的  了解小学生家长的儿童伤害预防监护能力, 并分析其关联因素, 为减少儿童伤害的发生提供参考。  方法  采用多阶段分层整群抽样方法, 于2021年5—6月从上海市(虹口、金山和宝山)3个行政区的3所小学抽取2 577名儿童家长开展问卷调查, 调查问卷根据本研究团队前期开发的儿童伤害预防家庭监护能力评估指标体系(6~11岁)制成。将评估结果转换为标准化得分进行描述性分析, 采用多重线性回归模型进行多因素分析。  结果  家长在环境、产品、行为与技能和心理4个一级指标的标准化得分分别为(0.91±0.08)(0.93±0.08)(0.97±0.04)(0.95±0.05)分, 监护能力标准化得分为(0.95±0.04)分。家长在知识、态度和实践3个维度的标准化得分分别为(0.99±0.03)(0.97±0.05)(0.89±0.10)分。母亲的伤害预防知、信、行及总分均高于父亲; 高学历家长的伤害预防知、信、行及总分均高于低学历家长; 家长认为"父母"这一社会角色越重要, 其得分越高。  结论  小学生家长儿童伤害预防的整体实践水平与其知识和态度之间存在差距。监护角色、学历和家长对父母角色重要性的认知是影响其伤害预防监护能力的主要因素。建议针对不同监护角色及不同受教育程度的家长有针对性地探索更适合、其更易接受的伤害预防监护干预措施。     

Preventing child unintentional injury deaths: prioritising the response to the New Zealand Child and Adolescent Injury Report Card

Objective: To develop recommendations for child unintentional injury prevention by comparing New Zealand's child unintentional injury mortality and injury prevention policies with those of European countries. Methods: Unintentional child injury death rates based on external cause of injury were calculated and ranked. NZ's score for each of the 12 domains (based on external causes of injury) from the New Zealand Child and Adolescent Report Card was compared to European scoring. Policy priorities are identified by domains where mortality makes up a high proportion of overall child unintentional injury mortality (high burden of injury) and where report card score for that domain is low in comparison to other countries (under‐utilisation of effective interventions). Results: Death as a motor vehicle occupant accounts for 49% of all child unintentional injury deaths, followed by pedestrian (10%) and drowning deaths (8%). The overall score for the 12 policy domains of the NZ Report Card ranks NZ as 15^th among the 25 European countries. There are important policy and legislative actions which NZ has not implemented. Conclusions: A number of evidence‐based injury prevention policy and legislative actions are available that could target areas of greatest childhood injury mortality in NZ. Implications: A set of injury prevention policy and legislation priorities are presented which, if implemented, would result in a significant reduction in the injury mortality and morbidity rates of NZ children.     

The Role of Adult Perceptions and Supervision Behavior in Preventing Child Injury

Supervision is an important factor in reducing injury risk. There are multiple factors that can affect the appropriate level of supervision including risk perception, anticipation of injury, and distracted behaviors. This study examined the perceived risks of child injury among parents and child caregivers and their supervision behavior among adults in an urban playground. Participant data from 25 individuals were collected through observations and anonymous self-reported surveys. More than half of the participants indicated practice of appropriate supervisory behavior, including attentiveness to their child’s behavior and proximity to their child during play. Caregivers were more likely to report more careful levels of supervision. One-fourth of participants reported a change in the supervisory behavior during periods of distraction, specifically with phone use. Of the variables tested, there was a significant association between the variable ‘talking to other adults’ during supervision and ‘prior injury’ (P value?=?0.04, 95% CI 0.03–0.91). Parents were more likely to report that they would leave their child unattended if they believed that the playground was a safe environment for play. There was a difference between self-reported behaviors and actual observed behavior, which is likely due to varying perspectives regarding child safety and injury prevention. In regards to injury risk, findings highlight the important role of appropriate supervisory behaviors and risk perceptions in preventing child injuries.     

深圳市横岗镇0～14岁儿童伤害状况分析

目的了解深圳市龙岗区横岗镇0～14岁伤害儿童的性别、年龄、受伤部位、伤害类型等流行特征;评价伤害造成儿童的健康损失及经济损失.方法采用整群抽样的方法,以横岗镇4个社区为研究社区,调查了897名0～14岁儿童2002年的伤害状况.结果深圳市龙岗区横岗镇0～14岁儿童非致命性伤害的年发生率为8.36%,男女比例为2.131;男童伤害发生率明显高于女童(P＜0.05).伤害类型前5位依次为意外跌落(52.50%)、机械伤(12.50%)、宠物咬伤(11.25%)、烧烫伤(8.75%)和中毒(6.25%).伤害损伤部位以四肢最常见,占53.33%,其次是头部和躯干部,分别占37.33%和9.33%.伤害医疗费用支出人均332.8元.结论应高度重视儿童伤害造成的损失,开展伤害干预控制研究,减少儿童伤害的发生.     

