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父母管教方式與農(nóng)村青少年自殺行為關(guān)系研究

發(fā)布時(shí)間:2018-05-12 00:03

  本文選題:青少年 + 自殺; 參考:《山東大學(xué)》2017年碩士論文


【摘要】:1.研究背景自殺是日益受到關(guān)注的公共衛(wèi)生問題之一。全球的自殺率是11.4/10萬(wàn),是15-29年輕人群的第二死亡原因,中國(guó)的自殺人數(shù)約占世界的22%。根據(jù)我國(guó)的實(shí)際情況,自殺行為可分為自殺死亡、自殺未遂、自殺準(zhǔn)備、自殺計(jì)劃、自殺意念。青少年的自殺行為引起了廣泛關(guān)注,雖然在10-14歲青少年中發(fā)生自殺死亡較為少見,但是自殺行為發(fā)生的頻率在青少年階段顯著增長(zhǎng),且青少年自殺意念、自殺計(jì)劃和自殺未遂是自殺死亡的危險(xiǎn)因素。不同國(guó)家中青少年的自殺率變化和自殺方式都存在各自的特點(diǎn)。早期識(shí)別和篩查青少年自殺危險(xiǎn)因素對(duì)預(yù)防青少年發(fā)生嚴(yán)重的自殺行為至關(guān)重要。目前對(duì)青少年自殺行為的相關(guān)因素調(diào)查大多來(lái)自于使用問卷的現(xiàn)況調(diào)查以及以醫(yī)院為基礎(chǔ)的隨訪調(diào)查。青少年自殺行為發(fā)生率存在性別、年齡上的差異,青少年自殺行為可能與精神障礙、情緒問題以及危害健康的行為相關(guān)。父母管教方式是指父母在教養(yǎng)孩子的過(guò)程中對(duì)待孩子的固有行為模式和行為傾向,有許多家長(zhǎng)都采取了嚴(yán)格的紀(jì)律對(duì)孩子進(jìn)行懲戒教育。父母管教方式的選擇可能和父母以及孩子自身都存在關(guān)系,且父母嚴(yán)厲管教方式與孩子的心理健康和情緒問題相關(guān)。目前我國(guó)關(guān)于父母管教方式對(duì)孩子自殺行為的研究較少,尤其是缺乏基V較大樣本量對(duì)這一關(guān)系進(jìn)行分析。本研究利用山東省農(nóng)村地區(qū)八所學(xué)校獲得的調(diào)查資料進(jìn)行分析,將對(duì)青少年自殺行為預(yù)防措施提供一定的科學(xué)依據(jù)。2.研究目的2.1探究青少年父母管教方式的特點(diǎn)以及對(duì)父母管教方式量表進(jìn)行信效度評(píng)價(jià);2.2探究農(nóng)村青少年自殺行為的人口學(xué)特征和心理學(xué)特征;2.3分別探究父親和母親管教方式對(duì)青少年自殺行為的影響。3.研究方法3.1研究對(duì)象本研究于2015年11-12月在山東省鄒城市、陽(yáng)谷縣和利津縣開展。每個(gè)縣(市)選取兩到三所學(xué)校進(jìn)行調(diào)查。最終這三個(gè)地區(qū)共調(diào)查了八所中學(xué),包括了五所初中和三所高中,調(diào)查對(duì)象來(lái)自這八所高中的初一至高二的在校學(xué)生。五所初中的所有初一學(xué)生以及三所高中的所有高一學(xué)生均接受調(diào)查,初二、初三、高二的學(xué)生則以班級(jí)為單位進(jìn)行整群隨機(jī)抽樣。目標(biāo)班級(jí)中的所有學(xué)生都接受調(diào)查。在調(diào)查開始之前,取得了學(xué)校相關(guān)人員和目標(biāo)班級(jí)學(xué)生的知情同意。3.2研究方法本研究使用青少年健康與行為問卷收集資料,采取了問卷自填的方式進(jìn)行調(diào)查。學(xué)生在開始回答問卷前,接受過(guò)問卷使用培訓(xùn)且具有公共衛(wèi)生背景的工作者會(huì)使用統(tǒng)一的引導(dǎo)語(yǔ),告知被調(diào)查者需要認(rèn)真閱讀問卷開頭的引導(dǎo)語(yǔ)并說(shuō)明這是一個(gè)匿名調(diào)查,以保證問卷回答的準(zhǔn)確性。問卷調(diào)查在常規(guī)上課時(shí)間進(jìn)行,完成問卷平均需要四十五分鐘。本研究取得山東大學(xué)公共衛(wèi)生學(xué)院倫理委員會(huì)和目標(biāo)學(xué)校相關(guān)人員的同意。陽(yáng)谷縣調(diào)查結(jié)束兩周后,分別在陽(yáng)谷縣初一、初二、高一、高二每個(gè)年級(jí)隨機(jī)抽取兩個(gè)班進(jìn)行重測(cè)調(diào)查,最后共有8個(gè)班進(jìn)行重測(cè),納入統(tǒng)計(jì)分析的共有490人。研究?jī)?nèi)容:青少年健康與行為問卷共包括七個(gè)部分,分別是一般健康狀況、青春期發(fā)育狀況、日;顒(dòng)和健康行為、性格和情緒、社會(huì)支持和家庭狀況、生活應(yīng)激事件、社區(qū)環(huán)境。本次分析中包括了基本信息(性別、出生年月、家庭經(jīng)濟(jì)狀況、父母親的教育水平、吸煙、飲酒情況)、心理狀況(絕望、情緒和行為問題)、自殺行為(自殺意念、自殺計(jì)劃和自殺未遂)以及父母嚴(yán)厲管教方式。3.3統(tǒng)計(jì)分析使用SPSS 18.0和AMOS 17.0軟件進(jìn)行統(tǒng)計(jì)分析。單因素比較分析使用分類變量采用t檢驗(yàn)、檢驗(yàn)或者Fisher精確概率法;采用Logistic回歸進(jìn)行單因素以及多因素分析,并使用結(jié)構(gòu)方程模型分析父母嚴(yán)厲管教方式與自殺行為之間的關(guān)系。4.研究結(jié)果4.1調(diào)查對(duì)象基本情況目標(biāo)班級(jí)中的調(diào)查人數(shù)為12301,最終共有11836個(gè)學(xué)生參與了調(diào)查,應(yīng)答率為96.22%。11836份問卷中其中5份為空白問卷,最終有11831份問卷納入統(tǒng)計(jì)分析,其中男性共6018(50.9%)。調(diào)查對(duì)象的平均年齡為14.97± 1.46。父親和母親的教育水平多集中在初中,比例分別是54.4%和46.9%,但是母親在小學(xué)或以下教育水平的比例要高于父親,而父親高中及以上學(xué)歷的比例要高于母親。大部分孩子的自我評(píng)定的家庭經(jīng)濟(jì)情況都處于一般(68.5%)。4.2父母管教方式量表信效度評(píng)價(jià)分別對(duì)父親和母親管教方式量表進(jìn)行探索性因子分析。探索性因子分析采用主成分法,以特征值1進(jìn)行因子提取,兩個(gè)量表都提取了 5個(gè)公因子,分別是體罰、敵意、缺乏照料、專制、忽略。