UCL Centre for International Health and Development, 30 Guilford Street, London WC1N 1EH, UK.
Arch Dis Child. 2010 Feb;95(2):136-40. doi: 10.1136/adc.2009.171660. Epub 2010 Feb 4.
The Chinese educational system is highly competitive from the start of primary school with great emphasis on academic performance and intolerance of failure. This study aimed to explore the pressures on primary schoolchildren, and to determine the relationship between these pressures and psychosomatic symptoms: abdominal pain and headache.
Cross-sectional survey using self-completion questionnaires.
SETTING/PARTICIPANTS: 9- to 12-year-olds in primary schools in urban and rural areas of Zhejiang Province, eastern China.
Proportion of children with defined school-related stressors and frequency of psychosomatic illness.
Completed questionnaires were obtained from 2191 children. All stressors were common in boys and girls and in urban and rural schools. Eighty-one per cent worry 'a lot' about exams, 63% are afraid of the punishment of teachers, 44% had been physically bullied at least sometimes, with boys more often victims of bullying, and 73% of children are physically punished by parents. Over one-third of children reported psychosomatic symptoms at least once per week, 37% headache and 36% abdominal pain. All individual stressors were highly significantly associated with psychosomatic symptoms. Children identified as highly stressed (in the highest quartile of the stress score) were four times as likely to have psychosomatic symptoms.
The competitive and punitive educational environment leads to high levels of stress and psychosomatic symptoms in Chinese primary schoolchildren. Measures to reduce unnecessary stress on children in schools should be introduced urgently.
中国的教育体系从小学阶段就极具竞争性，非常强调学习成绩，不能容忍失败。本研究旨在探讨小学生所面临的压力，并确定这些压力与身心症状（腹痛和头痛）之间的关系。
使用自我完成问卷的横断面调查。
地点/参与者：来自中国东部浙江省城乡小学的 9-12 岁儿童。
有明确学校相关压力源的儿童比例和身心疾病的发生频率。
共获得 2191 名儿童的完整问卷。所有压力源在男孩和女孩以及城市和农村学校中都很常见。81%的儿童非常担心考试，63%的儿童害怕老师的惩罚，44%的儿童至少有时受到过身体欺凌，男孩更常成为欺凌的受害者，73%的儿童受到父母的体罚。超过三分之一的儿童每周至少出现一次身心症状，37%头痛，36%腹痛。所有个体压力源均与身心症状高度相关。被确定为压力高的儿童（压力得分最高的四分之一）出现身心症状的可能性是其他儿童的四倍。
竞争激烈和惩罚性的教育环境导致中国小学生承受着高度的压力和身心症状。应紧急采取措施减轻学校中儿童不必要的压力。
