Comparative study on the situation of neglected children aged 3-6 year-olds between urban and rural areas of China / 中华流行病学杂志

Objective To investigate and analyze the situation of urban and rural neglected children aged 3-6,in China,so as to provide basis for the analysis and comparison on relevant risk factors.Methods 1163 urban children aged 3-6 (with 49.6％ males and 4.5％ with minority ethnicity) were investigated from 25 cities of 14 provinces,autonomous regions and municipalities in the whole country.Multi-stage stratified cluster sampling method was used.Again,using the same sampling method,4096 rural children (of whom 50.6％ were males with 6.2％ as minorities) were chosen from 26 cities of 10 provinces or municipalities.Identification of children being neglected was based on “Child Neglect Evaluation Norms of Children Aged 3-6 Years in Urban/Rural China”.SPSS-Windows 13.0 was employed for data analysis.Scores,frequency/degrees,age,sex and types (physical,emotional,educational,safety,medical and social) of children under negligence on every group of the regions,were calculated.x2 test (Chi-Square) and Analysis of variance (ANOVA) were processed to determine the significance of their differences.Results The overall frequencies of negligence were 28.0％ and 53.7％ respectively among the urban and rural children aged 3-6,while the total degrees of negligence were 42.2 and 44.4 respectively.Significant difference was found between children from the urban and the rural areas (P＜0.05).Significant difference was also found between urban and rural children on every age group (P＜0.05).The frequencies of negligence among males were 32.6％ and 55.9％ respectively in urban and rural areas while among females,the figures appeared to be 23.7％ and 51.6％ respectively.The degrees of negligence were 42.7 and 44.6 among male while 41.8 and 44.3 among female children,in the urban or rural areas.Significant differences were found on male or female between urban and rural groups (P＜0.05).Frequencies of negligence in urban children aged 3-6 for the six types were from 5.1％ to 12.9％,with the frequency in rural areas as 13.1％-26.6％.Significant difference was found between urban and rural group for any other type (P＜0.05),in addition to the safety type.The degrees of negligence in urban children aged 3-6 for the different type were between 39.4 and 43.4,while in the rural areas as from 36.5 to 48.2,with significant difference for every type (P＜0.05).The degrees of negligence related to education,emotion,or physical strength were more serious on children from the urban than from the rural areas.The highest frequency of child negligence was seen in the single-parent families on both urban and rural groups (42.9％ and 60.0％ respectively),with no significant difference found (P＞0.05).The urban and rural children aged 3-6 were mainly involved in single item of negligence,with incidence rates as 16.5％ and 22.7％ and proportions as 58.9％ and 45.1％ respectively,despite the factors as age or sex.Conclusion There were large differences on the situation of negligence between the urban and rural children aged 3-6.The frequencies and degrees of negligence in every age group and different sex for children living in the rural areas were higher than those urban children.The frequency of negligence among boys was higher than girls for both urban and rural areas.The rural children had suffered more serious negligence than the urban children at any other type,in addition to the ‘ safety'.Both urban and rural children had the highest frequency of negligence in single-parent family,and were mainly suffered from single item of negligence.

