de Lourdes Drachler Maria, de Carvalho Leite José Carlos, Marshall Tom, Anselmo Hess Almaleh Carla Maria, Feldens Carlos Alberto, Vitolo Márcia Regina
School of Allied Health Professions, University of East Anglia, Norwich, UK.
Acta Paediatr. 2007 Aug;96(8):1169-73. doi: 10.1111/j.1651-2227.2007.00385.x. Epub 2007 Jun 21.
To examine the effects of the home environment on unintentional domestic injuries and related health care attendance in infants from deprived families.
Ten mechanisms that caused unintentional domestic injury during the first year were investigated in a population-based study of 1-year-old children in southern Brazil. Odds ratios of injury-related health care attendance were estimated by number of injury mechanisms reported. Variation in number of mechanisms (in the whole sample) and odds ratios of care attendance (in children with reported injuries) were estimated for socioeconomic and psychosocial variables.
Among all children (394) 86% had injuries; 10.9% care attendance and 0.5% hospitalisation were reported, and 14.5% presented dental trauma. Injury-related care attendance increased with the number of injury mechanisms (linear trend OR = 1.34, 95% CI = 1.09-1.66). In multivariable linear regression, injury mechanisms increased with the number of home hazards (p = 0.047) and decreased with duration of exclusive breastfeeding (p = 0.039), maternal involvement-responsiveness (p = 0.037) and mother's paid work (p = 0.018). Injury-related health care attendance among children with reported injuries was positively associated with maternal involvement-responsiveness (OR = 2.27, 95% CI = 1.11-4.67) and home organization (OR = 2.25, 95% CI = 1.09-4.65).
Injury control can benefit from policy and practice that improve housing, reduce home hazards and promote breastfeeding, maternal bonds, safety practices and injury care.
研究家庭环境对贫困家庭婴儿非故意伤害及相关医疗护理的影响。
在巴西南部一项针对1岁儿童的基于人群的研究中，调查了导致第一年非故意伤害的10种机制。根据报告的伤害机制数量估算与伤害相关的医疗护理的比值比。针对社会经济和心理社会变量，估算了机制数量（在整个样本中）的变化以及护理比值比（在报告有伤害的儿童中）。
在所有儿童（394名）中，86% 有过伤害；报告有10.9% 的儿童接受了医疗护理，0.5% 的儿童住院治疗，14.5% 的儿童有牙齿外伤。与伤害相关的医疗护理随着伤害机制数量的增加而增加（线性趋势比值比 = 1.34，95% 置信区间 = 1.09 - 1.66）。在多变量线性回归中，伤害机制随着家庭危险因素数量的增加而增加（p = 0.047），随着纯母乳喂养持续时间的延长而减少（p = 0.039），随着母亲的参与度 - 反应性的提高而减少（p = 0.037），随着母亲从事有偿工作而减少（p = 0.018）。报告有伤害的儿童中，与伤害相关的医疗护理与母亲的参与度 - 反应性（比值比 = 2.27，95% 置信区间 = 1.11 - 4.67）和家庭组织（比值比 = 2.25，95% 置信区间 = 1.09 - 4.65）呈正相关。
伤害控制可受益于改善住房、减少家庭危险因素以及促进母乳喂养、母婴关系、安全措施和伤害护理的政策与实践。
