Yang Zi-ni, Pan Jian-ping
Department of Pediatrics, the No. 145 Hospital of People's Liberation Army, Laiyang, Shandong, Laiyang 265200, China.
Zhonghua Er Ke Za Zhi. 2003 Jul;41(7):501-7.
Child abuse and neglect (CNS) increasingly have become a serious problem in modern society all over the world. Children neglected and abused are at risk for maladaptation in behavioral, emotional, social, cognitive, and physical functioning. The purpose of this investigation was to develop the Child Neglect Scale for children aged 3 - 6 years in Chinese urban areas and to test the reliability and validity of this norm.
According to the principle and procedure of developing scales, a child neglect questionnaire was designed. Multistage sampling was used in the study in accordance with sex, age, the levels of economy and kindergartens, a random sample of 1,465 children aged 2 - 6 years was selected from 25 cities. Of the 1,465 subjects who completed the Child Neglect Questionnaires again 2 weeks later, 66 had completed data on each of the two occasions. The Child Neglect Questionnaires were completed by parents and caregivers. The data were analyzed using items analysis, factor analysis, internal consistency analysis and the reliability and validity of the norm were tested. The factor structure of the Child Neglect Scale was determined using an oblique rotation. The internal consistency was reflected in Cronbach's alpha. Since no existing categorization scheme on child neglect could be found in the literature, one was formulated in an attempt to efficiently and meaningfully group similar types of caregiver behaviors. The initial pool of potentially neglecting caregiver behaviors was drawn from literature. The most common patterns of parental behaviors were grouped according to six neglect subscale schemes found in the literature, with modifications made to increase item specificity and reduce overlap. The initial Child Neglect Questionnaire contained a 25-item physical neglect subscale, a 59-item emotional neglect subscale, a 23-item educational neglect subscale, a 20-item safety neglect subscale, a 10-item medical neglect subscale, a 9-item social neglect subscale.
Completed Child Neglect Questionnaires were obtained from 1,457 subjects, 726 males and 731 females. The overall findings of this study came from 1,163 subjects, because children aged 2 years (294 subjects) were removed from subjects by statistical method. The 91-item Child Neglect Scale was presented to the respondent as a child neglect questionnaire with a 9-item social neglect subscale and some items in other subscales were removed from the initial questionnaire by using statistical method. The questionnaire contained 17 physical neglect items, 40 emotional neglect items, 17 educational neglect items, a 10 safety neglect items, and 7 medical neglect items. The internal consistency of the overall Child Neglect Scale as reflected in Cronbach's alpha was 0.94, the split-half reliability was 0.88, the test-retest reliability was 0.92. For physical, emotional, educational, safety, medical neglect subscale, Cronbach's alpha, respectively was 0.80, 0.88, 0.84, 0.68, 0.60, the split-half reliability was 0.54 - 0.88, the test reliability was 0.89, 0.94, 0.87, 0.80, 0.77, respectively. The construct validity, face validity and exterior validity of the norm were good. For physical, emotional, educational, safety, medical neglect subscale and overall child neglect scale, the scores of percentiles 90 were used as cut-point. They were 35, 80, 40, 20, 15, 190, respectively.
The norm was consistent with China's economic-cultural background and reality. It not only may be used for research purpose but also may be useful in assessing parent's and child-oriented individual's behaviors and attitude as a measuring instrument.
虐待和忽视儿童(CNS)在全球现代社会中日益成为一个严重问题。被忽视和虐待的儿童在行为、情感、社交、认知和身体功能方面存在适应不良的风险。本研究的目的是编制中国城市地区3 - 6岁儿童忽视量表,并检验该常模的信效度。
根据量表编制的原则和程序,设计了一份儿童忽视问卷。本研究采用多阶段抽样,按照性别、年龄、经济水平和幼儿园类别,从25个城市随机抽取了1465名2 - 6岁儿童。在1465名完成儿童忽视问卷的受试者中,2周后再次填写问卷的有66人,两次均完成数据收集。儿童忽视问卷由家长和照料者填写。采用项目分析、因子分析、内部一致性分析对数据进行分析,并检验常模的信效度。儿童忽视量表的因子结构采用斜交旋转确定。内部一致性用Cronbach's alpha系数表示。由于文献中未找到现有的儿童忽视分类方案,因此制定了一个分类方案,试图对类似类型的照料者行为进行有效且有意义的分组。潜在忽视照料者行为的初始条目池来自文献。根据文献中发现的六个忽视子量表方案对最常见的父母行为模式进行分组,并进行修改以提高项目特异性并减少重叠。初始儿童忽视问卷包含一个25项的身体忽视子量表、一个59项的情感忽视子量表、一个23项的教育忽视子量表、一个20项的安全忽视子量表、一个10项的医疗忽视子量表、一个9项的社交忽视子量表。
共获得1457名受试者填写的儿童忽视问卷,其中男性726名,女性731名。本研究的总体结果来自1163名受试者,因为通过统计方法将2岁儿童(294名受试者)排除在研究对象之外。将91项儿童忽视量表作为儿童忽视问卷呈现给受访者,其中社交忽视子量表为9项,通过统计方法从初始问卷中删除了其他子量表中的一些条目。问卷包含17项身体忽视条目、40项情感忽视条目、17项教育忽视条目、10项安全忽视条目和7项医疗忽视条目。儿童忽视总量表的内部一致性(以Cronbach's alpha系数表示)为0.94,分半信度为0.88,重测信度为0.92。身体、情感、教育、安全、医疗忽视子量表的Cronbach's alpha系数分别为0.80、0.88、0.84、0.68、0.60,分半信度为0.54 - 0.88,重测信度分别为0.89、0.94、0.87、0.80、0.77。该常模的结构效度、表面效度和外部效度良好。身体、情感、教育、安全、医疗忽视子量表和儿童忽视总量表以第90百分位数作为切点,分别为35、80、40、20、15、190。
该常模符合中国的经济文化背景和实际情况。它不仅可用于研究目的,还可作为一种测量工具,用于评估家长和以儿童为导向的个人的行为和态度。