基于风险矩阵的社区0~3岁儿童意外伤害风险评估  

Risk assessment of unintentional injuries of community children aged 0~3 years based on risk matrix method

作　　者：王惠萍 姜若 吕军[2] 汤伟琴 袁红[3] 张一英[3] 向芳[3] 毛淋淇 郑继翠[4] 励晓红[2] WANG Huiping;JIANG Ruo;LYU Jun;TANG Weiqin;YUAN Hong;ZHANG Yiying;XIANG Fang;MAO Linqi;ZHENG Jicui;LI Xiaohong(Jiading Town Street and Community Health service Center in Jiading District,Shanghai 201800,China;School of Public Health,Fudan University/Chinese Research Center on Disability Issues at Fudan University/Collaborative Innovation Center of Social Risks Governance in Health,Shanghai 200032,China;Jiading District Center for Disease Control and Prevention in Shanghai,Shanghai 201800,China;The Affiliated Paediatric Hospital of Fudan University,Shanghai 201102,China)

机构地区：[1]上海市嘉定区嘉定镇街道社区卫生服务中心,上海201800 [2]复旦大学公共卫生学院/复旦大学中国残疾问题研究中心/国民健康社会风险预警协同创新中心,上海200032 [3]上海市嘉定区疾病预防控制中心,上海201800 [4]复旦大学附属儿科医院,上海201102

出　　处：《中国妇幼健康研究》2020年第2期197-202,共6页Chinese Journal of Woman and Child Health Research

基　　金：国家自然科学基金(编号:71573049、71373051、71573053);上海市嘉定区卫生和计划生育委员会科研项目(编号:2016-KY-20).

摘　　要：目的探讨社区儿童意外伤害风险等级评估方法,评估具体伤害类型等级,为针对性制定预防儿童伤害干预措施提供一定依据。方法采用风险矩阵法,综合考虑风险影响和风险概率两方面因素,对风险可能性和严重性进行专家论证。Kendall协调系数(KCC)评估专家内部一致性,计算Borda序值明确关键风险。结果共22名专家做出有效回答(有效应答率95.65%),在36类具体伤害中,对于1岁以内的儿童,风险等级"极高"有2类,均属于窒息伤害;2~3岁儿童风险等级"极高"也有2类,分别属于道路交通伤害和跌落伤害。按照Borda序值排列,结果不变。1岁以下儿童风险子类别发生概率和后果严重性计算的KCC分别为0.439和0.361(均P<0.001),2~3岁儿童的KCC分别为0.351和0.434(均P<0.001),专家意见具有一致性。结论不同年龄段儿童的风险等级不同,将风险矩阵法应用到预防儿童意外伤害领域,可为社区诊断不同年龄段儿童伤害类型等级提供方便快捷的方法,为社区卫生服务中心工作人员针对性预防儿童意外伤害提供科学依据,具有一定推广价值。Objective To explore risk level assessment method of unintentional injuries in community children and assess concrete injury type and grading,so as to provide a basis for formulating intervention measures to prevent children’s injury.Methods In risk matrix method,in comprehensive consideration of factors influencing severity and likelihood of risk,occurrence likelihood and consequence severity of risk were argued through expert consultation.The Kendall Coordination Coefficient(KCC)was employed to assess internal consistency among experts,calculate Borda ordinal value and determine key risks.Results 22 experts gave their valid answers,with 95.65%of effective response rate.Among 36 types of specific injuries,for children aged within 1 year,there were two types of"extremely high"risk level,which belong to asphyxial injury.For children aged 2~3 years,in the ranking of accident injury risk,there were two types of"extremely high"risk too,which were road traffic accident injury and fall injury.If according to the order of Borda ordinal value,the results were same.The KCC for the probability and severity of risk subtypes for children aged within1 year were 0.439 and 0.361 respectively(both P<0.001),and the KCC for the probability and severity of risk subtypes for those children aged 2~3 years were 0.351 and 0.434 respectively(both P<0.001).The opinions of all experts were consistent.Conclusion Ranking of risks varied with different ages of the children.Application of the risk matrix method into the field of preventing unintentional injuries in children benefits the community diagnosis of type and severity of unintentional injuries of children in different age groups due to its rapidness and convenience.It provides a scientific basis for targeted prevention of children’s unintentional injuries for the staffs of community health service centers,so it is of certain popularization value.

关 键 词：风险矩阵 儿童意外伤害 跌落伤 社区 

分 类 号：R179[医药卫生—妇幼卫生保健]