摘要
目的
(1)描述青少年心理亚健康状况以及青春期分期、青春期知信行和家庭关怀度状况;(2)探讨青少年心理亚健康状况与青春期分期、青春期知信行和家庭关怀状况的相关性;(3)探讨青春期生理发育、家庭关怀度与青春期知信行的关系;(4)进行青少年亚健康多维评定问卷的实证效度研究。
对象与方法
采用描述性相关性研究方法,于2011年4-6月份采用“青少年身心社会发展的调查问卷”对山东省10-19岁青少年4031名进行调查。应用青春期发育评估量表评估青少年躯体发育和青春期分期状况,应用家庭关怀度指数量表评估青少年家庭关怀状况,应用青春期知信行量表评估青少年与青春期相关的知识、态度和行为状况,应用长处和困难量表和青少年亚健康多维评定问卷(心理部分)测评青少年的心理状况,进行生理量表、心理量表、心理相关因素量表结果的描述,进行量表结果间的相关分析,进行青少年亚健康多维评定问卷(心理部分)的实效研究。数据采用SPSS13.0进行统计分析。
结果
1、随着年龄的增大,青少年躯体发育逐渐成熟,女孩青春期发育显著早于男孩;2、家庭关怀功能与青少年性别有关,但与青少年所处的青春期发育阶段无关;3、青春期知信行在性别间和青春期分期间有显著差异性,且与青春期分期间呈显著正相关;4、青春期知信行与青春期生理发育具有平行发展的趋势,二者随着青少年年龄增长,逐步成熟和完善;5、青春期知信行与家庭关怀度呈显著正相关,家庭关怀是青春期知信行成长的重要因素;6、青少年心理亚健康与家庭关怀度显著负相关;7、青少年心理亚健康与青春期知信行显著负相关;8、青少年心理亚健康与性别无关,但与青春期发育分期显著相关,随着青春期发育进展,心理状况趋向不良;9、青少年心理亚健康状况在父母婚姻状况、家庭收入、学习成绩、吸烟、饮酒、醉酒、疾病史、地市、级部和学校所在地等方面有显著差异;10、青少年亚健康多维评定问卷(心理部分)内部一致性良好,复测信度良好,与长处和困难问卷显著相关,显示量表本身结构及稳定性良好。两量表测评同一人群,结果趋势相同,但二者心理异常的检出率不同,维度方面各有长短。
结论
1、青少年躯体发育随年龄逐渐成熟,女孩青春期发育显著早于男孩。
2、青春期知信行与青春期生理发育具有平行发展的趋势;青春期知信行与家庭关怀度显著相关。
3、青少年心理状况受其青春期分期、家庭关怀、青春期知信行的显著影响。青少年心理状况随着青春期发育进展趋向不良,而随着家庭关怀度和青春期知信行的提高趋向良好。
4、青少年亚健康多维评定问卷(心理部分)信效度良好,可以用于青少年的心理社会健康的评估,但结果应根据被调查人群年龄、地区、年级等不同,进行汇报和具体分析。
Objective
To describe adolescent development status of physiology and psychology, puberty stage, knowledge, attitudes and behaviors of puberty (puberty-KAB) and status of family care; to explore the relationship between adolescent psychological sub-health and puberty stage, and the relationship between puberty-KAB and family care; to discuss the relationship among puberty development, family care degree and puberty-KAB and to evaluate the empirical validity of Multidimensional Sub-health Questionnaire of Adolescents (MSQA).
Subjects & Methods
The descriptive analysis and correlation analysis were applied in the survey. A survey titled The Status of Adolescent Physiological and Psychological Development was conducted to include 4031 adolescents aging from 10 to 19 years old from April to June in 2011. A range of different instruments were employed such as Puberty Development Scale, Puberty-KAB, Multidimensional Sub-health Questionnaire of Adolescents (MSQA) and so on. All the instruments were used to assess adolescent developmental status from physiology, psychology and related factors. All the data were analyzed by SPSS 13.0 Statistical methods.
Results
1. As the age increased, adolescents became more physiologically mature and the puberty development of girls was remarkable earlier than that of boys;
2. There was a correlation between family care and adolescent gender while the correlation between family care and puberty stage was not found;
3. The scores of puberty-KAB were significantly different in gender and puberty stage and positively correlated with puberty stage;
4. Puberty-KAB had a parallel development with adolescent physiology and both became mature gradually with aging;
5. Puberty-KAB was positively correlated with family care and family care was an important factor of puberty-KAB development;
6. Adolescent psychological sub-health was negatively correlated with family care;
7. Adolescent psychological sub-health was negatively correlated with puberty-KAB;
8. Adolescent psychological sub-health was not significantly correlated with gender but correlated with puberty stage and with the development of puberty, the psychological status turned unhealthy;
9. The scores of psychological sub-health were significantly different in parents marital status, family income, school performance, smoking, drinking, drunk, disease history, region, grade and location of school;
10. The internal consistent reliability and test-retest reliability of MSQA-psychology were good, and the scores of MSQA-psychology were significantly correlated with that of Strengths and Difficulties Questionnaire (SDQ), which demonstrated the structure and stability of MSQA-psychology were good. Both of the two questionnaires can be used to evaluate the same population group and presented the same trend, however, the identification rates of psychological disorders were different.
