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重庆某区青春发动时相提前儿童生活质量及其影响因素的研究

【作者】 程绪婷

【导师】 王宏;

【作者基本信息】 重庆医科大学, 流行病与卫生统计学, 2018, 硕士

【摘要】 目的编制《青春期儿童生活质量量表》,为青春期儿童生活质量测量工具的进一步开发提供依据;测定和比较青春发动时相提前儿童和非提前儿童生活质量,探讨青春发动时相提前儿童生活质量的影响因素,为其生活质量的干预提供依据。方法1.结合文献查阅和小组讨论形成量表初始条目池;选取5年级1个班学生进行小范围测试,确定初始量表;选取4-8年级共511人进行预调查,采取7种条目筛选方法和探索性因子分析对初始量表进行条目筛选,形成正式测试量表,并对其可行性、信度和效度进行初步考评。2.采用分层整群抽样方法,从重庆某区选取城乡的中小学各2所(共8所学校),包括4-9年级共3486名学生,运用《青春期儿童生活质量量表》、《青春期发育事件自评量表(PDS)》等进行现况调查,并釆用多元逐步回归分析影响青春发动时相提前儿童生活质量的因素。结果通过条目专业筛选和统计筛选后,形成包含生理、心理、社会和青春期4维度10个因子共39个条目组成的《青春期儿童生活质量量表》。初步考评结果显示,总量表和4个维度的Cronbach’sα系数分别为0.89、0.81、0.77、0.85和0.64;总量表和4个维度的重测相关系数(Pearson相关系数)分别为0.88、0.76、0.78、0.82和0.72;验证性因子分析表明模型拟合良好,χ2/df=4.24,CFI=0.95、NFI=0.94、NNFI=0.92、GFI=0.96、AGFI=0.92、RMSEA=0.08;以“儿少主观生活质量量表”为效标进行评价,量表总分与效标总分的相关系数为0.76。现况调查显示,在调查的3486名4-9年级学生中,青春发动时相提前、正常、延迟儿童检出率分别为20.0%、64.1%和15.9%;青春发动时相提前儿童生活质量总分(134.99±18.75)低于正常儿童(139.64±18.71)和延迟儿童(139.73±17.52)(P<0.05),除青春期维度得分提前组(20.29±3.88)和正常组(20.07±3.76)高于延迟组(19.70±3.68)(P>0.05),其余3个维度得分均是提前组低于正常组和延迟组(P值均<0.05)。单因素分析结果表明,父母文化程度、家庭关系、学习成绩、学校环境、亲密朋友数量等15个因素对提前组儿童生活质量有影响。多元逐步回归分析显示,抑郁、家庭关系差、亲密朋友数量少和青春期态度得分低是影响青春发动时相提前儿童生活质量的主要因素。结论《青春期儿童生活质量量表》的初步考评具有较好的信效度,可以作为正式评价青春发育期儿童生活质量的测定工具。青春发动时相提前儿童生活质量低于正常和延迟儿童,在提高青春发动时相提前儿童生活质量的过程中,可以考虑从改善抑郁、家庭关系、亲密朋友数量和提高青春期态度得分等方面着手。

【Abstract】 Objective To develop the quality of life for children in puberty and to provide a basis for further development of the measurement tools for the quality of life for children in puberty.Then to investigate and compare the quality of life on children in early pubertal timing or not,and to explore the influencing factors of the quality of life on children in early pubertal timing for providing a basis for future intervention.Methods 1.Initial entry pool for the scale was constructed by literature review and panel discussion.Initial scale was constructed through a small-group study of children from Grade 5.A total of 511 children in grade 4-8 were selected for pre-survey.Seven kinds of screening methods and exploratory factor analysis were used to screen the initial scale to form a formal test scale,and the feasibility,reliability and validity were evaluated.2.Stratified cluster sampling was used to recruit 3486 children in grade 4-9 from 4 primary schools and 4 secondary schools in urban and rural areas from a district of Chongqing.All the children were surveyed with “Quality of life for children in puberty”,“Puberty Development Scale(PDS)”,and so on.The influencing factors for quality of life on children in early pubertal timing were analyzed by multiple stepwise regression.Results There were 39 items for ten factors and four dimensions which were physiology,psychology,society and puberty after professional screening and statistical screening.Preliminary evaluation showed the Cronbach’s alpha coefficient for the total scale and the four dimensions were 0.89,0.81,0.77,0.85 and 0.64,respectively.While the test-retest Pearson correlation coefficient for the total scale and the four dimensions were 0.88,0.76,0.78,0.82 and 0.72,respectively.Confirmatory factor analysis showed the model well fitted,which were χ2/df=4.24,CFI=0.95,NFI=0.94,NNFI=0.92,GFI=0.96,AGFI=0.92 and RMSEA=0.08.The scale of “Inventory of Subjective Life Quality(ISLQ)” was used as a standard to measure the scale of “Quality of life for children in puberty”,and the correlation coefficient between the two scales was 0.76.The prevalence of children in early pubertal timing,on time,late pubertal timing were 20.0%,64.1% and 15.9%,respectively.The total score of quality of life on children in early pubertal timing(134.99±18.75)was significantly lower than normal children(139.64±18.71)and children in late pubertal timing(139.73±17.52)(P<0.05).Though the dimensions of physiology,psychology and society showed the same result,the score of dimension of puberty which children in early pubertal timing(20.29±3.88)and normal(20.07±3.76)were significantly higher than children in late pubertal timing(19.70±3.68)(P<0.05).Univariate analysis showed that degree of education for parents,relationship of family,academic achievement,school environment,the number of close friends and about 15 factors had impact on quality of life on children in early pubertal timing.Multiple stepwise regression analysis showed that depression,poor relationship of family,few close friends and lower score of attitude for adolescence were main influencing factors for the quality of life on children in early pubertal timing.Conclusions The quality of life for children in puberty has good reliability and validity through preliminary evaluation,and it can be used as a tool to evaluate the quality of life on children in puberty in the formal investigation.The quality of life on children in early pubertal timing was lower than normal children and children in late pubertal timing.Intervention measures from improvement of depression,relationship of family,the number of close friends and attitude for adolescence are considered to improve the quality of life on children in early pubertal timing.

  • 【网络出版投稿人】 重庆医科大学
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