Thompson Richard, Kaczor Kim, Lorenz Douglas J, Bennett Berkeley L, Meyers Gabriel, Pierce Mary Clyde
Richard H. Calica Center for Innovation in Children and Family Services, Juvenile Protective Association, Chicago, Ill.
Division of Emergency Medicine, Ann & Robert H. Lurie Children's Hospital of Chicago, Chicago, Ill.
Acad Pediatr. 2017 Jan-Feb;17(1):34-44. doi: 10.1016/j.acap.2016.02.014. Epub 2016 Feb 26.
To determine the association between use of physical discipline and parental report of physically aggressive child behaviors in a cohort of young children who were without indicators of current or past physical abuse.
The data for this study were analyzed from an initial cohort of patients enrolled in a prospective, observational, multicenter pediatric emergency department-based study investigating bruising and familial psychosocial characteristics of children younger than 4 years of age. Over a 7-month period, structured parental interviews were conducted regarding disciplinary practices, reported child behaviors, and familial psychosocial risk factors. Children with suspected physical abuse were excluded from this study. Trained study staff collected data using standardized questions. Consistent with grounded theory, qualitative coding by 2 independent individuals was performed using domains rooted in the data. Inter-rater reliability of the coding process was evaluated using the kappa statistic. Descriptive statistics were calculated and multiple logistic regression modeling was performed.
Three hundred seventy-two parental interviews were conducted. Parents who reported using physical discipline were 2.8 (95% confidence interval [CI], 1.7-4.5) times more likely to report aggressive child behaviors of hitting/kicking and throwing. Physical discipline was used on 38% of children overall, and was 2.4 (95% CI, 1.4-4.1) times more likely to be used in families with any of the psychosocial risk factors examined.
Our findings indicated that the use of physical discipline was associated with higher rates of reported physically aggressive behaviors in early childhood as well as with the presence of familial psychosocial risk factors.
在一组无当前或既往身体虐待指标的幼儿队列中,确定体罚的使用与家长报告的儿童身体攻击性行为之间的关联。
本研究的数据来自一项前瞻性、观察性、多中心的基于儿科急诊科的研究的初始患者队列,该研究调查了4岁以下儿童的瘀伤和家庭心理社会特征。在7个月的时间里,就管教方式、报告的儿童行为和家庭心理社会风险因素进行了结构化的家长访谈。疑似身体虐待的儿童被排除在本研究之外。训练有素的研究人员使用标准化问题收集数据。与扎根理论一致,由2名独立人员使用源于数据的领域进行定性编码。使用kappa统计量评估编码过程的评分者间信度。计算描述性统计量并进行多因素逻辑回归建模。
进行了372次家长访谈。报告使用体罚的家长报告儿童出现击打/踢打和投掷等攻击性行为的可能性高出2.8倍(95%置信区间[CI],1.7 - 4.5)。总体上,38%的儿童受到体罚,在存在任何所研究的心理社会风险因素的家庭中,使用体罚的可能性高出2.4倍(95% CI,1.4 - 4.1)。
我们的研究结果表明,体罚的使用与幼儿期报告的身体攻击性行为的较高发生率以及家庭心理社会风险因素的存在有关。