摘要
目的探讨3~6岁儿童各类型电子屏幕使用时间及其与心理行为发育问题的关联,为儿童屏幕使用和心理健康促进提供科学依据。方法以上海亲子队列中完成3~6岁随访的3875对母子为研究对象,问卷调查儿童每日平板、手机、电视、投影及其他类型屏幕使用时间,使用年龄-发育进程问卷(ASQ-3)和长处与困难问卷(家长版)(SDQ)评价儿童心理行为发育问题。采用χ^(2)检验、Mann-Whitney U和Kruskal-Wallis秩和检验比较不同特征儿童心理行为发育问题检出率和屏幕时间,多因素二元Logistic回归分析屏幕时间与心理行为发育问题的关联。结果49.91%的儿童每天屏幕时间超过1 h,电视、平板、手机屏幕时间分别为0.39(0.25,0.96)、0.25(0,0.61)、0.18(0,0.25)h/d。男童精细动作、解决问题、个人-社会能区可疑发育迟缓以及存在亲社会行为不足和外化行为的检出率(8.54%,6.77%,5.46%,30.07%,27.39%)均高于女童(4.64%,4.85%,2.48%,22.10%,22.36%)(χ^(2)值分别为23.76,6.49,22.37,31.81,13.06,P值均<0.05)。不同父母文化程度儿童沟通、精细动作和解决问题能区可疑发育迟缓以及存在内化行为和外化行为的检出率差异有统计学意义(χ^(2)值分别为14.37,15.18,21.10,11.66,9.27;16.34,26.75,32.89,16.97,6.37,P值均<0.05);母亲孕期是否有焦虑/抑郁症状的儿童解决问题能区可疑发育迟缓以及存在亲社会行为不足、内化行为和外化行为的检出率差异有统计学意义(χ^(2)值分别为5.61,9.05,21.90,7.17;8.75,6.06,12.76,5.55,P值均<0.05)。男童总屏幕时间多于女童(1.07,1.00 h/d,Z=-2.08,P=0.04)。父母大学及以上文化程度的儿童总屏幕时间、手机和电视屏幕时间相比父母其他文化程度的儿童更短(父亲:H值分别为42.01,44.49,21.24;母亲:H值分别为42.31,39.21,26.47,P值均<0.01)。各类屏幕时间中,手机屏幕时间影响心理行为发育最多;调整模型后,儿童手机屏幕时间增加,能区可疑发育迟缓、情绪行为异常风险增加(P值均<0.05);平板、手机、电视屏幕时间与外化行为均呈正相关(OR值分别为1.36,1.57,1.27,P值均<0.05)。结论儿童屏幕时间与心理行为发育问题的发生风险呈正相关,以手机屏幕时间的影响最为显著。家长应当限制儿童的屏幕时间,避免屏幕时间过长影响心理行为发育。
Objective To investigate the distribution of various types of screen time and examine the association of screen time with psychological and behavioral development problems in children aged 3-6 years,so as to provide scientific basis for children's screen use and mental health promotion.Methods A total of 3875 mother-child dyads who completed the follow-up in Shanghai Maternal-Child Pairs Cohort were included.The daily usage time of children's tablet,mobile phone,TV,projectors,and other types of screens were obtained in questionnaire survey.Children's psychological and behavioral development problems were evaluated by Age-Stage Questionnaire,Third Edition(ASQ-3)and Strengths and Difficulties Questionnaire(Parent version)(SDQ).The Chi-square test,Mann-Whitney U and Kruskal-Wallis rank sum test were used to compare the detection rate of psychological and behavioral development problems and screen time in children with different characteristics.Multivariate binary Logistic regression was used to analyze the association of screen time with psychological and behavioral development problems.Results There were 49.91%of children having screen time more than 1 h/d.Children's TV,tablet and mobile phone screen time were 0.39(0.25,0.96),0.25(0,0.61)and 0.18(0,0.25)h/d.The detection rates of suspected developmental delay in fine motor,problem-solving and personal-social domains and pro-social behavior deficiency and externalizing behaviors in boys(8.54%,6.77%,5.46%,30.07%,27.39%)were higher than that in girls(4.64%,4.85%,2.48%,22.10%,22.36%)(χ^(2)=23.76,6.49,22.37,31.81,13.06,P<0.05).There were statistically significant differences in the detection rates of suspected developmental delay in communication,fine motor and problem-solving,as well as internalizing behavior and externalizing behavior of children with different parents'educational levels(χ^(2)=14.37,15.18,21.10,11.66,9.27;16.34,26.75,32.89,16.97,6.37,P<0.05).There were significant differences in the detection rates of suspected developmental delay in problem-solving,prosocial behavior deficiency,internalizing behavior and externalizing behavior of children whose mothers had anxiety/depression symptoms during pregnancy(χ^(2)=5.61,9.05,21.90,7.17;8.75,6.06,12.76,5.55,P<0.05).The average total screen time of boys was longer than that of girls(1.07,1.00 h/d,Z=-2.08,P=0.04).Compared with children with other educational levels of their parents,the total screen time,mobile phone and TV screen time of children whose parents had college education or above were short(father:H=42.01,44.49,21.24,mother:H=42.31,39.21,26.47,P<0.01).Among all types of screen time,mobile phone screen time had the most impact on psychological and behavioral development.More mobile phone screen time increased the risk of suspected developmental delay and abnormal emotional behavior(P<0.05).Screen time of tablet,mobile phone and TV were positively correlated with externalizing behavior(OR=1.36,1.57,1.27,P<0.05).Conclusions Screen time is related to children's psychological and behavioral development problems and mobile phones affect the most.Parents should limit their children's screen time to avoid excessive screen time affecting their psychological and behavioral development.
作者
黄金娇
叶佩琪
魏倩
吕萍萍
石宇阳
史慧静
HUANG Jinjiao;YE Peiqi;WEI Qian;LYU Pingping;SHI Yuyang;SHI Huijing(Department of Maternal,Child and Adolescent Health,School of Public Health,Fudan University,Shanghai(200032),China)
出处
《中国学校卫生》
CAS
北大核心
2023年第12期1833-1838,共6页
Chinese Journal of School Health
基金
上海市第六轮加强公共卫生体系建设重点学科建设项目(GWVI-11.1-32)。
关键词
注视
眼
时间
精神卫生
回归分析
儿童
学龄前
Fixation,ocular
Time
Mental health
Regression analysis
Child,preschool