分別對(duì)父親和母親管教方式量表進(jìn)行驗(yàn)證性因子分析。父親和母親管教方式量表的驗(yàn)證性因子分析模型中,擬合優(yōu)度指數(shù)(GFI)、調(diào)整的擬合優(yōu)度指數(shù)(AGFI)、規(guī)范擬合指數(shù)(NFI)、不規(guī)范擬合指數(shù)(NNFI)、比較擬合指數(shù)(CFI)、增值擬合指數(shù)(IFI)均在0.9以上,RMSEA在父親管教方式量表中是0.060,在母親中是0.066。分別對(duì)父親和母親管教方式進(jìn)行調(diào)查的管教方式量表進(jìn)行信度檢驗(yàn)。父親管教方式量表的Cronbach's α系數(shù)是0.847,分半信度系數(shù)是0.683,重測(cè)信度系數(shù)是0.652。母親管教方式Cronbach's α系數(shù)的是0.845,分半相關(guān)系數(shù)是0.704,重測(cè)信度為0.637。4.3青少年自殺行為情況報(bào)告終生曾有自殺意念的學(xué)生數(shù)有2400(20.3%),自殺計(jì)劃者1131(9.6%),自殺未遂者461(3.9%)人。青少年自殺意念、自殺計(jì)劃、自殺未遂中,女性報(bào)告率均高于男性,16歲年齡組的自殺意念報(bào)告率最高(25.2%),17歲年齡組的自殺計(jì)劃報(bào)告率最高(11.7%),15歲年齡組的自殺未遂報(bào)告率最高(4.7%)。情緒與行為問題得分最高組的報(bào)告率均高于其他組,絕望得分越高報(bào)告率越大,吸煙、飲酒的報(bào)告率高,且都具有統(tǒng)計(jì)學(xué)意義(P0.05)。單因素logistic回歸發(fā)現(xiàn),女性(OR=1.43,95%CI:1.31-1.57)、年齡大于等于15歲(OR=3.30,95%CI:2.41-4.53)、吸煙(OR=2.42,95%CI:2.19-2.67)、飲酒(OR=2.43,95%CI:2.22-2.67)、內(nèi)向性問題(OR=7.69,95%CI:6.82-8.67)、外向性問題(OR=6.23,95%CI:5.53-7.02)、絕望(OR=2.61,95%CI:2.33-2.91)是自殺意念的危險(xiǎn)因素;女性(OR=1.22,95%CI:1.08-1.38)、年齡大于等于15歲(OR=2.21,95%CI:1.49-3.27)、吸煙(OR=2.63,95%CI:2.31-2.99)、飲酒(OR=2.39,95%CI:.11-2.71)、內(nèi)向性問題(OR=7.18,95%CI:6.08-8.48)、外向性問題(OR=6.86,95%CI:5.81-8.11)、絕望(OR=3.19,95%CI:2.75-3.71)是自殺計(jì)劃的危險(xiǎn)因素;女性(OR=1.34,95%CI:1.11-1.62)、年齡大于等于15歲(OR=2.38,95%CI:1.28-4.45)、吸煙((OR=2.87,95%CI:2.37-3.47)、飲酒(OR=2.70,95%CI:2.23-3.27)、內(nèi)向性問題(OR=6.81,95%CI:5.29-8.75)、外向性問題(OR=6.48,95%CI:5.04-8.33)、絕望(OR=3.04,95%CI:2.41-3.82)是自殺未遂的危險(xiǎn)因素。4.4中國(guó)父母管教方式情況父親管教方式量表總得分為32.13±8.82,母親管教方式量表總得分為31.75±8.73。除了母親對(duì)孩子的缺乏管教不具有男女差異外,其他維度以及總分在兩個(gè)量表中均具有統(tǒng)計(jì)學(xué)意義(P0.05),男孩各個(gè)分量表得分以及總分均高于女孩。4.5父母管教方式與自殺行為關(guān)系多因素分析發(fā)現(xiàn),父親嚴(yán)重嚴(yán)厲管教方式與自殺意念(OR=1.57,95%CI:1.39-1.78)、自殺計(jì)劃(OR=2.00,95%CI:1.70-2.35)和自殺未遂(OR=2.23,95%CI:1.74-2.86)相關(guān);母親中等(OR=1.15,95%CI:1.02-1.30)、嚴(yán)重嚴(yán)厲管教方式(OR=1.16,95%CI:1.43-1.86)與自殺意念相關(guān),母親嚴(yán)重嚴(yán)厲管教方式與自殺計(jì)劃(OR=1.97,95%CI:1.67-2.33)、自殺未遂(OR=1.95,95%CI:1.51-2.50)相關(guān)。父母管教方式與自殺行為的結(jié)構(gòu)方程模型中發(fā)現(xiàn),(1)父母管教方式直接對(duì)自殺行為起作用;(2)行為和情緒問題在父母管教方式對(duì)自殺行為影響中起調(diào)節(jié)作用,父母嚴(yán)厲管教方式會(huì)增加發(fā)生行為和情緒問題,情緒和行為問題會(huì)直接對(duì)自殺行為發(fā)生作用,也會(huì)通過(guò)物質(zhì)濫用間接對(duì)自殺行為發(fā)揮作用;(3)物質(zhì)濫用受到父母管教方式以及情緒和行為問題影響,直接對(duì)自殺行為起作用。5.結(jié)論和建議5.1研究結(jié)論(1)父母嚴(yán)厲管教方式量表可分為體罰、敵意、缺乏照料、專制、忽略五個(gè)因子,總量表信效度較好。(2)相對(duì)于女孩,男孩更容易受到父母的嚴(yán)厲管教。父母各自的教育程度、家庭經(jīng)濟(jì)狀況不同,采用嚴(yán)厲管教方式總分存在差異。(3)青少年的自殺行為與性別、年齡、吸煙、飲酒、內(nèi)向性和外向性問題以及絕望相關(guān);父親嚴(yán)重嚴(yán)厲管教方式與自殺意念、自殺計(jì)劃和自殺未遂相關(guān);母親中等、嚴(yán)重嚴(yán)厲管教方式與自殺意念相關(guān),母親嚴(yán)重嚴(yán)厲管教方式與自殺計(jì)劃、自殺未遂相關(guān)。(4)父母嚴(yán)厲管教方式和青少年情緒和行為問題與物質(zhì)濫用成正相關(guān),嚴(yán)厲管教方式對(duì)青少年自殺行為起直接作用,也通過(guò)情緒和行為問題以及物質(zhì)濫用的中介效應(yīng)對(duì)自殺行為起作用。5.2預(yù)防建議(1)提高父母對(duì)管教方式的認(rèn)識(shí),避免采取體罰、口頭責(zé)備等嚴(yán)厲管教方式。(2)青春期的自殺行為應(yīng)當(dāng)受到重視,切實(shí)關(guān)注孩子的心理和情緒問題。(3)重視受到嚴(yán)重嚴(yán)厲管教方式孩子的精神和行為健康,對(duì)他們給與更多的關(guān)注和社會(huì)支持。