News Reports and Their Role in Child Agricultural Injury Prevention

Objectives: The news media can be important sources of health information. News reports of child agricultural injuries were examined to assess what was reported and to evaluate potential implications for health communication and surveillance efforts. Methods: A content analysis was conducted of a convenience sample of 113 US news reports from 2012 to 2014 involving agricultural injuries to children less than 18 years of age. The data collection instrument included basic elements of injury surveillance, as well as variables related to injury causation and prevention. Results: Law enforcement personnel were the main source of information on the injury event (79%). Severity, age, sex, injury mechanism, and source were reported more than 90% of the time. However, few news reports mentioned use or lack of protective equipment (12%) or a prevention message (6%). Recommended prevention messages from the research team included keeping young children out of the farm worksite (38%) and following guidelines for age-appropriate work and recreational activities (31%). Conclusions: This study shows that news reports provide a valuable and relatively inexpensive addition to other childhood agricultural injury data sources. They highlight current serious events and have potential to be an effective communication tool with respect to education, prevention, and framing the public’s perception of injury risk. An important next step may be to partner with law enforcement to develop three to five prevention messages that can be shared with reporters to educate readers on risks and steps that can be taken to prevent similar injuries on farms and ranches.     

Maternal Self-Assessed Health and Emotionality Predict Maternal Response to Child Illness

This study examined relations between mothers' neuroticism, depression, and self-assessed health and both behavioral and emotional responses to child illness. Individual difference measures (neuroticism, depression, and health) were completed by 98 mothers who also indicated their responses to hypothetical child illness scenarios. In addition, mothers rated their children's health. Findings indicated that mothers with poorer self-assessed health responded to the vignettes with more negative emotions, reported more extensive caretaking behaviors, tolerated more extreme sick-role behaviors from the child, and rated their child's overall health more poorly. Maternal depression was related to the report of more negative emotions and more extensive caretaking behaviors. Maternal neuroticism was related only to negative affect in response to the vignettes. Findings suggest that mothers' self-assessed health and depressive symptoms may influence their role as caretakers of their children's health and may be important variables in understanding the development of health cognition and behavior in children.     

新生儿乙型肝炎疫苗首针及时接种的Logistic回归分析

目的分析新生儿出生后24h内乙型肝炎疫苗（Hepatitis B Vaccine,HepB）首针（HepB1）及时接种的影响因素,为提高HepB1及时接种率提供依据。方法以调查地类型、住院分娩、监护人职业、文化程度、民族、是否知道接种疫苗、是否主动带孩子接种疫苗等指标建立Logistic回归方程,分析影响HepB1及时接种的因素。结果852名调查儿童中,HepB1及时接种234名,及时接种率27．46％。其中在县级及以上医院出生的儿童HepB1及时接种率54．05％,在乡级卫生院出生的儿童HepB1及时接种率46．86％,在家中出生的儿童HepB1及时接种率6．71％。多因素分析显示,住院分娩、儿童监护人的文化程度是影响HepB1及时接种的因素,调查地类型、监护人职业、民族、是否知道接种疫苗、是否主动带孩子接种疫苗等虽与HepB1及时接种有关联,但并不是影响因素。结论提高住院分娩率,加大素质教育的投入,是提高HepB1及时接种率的主要措施。     

Caregiver Reports of Serious Injuries in Children Who Remain at Home After a Child Protective Services Investigation

The study objectives were to examine serious injuries requiring medical attention among children who remain at home after a child welfare/child protective services (CPS) maltreatment investigation in the US and to determine whether child/caregiver characteristics and ongoing CPS involvement are related to injuries requiring medical attention. Using the National Survey of Child and Adolescent Well-being, we analyzed data on the subsample of children who remained at home (N = 3,440). A multivariate logistic regression model included child characteristics, chronic illness and disability in the child, level of CPS involvement, subsequent foster care placement, caregiver characteristics, and caregiver/family psychological variables. Injuries requiring medical attention were identified in 10.6% of the in-home population over a15-month period, with no differences in rates by age. Children with a chronic medical condition (OR = 2.07; 95% CI, 1.20–3.58) and children with depressed caregivers (OR = 2.28; 95% CI, 1.45–3.58) were more likely to have an injury that required medical care. Older caregivers (>54 years) were less likely (OR = 0.15; 95% CI, 0.03–0.69) to have a child with an injury requiring care. Injuries were not related to further involvement with CPS after the initial maltreatment investigation. Children with chronic medical conditions who remained in their biological homes or whose caregivers were depressed were likely to experience an injury requiring medical attention. Older caregivers were less likely to report a child injury. Extending existing health policies for foster children to children who remain at home following referral to CPS may encourage more comprehensive injury prevention for this population.