The status of child neglect for children aged 3 - 17 years in China / 中华预防医学杂志

<p><b>OBJECTIVE</b>To explore the status of child neglect among urban areas children and adolescents aged 3 - 17 years in China.</p><p><b>METHODS</b>Using multi-stage stratified cluster sampling method, 8001 children and adolescents were recruited from 30 cities of 14 provinces in December 2008. The investigation was carried based on The 3 - 6 years old children Neglect Norms of city in China and The 6 - 17 years old children Neglect Norms of city in China. SPSS 13.0 was employed for analyzing neglect rate and degree for group of areas, age, sex and neglect type (including neglect of physical, emotional, educational, medical, safety and social).</p><p><b>RESULTS</b>The degrees of child neglect for urban children aged 3 - 6 (children aged 6 were not in school), 6 - 8 (children aged 6 were school children), 9 - 11, 12 - 14 and 15 - 17 were 42.2 ± 6.9, 42.8 ± 8.4, 42.1 ± 9.1, 46.4 ± 9.2 and 49.7 ± 8.4(P < 0.05), the neglect rates were 28.0% (326/1163), 28.8% (431/1496), 27.2% (543/1962), 22.4% (373/1664) and 32.8% (563/1716) (P < 0.05), respectively. There were differences in six neglect types for each group; the neglect degrees and rates were high in the group aged 12 - 14 and 15 - 17 (46.4 ± 9.2 and 49.1 ± 8.4, 22.4% (373/1664) and 32.8% (563/1716), respectively); for each neglect type, the neglect degree of children aged 15 - 17 were highest (52.8 ± 8.0, 47.3 ± 11.6, 49.5 ± 10.8, 42.4 ± 10.3, 52.2 ± 16.0, 56.0 ± 10.1). The degree and rate of neglect in West were highest, Middle was next, the East was lowest (the neglect degrees were 45.4 ± 9.1, 45.0 ± 9.3 and 44.0 ± 8.8, P < 0.05;the rates were 30.7% (1340/4361), 25.0% (756/3024) and 21.2% (131/616), P < 0.05). Degree and rate of child neglect for children without siblings were lower than children with siblings (the neglect degrees were 44.2 ± 9.0 and 47.6 ± 9.1, P < 0.01; the rates were 26.1% (1572/6017) and 33.0% (655/1984), P < 0.01). Neglect degree of school children aged 6 years old (43.1 ± 7.3) was higher than children not in school (40.7 ± 7.8) (P < 0.01), but neglect rate was lower (the rates were 35.4% (60/169) and 21.3% (84/394), P < 0.01).</p><p><b>CONCLUSION</b>Neglect degree and rate of urban children and adolescents aged 3 - 17 years in China were both high, and neglect deserved more attentions.</p>

Study on the current situation and influential factors of child neglect among aged 3-6 year-olds in the urban areas of China / 中华流行病学杂志

<p><b>OBJECTIVE</b>Children aged 3 - 6 years in the urban areas of China were surveyed for the first time to find out the state of child neglect (CN) as well as the major relevant risk factors so as to provide evidence for developing intervention measures.</p><p><b>METHODS</b>1163 children (of whom 49.6% were males and 4.5% were minority nationality) were randomly sampled under multistage stratification, from 25 cities which representing 15 provinces of China. Based on the Child Neglect Norms used by China, prevalence of CN was identified and SPSS-Windows 11.0 was employed for statistical analysis. Scores, frequency/degrees, age, sex and 5 types (physical, emotional, educational, medical and safety) of CN on every group of the regions, were calculated. Multifactorial analysis was conducted through Binary Logistic Regression and multiple linear regression to determine the relevant risk factors.</p><p><b>RESULTS</b>(1) The average degree of CN for the 3 - 6 year-olds was 42.2, with its prevalence as 28.0%. Degrees of CN for the groups of 3, 4, 5, 6-year-olds were 41.7, 42.2, 42.1 and 43.1 (F = 0.988, P > 0.05), with frequencies of 25.0%, 25.3%, 27.9% and 35.4% (chi(2) = 4.798, P > 0.05), respectively. Degrees for CN in males and females were 42.7 and 41.8 (F = 2.502, P > 0.05) with the frequencies as 32.6% and 23.7% (chi(2) = 6.585, P < 0.05), respectively. Degrees of CN for the five types were 39.4-43.4 with the frequencies as 5.1%-12.9%, respectively. No significant difference was found in the frequency of the types (with an exception on 'physical neglect') between males and females (P > 0.05). The highest frequency (42.9%) of CN was seen in the single-parent families and the lowest in large family with three generations (25.5%). (2) According to monofactorial chi(2) test, the possible risk factors of CN would include: educational background, occupation and decrease of income of the parents during last year, etc. (3) Binary Logistic regression analysis showed that the influential factors to the occurrence of CN would include: father's educational background, sex of the child and mother's occupation, etc. (4) Multiple linear regression showed that the influential factors to the degree of CN were: family structure, number of supporting family members, relationship between parents and children, etc.</p><p><b>CONCLUSION</b>The degree and frequency of CN among children aged 3 to 6 in the urban areas of China were high but similar among the four age groups. Male children had a higher frequency of neglect than females, but with similar degree. Children in single-parent families had the highest frequency. The major influential factors of CN would include: educational background, occupation, family structure, family income of the parents which were similar to the results reported from foreign literature.</p>

