【作者】 程少贵；

【导师】 陶芳标； 郝加虎；

【作者基本信息】 安徽医科大学 ， 儿少卫生与妇幼保健学， 2008， 硕士

【摘要】 目的调查农村中学学生父母外出打工现状,了解留守青少年学生心理病理症状的检出率和健康危险行为报告率,探讨留守状况对心理健康和健康危险行为的影响。方法采用现况调查的方法,对安徽省某县两所农村中学3 410名初一～高三学生进行问卷调查,调查内容包括学生的一般人口学指标、父母外出打工情况、心理卫生问题、青少年健康危险行为和意外伤害状况等,分析父母外出打工对留守青少年学生心理健康和健康危险行为的影响。3 246名完整家庭的学生问卷纳入分析。结果研究样本为3 246名中学生,其中父亲外出打工的有2 244人(69.1%),母亲打工的1 209人(37.2%),父母均打工的有1 130人(34.8%),只有28.4%学生父母没有外出打工,留守青少年占71.6%。留守学生平均年龄(15.77±1.46岁)大于非留守学生(15.66±1.47岁),差异有统计学显著意义(t =2.08,P﹤0.05),留守学生和非留守学生的性别分布差异无统计学意义(χ2=0.39, P=0.20)。留守学生中,父亲平均外出打工时间(10.7±4.2年)比母亲平均外出打工时间(6.3±3.9年)长,差异有统计学意义(U =30.8,P﹤0.01)。按监护类型分,单亲监护的学生有46.2%,隔代监护的学生占33.7%的学生,11.6%学生自我监护,另有2.3%和6.1%由同辈监护或其他亲戚监护。留守学生父母文化程度普遍较低,对学生的监护主要局限于生活照顾和生病照料,对孩子的学习辅导较少。留守青少年心理健康状况较差,他们中有一种或几种心理病例症状(心理卫生问题)的检出率为32.2%,而非留守学生为12.7%,差异有统计学意义(χ2=128.34,P=0.000);留守青少年的心理健康状况存在性别差异,女生心理卫生问题检出率为40.4%,高于男生(25.3%),差异具有统计学意义(χ2=60.37,P=0.000);16岁以上的留守学生在强迫症状、人际关系敏感、精神病性三个方面心理卫生问题检出率高于16岁及以下组,差异具有统计学意义;父母双方均外出打工的中学生心理卫生问题检出率为36.3%,高于父母单方外出打工组学生(28.2%),差异有统计学意义(χ2=17.17,P=0.000);单亲监护学生心理卫生问题检出率为22.5%低于隔代监护(43.5%)和同辈、亲戚、自我监护(36.4%)学生,差异有统计学意义(χ2=96.17,P=0.000)。多因素Logistic回归分析表明,控制父母文化程度、青少年性别、年龄、家庭住居地后,母亲打工和父母双方打工是青少年心理问题的危险因素。留守学生与非留守学生健康危险行为发生率差异无统计学意义,其中不参加体育锻炼、被恶意取笑、每天上网、与别人打架、有过离家出走想法的报告率分别为39.9%、20.1%、14.8%、9.1%、7.4%。但除上网行为外,父母双方外出打工学生的各类健康危险行为和意外伤害发生率均高于父母只有一方外出打工的学生,差异有统计学意义;留守青少年学生各类健康危险行为存在性别差异,男生高于女生,差异有统计学意义。结论农村中学学生留守率较高,除单亲监护外,隔代监护是主要的监护类型。留守青少年学生比非留守学生出现较多的心理卫生问题,父母双方均外出打工学生心理卫生问题检出率高于父母只有一方外出打工学生,提示留守状态和亲子关系缺失对青少年学生的心理健康产生了较大影响,应鼓励农村家庭应尽可能留一方父母在家照顾子女上学。留守青少年学生中,男生比女生出现较多的健康危险行为,而女生比男生心理卫生问题检出率要高,应特别关注女性留守青少年学生心理健康和男性青少年学生健康危险行为的预防。尽管留守青少年学生与非留守青少年学生的健康危险行为差异无统计学意义,但父母双方外出打工的学生健康危险行为和意外伤害事件的发生率均高于父母只有一方外出打工的学生,提示缺少父母的有效监管可能增加留守青少年学生的健康危险行为。更多还原

