本文關(guān)鍵詞：中國西部?jī)墒。ㄊ校q兒童受忽視現(xiàn)狀及影響因素研究，由筆耕文化傳播整理發(fā)布。

        目的:為了解西部?jī)墒。ㄊ校┺r(nóng)村0-6歲兒童、城市6-17歲中小學(xué)生受忽視現(xiàn)狀，找出其受忽視的影響因素，為有針對(duì)性地制定改善兒童忽視的工作措施提供科學(xué)依據(jù)。方法：1.對(duì)象的選擇：（1）農(nóng)村0-6歲兒童忽視現(xiàn)況調(diào)查：采用多階段分層整群隨機(jī)抽樣的方法，先在西部地區(qū)陜西省和重慶市中分別隨機(jī)抽取3個(gè)市（區(qū)），然后分別從每個(gè)市（區(qū)）抽取經(jīng)濟(jì)文化水平高、中、低各一個(gè)農(nóng)村鄉(xiāng)/鎮(zhèn)，每個(gè)鄉(xiāng)/鎮(zhèn)隨機(jī)抽取一個(gè)村，村中0-6歲每個(gè)年齡段隨機(jī)調(diào)查10名健康兒童，男、女各半。（2）城市6-17歲中小學(xué)生忽視現(xiàn)況調(diào)查：采用多階段分層整群隨機(jī)抽樣方法，先在西部地區(qū)陜西省和重慶市中分別隨機(jī)抽取經(jīng)濟(jì)、文化水平中等的2個(gè)市（區(qū)），，每個(gè)市（區(qū)）隨機(jī)抽取城市小學(xué)、中學(xué)（包括初中部和高中部）各1所，每所學(xué)校內(nèi)每個(gè)年級(jí)（小學(xué)1～6年級(jí)、初中1～3年級(jí)、高中1～2年級(jí)）中各抽1個(gè)班級(jí)，班級(jí)內(nèi)所有符合調(diào)查條件的學(xué)生全部作為調(diào)查對(duì)象。2．調(diào)查方法：自制調(diào)查問卷，0-6歲農(nóng)村兒童、6-8歲小學(xué)生由其監(jiān)護(hù)人填寫，9-17歲中小學(xué)生有調(diào)查對(duì)象本人填寫，于2010年12月-2011年3月期間對(duì)我國西部陜西省和重慶市農(nóng)村0-6歲兒童、2008年11-12月期間對(duì)兩�。ㄊ校┏鞘�6-17歲中小學(xué)生一般人口信息、受忽視現(xiàn)狀及其影響因素進(jìn)行調(diào)查。3.計(jì)分和評(píng)價(jià)方法：兒童忽視調(diào)查問卷評(píng)價(jià)量表包含兒童身體、情感、教育、安全、醫(yī)療、社會(huì)6個(gè)層面的測(cè)查題，正向計(jì)分題對(duì)每個(gè)備選答案分別賦1、2、3、4分，題前字母編碼尾字母帶“R”的反向計(jì)分題對(duì)每個(gè)備選答案分別賦分4、3、2、1分。根據(jù)調(diào)查對(duì)象的填答情況，計(jì)算出調(diào)查對(duì)象的忽視總分和6個(gè)忽視層面忽視得分。調(diào)查對(duì)象在任一層面上的得分超過該層面規(guī)定的界值點(diǎn)，即被認(rèn)定在該層面上受到了忽視；調(diào)查對(duì)象在任一層面受到了忽視，都最終被認(rèn)定為受到了忽視（總忽視）。兒童受忽視情況由忽視率和忽視度來反映，受到忽視的兒童數(shù)與調(diào)查兒童數(shù)的比值為忽視率，忽視率反映兒童受忽視的頻率；調(diào)查對(duì)象忽視分值與忽視滿分值的比值為忽視度，忽視度反映兒童受忽視的強(qiáng)度。結(jié)果：1.農(nóng)村0-6歲兒童調(diào)查結(jié)果：（1）共調(diào)查1488名兒童，農(nóng)村0-6歲兒童總忽視率和總忽視度分別為31.59%和48.32；男、女兒童總忽視率分別為32.63%和30.38%，組間差異無統(tǒng)計(jì)學(xué)意義（χ2=0.86,P>0.05），男、女兒童總忽視度分別為48.56和48.05，組間差異亦無統(tǒng)計(jì)學(xué)意義（U=1.51,P>0.05）；0-2歲組、3-6歲組兒童總忽視率分別為30.25%和32.75%，組間差異無統(tǒng)計(jì)學(xué)意義（χ2=1.07,P>0.05），兩年齡組總忽視度分別為47.36和49.16，組間差異有統(tǒng)計(jì)學(xué)意義（U=-5.33，P<0.001）；三代同堂家庭和核心家庭兒童總忽視率、總忽視度均低于單親家庭和再婚家庭兒童（χ2=10.03，F(xiàn)=2.83,P<0.05）；留守兒童總忽視率和總忽視度均高于非留守兒童（χ2=30.30，U=6.76,P<0.05）；陜西省兒童總忽視率和總忽視度均低于重慶市兒童（χ2=9.42，U=8.40,P<0.05）。（2）重慶市男、女兒童忽視率組間差異無統(tǒng)計(jì)學(xué)意義(χ2=2.22,P>0.05),但男童忽視度高于女童（U=2.34,P<0.05），重慶市0-2歲組、3-6歲組兒童忽視率和忽視度組間差異均無統(tǒng)計(jì)學(xué)意義（χ2=2.10,U=-0.56,P>0.05），重慶市不同家庭類型忽視率和忽視度組間差異均無統(tǒng)計(jì)學(xué)意義（χ2=2.22,F=1.09,P>0.05）；留守兒童忽視率和忽視度均高于非留守兒童（χ2=12.34，U=-5.12,P<0.01）。（3）陜西省男、女兒童忽視率和忽視度組間差異均無統(tǒng)計(jì)學(xué)意義(χ2=0.04, U=0.04,P>0.05),陜西省0-2歲組兒童忽視率高于3-6歲組兒童（χ2=5.15，P<0.05），忽視度低于3-6歲組兒童（U=-4.81, P<0.001），陜西省不同家庭類型兒童忽視率和忽視度組間差異均有統(tǒng)計(jì)學(xué)意義（χ2=11.70，F(xiàn)=5.64, P<0.05），陜西省留守兒童忽視率和忽視度均高于非留守兒童（χ2=17.10，F(xiàn)=-3.92,P<0.05）。多因素非條件logistic回歸分析結(jié)果顯示：留守兒童（OR=1.54；95%CI，1.20-1.97）、單親或再婚家庭（OR=1.38；95%CI，1.16-1.65）、父親職業(yè)為外出務(wù)工或在家務(wù)農(nóng)（OR=0.87；95%CI，0.78-0.97）、母親的文化程度較低（OR=1.27；95%CI，1.07-1.52）、冷淡疏遠(yuǎn)的父子關(guān)系（OR=1.43；95%CI，1.07-1.91）等5個(gè)因素是我國西部?jī)墒。ㄊ校┺r(nóng)村0-6歲兒童忽視率升高的主要影響因素。2.城市6-17歲中小學(xué)調(diào)查結(jié)果：共調(diào)查1604名中小學(xué)生，城市中小學(xué)生忽視率和忽視度分別為30.30%和（45.27±8.71）；男、女生忽視率分別為34.88%、25.23%，男生忽視率高于女生（χ2=17.62，P<0.001）,男、女生忽視度分別為（46.50±8.79）、（43.92±8.42），男生忽視度高于女生（U=5.99, P<0.001）；6～8、9～11、12～17歲城市中小學(xué)生忽視率分別為30.69%、28.74%、31.71%，組間差異無統(tǒng)計(jì)學(xué)意義（χ2=1.41，P>0.05）,忽視度分別為（43.34±6.86）、（42.90±8.42）、（48.49±8.69），組間差異有統(tǒng)計(jì)學(xué)意義（F=84.49，P<0.001），12～17歲中學(xué)生忽視度最高；三代同堂家庭和核心家庭子女忽視率和忽視度均低于單親家庭和再婚家庭子女（χ2=9.44，F(xiàn)=4.53, P<0.05）；獨(dú)生子女忽視率和忽視度均低于非獨(dú)生子女（χ2=11.27，U=-6.38,P<0.05）。