幼儿期视屏行为和户外活动及其交互作用与学龄前期多动行为的关联  

The Association between Screen Time Behavior in Early Childhood,Outdoor Activities and their Interaction with Hyperactive Behavior in Preschool Children

作　　者：陈慧婷 吴玉岚 曾飞翔[2] 温冬艳 刘伟莹 陈若青 李旅萍[2] 金宇[1] CHEN Huiting;WU Yulan;ZENG Feixiang;WEN Dongyan;LIU Weiying;CHEN Ruoqing;LI Lvping;JIN Yu(Department of Maternal and Child Health,School of Public Health,Sun Yat-Sen University//Research Center for Child and Adolescent Psychology,Behavior and Development,School of Public Health,Sun Yat-Sen University,Guangzhou 510080,China;Department of Rehabilitation Medicine,Huizhou Third People’s Hospital,Huizhou 516000,China;School of Public Health(Shenzhen),Sun Yat-sen University,Shenzhen 518000,China)

机构地区：[1]中山大学公共卫生学院妇幼卫生系//中山大学公共卫生学院儿童青少年心理行为发育研究中心,广东广州510080 [2]惠州市第三人民医院康复医学科,广东惠州516000 [3]中山大学公共卫生学院(深圳),广东深圳518000

出　　处：《中山大学学报（医学科学版）》2024年第6期891-901,共11页Journal of Sun Yat-Sen University:Medical Sciences

基　　金：广东省基础与应用基础研究基金(2023A1515012442);惠州市第三人民医院儿童孤独症谱系障碍筛查及诊断治疗项目(HT-99982022-0032)。

摘　　要：【目的】调查儿童一岁半时视屏内容类型及屏幕暴露频率与学龄前期多动行为的关联,并探究户外活动与视屏行为的交互作用对关联关系的影响,为儿童行为问题的预防及干预提供理论依据及可行方案。【方法】2022年6月至2023年6月,在广东省惠州市惠城区使用分层整群抽样的方法抽取61所幼儿园中5648名儿童的家长及教师进行调查,采用Conners教师评定量表(TRS)评估儿童的多动行为,使用自编问卷调查儿童的基本信息、一岁半时视屏内容类型、屏幕暴露频率及户外活动频率。使用多元Logistic回归进行统计分析,在控制儿童的年龄、性别、父母亲受教育程度等因素的条件下,探究视屏行为与多动行为的关联及其与户外活动的交互作用。【结果】儿童学龄前期多动行为总体检出率为3.2%,品行问题为2.1%、多动问题为2.1%、注意力不集中-被动问题为1.3%、多动指数为0.9%。校正混杂因素后,多元Logistic回归分析显示儿童一岁半时屏幕暴露为“每周2~4次”与学龄前期多动行为的检出率升高有关,比值比(OR)[95%置信区间(CI)]为1.682(1.141,2.480)。每天均有屏幕暴露与学龄前期多动行为、品行问题、多动问题、注意力不集中-被动问题和多动指数的检出率升高均存在关联,OR(95%CI)分别为2.136(1.218,3.746)、2.321(1.185,4.546)、2.300(1.208,4.380)、2.776(1.267,6.085)和3.640(1.525,8.687),但这种关联在一岁半时每天进行户外活动的儿童中并未发现(交互作用P值<0.001)。未发现视屏内容类型与多动行为的关联(P>0.05)。【结论】幼儿期屏幕暴露频率与学龄前期多动行为问题显著相关,户外活动可以削弱高频屏幕暴露与多动行为之间的关联关系,提示家长及学校应重视对幼儿视屏行为和户外活动的科学引导,合理安排幼儿一日生活,为儿童行为健康发展奠定良好基础。【Objective】To investigate the association between screen content and the frequency of screen exposure at the age of one and a half years and hyperactive behavior in preschool,and to explore how the association is affected by the interaction between outdoor activities and screen behaviors,which could provide theoretical basis and feasible solutions for the prevention and intervention of behavioral problems in childhoood.【Methods】The survey was conducted from June 2022 to June 2023 in Huicheng District,Huizhou(China)stratified by whole cluster sampling methods.Parents and teachers of 5648 children in 61 kindergartens were sampled for questionnaire surveys.The Conners Teacher Rating Scale(TRS)was used to investigate hyperactive behavior.A self-administered questionnaire was used to investigate basic demographic information of children,screen content,frequency of screen exposure and outdoor activities at the age of one and a half years.Multivariate logistic regression was used to explore the association between video screen behavior and hyperactive behavior and its interaction with outdoor activities by controlling for covariates such as children’s age,gender,and parental education.【Results】Result showed the overall prevalence of 3.2%for hyperactive behavior,2.1%for conduct problems,2.1%for hyperactivity problems,1.3%for inattention-passivity problems,and 0.9%for hyperactivity index.After adjusting for confounding factors,multiple logistic regression analysis showed that screen exposure of"two to four times a week"at one and a half years old was associated with an increased detection rate of hyperactive behaviors in preschool children,with an estimated ORs(95%CI)of 1.682(1.141,2.480).Daily screen exposure was associated with increased detection rates of hyperactive behavior,conduct problems,hyperactivity issues,inattention-passivity problems,and hyperactivity index in pre-school age.The estimated ORs(95%CI)were 2.136(1.218,3.746),2.321(1.185,4.546),2.300(1.208,4.380),2.776(1.267,6.085)and 3.640(1.525,8.

关 键 词：多动行为 注意缺陷多动障碍 视屏行为 户外活动 学龄前儿童 

分 类 号：R179[医药卫生—妇幼卫生保健]