[Abstract]:1. research background suicide is one of the increasingly popular public health problems. The global suicide rate is 11.4/10 million, which is the second cause of death in 15-29 young people. The number of Chinese suicide accounts for about the world's 22%. according to the actual situation of our country, suicidal behavior can be divided into suicide death, suicide attempt, suicide preparation, suicidal plan, suicidal ideation. Suicide behavior in adolescents has aroused widespread concern, although suicide deaths in 10-14 year olds are rare, but the frequency of suicide is significantly increased in adolescents, and adolescents' suicidal ideation, suicide plans and attempted suicide are risk factors for suicide deaths. Early identification and screening of young suicide risk factors are essential to prevent young people from committing serious suicides. The current survey of adolescent suicides mostly comes from the current survey of using the questionnaire and the follow-up survey based on the hospital. There are gender, age differences, and teenage suicides may be related to mental disorders, emotional problems, and health hazards. Parental discipline means parents' behavior patterns and behavior tendencies to treat their children during the process of nurturing their children, and many parents have taken strict discipline to punish their children. Education. The choice of parental management may be related to both parents and children themselves, and the strict management of parents is related to the mental health and emotional problems of the children. At present, there is little research on the behavior of children's suicidal behavior by parental discipline in our country, especially the lack of basic V. Based on the investigation data obtained by eight schools in rural areas of Shandong Province, this paper provides a scientific basis for the prevention measures of adolescent suicidal behavior. 2.1 to explore the characteristics of the mode of parental management for young people and to evaluate the reliability and validity of the parental management style scale, and 2.2 to explore the suicidal behavior of rural adolescents. Oral and psychological characteristics; 2.3 the study of the influence of father and mother's management on adolescent suicidal behavior (.3. research method 3.1) was conducted in 11-12 months of 2015 in Zoucheng, Yanggu and Lijin, Shandong province. Each county (city) selected two to three schools to investigate. Finally, the three areas were investigated. Eight middle schools, including five junior high schools and three high schools, were investigated from the first first to senior two students in the eight high schools. All the junior middle school students in five junior middle schools and all the senior high school students in three high school were investigated. All the students received the investigation. Before the start of the investigation, the study method of