Conclusions
1. As the age increased, adolescents became more physiologically mature and the puberty development of girls was remarkable earlier than that of boys;
2. Puberty-KAB had a parallel development with adolescent physiology and Puberty-KAB was positively correlated with family care;
3. Adolescent psychological status was impacted by puberty stage, family care and puberty-KAB; with the development of puberty, psychological status tended to be unhealthy while as family care and puberty-KAB increased, the psychological status became more healthy;
4. MSQA-psychology had good reliability and validity and can be used to assess adolescent psychosocial health, but the results should be reported and analyzed depending on different age groups, regions and grades.
引文
[1]叶芳.改进德尔菲(Delphi)法研究亚健康的描述性定义及评价标准[D],北京:中国协和医科大学,2008,2.
[2]Ter Wolbeek M, van Doornen LJ, Coffeng LE, et al. Cortisol and severe fatigue:a longitudinal study in adolescent girls[J]. Psychoneuroendocrinology,2007,32(2): 171-182.
[3]David M. Fergusson, L. John horwood, Elicabeth M. Ridder, et al. Subthreshold depression in adolescence and mental health outcomes in adulthood [J]. Arch GenPsychiatry,2005,62(1):66-72.
[4]Georgiades K, Lewinsohn PM, Monroe SM, et al. Major depressive disorder in adolescence:the role of subthreshold symptoms[J]. J Am Acad Child Adolesc Psychiatry,2006,45(8):936-944.
[5]Richards J,Turk J,White S.Children and adolescents with Chronic Fatigue Syndrome in non-specialist settings:beliefs,functional impairment and psychiatric disturbance[J]. Eur Child Adolesc Psychiatry,2005,14(6):310-318.
[6]Cuijpers P, Smit F. Subthreshold depression as a risk indicator for major depressive disorder:a systematic review of prospective studies[J]. Acta Psychiatr Scand,2004,109(5):325-331.
[7]万宇辉.青少年亚健康与多种身心健康问题的相关性研究[D].安徽:安徽医科大学,2009.
[8]Chalder T, Goodman R, Wessely S, et al. Epidemiology of chronic fatigue syndrome and self reported myalgic encephalomyelitis in 5-15 year olds:cross sectional study [J]. BMJ,2003,327(7416):654-655.
[9]罗英姿,王湘,朱熊兆,等.高中生抑郁水平调查及其影响因素研究[J].中国临床心理学杂志,2008,16(3):274-277.
[10]许娟,林德南,王坚杰,等.合肥市和深圳市小学生抑郁症状及其影响因素比较[J].中国心理卫生杂志,2008,22(4):246-224.
[11]万宇辉.青少年亚健康与多种身心健康问题的相关性研究[D].安徽:安徽医 科大学,2009.
[12]吕姿之.健康教育与健康促进[M].北京:北京医科大学出版社,2002,52.
[13]申荷永,高岚.心理教育[M].广州:暨南大学出版社,1997.
[14]杨新华,屈正良,朱翠英,等.大学新生自尊、生活事件、家庭环境与心理健康的相关性研究[J].中国行为医学科学,2008,17:65-66.
[15]Harlos JJ, Power TG. Relations Among Single Mothens'Amrene of Their Adolescents' Stressors, Maternal Monitorin[J]. Mother—Adolescent Communication And Adolescent Adjustment,2000,15:546-560.
[16]张天亮,翟静,王成关,等.初中生心理问题与父母教养方式的相关性研究[J].中国行为医学科学,2005,14:844-846.
[17]翟静,郭传琴,刘贤臣,等.中学生家庭因素与行为问题的对照研究[J].中国行为医学科学,2001,10:229-231.
[18]刘书君.长处和困难问卷(SDQ)中文版的信度和效度研究[D].成都:四川大学华西医院心理卫生中心,2006.
[19]寇建华,杜亚松,夏黎明.长处和困难问卷(学生版)上海常模的制订[J].中国健康心理学杂志,2007,15(1):3-5.
[20]梁芳.辽宁省儿童青少年精神障碍评定方法及危险因素分析[D].大连:大连医科大学,2008.
