背景:儿童和青少年的意外伤害是全球范围内的主要公共卫生问题。这些伤害不仅对儿童的生理和心理产生负面影响,也给家庭和社会带来巨大的经济损失和社会负担。意外伤害是中国青少年致残和死亡的主要原因,留守儿童(LBC)更容易遭受意外伤害。本研究的目的是通过比较LBC与非留守儿童(NLBC)的差异,评估中国儿童和青少年意外伤害的类型和发生率,并探讨个人和环境因素的影响。
方法:这项横断面研究于2019年1月和2月进行。此外,采用自填式问卷的形式,收集辽宁省10~19岁儿童青少年2786人,包括意外伤害调查,意外伤害感知问卷,青少年多维亚健康问卷(MSQA),负面生活事件,“我的班级”问卷和欺凌/受害者问卷。采用多因素logistic回归分析探讨儿童青少年意外伤害的相关因素。采用二元logistic回归分析探讨LBC与NLBC意外损伤的影响因素。
结果:意外伤害前三名为坠落伤(29.7%),在我们的研究人群中扭伤(27.2%)和烧伤和烫伤(20.3%)。LBC的意外伤害发生率高于NLBC。烧伤和烫伤,LBC的割伤和动物咬伤高于NLBC。结果表明,初中生(比值比(OR)=1.296,CI=1.066-1.574)比小学生更容易报告多次意外伤害。女孩(OR=1.252,CI=1.042-1.504)报告多次意外伤害的几率更高。非故意伤害感知水平低的儿童青少年多发伤的几率高于非故意伤害感知水平高的儿童青少年(OR=1.321,C=1.013~1.568)。心理健康症状水平较高的儿童和青少年(OR=1.442,CI=1.193-1.744)报告多次意外伤害的几率较高。与从未经历过负面生活事件的青少年相比,经历过多次负性生活事件(OR=2.724,CI=2.121~3.499)的青少年更有可能多次遭受意外伤害.低水平的纪律和秩序(OR=1.277,CI=1.036-1.574)报告多次意外伤害的几率更高。与未被欺负的同龄人相比,被欺负的在校青少年更有可能多次受伤(OR=2.340,CI=1.925-2.845)。低水平的意外伤害感知,经历过负面生活事件和欺凌对LBC的影响大于对NLBC的影响。
结论:调查发现,至少一次意外伤害的发生率为64.8%。学校层面,性别,意外伤害感知,亚健康,负面生活事件,纪律和秩序以及欺凌与意外伤害事件有关。与NLBC相比,LBC的意外伤害发生率较高,应该特别注意这个群体。
Unintentional injuries among children and adolescents are a major public health problem worldwide. These injuries not only have negative effects on children\'s physiology and psychology, but also bring huge economic losses and social burdens to families and society. Unintentional injuries are the leading cause of disability and death among Chinese adolescents, and left-behind children (LBC) are more prone to experience unintentional injury. The purpose of this study was to evaluate the type and incidence of unintentional injury among Chinese children and adolescents and explore the influences of personal and environmental factors by comparing the differences between LBC and not left-behind children (NLBC).
This cross-sectional study was conducted in January and February 2019. Additionally, 2786 children and adolescents from 10 to 19 years old in Liaoning Province in
China were collected in the form of self-filled questionnaires, including Unintentional Injury Investigation, Unintentional Injury Perception Questionnaire, Multidimensional Subhealth Questionnaire of Adolescent (MSQA), Negative life events, \"My Class\" questionnaire and Bullying/victim Questionnaire. Multiple logistic regression analysis was used to explore the factors associated with unintentional injury among children and adolescents. Binary logistic regression analysis was used to explore the factors affecting unintentional injuries between LBC and NLBC.
The top three unintentional injuries were falling injuries (29.7%), sprains (27.2%) and burns and scalds (20.3%) in our study population. The incidence of unintentional injuries in LBC was higher than that in NLBC. Burn and scalds, cutting injury and animal bites in LBC were higher than those in NLBC. The results show that junior high school students (odds ratio (OR) = 1.296, CI = 1.066-1.574) were more likely to report multiple unintentional injuries than primary school students. Girls (OR = 1.252, CI = 1.042-1.504) had higher odds of reporting multiple unintentional injuries. The odds of multiple injuries in children and adolescents with low levels of unintentional injury perception were higher than those in children and adolescents with high levels of unintentional injury perception (OR = 1.321, C = 1.013-1.568). Children and adolescents with a higher levels of mental health symptoms (OR = 1.442, CI = 1.193-1.744) had higher odds of reporting multiple unintentional injuries. Compared with teenagers who had never experienced negative life events, teenagers who had experienced negative life events many times (OR = 2.724, CI = 2.121-3.499) were more likely to suffer unintentional injuries many times. Low-level discipline and order (OR = 1.277, CI = 1.036-1.574) had higher odds of reporting multiple unintentional injuries. In-school adolescents who were bullied were more likely to report being injured multiple times than their counterparts who were not bullied (OR = 2.340, CI = 1.925-2.845). Low levels of unintentional injury perception, experienced negative life events and bullying had greater impacts on LBC than on NLBC.
The survey found that the incidence of at least one unintentional injury was 64.8%. School level, sex, unintentional injury perception, subhealth, negative life events, discipline and order and bullying were associated with incidents of unintentional injury. Compared with NLBC, LBC had a higher incidence of unintentional injury, and special attention should be given to this group.