浙江省中学生非致死性伤害流行特征及危险因素分析
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摘要
目的了解浙江省中学生非致死性伤害流行特征及其影响因素,为预防和控制中学生非致死性伤害提供依据。方法于2017年4—5月,采用多阶段分层整群抽样方法,抽取浙江省30个县(市、区) 442所中学24 157名在校学生进行问卷调查,内容包括社会人口学特征、伤害发生情况及伤害相关行为。采用Logistic回归模型分析中学生非致死性伤害发生的影响因素。结果有效调查中学生23 462人,近12个月内非致死性伤害发生率为20.86%。男生和女生非致死性伤害发生率分别为24.15%和17.33%,男生高于女生(P<0.05)。城市和农村学生非致死性伤害发生率分别为20.17%和21.19%,差异无统计学意义(P>0.05)。初中、普通高中和非普通高中学生非致死性伤害发生率分别为22.17%、19.42%和19.51%,差异有统计学意义(P<0.05)。多因素Logistic回归分析结果显示,男生(女生:OR=0.805,95%CI:0.728～0.890)、学习成绩差(OR=1.149,95%CI:1.018～1.298)、吸烟(OR=1.260,95%CI:1.083～1.466)、饮酒(OR=1.410,95%CI:1.279～1.553)、体育活动(OR:1.244～1.527,95%CI:1.098～1.767)、孤独(OR:1.336～1.500,95%CI:1.219～1.682)、悲伤(OR=1.308,95%CI:1.186～1.441)、旷课(OR=1.390,95%CI:1.182～1.634)、离家出走(OR=1.242,95%CI:1.076～1.435)、打架(OR=1.771,95%CI:1.594～1.967)和被欺凌(OR=2.071,95%CI:1.869～2.294)是中学生发生非致死性伤害的危险因素。结论中学生非致死性伤害发生率为20.86%,非致死性伤害的发生与性别、吸烟、饮酒、负性情绪和暴力等因素有关。
Objective To understand the epidemiological characteristics of nonfatal injury and its influencing factors among middle school students in Zhejiang Province,and to provide evidence for prevention and control of nonfatal injury of adolescents.Methods Using multi-stage stratified cluster sampling method,24 157 middle school students from 442 schools in 30 counties(cities,districts) of Zhejiang Province were selected to investigate socio-demographic characteristics,the occurrence of nonfatal injury and injury-related behaviors from April to May of 2017. Logistic regression model was used to analyze influencing factors for nonfatal injury among middle school students. Results The incidence of nonfatal injuries in 23 462 secondary school students in the past 12 months was 20.86%. The incidence of nonfatal injury was 24.15% in boys,which was higher than 17.33% in girls(P<0.05). The incidence of nonfatal injury was 20.17% in urban students and 21.19% in rural students,and the difference between them was not statistically significant(P>0.05). The incidence of nonfatal injury was 22.17% in junior high school students, 19.42% in senior high school students and 19.51% in vocational high school students, and there was statistically significant difference between them(P <0.05). The results of the multivariate logistic regression analysis showed that boys(girls: OR=0.805, 95% CI: 0.728-0.890), poor academic performance(OR=1.149, 95% CI: 1.018-1.298), smoking(OR=1.260,95%CI:1.083-1.466),drinking(OR=1.410,95%CI:1.279-1.553),more physical activity(OR: 1.244-1.527, 95% CI: 1.098-1.767), loneliness(OR: 1.336-1.500, 95% CI: 1.219-1.682), sadness(OR=1.308, 95% CI:1.186-1.441),absenteeism(OR=1.390,95%CI:1.182-1.634),running away from home(OR=1.242,95%CI:1.076-1.435),fighting(OR=1.771,95%CI:1.594-1.967) and being bullied(OR=2.071,95%CI:1.869-2.294) were risk factors for nonfatal injury in middle school students. Conclusion The incidence of nonfatal injuries among secondary school students was20.86%. Male students were the high risk group. The incidence of nonfatal injury was related to gender,smoking,drinking,negative emotions and violence.
