珠海市拱北社区幼儿园儿童伤害发生现况及其影响因素分析
摘要
目的 了解珠海市拱北社区幼儿园儿童意外伤害现况和影响因素，为开展伤害的预防工作提供依据。
方法 分层随机整群抽取11所幼儿园，对1308名2～6岁儿童的父母进行回顾性调查，了解研究对象在2002年3月至2003年3月期间的意外伤害情况。同时调查辖区内29所幼儿园的安全因素和保教人员的伤害知识水平。
结果 珠海市拱北社区幼儿园儿童的意外伤害发生率为54.6％。常见的伤害种类是跌伤(28.7％)、碰伤(18.3％)、咬伤和抓伤(12.4％)。男童的跌伤和硬物击伤发生率高于女童。伤害发生的危险因素为儿童左利手、母亲不良管教方式、孩子骑童车母亲未监管、儿童坐立不定、家庭月总收入、家里有玻璃家具；保护因素为家庭备有急救小药箱、母亲对伤害认识正确、母亲定期检查玩具。A、B、C三类幼儿园安全评分结果的差别有统计学意义，C类幼儿园中存在较多安全隐患。三类幼儿园保教人员的伤害知识水平无差别(P＞0.05)，但对伤害的正确态度、安全行为、开展安全教育工作方面有差别(P＜0.01)，A类优于B类和C类。
结论 珠海市拱北社区2～6岁幼儿园儿童意外伤害发生率为54.6％。应针对本社区儿童意外伤害发生的影响因素，采取综合安全防范措施。
Objective To investigate the situation and affecting factors of unintentional injuries among the kindergarten children in Gongbei community of Zhuhai city , and to provide evidence for community -based injury prevention programs.
Methods A stratified sampling study was conducted among 1308 children aged 2-6 years in 11 kindergartens in Gongbei community of Zhuhai city to investigate the current situation of unintentional injuries from March 2002 to March 2003 by questionnaire survey ,and at the same time to investigate the safety factors of 29 kindergartens in Gongbei community and the teachers' injury knowledge level.
Results The incidence of unintentional injuries among the children in Gongbei community was 54.6%. The most 3 common types of injuries were fall (28.7%), collision (18.3%), bite and scratch (12.4%). The rates in fall and hit of the boys were higher than those of the girls. The risk factors were identified as follows: child's left-hander; mother's ill educational mode; child's riding bicycle without mother's custody; child's fidge; gross monthly earnings of family ; glass furnitures in family. The protective factors were also identified as follows: with first-aid box at home; mother's correct attitude and safe behaviors towards injuries; mother's regular toy-checking. The safety scores of the three kinds of kindergartens were different. There was no significant difference in the teachers' knowledge level of the three kinds kindergartens ( P>0.05) , but there was significant difference in terms of right attitudes towards injuries, safety behaviors and safety education programs (P0.01), class A kindergarten was
better than class B and class C.
Conclusion Incidence of injuries in kindergarten children was 54.6%. Comprehensive safety measures should be taken to deal with the affecting factors of children's unintentional injuries in the community.
方法 分层随机整群抽取11所幼儿园，对1308名2～6岁儿童的父母进行回顾性调查，了解研究对象在2002年3月至2003年3月期间的意外伤害情况。同时调查辖区内29所幼儿园的安全因素和保教人员的伤害知识水平。
结果 珠海市拱北社区幼儿园儿童的意外伤害发生率为54.6％。常见的伤害种类是跌伤(28.7％)、碰伤(18.3％)、咬伤和抓伤(12.4％)。男童的跌伤和硬物击伤发生率高于女童。伤害发生的危险因素为儿童左利手、母亲不良管教方式、孩子骑童车母亲未监管、儿童坐立不定、家庭月总收入、家里有玻璃家具；保护因素为家庭备有急救小药箱、母亲对伤害认识正确、母亲定期检查玩具。A、B、C三类幼儿园安全评分结果的差别有统计学意义，C类幼儿园中存在较多安全隐患。三类幼儿园保教人员的伤害知识水平无差别(P＞0.05)，但对伤害的正确态度、安全行为、开展安全教育工作方面有差别(P＜0.01)，A类优于B类和C类。
结论 珠海市拱北社区2～6岁幼儿园儿童意外伤害发生率为54.6％。应针对本社区儿童意外伤害发生的影响因素，采取综合安全防范措施。
Objective To investigate the situation and affecting factors of unintentional injuries among the kindergarten children in Gongbei community of Zhuhai city , and to provide evidence for community -based injury prevention programs.