多因素非條件logistic回歸分析結(jié)果顯示：男生（OR=0.63；95%CI，0.50-0.79）、低年齡組小學(xué)生（OR=0.84；95%CI，0.72-0.98）、居住在省會(huì)或直轄市（OR=0.79；95%CI，0.63-0.98）、父親文化程度較低（OR=1.40；95%CI，1.25-1.56）、與父母關(guān)系不好或一般（OR=2.89；95%CI，2.27-3.67）等5個(gè)因素是我國西部?jī)墒。ㄊ校┏鞘兄行W(xué)生忽視率升高的主要影響因素。結(jié)論：1.中國西部陜西、重慶兩�。ㄊ校┺r(nóng)村0-6歲兒童忽視率低于同期全國農(nóng)村0-6歲兒童受忽視水平，但忽視度高于全國農(nóng)村0-6歲兒童受忽視水平，影響忽視率升高的主要因素是留守兒童、單親或再婚家庭、父親職業(yè)為外出務(wù)工或在家務(wù)農(nóng)、母親的文化程度較低、冷淡疏遠(yuǎn)的父子關(guān)系。2.中國西部陜西、重慶兩�。ㄊ校┏鞘�6-17歲中小學(xué)生受忽視程度較嚴(yán)重，6-8歲和9-11歲小學(xué)生、12～17歲中學(xué)生受忽視頻率和強(qiáng)度均高于同期全國城市6-17歲中小學(xué)生受忽視水平，影響忽視率升高的主要因素是男生、低年齡組小學(xué)生、居住在省會(huì)或直轄市、父親文化程度較低、與父母關(guān)系不好或一般。

    Objective To learn the current neglected situation and impact factors ofchildren aged0-17years old in two provinces in western China; findimpact factors and provide scientific evidences for effective interventions.Methods The participants of this study:(1) The investigation of ruralchildren aged0-6years old was conducted by using multistage stratifiedcluster sampling method. Three cities or districts were randomly chosenfrom Chongqing and Shanxi province, and the countries or towns werechosen by the three levels (set as high, middle and low) of economy andculture. One village was included in the present study from each country ortown respectively, and5boys and5girls of every range, from0to6yearsold,60in total, were randomly chosen from each village.(2) Theinvestigation of urban children aged from6to17years old was conductedby using multistage stratified cluster sampling method. Two cities ordistricts were randomly chosen from Chongqing and Shanxi province bythe level of economy and culture. One primary school and one seniormiddle school (included both senior and junior) were chosen in each city ordistrict. In each school, one class was randomly chose from every grade (primary school: from one to six grade; junior middle school: from one tothree grade; senior high school: from one to three grade), and the allstudents in that class were participated in this study.The method of investigation: the rural participants aged from0-6andthe primary students aged from6to8, the questionnaire was filled by theirguardian; and the participants aged from9-17, the questionnaire wasanswered by themselves. The investigation of rural children in theChongqing and Shanxi province was conducted during Dec2010to Mar2011, and the investigation of primary and high school students was takenduring Nov2008to Dec2008.The standard and the method of evaluation: the scale of questionaireabout neglected children contains the question of the child’s physical,emotional, education, security, medical and social aspects.For each alternative answers, forward questions was set the score of1,2,3and4, respectively. The reverse question before the letter coding andend the letter with "R" was set as the score of4,3,2and1respectively, foreach alternative answers. According to the survey, we calculate the totalscore of neglected and six level of score