家庭照护质量对0～3岁弱势儿童心理行为发育的影响OA
Effects of Home Caregiving Quality on the Psychological and Behavioral Development of Vulnerable Children Aged 0-3 Years
目的 探讨家庭照护质量对0～3 岁儿童心理行为发育的短期和长期效应.方法 采用前瞻性研究设计,从上海市两个区的托育机构和社区卫生服务中心按照分层整群抽样法选取220 名0～3 岁弱势儿童及其主要照护人,开展基线和1 年后的随访调查.采用卡方检验和 Logistic 多因素回归分析探讨进行回应性照护和养育行为对儿童心理行为发育的影响.结果 基线照护人尊重儿童的自主性(OR=0.869,95%CI=0.583～0.920,P=0.031)和养育支持(OR=0.779,95%CI=0.464～0.912,P=0.020)越差,儿童解决问题能区发育迟缓风险越高;养育中的社会刺激越少,儿童沟通能区的发育迟缓风险越高(OR=0.885,95%CI=0.852～0.963,P=0.032);家长获得的养育支持越少,儿童的精细运动发育迟缓风险越高(OR=0.794,95%CI=0.653～0.952,P=0.043).基线在沟通、精细运动、解决问题及个人-社会4 个能区存在发育迟缓的儿童,在1 年后随访时再次出现同领域发育迟缓的风险均显著升高(沟通:OR=5.988,95%CI=2.344～14.502,P<0.001;精细运动:OR=5.618,95%CI=1.690～22.241,P<0.001;解决问题:OR=15.152,95%CI=1.854～44.841,P=0.004;个人-社会:OR=2.525,95%CI=1.041～6.340,P=0.041),而正常发育儿童后续迟缓风险显著降低.结论 早期照护质量对儿童的心理行为发育具有即时的影响,并通过影响发育结局对后期的发育产生持续影响.
Objective To explore the short-term and long-term effects of caregiving quality on the psy-chological and behavioral development among children aged 0-3 years.Methods A prospective study design was adopted,and 220 vulnerable children aged 0-3 years and their primary caregivers were recruited from child care facilities and community healthcare service centers in two districts of Shanghai by stratified cluster sam-pling.Baseline and one-year follow-up surveys were conducted.Chi-square tests and multivariate Logistic regres-sion analyses were conducted to examine the effects of responsive caregiving and parenting behaviors on the psy-chological and behavioral development of children.Results Children whose caregivers with poorer respect for children's autonomy(OR=0.869,95%CI=0.583-0.920,P=0.031)and poorer caregiving support(OR=0.779,95%CI=0.464-0.912,P=0.020)at baseline had a higher risk of developmental delay in the prob-lem-solving domain.In addition,reduced social stimulation in caregiving was linked to a higher risk of develop-mental delay in the communication domain(OR=0.885,95%CI=0.852-0.963,P=0.032).Insufficient car-egiving support received by parents increased the risk of fine-motor developmental delay in children(OR=0.794,95%CI=0.653-0.952,P=0.043).Children who already exhibited developmental delay in communi-cation,fine motor,problem-solving,or personal-social domain at baseline were more likely to experience delay in the same domain at the one-year follow-up(communication:OR=5.988,95%CI=2.344-14.502,P<0.001;fine motor:OR=5.618,95%CI=1.690-22.241,P<0.01;problem-solving:OR=15.152,95%CI=1.854-44.841,P=0.004;personal-social:OR=2.525,95%CI=1.041-6.340,P=0.041).In con-trast,children with normal development at baseline demonstrated substantially lower risks of subsequent develop-mental delay.Conclusion Early caregiving quality has an immediate effect on children's psychological and be-havioral development,and it continues to influence later development through affecting developmental outcomes.
王懿凡;刘婉晴;童连
复旦大学公共卫生学院妇幼与儿少卫生教研室 公共卫生安全教育部重点实验室,上海 200032复旦大学公共卫生学院妇幼与儿少卫生教研室 公共卫生安全教育部重点实验室,上海 200032复旦大学公共卫生学院妇幼与儿少卫生教研室 公共卫生安全教育部重点实验室,上海 200032
医药卫生
回应性照护照护质量弱势儿童发育迟缓婴幼儿
responsive caregivingcaregiving qualityvulnerable childrendevelopmental delayinfants and toddlers
《中国医学科学院学报》 2026 (4)
640-646,7
国家社会科学基金(20BRK048)
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