informed consent.3.2 of the school related and target class students was obtained. The study used the questionnaire of adolescent health and behavior to collect data. Public health workers will use a unified guide to inform the respondents that the respondents need to read the beginning of the questionnaire carefully and show that this is an anonymous survey to ensure the accuracy of the questionnaire. The questionnaire survey was carried out in regular class time and the average of the completion of the questionnaire was forty-five minutes. This study obtained the public of Shandong University public. The ethics committee of the Institute of health and the relevant staff of the target school have agreed. After two weeks of the completion of the survey in Yanggu County, two classes were randomly selected for retest in the first, second, high, and second grades of Yanggu County, and 8 classes were retested in a total of 8 classes. The research content: adolescent health and behavior questions The volume consisted of seven parts: general health status, puberty development, daily activity and health behavior, personality and emotion, social support and family status, life stress events, and community environment. This analysis included basic information (sex, birth year, family economic condition, educational level of parents, smoking, drinking). Psychological status (despair, emotional and behavioral problems), suicidal behavior (suicidal ideation, suicide plan and suicide attempt) and.3.3 statistical analysis of parental strict control methods using SPSS 18 and AMOS 17 software for statistical analysis. Single factor comparative analysis used classified variables to use t test, test or Fisher precision probability method; use Logistic Single factor and multi factor analysis were carried out, and structural equation model was used to analyze the relationship between strict management of parents and suicidal behavior. Results 4.1 the total number of subjects in the basic target class was 12301, and 11836 students participated in the investigation, and the response rate was 5 of them. 4.1 For the blank questionnaire, 11831 questionnaires were finally included in the statistical analysis, among which men were 6018 (50.9%). The average age of the respondents was 14.97 + 1.46. and the education level of fathers and mothers was mostly concentrated in junior middle school. The proportion of the parents was 54.4% and 46.9% respectively, but the proportion of the mother at primary school or below was higher than that of the father, while the father was high school and above. The proportion of educational background is higher than that of the mother. Most of the children's self-assessment of family economic situation is in the general (68.5%).4.2 parents' management style scale. 