中国六座城市中学生健康素养与意外伤害发生的关系
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摘要
目的了解中学生健康素养与意外伤害发生之间的关联,为制定干预学生意外伤害发生的策略提供依据。方法 2015年11月至2016年1月,采用方便整群抽样方法,在沈阳、蚌埠、新乡、内蒙古乌兰察布市、重庆和阳江市抽取初、高中学生22 628名进行问卷调查。调查内容包括一般人口统计学指标、健康素养水平和意外伤害评定量表。比较不同特征的中学生健康素养水平、意外伤害发生率的差异,并分析健康素养对意外伤害发生的影响。结果中学生青少年互动性健康素养问卷总得分为(104.06±18.68)分。高中生、农村学生、非独生子女、住校生、家庭经济状况差和父/母文化程度低的学生健康素养得分均低于相对应组的学生,差异均有统计学意义(t值分别为20.598,-13.081,5.266,-17.530,294.662,-18.116,-20.244,P值均<0.01)。意外伤害的发生率为46.7%,男生、初中生、农村学生、非独生子女、父/母亲文化程度较低的学生意外伤害发生率均高于相对应组的学生,且差异均有统计学意义(P值均<0.01)。发生意外伤害的中学生健康素养总分和健康意识、精神成长、压力管理、人际关系4个维度的得分均低于无意外伤害的学生,而体力活动、营养的得分高于无意外伤害的学生(P值均<0.01)。多因素Logistic回归分析发现,中、低水平的健康素养增加意外伤害的发生风险(OR值分别为1.323,1.410,P值均<0.01)。结论可通过提高学生的健康素养水平,减少意外伤害的发生。
Objective The purpose of this study was to examine associations between health literacy( HL) and unintentional injuries in junior and high school students in China. Methods A total of 22 628 junior and high school students in China were enrolled in this study from November 2015 to January 2016. Questionnaires survey was conducted to collect information on demographics,HL and unintentional injuries. Rates on HL and unintentional injuries were compared in adolescents with specific characteristics. Multiple logistic regression analyses were conducted to examine relations between them. Results The score of CAIHLQ was( 104.06±18.68). Students who were high school students,rural residence,non-only child in family,resident student,lower parental education level and lower family income had significantly lower HL scores than the corresponding other students. The prevalence of unintentional injuries was 46.7%. Boys reported more injuries problems than girls. The incidences of unintentional injuries among students in junior school,from rural area,being non-only child in family,with lower parental education level was significantly higher prevalence of injuries than their peers. Students with unintentional injuries had lower scores of total HL,health awareness,self-actualization,stress management and interpersonal relationship than non-unintentional injuries,while had higher the scores of physical activities and dietary behavior. Data from multiple Logistic regression analyses showed that moderate or low level of health literacy increased the risk of unintentional injuries( OR = 1. 323,95% CI = 1. 223-1. 432; OR = 1. 410,95% CI = 1. 319-1. 507; P<0.01). Conclusion Lower HL may increase the risk of unintentional injuries among middle school students. Health literacy improvement may reduce the incidence of unintentional injuries among middle school students.
Objective The purpose of this study was to examine associations between health literacy( HL) and unintentional injuries in junior and high school students in China. Methods A total of 22 628 junior and high school students in China were enrolled in this study from November 2015 to January 2016. Questionnaires survey was conducted to collect information on demographics,HL and unintentional injuries. Rates on HL and unintentional injuries were compared in adolescents with specific characteristics. Multiple logistic regression analyses were conducted to examine relations between them. Results The score of CAIHLQ was( 104.06±18.68). Students who were high school students,rural residence,non-only child in family,resident student,lower parental education level and lower family income had significantly lower HL scores than the corresponding other students. The prevalence of unintentional injuries was 46.7%. Boys reported more injuries problems than girls. The incidences of unintentional injuries among students in junior school,from rural area,being non-only child in family,with lower parental education level was significantly higher prevalence of injuries than their peers. Students with unintentional injuries had lower scores of total HL,health awareness,self-actualization,stress management and interpersonal relationship than non-unintentional injuries,while had higher the scores of physical activities and dietary behavior. Data from multiple Logistic regression analyses showed that moderate or low level of health literacy increased the risk of unintentional injuries( OR = 1. 323,95% CI = 1. 223-1. 432; OR = 1. 410,95% CI = 1. 319-1. 507; P<0.01). Conclusion Lower HL may increase the risk of unintentional injuries among middle school students. Health literacy improvement may reduce the incidence of unintentional injuries among middle school students.
引文
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[12]王雪莹,孟献萍,张诗晨,等.某高职院校女生健康素养与躯体亚健康状态的相关性[J].中国学校卫生,2016,37(1):122-126.
[13]ZHANG S C,TAO F B,WU X Y,et al.Low health literacy and psychological symptoms potentially increase the risks of non-suicidal selfinjury in Chinese middle school students[J].BMC Psychiatry,2016,16(1):327.