of neglected. Once survey in anylayer of the surface of the score exceed the level prescribed cutoff point, weshould identify that it is the neglected level; and the survey at any one levelhas been neglected, then that will be eventually identified as being ignored,the total neglect. The neglected situation of children was determined by the neglect rate and degree of neglect; the neglect rate was calculated by thenumber of neglected children and the number of children who recruited; theneglect rate reflected the frequency of children being neglected, the degreeof neglect was calculated by the neglected score of children and the totalscore of neglected; the degree of neglect reflected the degree of childrenneglected.Results:(1) The results of the rural children investigation:①1488subjects, aged from0to6, were recruited in the present study. Resultsshowed that the total prevalence of neglected rural children were31.59%,48.32%respectively. No significant was found on the prevalence ofneglected for boys (32.63%) and girls (30.38%)(χ2=0.86, U=1.51, P>0.05).The total neglected rate of children aged0-2and3-6years old was30.25%and32.75%respectively. The degree of neglected was47.36and49.16,and showed no significant difference as well (U=-5.33, P<0.05). The totalneglected rate and the degree of neglected in Shanxi province were lowerthan that of Chongqing (χ2=9.42, U=8.40, P<0.05). Total neglected rate anddegree of neglected in three generations and the core families were lowerthan that of single and remarried families (χ2=10.03, F=2.83, P<0.05).Further, the total neglected rate and the degree of neglected in left-behindchildren was higher than that of non left-behind children.(2) There was nosignificant difference at the rate of neglected between boys and girls(χ2=2.22, P>0.05). However, the degree of neglected of boys was higher than that of girls in Chongqing (U=2.34, P<0.05). The neglected rate anddegree of0-2and3-6years old children showed no significant difference(χ2=2.10, U=-0.56, P>0.05). There were no significant difference amongdifferent type of families on the rate and degree of neglected (χ2=2.22,F=1.09, P>0.05). The neglected rate and degree of left behind childrenwere higher than that of non-left behind children (χ2=12.34, U=-5.12,P<0.01).(3) There was no significant difference at the rate and degree ofneglected between boys and girls (χ2=0.04, U=0.04, P>0.05). However, therate of neglected of children aged from0-2was higher than that of childrenaged from3-6in Shanxi province (χ2=5.15, P<0.05), and the degree ofneglected of children aged from0-2was lower than that of children agedfrom3-6(U=-4.81, P<0.001). There were significant among different typeof families on the neglected rate and degree (χ2=17.10, F=-3.92, P<0.05),and the neglected rate and degree of left behind children were all higherthan that of non-left behind children (χ2=11.70, F=5.64, P<0.05).Based on multivariate non-conditional logistic regression analysis, thedeterminants of stunting among the strand children were: left-behind(OR=1.54;95%CI,1.20-1.97); the style of family(OR=1.38;95%CI,1.16-1.65); father’s occupation (OR=0.87;95%CI,0.78-0.97); the educationof children’s mother (OR=1.27;95%CI,1.07-1.52); relationship betweenchildren and their fathers (OR=1.43;95%CI,1.07-1.91).