5 common factors were extracted, which were corporal punishment, hostility, lack of care, despotism, neglect. The confirmatory factor analysis was carried out on the father and mother's management style scale respectively. In the confirmatory factor analysis model of father and mother's management style scale, the goodness of fit index (GFI), the adjusted goodness of fit index (AGFI), and the standard fitting index (NFI) were used. The non standard fitting index (NNFI), the comparison fitting index (CFI), the value added fitting index (IFI) were above 0.9, and the RMSEA was 0.060 in the father's management style scale. In the mother, the degree of trust was tested by 0.066. for the father and the mother's management mode respectively. The Cronbach's alpha coefficient of the father's management style scale was 0.847, The coefficient of split half reliability was 0.683. The retest reliability coefficient was 0.845 for 0.652. mother tube Cronbach's alpha coefficient and 0.704 in half correlation coefficient. The retest reliability was 2400 (20.3%), 1131 (9.6%) of suicide planners and 461 (3.9%) in suicide attempt. In the year of suicidal ideation, suicide plan and suicide attempt, the rate of female reporting was higher than that of men. The rate of suicidal ideation was the highest (25.2%) in the age group of 16 years (25.2%). The rate of suicidal planning was the highest (11.7%) in the age group of 17 years, and the highest rate of attempted suicide in the group of 15 years (4.7%). The reporting rate of the highest group of emotional and behavioral problems was higher than that of the other groups. The higher the reporting rate of despair, the higher the reporting rate, the high reporting rate of smoking, drinking, and statistically significant (P0.05). Single factor Logistic regression found that women (OR=1.43,95%CI:1.31-1.57), age greater than 15 years (OR=3.30,95%CI:2.41-4.53), smoking (OR=2.42,95%CI:2.19-2.67), drinking (OR=2.43,95%CI:2.22-2.67), introverted problems (OR=7.69,95) %CI:6.82-8.67), extroversion (OR=6.23,95%CI:5.53-7.02), OR=2.61,95%CI:2.33-2.91 is a risk factor for suicidal ideation; women (OR=1.22,95%CI:1.08-1.38), age greater than 15 years (OR=2.21,95%CI:1.49-3.27), smoking (OR=2.63,95%CI: 2.31-2.99), alcohol (OR=2.39,95%CI:.11-2.71), and introverted problems (OR=7.18,95%CI:6.08-8.) 48), extroversion (OR=6.86,95%CI:5.81-8.11), OR=3.19,95%CI:2.75-3.71 is a risk factor for suicidal plans; women (OR=1.34,95%CI:1.11-1.62), age greater than 15 years (OR=2.38,95%CI:1.28-4.45), smoking (OR=2.87,95%CI:2.37-3.47), drinking (OR=2.70,95%CI:2.23-3.27), introversion (OR=6.81,95%CI:5.29-8.75), and extroversion (OR=6.81,95%CI:5.29-8.75). OR=6.48,95%CI:5.04-8.33, OR=3.04,95%CI:2.41-3.82 is the risk factor for suicide attempt.4.4 Chinese parents' teaching method of parental discipline, the total score of the father management style scale is 32.13 + 8.82, the total score of the mother management style scale is 31.75 + 8.73. except that the mother's lack of control on the children does not have the difference between men and women, and other