Methods A stratified sampling study was conducted among 1308 children aged 2-6 years in 11 kindergartens in Gongbei community of Zhuhai city to investigate the current situation of unintentional injuries from March 2002 to March 2003 by questionnaire survey ,and at the same time to investigate the safety factors of 29 kindergartens in Gongbei community and the teachers' injury knowledge level.
Results The incidence of unintentional injuries among the children in Gongbei community was 54.6%. The most 3 common types of injuries were fall (28.7%), collision (18.3%), bite and scratch (12.4%). The rates in fall and hit of the boys were higher than those of the girls. The risk factors were identified as follows: child's left-hander; mother's ill educational mode; child's riding bicycle without mother's custody; child's fidge; gross monthly earnings of family ; glass furnitures in family. The protective factors were also identified as follows: with first-aid box at home; mother's correct attitude and safe behaviors towards injuries; mother's regular toy-checking. The safety scores of the three kinds of kindergartens were different. There was no significant difference in the teachers' knowledge level of the three kinds kindergartens ( P>0.05) , but there was significant difference in terms of right attitudes towards injuries, safety behaviors and safety education programs (P0.01), class A kindergarten was
better than class B and class C.
Conclusion Incidence of injuries in kindergarten children was 54.6%. Comprehensive safety measures should be taken to deal with the affecting factors of children's unintentional injuries in the community.
引文
[1] Walsh SS , Jarvis SN, Towner EM, et al . Annual incidence of unintentional injury among 54,000 children. Inj Prev, 1996,2:16-20
[2]杨汴生．儿童青少年意外伤害研究动态．中国校医，1996,10(4)：310-313
[3]丁宗一．儿童期意外伤害．中国儿童保健杂志，2000,8(6)：383-385
[4]金会庆，张树林，陈朴，解梅，王文跃．儿童非致死性意外伤害的流行病学研究．人类工效学，1999,5(1)：1-5
[5]儿童意外死亡流行病学研究协作组．中国妇幼卫生项目县儿童意外死亡流行病学研究．中华儿科杂志，1995,33(4)：206-208
[6]刘筱娴，司达敏，施东华．儿童伤害的因素及其干预控制．中华预防医学杂志，2000,34(4)：250-252
[7]金会庆，孙业恒，张树林，陈朴．事故倾性儿童相关生理心理特征的Logistic 回归分析．中国学校卫生，1999,20(1)：53-54
[8]蒋竞雄，丁宗一，闫桂凤，王文英，惠京红，许金华．河北省怀来县儿童意外损伤的流行病学研究．中华儿科杂志，1999,37(11)：657-660
[9]刘玲，刘筱娴，文秋生，王鸿娟，李建芬，鲁永辉．贵阳市城区 2193 例学龄前儿童意外伤害及影响因素的研究．中国儿童保健杂志，2001，9(2)：91-93
[10]熊忠贵，刘筱娴．湖北部分地区2000～2001年0～14岁儿童伤害特征研究．中国儿童保健杂志，2003,11(1)：17-19
[11] Turegun M. An extraordinary cause of scalding injury in childhood. Burns, 1997,23(2): 169-173
[12] Yossi H., Mary O. Data linkage-social and behavioral determinants of injuries. Inj Prev, 1998,4:176-180
[13]吴康敏，徐泳华，李丽，姬巧云，郭贞美，倪素君，董仁威，邬瑞辉．成都市市区学龄前期儿童伤害发生现状及其危险因素．中华预防医学杂志， 2001,35(3)：181-184
[14]向兵，刘筱娴，孙凌毅，沈敏，夏宇虹，郭善瑗．武汉市武昌区3～6岁儿童意外伤害现况研究．中国健康教育，2002,18(6)：340-344
[15]王声涌．我国的伤害流行病学研究亟需开展．中华流行病学杂志，
1997,18(3)：131-133
[16]中国建筑工业出版社编辑部．现行建筑设计规范大全．北京：中国建筑工业出版社．1994，第一版；443-448