[14]PAASCHE-ORLOW M K,PARKER R M,GAZMARARIAN J A,et al.The prevalence of limited health literacy[J].J Gen Int Med,2005,20(2):175-184.
[15]杨剑,刘晓玲,周亚敏,等.澳门地区中学生伤害现况及影响因素分析[J].中国公共卫生,2014,30(1):98-101.
[16]顾璇,卞莉,李红影,等.蚌埠市中学生伤害发生现状及其与社会适应的关系分析[J].实用预防医学,2014,21(9):1065-1068.
[17]STEINBERG L,ALBERT D,CAUFFMAN E,et al.Age differences in sensation seeking and impulsivity as indexed by behavior and self-report:evidence for a dual systems model[J].Dev Psychol,2008,44(6):1764-1768.
[18]STURMAN D A,MOGHADDAM B.The neurobiology of adolescence:changes in brain architecture,functional dynamics,and behavioral tendencies[J].Neurosci Biobehav Rev,2011,35(8):1704-1712.
[19]SALAM R A,ARSHAD A,DAS J K,et al.Interventions to prevent unintentional injuries among adolescents:a systematic review and metaanalysis[J].J Adoles Health,2016,59(4S):S76-S87.
[20]冀艳虎,李丽萍,卢耀贵,等.农村地区中学生自行车伤害危险因素病例对照研究[J].中华疾病控制杂志,2012,16(2):102-104.
[2]杨剑,刘晓玲,周亚敏,等.澳门地区中学生伤害现况及影响因素分析[J].中国公共卫生,2014,30(1):98-101.
[3]汤建军,郝加虎,韩慧,等.蚌埠市中学生手机使用依赖与伤害发生的关系[J].中国学校卫生,2016,37(2):208-211.
[4]余小鸣,张译天,黄思哲,等.青少年意外伤害与健康危险行为的关联研究[J].中华行为医学与脑科学杂志,2017,26(2):163-166.
[5]RATZAN S C,PARKER R M.Introduction.In National library of medicine current bibliographies in medicine:health literacy[R]//SELDEN C R,ZORN M,RATZAN S C.NLM Pub.No.CBM 2000-1.Bethesda:National Institutes of Health,U.S.Department of Health and HumanServices,2000.
[6]KEFALIDES P T.Illiteracy:the silent barrier to health care[J].Ann Int Med,1999,130(4 Pt 1):333-336.
[7]张诗晨,万宇辉,陶舒曼,等.中国青少年互动性健康素养问卷的信度和结构效度评价[J].中国学校卫生,2014,35(3):332-336.
[8]国家卫生和计划生育委员会,中国国家标准化管理委员会.儿童青少年伤害监测方法GB/T 31180-2014[S].北京:中国标准出版社,2015.
[9]国家卫生和计划生育委员会宣传司,中国健康教育中心.2013年中国居民健康素养监测报告[EB/OL].[2014-12-17].http://www.nhfpc.gov.cn/ewebeditor/uploadfile/2014/12/20141217091407553.pdf.
[10]郭静,杜正芳,马莎.北京市大学生健康素养调查[J].中国健康教育,2011,27(6):442-444,450.
[11]郭帅军,余小鸣,王璐,等.我国初中生健康素养现状及其影响因素分析[J].中国儿童保健杂志,2013,21(1):37-39.
[12]王雪莹,孟献萍,张诗晨,等.某高职院校女生健康素养与躯体亚健康状态的相关性[J].中国学校卫生,2016,37(1):122-126.
[13]ZHANG S C,TAO F B,WU X Y,et al.Low health literacy and psychological symptoms potentially increase the risks of non-suicidal selfinjury in Chinese middle school students[J].BMC Psychiatry,2016,16(1):327.
[14]PAASCHE-ORLOW M K,PARKER R M,GAZMARARIAN J A,et al.The prevalence of limited health literacy[J].J Gen Int Med,2005,20(2):175-184.
[15]杨剑,刘晓玲,周亚敏,等.澳门地区中学生伤害现况及影响因素分析[J].中国公共卫生,2014,30(1):98-101.
[16]顾璇,卞莉,李红影,等.蚌埠市中学生伤害发生现状及其与社会适应的关系分析[J].实用预防医学,2014,21(9):1065-1068.
[17]STEINBERG L,ALBERT D,CAUFFMAN E,et al.Age differences in sensation seeking and impulsivity as indexed by behavior and self-report:evidence for a dual systems model[J].Dev Psychol,2008,44(6):1764-1768.
[18]STURMAN D A,MOGHADDAM B.The neurobiology of adolescence:changes in brain architecture,functional dynamics,and behavioral tendencies[J].Neurosci Biobehav Rev,2011,35(8):1704-1712.
[19]SALAM R A,ARSHAD A,DAS J K,et al.Interventions to prevent unintentional injuries among adolescents:a systematic review and metaanalysis[J].J Adoles Health,2016,59(4S):S76-S87.
[20]冀艳虎,李丽萍,卢耀贵,等.农村地区中学生自行车伤害危险因素病例对照研究[J].中华疾病控制杂志,2012,16(2):102-104.