【Abstract】 Objectives The study aims to investigate the current situation of parental migrant working of rural middle-school students , and to explore the prevalence of psychopathological symptoms and health-risk behaviors of left-behind adolescents, providing evidence for the adverse effects of parents’migrant working on adolescents’psychological and behavioral health.Methods The cross-sectional investigation was conducted in 3 410 students from 7th grade to 12th grade in two middle schools in X county of Anhui Province. The students completed the anonymous questionnaire including the demographic characteristics, migrant working of parents, psychopathological symptoms and health risk behaviors and unintentional injuries. The group difference of mental health status and the incidences of health risk behaviors related to parental migrant working were estimated according to different demographic characteristics respectively. 3246 questionnaires of the intact family were included and analyzed.Results Of 3 246 students investigated in this survey, 2 244 students (69.1%) whose fathers are migrant workers,1 209 (37.2%) students whose mothers are migrant workers, 1 130 (34.8%) whose parents are both migrant workers and 71.6% of all students are left-behind adolescents. The mean age of left-behind students (15.77±1.46) is significantly older than that of non-left behind ones (15.66±1.47) (t=2.08,P﹤0.05). There is no significantly statistical difference in gender distribution between left-behind and non-left behind students (χ2=0.39, P=0.20). Mean time of paternal migrant working (10.7±4.2 years) is statistically longer than that of maternal migrant working (6.3±3.9 years) (U =30.8,P﹤0.01). 46.2% of left-behind students were supervised by their single parents, 33.7% students by their grandparents, up to 11.6% students by themselves, and 2.3% and 6.1% students by compeers and other relatives respectively. Generally, the educational level of migrant working parents is rather low, the care that left-behind students received from parents mainly focus on daily life and seldom on learning.The incidence of psychopathological problems among left-behind students (32.2%) is significantly higher than that of non-left behind ones (12.7%) (χ2=128.337,P=0.000). Moreover, the incidence of psychopathological problems among female students (40.4%) is significantly higher than male students (25.3%) (χ2=60.372,P=0.000). The prevalences of obsession-compulsion,interpersonal sensitivity and psychoticism among students above 16 years old are significantly higher than the students below 16 years old. Parental migrant working significantly affects the psychological development of adolescents. The prevalence of mental health problems among the students (36.3%) whose parents are both migrant workers is significantly higher compare to other students whose father or mother are migrant workers (26.2%) (χ2=17.174,P=0.000). The prevalence of mental health problems among the students (22.5%) supervised by single parents is statistically lower than the students supervised by grandparents (43.5%) and by compeers, other relatives and themselves (36.4%) (χ2=96.167,P=0.000). Using multivariate logistic regression model, it showed that migrant working of mothers and parents was the risk factor for adolescents’mental health problems, with mother and father’s education level, sex and age of adolescents, settlement of family controlled as covariants.There is no statistical difference of health risk behaviors between left-behind and non-left behind students. The incidences of lack of physical exercise, being mocked, Internet addiction, fighting and having the idea of going away from home are 39.9%, 20.1%, 14.8%, 9.1% and 7.4% respectively. There is significant relationship between parental migrant working and health risk behaviors of adolescents. The incidences of health risk behaviors (except Internet addiction) and unintentional injuries among the students whose parents are both migrant workers are statistically higher, compared with students whose father or mother are migrant workers. There is significant gender difference in health risk behaviors among left behind students with boys are at much more risk.Conclusions High proportions of middle-school students in rural areas are left-behind. These left-behind students are mostly supervised by their single parents or grandparents. Left-behind students have more psychopathological symptoms compared with non-left behind ones, indicating that bonding of parents and children is the leading cause of adolescent mental health problems and it is essential to encourage parents staying home and taking care of their school-age children. The prevalence of psychopathological symptoms is higher among the students whose parents are both migrant workers than other students whose father or mother are migrant workers. Among these left-behind students,boys have more health risk behaviors than the girls,while girls have more mental health problems than boys. Therefore, more attention should be paid to prevent psychopathological symptoms of female students and health risk behaviors of male students. The incidences of health risk behaviors and unintentional injuries are higher among the students whose both parents are migrant workers than other students whose single parents are migrant workers. There is no statistical difference of health risk behavior between left-behind and non-left behind students,however,the incidences of health risk behaviors and unintentional injuries among the students whose parents are both migrant workers are higher than students whose father or mother are migrant workers,which indicated the lack of effective supervision of parents might increase the health risk behaviors of left-behind students.更多还原