Objective To understand the epidemiological characteristics of nonfatal injury and its influencing factors among middle school students in Zhejiang Province,and to provide evidence for prevention and control of nonfatal injury of adolescents.Methods Using multi-stage stratified cluster sampling method,24 157 middle school students from 442 schools in 30 counties(cities,districts) of Zhejiang Province were selected to investigate socio-demographic characteristics,the occurrence of nonfatal injury and injury-related behaviors from April to May of 2017. Logistic regression model was used to analyze influencing factors for nonfatal injury among middle school students. Results The incidence of nonfatal injuries in 23 462 secondary school students in the past 12 months was 20.86%. The incidence of nonfatal injury was 24.15% in boys,which was higher than 17.33% in girls(P<0.05). The incidence of nonfatal injury was 20.17% in urban students and 21.19% in rural students,and the difference between them was not statistically significant(P>0.05). The incidence of nonfatal injury was 22.17% in junior high school students, 19.42% in senior high school students and 19.51% in vocational high school students, and there was statistically significant difference between them(P <0.05). The results of the multivariate logistic regression analysis showed that boys(girls: OR=0.805, 95% CI: 0.728-0.890), poor academic performance(OR=1.149, 95% CI: 1.018-1.298), smoking(OR=1.260,95%CI:1.083-1.466),drinking(OR=1.410,95%CI:1.279-1.553),more physical activity(OR: 1.244-1.527, 95% CI: 1.098-1.767), loneliness(OR: 1.336-1.500, 95% CI: 1.219-1.682), sadness(OR=1.308, 95% CI:1.186-1.441),absenteeism(OR=1.390,95%CI:1.182-1.634),running away from home(OR=1.242,95%CI:1.076-1.435),fighting(OR=1.771,95%CI:1.594-1.967) and being bullied(OR=2.071,95%CI:1.869-2.294) were risk factors for nonfatal injury in middle school students. Conclusion The incidence of nonfatal injuries among secondary school students was20.86%. Male students were the high risk group. The incidence of nonfatal injury was related to gender,smoking,drinking,negative emotions and violence.
引文
[1]叶鹏鹏,金叶,耳玉亮,等.1990年与2013年中国0~14岁儿童伤害疾病负担分析[J].中华流行病学杂志,2017,38(10):1335-1341.
[2]LINNAN H W,DUAN J H,CHEN X X,et al.Child injury surveillance that guides interventions:the Beijing primary healthcare experience[J].Inj Prev,2011,17(2):74-78.
[3]STREET E J,JACOBSEN K H.Injury incidence among middle school students aged 13-15 years in 47 low-income and middle-income countries[J].Inj Prev,2016,22(6):432-436.
[4]HU M,HU G Q,SUN Z Q,et al.Epidemiological survey of the prevalence of non-fatal injury among children aged 5-14 years in China[J].Biomed Environ Sci,2012,25(4):407-412.
[5]MOLCHO M,HAREL Y,PICKETT W,et al.The epidemiology of non-fatal injuries among 11-,13-and 15-year old youth in 11countries:findings from the 1998 WHO-HBSC cross national survey[J].Int J Inj Contr Saf Promot,2006,13(4):205-211.
[6]Centers for Disease Control and Prevention.2017 State and Local Youth Risk Behavior Survey[EB/OL].[2019-05-05].https://www.cdc.gov/healthyyouth/data/yrbs/questionnaires.htm.
[7]World Health Organization.Global school-based students health survey(GSHS)[EB/OL].[2019-05-05].http://www.who.int/ncds/surveillance/gshs/nepal/en.
[8]张译天,万幸,余小鸣,等.2005-2015年中国青少年伤害发生率的Meta分析[J].中国儿童保健杂志,2016,24(10):1062-1069.
[9]PELTZER K,PENGPID S.Injury and social correlates among in-school adolescents in four Southeast Asian countries[J].Int JEnviron Res Public Health,2012,9(8):2851-2862.
[10]PELTZER K,PENGPID S.Unintentional injuries and psychosocial correlates among in-school adolescents in Malaysia[J].Int JEnviron Res Public Health,2015,12(11):14936-14947.
[11]彭娟娟,高宁,喻彦,等.上海市中小学生非致死性伤害流行病学研究[J].上海预防医学,2018,30(9):723-729.
[12]CHEN G,SMITH G A,DENG S,et al.Nonfatal injuries among middle-school and high-school students in Guangxi,China[J].Am J Public Health,2005,95(11):1989-1995.
[13]JILDEH C,ABDEEN Z,A L SABBAH H,et al.Unintentional injuries among school-aged children in Palestine:Findings from the National Study of Palestinian Schoolchildren(HBSC-WBG2006)[J].Int J Population Res,2013:1-7.
[14]ESPELAGE D L,DAVIS J P,BASILE K C,et al.Alcohol,prescription drug misuse,sexual violence,and dating violence among high school youth[J].J Adolesc Health,2018,63(5):601-607.
[15]樊丽辉,邵永强,杨君崎,等.温州市居民伤害流行现况分析[J].预防医学,2016,28(11):1136-1138,1141.
[16]ESSER M B,WADHWANIYA S,GUPTA S,et al.Characteristics associated with alcohol consumption among emergency department patients presenting with road traffic injuries in Hyderabad,India[J].Injury,2016,47(1):160-165.
[17]NGUYEN N P,PASSMORE J,TRAN L T,et al.Role of alcohol in hospitalized road trauma in Vietnam[J].Traffic Inj Prev,2013,14(4):329-334.