dimensions The degree and total score were statistically significant in the two scales (P0.05). The scores of each subscale and total score of boys were higher than that of the girls'.4.5 parental management and suicidal behavior. The father's severe severe discipline and suicide ideation (OR=1.57,95%CI: 1.39-1.78), suicide plan (OR=2.00,95%CI:1.70-2.35) and self OR=2.23,95%CI:1.74-2.86 related; mother medium (OR=1.15,95%CI:1.02-1.30), severe severe discipline (OR=1.16,95%CI:1.43-1.86) related to suicidal ideation. Mother's severe severe discipline was associated with suicide plan (OR=1.97,95%CI:1.67-2.33), suicide attempt (OR=1.95,95%CI:1.51-2.50). Parental discipline and suicide behavior In the structural equation model, it was found that (1) parental management played a direct role in suicidal behavior; (2) behavioral and emotional problems played a regulatory role in the effect of parental discipline on suicidal behavior, and parents' strict discipline would increase behavioral and emotional problems, emotional and behavioral problems would directly affect suicide and also pass through the action. Substance abuse exerts an indirect effect on suicidal behavior; (3) substance abuse is affected by parental discipline and emotional and behavioral problems, and it plays a direct role in suicidal behavior.5. conclusion and 5.1 research conclusions (1) parental strict management forms can be divided into corporal punishment, hostility, lack of care, autocracy, five factors, and total aggregate reliability and validity. (2) relative to girls, boys are more likely to be disciplined by their parents. Their parents' educational level, their family economic conditions, and the total score of strict management are different. (3) the suicide behavior of young people is related to sex, age, smoking, drinking, introversion and extroversion and despair. Suicidal ideation, suicide plan and suicide attempt; mother medium, severe severe discipline and suicidal ideation, mother's severe severe discipline and suicide plan, suicide attempt. (4) severe parental control and adolescent emotional and behavioral problems are positively related to substance abuse, and strict disciplining ways for adolescents to commit suicide In order to play a direct role, it also plays the role of.5.2 prevention for suicide by emotional and behavioral problems and the mediating effect of substance abuse (1) improving parents' understanding of the way of management, avoiding corporal punishment, oral reproach and other severe ways of management. (2) adolescent suicide should be paid attention to and pay attention to the psychology and emotion of the child. Problems: (3) attach importance to the mental and behavioral health of children who are severely disciplined, giving them more attention and social support.

【學(xué)位授予單位】:山東大學(xué)
【學(xué)位級(jí)別】:碩士
【學(xué)位授予年份】:2017
【分類號(hào)】:D669.9

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