Liu Li, Fan Lijun, Hou Xiang-Yu, Wu Chuan-An, Yin Xiao-Na, Wen Guo-Min, Sun Dengli, Xian Dan-Xia, Jiang Hui, Jing Jin, Jin Yu, Chen Wei-Qing
Guangzhou Key Laboratory of Environmental Pollution and Health Assessment, Guangdong Provincial Key Laboratory of Food, Nutrition and Health, Department of Medical Statistics and Epidemiology, School of Public Health, Sun Yat-sen University, Guangzhou, China.
School of Public Health and Social Work, Australia China Centre for Public Health, Queensland University of Technology, Brisbane, QLD, Australia.
Front Pediatr. 2018 Aug 6;6:217. doi: 10.3389/fped.2018.00217. eCollection 2018.
Previous studies have demonstrated the impacts of genetic, family, and community factors on child conduct problems (CPs). However, little is understood regarding the association between family childcare types and child conduct problem behaviors, as well as whether and to what extent caregiver-child interaction mediates the above association. 9,289 children first entering kindergartens in the Longhua New District of Shenzhen, China were enrolled in this cross-sectional study. Primary caregivers were invited to fulfill a self-administered structured questionnaire containing data regarding socio-demographics, family childcare types, caregiver-child interaction, and child conduct problem behaviors (measured by the Conners' Conduct Problem Subscale). A series of multiple logistic and linear regression models were employed to assess the associations among family childcare, caregiver-child interaction, and child conduct problem behaviors. Family childcare types other than by parents together (i.e., mother alone, mother with others, grandparents, or changing caregivers) were all significantly associated with higher risks of conduct problem behaviors in young children (adjusted ORs ranged from 2.18 to 2.55, and adjusted βs ranged from 0.043 to 0.073; all < 0.05), after adjusting for confounders including child age, gender, parental education level, parental age at pregnancy, marital status, and family income. The following family childcare types (mother alone, or grandparents, or changing caregivers) vs. the childcare by parents together showed significant relative indirect effects on conduct problem behaviors through caregiver-child interaction, indicating the significant mediation effect of caregiver-child interaction on the above associations. Mediation of caregiver-child interaction on the effect of being cared by mother with others relative to care by parents together on child conduct problem behaviors was yet non-significant. Family childcare types other than by parents together are associated with increased risks for conduct problem behaviors in young children. Caregiver-child interaction may function as a potential mediator for the above association.
以往的研究已经证明了基因、家庭和社区因素对儿童行为问题的影响。然而，对于家庭育儿类型与儿童行为问题行为之间的关联，以及照顾者与儿童的互动是否以及在多大程度上介导了上述关联，人们了解甚少。本横断面研究纳入了中国深圳龙华新区首次进入幼儿园的9289名儿童。邀请主要照顾者填写一份自填式结构化问卷，内容包括社会人口统计学、家庭育儿类型、照顾者与儿童的互动以及儿童行为问题行为（通过康纳斯行为问题分量表测量）。采用一系列多元逻辑回归和线性回归模型来评估家庭育儿、照顾者与儿童的互动以及儿童行为问题行为之间的关联。除父母共同育儿外的其他家庭育儿类型（即母亲独自育儿、母亲与他人一起育儿、祖父母育儿或更换照顾者），在调整了包括儿童年龄、性别、父母教育水平、父母怀孕时的年龄、婚姻状况和家庭收入等混杂因素后，均与幼儿出现行为问题行为的较高风险显著相关（调整后的比值比范围为2.18至2.55，调整后的β值范围为0.043至0.073；均P<0.05）。以下家庭育儿类型（母亲独自育儿、祖父母育儿或更换照顾者）与父母共同育儿相比，通过照顾者与儿童的互动对行为问题行为显示出显著的相对间接影响，表明照顾者与儿童的互动对上述关联具有显著的中介作用。照顾者与儿童的互动对母亲与他人一起照顾相对于父母共同照顾对儿童行为问题行为的影响的中介作用尚不显著。除父母共同育儿外的其他家庭育儿类型与幼儿出现行为问题行为的风险增加有关。照顾者与儿童的互动可能是上述关联的潜在中介因素。