Investigation and analysis of child neglect in 1163 urban children aged 3 - 6 years / 中华儿科杂志

<p><b>OBJECTIVE</b>Child abuse and neglect (CNS) increasingly have become a serious problem in modern society all over the world. Children neglected and abused are at risk for maladaptation in behavioral, emotional, social, cognitive, and physical functioning. The purpose of this investigation was to develop the Child Neglect Scale for children aged 3 - 6 years in Chinese urban areas and to test the reliability and validity of this norm.</p><p><b>METHODS</b>According to the principle and procedure of developing scales, a child neglect questionnaire was designed. Multistage sampling was used in the study in accordance with sex, age, the levels of economy and kindergartens, a random sample of 1,465 children aged 2 - 6 years was selected from 25 cities. Of the 1,465 subjects who completed the Child Neglect Questionnaires again 2 weeks later, 66 had completed data on each of the two occasions. The Child Neglect Questionnaires were completed by parents and caregivers. The data were analyzed using items analysis, factor analysis, internal consistency analysis and the reliability and validity of the norm were tested. The factor structure of the Child Neglect Scale was determined using an oblique rotation. The internal consistency was reflected in Cronbach's alpha. Since no existing categorization scheme on child neglect could be found in the literature, one was formulated in an attempt to efficiently and meaningfully group similar types of caregiver behaviors. The initial pool of potentially neglecting caregiver behaviors was drawn from literature. The most common patterns of parental behaviors were grouped according to six neglect subscale schemes found in the literature, with modifications made to increase item specificity and reduce overlap. The initial Child Neglect Questionnaire contained a 25-item physical neglect subscale, a 59-item emotional neglect subscale, a 23-item educational neglect subscale, a 20-item safety neglect subscale, a 10-item medical neglect subscale, a 9-item social neglect subscale.</p><p><b>RESULTS</b>Completed Child Neglect Questionnaires were obtained from 1,457 subjects, 726 males and 731 females. The overall findings of this study came from 1,163 subjects, because children aged 2 years (294 subjects) were removed from subjects by statistical method. The 91-item Child Neglect Scale was presented to the respondent as a child neglect questionnaire with a 9-item social neglect subscale and some items in other subscales were removed from the initial questionnaire by using statistical method. The questionnaire contained 17 physical neglect items, 40 emotional neglect items, 17 educational neglect items, a 10 safety neglect items, and 7 medical neglect items. The internal consistency of the overall Child Neglect Scale as reflected in Cronbach's alpha was 0.94, the split-half reliability was 0.88, the test-retest reliability was 0.92. For physical, emotional, educational, safety, medical neglect subscale, Cronbach's alpha, respectively was 0.80, 0.88, 0.84, 0.68, 0.60, the split-half reliability was 0.54 - 0.88, the test reliability was 0.89, 0.94, 0.87, 0.80, 0.77, respectively. The construct validity, face validity and exterior validity of the norm were good. For physical, emotional, educational, safety, medical neglect subscale and overall child neglect scale, the scores of percentiles 90 were used as cut-point. They were 35, 80, 40, 20, 15, 190, respectively.</p><p><b>CONCLUSIONS</b>The norm was consistent with China's economic-cultural background and reality. It not only may be used for research purpose but also may be useful in assessing parent's and child-oriented individual's behaviors and attitude as a measuring instrument.</p>