[17]王声(氵勇)．伤害流行病学研究的内容和方法．预防医学文献信息，1998,4：299-301
[18]余晓丹，刘筱娴．厦门市城区集居学龄前儿童意外伤害危险因素病例对照研究．中国儿童保健杂志，2000,8(6)：358-360
[19]林汉生，郭畅，王声(氵勇)，范存欣．广州某中学学生常见伤害类型及其原因分析．中国学校卫生，2001,22(6)：513-514
[20]卢志坚，陈锡永，杨继红，付宏营，杜韶女，陈学忠，刘雪艳．韶关市儿童青少年伤害分布特点及影响因素的研究．现代预防医学，2000,27(1)：42-44
[21] Petridou E. Childhood injuries in the European Union: Can epidemiology contribute to their control?. Acta P(?)diatr,2000,89:1244-1249
[22] Wazana A. Are there injury - prone children? A critical review of the literature. Can J Psychiatry, 1997,42(6):602-610
[23] Bijur PE, Golding J, Haslum M. Persistence of occurrence of injury: can injuries of preschool children predict injuries of school-aged children?. Pediatrics, 1998,82(5):707-712
[24]金会庆，张树林，潘涛．事故倾性与外周血神经递质水平关系的研究．疾病控制杂志，1999，3：263-265
[25] Jaquess DL, Finney JW. Previous injuries and behavior problems predict children's injuries. J Pediatr Psychol, 1994,19:79-89
[26] Potts R, Martinez IG, Dedmon A. Childhood risk taking and injury: self-report and informant measures. J Pediatr Psychol, 1995,20:5-12
[27]刘湘云，林传家，薛沁冰，陈荣华主编．儿童保健学．南京：江苏科学技术出版社．1999，第二版：55-58
[28]李亚萍．城市学龄前儿童意外伤害的社会因素及其干预策略分析．医学与社会，2001，14(6)：24-26
[29] John B.C. , Petra T, Terry N. A case-control study of child bicycle injuries: Relationship of risk to exposure. Accid. Anal.and Prey, 1995,27(6):839-844
[30]范新宇，陈丽萍．美国儿童青少年玩具伤害概况与安全使用的11项建议．中国校医，1998,12(5)：398-399
[31]莫尚．美国改革儿童服装．现代育儿报，2003,3：10
[32] Jennifer M.W, Kathi J.M. Maternal factors and child's health care use. Soc. Sci. Med. 1995,40(5):623-628
[33]朱立波翻译．可控制的家居儿童意外伤害的决定因素．中国健康教育，1996,12(2)：17-18
[34]李丽萍，黄革．伤害儿童的父母其相关因素的病例对照研究．疾病控制杂志，1999,3(4)：256-257
[35]司达敏，刘筱娴，李激．麻城市农村某社区7～14岁儿童伤害发生影响因素病例对照研究．中国儿童保健杂志，2001，9(6)：391-394
[36] Durkin MS, Davidson LL, Kuhn L, O'Connor P, Barlow B. Low-income neighborhoods and the risk of severe pediatric injury :a small-area analysis in northern Manhattan. Am J Public Health, 1994,84(4):587-592
[37]王黎君，杨功焕．儿童发生伤害的危险因素．疾病监测，2001，16(6)：233-236
[38]吕姿之主编．健康教育与健康促进．北京：北京医科大学中国协和医科大学联合出版社．1998，第一版：52-54
[39]李福海摘．儿童游乐场地面与器械安全性研究．国外医学社会医学分册，1998,15(2)：88-89
[40]李丽萍，冯家琳．297例住院儿童意外伤害情况分析．中国儿童保健杂志，1999,7(1)：24-25
[41]丁宗一．大力开展儿童期意外损伤的监测与干预．中华儿科杂志，1999,37(11)：653-654
[42] Garling A, Garling T Mothers' anticipation and prevention of unintentional injury to young children in the home. J Pediatr Psychol, 1995,20:23-36
[2]杨汴生．儿童青少年意外伤害研究动态．中国校医，1996,10(4)：310-313
[3]丁宗一．儿童期意外伤害．中国儿童保健杂志，2000,8(6)：383-385
[4]金会庆，张树林，陈朴，解梅，王文跃．儿童非致死性意外伤害的流行病学研究．人类工效学，1999,5(1)：1-5
[5]儿童意外死亡流行病学研究协作组．中国妇幼卫生项目县儿童意外死亡流行病学研究．中华儿科杂志，1995,33(4)：206-208
[6]刘筱娴，司达敏，施东华．儿童伤害的因素及其干预控制．中华预防医学杂志，2000,34(4)：250-252
[7]金会庆，孙业恒，张树林，陈朴．事故倾性儿童相关生理心理特征的Logistic 回归分析．中国学校卫生，1999,20(1)：53-54
[8]蒋竞雄，丁宗一，闫桂凤，王文英，惠京红，许金华．河北省怀来县儿童意外损伤的流行病学研究．中华儿科杂志，1999,37(11)：657-660
[9]刘玲，刘筱娴，文秋生，王鸿娟，李建芬，鲁永辉．贵阳市城区 2193 例学龄前儿童意外伤害及影响因素的研究．中国儿童保健杂志，2001，9(2)：91-93