(2) The results of the rural children investigation:1604subjects, aged from6to17, were recruited in the present study. Results showed that thetotal prevalence of neglected primary and secondary school students were30.30%, and the total neglected degrees were45.27±8.71; also, theprevalence of neglected of boys and girls were34.88%and25.23%respectively (χ2=17.62, P<0.001), and the neglected rate of boys werehigher than that of girls (χ2=17.62, P<0.001). The neglected degrees were46.50±8.79and43.92±8.42, and the neglected degree of boys were higherthan that of girls (U=5.99, P<0.001). The prevalence of neglected on6-8,9-11and12-17years age groups were30.69%,28.74%,31.71%(χ2=1.41,P>0.05) respectively, and the neglected degrees were43.34±6.86,42.90±8.42,48.49±8.69(F=84.49, P<0.001) respectively. Our datademonstrated the neglected degrees in12-17years age group were highest;further, both the prevalence and degree of neglected in three generationsfamilies were lowest, however, they were highest in single-parent families(χ2=9.44, F=4.53, P<0.05); the one child families were significantly lowerthan non-one child families both in the prevalence and degree of neglected(χ2=11.27, U=-6.38, P<0.05).Based on multivariate non-conditional logistic regression analysis, thedeterminants of stunting among the children were: boys (OR=0.63;95%CI,0.50-0.79); young primary students’ group (OR=0.84;95%CI,0.72-0.98);living in the capital cities or municipalities (OR=0.79;95%CI,0.63-0.98);the low education of children’s father (OR=1.40;95%CI,1.25-1.56); relationship between children and their parents (OR=2.89;95%CI,2.27-3.67).Conclusions:(1) The neglected situation of rural children was seriousin the Shanxi and Chongqing provinces. The frequencies of neglected ofrural children from aged0-6in these places were lower than that of thenation at the same period, however, the degree of neglected was higherthan that of the nation. The main impact factors were the left-behindchildren, single parent or remarried family, the migrant work or homefarming of father, the low level of maternal education and the estrangedfather-child relationships.(2) The neglected situation of urban primary and secondary schoolstudents were serious in the western China. The frequencies and degree ofneglected of children who aged from6-8,9-11and12-17in these placeswas higher than that of the nation at the same period. The main impactfactors were: boys, younger primary students, live in the capital cities ormunicipalities, the low level of paternal education, the bad relationshipamong parents.

        中國西部?jī)墒。ㄊ校q兒童受忽視現(xiàn)狀及影響因素研究

英漢縮略語名詞對(duì)照5-6摘要6-11ABSTRACT11-16前言17-19第一部分 中國西部?jī)墒。ㄊ校┺r(nóng)村 0-6 歲兒童受忽視現(xiàn)狀及影響因素分析19-34    1 對(duì)象與方法19-23    2 結(jié)果23-31    3 討論31-34第二部分 中國西部?jī)墒。ㄊ校┏鞘?6-17 歲中小學(xué)生受忽視現(xiàn)狀及影響因素研究34-46    1 對(duì)象與方法34-37    2 結(jié)果37-43    3 討論43-46全文總結(jié)46-47創(chuàng)新與不足47-48參考文獻(xiàn)48-52附表 152-56附表 256-59文獻(xiàn)綜述59-69    參考文獻(xiàn)65-69致謝69-70攻讀碩士期間發(fā)表的論文70-71

  本文關(guān)鍵詞：中國西部?jī)墒。ㄊ校q兒童受忽視現(xiàn)狀及影響因素研究，由筆耕文化傳播整理發(fā)布。