Wei Qianwei, Zhang Cuihong, Zhang Jingxu, Luo Shusheng, Wang Xiaoli
Peking University Health Science Center, Beijing.
Infant Ment Health J. 2018 Mar;39(2):209-219. doi: 10.1002/imhj.21699. Epub 2018 Feb 27.
Poverty and its associated factors put people at risk for depression. The aims of this study were to describe the prevalence of depressive symptoms (DS) of primary caregivers and socioemotional development (SED) delays of young children in poor rural areas of China, and to explore the association between them. Cross-sectional data of 2,664 children aged 3 to 35 months and their primary caregivers were used for analysis. Characteristics of the child, caregiver, and family were collected through face-to-face caregiver interviews. DS were assessed by the Zung Self-Rating Depression Scale (W.W. Zung, 1965, as cited in World Health Organization, ), and SED was evaluated by the Ages and Stage Questionnaires: Social-Emotional (J. Squires, D. Bricker, & L. Potter, 1997). The χ test, stratification analysis, and logistic regression analyses were used to explore the association. Among the caregivers, 40.3% (95% confidence interval [CI] [38.4, 42.1]), reported DS. Caregivers who were male, older and ethnic minorities as well as had a low level of education, a low family income, or more children were more likely to have DS. Of the children, 24.4% (95% CI [22.8, 26.0]) were recognized with SED delays. Older children displayed more delays than did younger children, but no significant differences between males and females were found. SED delays were significantly associated with mother outmigrating, male caregivers, older age, ethnic minorities, and low education or families with a single parent, low-income, and having more children. Caregivers having DS, odds ratio (OR) = 2.40, 95% CI [1.99, 2.88], was a significant predictor of increased odds of SED delays; other factors were single-parent family, OR = 1.99, 95% CI [1.37, 2.89], inadequate care, OR = 1.69, 95% CI [1.30, 2.21], physical punishment, OR = 1.61, 95% CI [1.33, 1.95], ethnic minorities, OR = 1.41, 95% CI [1.17, 1.71], and child age in months, OR = 1.03, 95% CI [1.02, 1.04], according to the logistic regression analysis. DS are prevalent among caregivers with young children in poor rural areas. Interventions to improve the mental health of caregivers and their parenting behaviors are needed to improve children's SED.
贫困及其相关因素使人们面临患抑郁症的风险。本研究的目的是描述中国农村贫困地区主要照料者的抑郁症状（DS）患病率以及幼儿社会情感发展（SED）延迟情况，并探讨两者之间的关联。使用了2664名3至35个月大儿童及其主要照料者的横断面数据进行分析。通过与照料者面对面访谈收集儿童、照料者和家庭的特征。DS通过zung自评抑郁量表（W.W. Zung，1965年，引自世界卫生组织）进行评估，SED通过年龄与阶段问卷：社会情感问卷（J. Squires、D. Bricker和L. Potter，1997年）进行评估。采用χ检验、分层分析和逻辑回归分析来探讨这种关联。在照料者中，40.3%（95%置信区间[CI][38.4, 42.1]）报告有DS。男性、年龄较大、少数民族、教育程度低、家庭收入低或子女较多的照料者更有可能有DS。在儿童中，24.4%（95% CI[22.8, 26.0]）被认定存在SED延迟。年龄较大的儿童比年龄较小的儿童表现出更多延迟，但未发现性别之间存在显著差异。SED延迟与母亲外出务工、男性照料者、年龄较大、少数民族、低教育程度或单亲、低收入及子女较多的家庭显著相关。根据逻辑回归分析，有DS的照料者，优势比（OR）=2.40，95% CI[1.99, 2.88]，是SED延迟几率增加的显著预测因素；其他因素包括单亲家庭，OR = 1.99，95% CI[1.37, 2.89]，照料不足，OR = 1.69，95% CI[1.30, 2.21]，体罚，OR = 1.61，95% CI[1.33, 1.95]，少数民族，OR = 1.41，95% CI[1.17, 1.71]，以及儿童月龄，OR = 1.03，95% CI[1.02, 1.04]。DS在农村贫困地区幼儿的照料者中普遍存在。需要采取干预措施来改善照料者的心理健康及其养育行为，以促进儿童的SED。