[10]熊忠贵，刘筱娴．湖北部分地区2000～2001年0～14岁儿童伤害特征研究．中国儿童保健杂志，2003,11(1)：17-19
[11] Turegun M. An extraordinary cause of scalding injury in childhood. Burns, 1997,23(2): 169-173
[12] Yossi H., Mary O. Data linkage-social and behavioral determinants of injuries. Inj Prev, 1998,4:176-180
[13]吴康敏，徐泳华，李丽，姬巧云，郭贞美，倪素君，董仁威，邬瑞辉．成都市市区学龄前期儿童伤害发生现状及其危险因素．中华预防医学杂志， 2001,35(3)：181-184
[14]向兵，刘筱娴，孙凌毅，沈敏，夏宇虹，郭善瑗．武汉市武昌区3～6岁儿童意外伤害现况研究．中国健康教育，2002,18(6)：340-344
[15]王声涌．我国的伤害流行病学研究亟需开展．中华流行病学杂志，
1997,18(3)：131-133
[16]中国建筑工业出版社编辑部．现行建筑设计规范大全．北京：中国建筑工业出版社．1994，第一版；443-448
[17]王声(氵勇)．伤害流行病学研究的内容和方法．预防医学文献信息，1998,4：299-301
[18]余晓丹，刘筱娴．厦门市城区集居学龄前儿童意外伤害危险因素病例对照研究．中国儿童保健杂志，2000,8(6)：358-360
[19]林汉生，郭畅，王声(氵勇)，范存欣．广州某中学学生常见伤害类型及其原因分析．中国学校卫生，2001,22(6)：513-514
[20]卢志坚，陈锡永，杨继红，付宏营，杜韶女，陈学忠，刘雪艳．韶关市儿童青少年伤害分布特点及影响因素的研究．现代预防医学，2000,27(1)：42-44
[21] Petridou E. Childhood injuries in the European Union: Can epidemiology contribute to their control?. Acta P(?)diatr,2000,89:1244-1249
[22] Wazana A. Are there injury - prone children? A critical review of the literature. Can J Psychiatry, 1997,42(6):602-610
[23] Bijur PE, Golding J, Haslum M. Persistence of occurrence of injury: can injuries of preschool children predict injuries of school-aged children?. Pediatrics, 1998,82(5):707-712
[24]金会庆，张树林，潘涛．事故倾性与外周血神经递质水平关系的研究．疾病控制杂志，1999，3：263-265
[25] Jaquess DL, Finney JW. Previous injuries and behavior problems predict children's injuries. J Pediatr Psychol, 1994,19:79-89
[26] Potts R, Martinez IG, Dedmon A. Childhood risk taking and injury: self-report and informant measures. J Pediatr Psychol, 1995,20:5-12
[27]刘湘云，林传家，薛沁冰，陈荣华主编．儿童保健学．南京：江苏科学技术出版社．1999，第二版：55-58
[28]李亚萍．城市学龄前儿童意外伤害的社会因素及其干预策略分析．医学与社会，2001，14(6)：24-26
[29] John B.C. , Petra T, Terry N. A case-control study of child bicycle injuries: Relationship of risk to exposure. Accid. Anal.and Prey, 1995,27(6):839-844
[30]范新宇，陈丽萍．美国儿童青少年玩具伤害概况与安全使用的11项建议．中国校医，1998,12(5)：398-399
[31]莫尚．美国改革儿童服装．现代育儿报，2003,3：10
[32] Jennifer M.W, Kathi J.M. Maternal factors and child's health care use. Soc. Sci. Med. 1995,40(5):623-628
[33]朱立波翻译．可控制的家居儿童意外伤害的决定因素．中国健康教育，1996,12(2)：17-18
[34]李丽萍，黄革．伤害儿童的父母其相关因素的病例对照研究．疾病控制杂志，1999,3(4)：256-257
[35]司达敏，刘筱娴，李激．麻城市农村某社区7～14岁儿童伤害发生影响因素病例对照研究．中国儿童保健杂志，2001，9(6)：391-394
[36] Durkin MS, Davidson LL, Kuhn L, O'Connor P, Barlow B. Low-income neighborhoods and the risk of severe pediatric injury :a small-area analysis in northern Manhattan. Am J Public Health, 1994,84(4):587-592
[37]王黎君，杨功焕．儿童发生伤害的危险因素．疾病监测，2001，16(6)：233-236
[38]吕姿之主编．健康教育与健康促进．北京：北京医科大学中国协和医科大学联合出版社．1998，第一版：52-54
[39]李福海摘．儿童游乐场地面与器械安全性研究．国外医学社会医学分册，1998,15(2)：88-89
[40]李丽萍，冯家琳．297例住院儿童意外伤害情况分析．中国儿童保健杂志，1999,7(1)：24-25
[41]丁宗一．大力开展儿童期意外损伤的监测与干预．中华儿科杂志，1999,37(11)：653-654
[42] Garling A, Garling T Mothers' anticipation and prevention of unintentional injury to young children in the home. J Pediatr Psychol, 1995,20:23-36