[18]DRISCOLL T R,HARRISON J A,STEENKAMP M.Review of the role of alcohol in drowning associated with recreational aquatic activity[J].Inj Prev,2004,10(2):107-113.
[19]LUNETTA P,SMITH G S,PENTTIL魧A,et al.Unintentional drowning in Finland 1970-2000:a population-based study[J].Int J Epidemiol,2004,33(5):1053-1063.
[20]ALBASHTAWY M,AL-AWAMREH K,GHARAIBEH H,et al.Epidemiology of nonfatal injuries among schoolchildren[J].J Sch Nurs,2016,32(5):329-336.
[21]PELTZER K.Injury and social determinants among in-school adolescents in six African countries[J].Inj Prev,2008,14(6):381-388.
[2]LINNAN H W,DUAN J H,CHEN X X,et al.Child injury surveillance that guides interventions:the Beijing primary healthcare experience[J].Inj Prev,2011,17(2):74-78.
[3]STREET E J,JACOBSEN K H.Injury incidence among middle school students aged 13-15 years in 47 low-income and middle-income countries[J].Inj Prev,2016,22(6):432-436.
[4]HU M,HU G Q,SUN Z Q,et al.Epidemiological survey of the prevalence of non-fatal injury among children aged 5-14 years in China[J].Biomed Environ Sci,2012,25(4):407-412.
[5]MOLCHO M,HAREL Y,PICKETT W,et al.The epidemiology of non-fatal injuries among 11-,13-and 15-year old youth in 11countries:findings from the 1998 WHO-HBSC cross national survey[J].Int J Inj Contr Saf Promot,2006,13(4):205-211.
[6]Centers for Disease Control and Prevention.2017 State and Local Youth Risk Behavior Survey[EB/OL].[2019-05-05].https://www.cdc.gov/healthyyouth/data/yrbs/questionnaires.htm.
[7]World Health Organization.Global school-based students health survey(GSHS)[EB/OL].[2019-05-05].http://www.who.int/ncds/surveillance/gshs/nepal/en.
[8]张译天,万幸,余小鸣,等.2005-2015年中国青少年伤害发生率的Meta分析[J].中国儿童保健杂志,2016,24(10):1062-1069.
[9]PELTZER K,PENGPID S.Injury and social correlates among in-school adolescents in four Southeast Asian countries[J].Int JEnviron Res Public Health,2012,9(8):2851-2862.
[10]PELTZER K,PENGPID S.Unintentional injuries and psychosocial correlates among in-school adolescents in Malaysia[J].Int JEnviron Res Public Health,2015,12(11):14936-14947.
[11]彭娟娟,高宁,喻彦,等.上海市中小学生非致死性伤害流行病学研究[J].上海预防医学,2018,30(9):723-729.
[12]CHEN G,SMITH G A,DENG S,et al.Nonfatal injuries among middle-school and high-school students in Guangxi,China[J].Am J Public Health,2005,95(11):1989-1995.
[13]JILDEH C,ABDEEN Z,A L SABBAH H,et al.Unintentional injuries among school-aged children in Palestine:Findings from the National Study of Palestinian Schoolchildren(HBSC-WBG2006)[J].Int J Population Res,2013:1-7.
[14]ESPELAGE D L,DAVIS J P,BASILE K C,et al.Alcohol,prescription drug misuse,sexual violence,and dating violence among high school youth[J].J Adolesc Health,2018,63(5):601-607.
[15]樊丽辉,邵永强,杨君崎,等.温州市居民伤害流行现况分析[J].预防医学,2016,28(11):1136-1138,1141.
[16]ESSER M B,WADHWANIYA S,GUPTA S,et al.Characteristics associated with alcohol consumption among emergency department patients presenting with road traffic injuries in Hyderabad,India[J].Injury,2016,47(1):160-165.
[17]NGUYEN N P,PASSMORE J,TRAN L T,et al.Role of alcohol in hospitalized road trauma in Vietnam[J].Traffic Inj Prev,2013,14(4):329-334.
[18]DRISCOLL T R,HARRISON J A,STEENKAMP M.Review of the role of alcohol in drowning associated with recreational aquatic activity[J].Inj Prev,2004,10(2):107-113.
[19]LUNETTA P,SMITH G S,PENTTIL魧A,et al.Unintentional drowning in Finland 1970-2000:a population-based study[J].Int J Epidemiol,2004,33(5):1053-1063.
[20]ALBASHTAWY M,AL-AWAMREH K,GHARAIBEH H,et al.Epidemiology of nonfatal injuries among schoolchildren[J].J Sch Nurs,2016,32(5):329-336.
[21]PELTZER K.Injury and social determinants among in-school adolescents in six African countries[J].Inj Prev,2008,14(6):381-388.