Zhang Pei-bin, Chen Rong-hua, Deng Jing-yun, Xu Bai-rong, Hu You-fang
Children's Health Care Research Center in the Second Affiliated Hospital of Nanjing Medical University, Nanjing 210011, China.
Zhonghua Er Ke Za Zhi. 2003 Jul;41(7):497-500.
The main causes of death in children aged 0 - 4 were accidental suffocation and drowning which had a significant relation with parents' lack of prevention knowledge and effective measures. By comparing parents' acknowledge and behavior in preventing accidental suffocation and drowning and the mortality rate of accidental suffocation and drowning after intervening with those before the intervening, evaluation was made on intervening efficacy of health education.
Six counties in north Jiangsu were involved in the survey. Two townships drawn from each county were divided into the intervened group and the controlled group. Health education was carried out in the intervened group for one year in 2000. Twenty to 30 parents of infants and children aged 1 - 4 drawn randomly from every township in the intervened group were taken as investigation subjects before and after intervening, and a questionnaire was made for them to answer. Meanwhile, the mortality rates of accidental suffocation and drowning were measured.
Followed by health education for a year, the parents' opinion about whether unintentional injury can be avoided or not has changed from 18.8% to 20.5% to 1.8% - 2.9%, and parents' knowledge about how to give first aid in spot has increased from 11.1% - 13.5% to 41.1% - 56.8%. The parents' behavior that not sleeping with their infants in the same beds and not tying infants in a candle with blanket, and setting up fence beside pools and rivers has increased by 75.7%, 61.5% and 61.2%, respectively, while their relative knowledge has increased by 212.7% and 194.3%. In the intervened group, the mortality rates of infants' accidental suffocation per 100,000 has fallen from 487.8 to 71.2, dropped by 85.4%; and the mortality rates of drowning in children aged 1 - 4 per 100,000 has fallen from 60.0 to 36.2, dropped by 39.7%. In comparison, in the controlled group, the mortality rates of infants' accidental suffocation per 100,000 has fallen from 344.1 to 276.4, dropped by 19.7%; and the mortality rates of drowning in children aged 1 - 4 per 100,000 has increased by 26.3%, from 51.7 to 65.3.
Health education to parents is an effective intervening measure for prevention of accidental suffocation and drowning. The goal of health education should be to change inadequate behavior and dangerous environment in which unintentional injury is easily happened. The intervening measures that not sleeping with their infants in the same beds and not tying infants in a candle with blanket, and putting up fence beside pools and rivers are feasible and practicable.
0 - 4岁儿童主要死亡原因是意外窒息和溺水,这与家长缺乏预防知识和有效措施密切相关。通过比较家长在预防意外窒息和溺水方面的认知与行为,以及干预前后意外窒息和溺水死亡率,评估健康教育的干预效果。
调查涉及苏北6个县。从每个县抽取两个乡镇,分为干预组和对照组。2000年对干预组进行为期一年的健康教育。在干预组每个乡镇随机抽取20 - 30名1 - 4岁婴幼儿家长作为干预前后的调查对象,并制作问卷让他们回答。同时,统计意外窒息和溺水死亡率。
经过一年健康教育,家长认为意外伤害可避免的比例从18.8%升至20.5%后降至1.8% - 2.9%,家长现场急救知识知晓率从11.1% - 13.5%升至41.1% - 56.8%。家长与婴儿不同床睡、不将婴儿裹在毯子里蜡烛包以及在池塘和河流边设置围栏的行为分别增加了75.7%、61.5%和61.2%,相关知识分别增加了212.7%和194.3%。干预组中,每10万例婴儿意外窒息死亡率从487.8降至71.2,下降了85.4%;1 - 4岁儿童溺水死亡率从60.0降至36.2,下降了39.7%。相比之下,对照组中,每10万例婴儿意外窒息死亡率从344.1降至276.4,下降了19.7%;1 - 4岁儿童溺水死亡率上升了26.3%,从51.7升至65.3。
对家长进行健康教育是预防意外窒息和溺水的有效干预措施。健康教育的目标应是改变易发生意外伤害的不当行为和危险环境。与婴儿不同床睡、不将婴儿裹在毯子里蜡烛包以及在池塘和河流边设置围栏的干预措施可行且实用。