[21]齐秀玉,陶芳标,胡传来,等.中国青少年亚健康多维问卷编制[J].中国公共卫生,2008,24(9):1025-1028.
[22]邢超,陶芳标,袁长江,等.青少年亚健康多维评定问卷信度和效度评价[J].中国公共卫生,2008,24(9):1031-1033.
[23]万宇辉,胡传来,陶芳标,等.青少年亚健康多维评定问卷反应度分析[J].中国公共卫生,2008,24(9):1035-1036.
[24]陶芳标,邢超,袁长江,等.青少年亚健康多维评定问卷的全国常模制定[J].中国学校卫生,2009,30(4):292-295.
[25]徐长恩,王若蛟,郝加虎,等.大学生亚健康状态新划界标准的应用[J].中国学校卫生,2010,31(12):1423-1425.
[26]廖学舟,张娟,张隆明,等.鄂州市青少年亚健康现状及影响因素[J].中国社 会医学杂志,2010,27(1):8-10.
[27]屠春雨,邢超,傅利军,等.绍兴市青少年亚健康状态划界标准[J].中国学校卫生,2010,31(12):1415-1419.
[28]邵际晓,王宏,李雷雷,等.重庆市青少年亚健康状况调查[J].现代预防医学,2011,38(9):1667-1669.
[29]Zang YL, Zhao Y, Yang Q, et al. A randomised trial on pubertal development and health in China[J]. Journal of Clinical Nursing,2011. In press.
[30]潘晖,代合治.山东省17个地级市生活质量比较研究[J].曲阜师范大学学报,2007,33(3):116-120.
[31]卫生部妇幼保健与社区卫生司.卫生部关于印发《国家基本公共卫生服务规范(2009年版)》的通知[EB/OL].2009-10-10[2011-8-4].http://www.moh.gov.cn/publicfiles/business/htmlfiles/mohfybjysqwss/s3577/200 910/43183.htm.
[32]Petersen AC, Crockett L, Richards M, et al. A self-report measure of pubertal status:Reliability,validity, and initial norms[J]. Journal of Youth and Adolescence, 1988,17(2):117-133.
[33]Carskadon MA & Acebo C. A self-administered rating scale for pubertal development[J]. The Journal Of Adolescent Health:Official Publication Of The Society For Adolescent Medicine,1993,14(3):190-195.
[34]Chan NPT, Sung RYT, Kong APS, et al. Reliability of pubertal self-assessment in Hong KongChinese children[J]. Journal of Paediatrics and Child Health,2008, 44(6):353-358.
[35]Chan NPT, Sung RYT, Nelson EAS, et al. Measurement of Pubertal Status with a Chinese Self-report Pubertal Development Scale[J]. Maternal and Child Health Journal,2010,14(3):466-473.
[36]Zang YL, Zhao Y, Yang Q, et al. A randomised trial on pubertal development and health in China[J]. Journal of Clinical Nursing,2011. In press.
[37]Smilkstein G. The family APGAR:a proposal for a family function test and its use by physicians[J]. Journal of Family Practice,1978,6(6):1231-1239.
[38]Chan DH, Ho SC & Donnan SPB. A survey of family APGAR in Shatin private ownership homes[J]. The Hong Kong Practitioner,1988,10(7):3295-3299.
[39]Anonymous. Family APGAR[EB/OL],1978[2011-7-13]. http://www.iprc.unc.edu/longscan/pages/measures/Baseline/Family%20APGAR.p df.
[40]Goodman R. The Strengths and Difficulties Questionnaire:a research note[J]. Journal Of Child Psychology And Psychiatry, And Allied Disciplines,1997,38(5): 581-586.
[41]Goodman R. The extended version of the Strengths and Difficulties Questionnaire as a guide to child psychiatric caseness and consequent burden[J]. Journal of Child Psychology and Psychiatry,1999,40(5):791-799.
[42]Goodman R, Meltzer H & Bailey V. The strengths and difficulties questionnaire: A pilot study on the validity of the self-report version[J]. European Child& Adolescent Psychiatry,1998,7(3):125-130.
[43]youthinmind. SDQ:information for researchers and professionals about the Strengths and Difficulties Questionnaire [EB/OL].2009-9-12[2011-8-3]. http://www.sdqinfo.org/.
[44]邢超.青少年亚健康多维评定问卷编制与信效度测定[D].安徽:安徽医科大学,2009.
[45]BMI for age (5-19years) http://www. who.int/growthref/who2007_bmi_for_age/en/index.html
[46]The International Classification of adult underweight, overweight and obesity according to BMI http://apps.who.int/bmi/index.jsp?introPage=intro_3.html
[47]2010国民体质监测公报全国7-19岁儿童青少年各项体质指标平均数http://wenku.baidu.com/view/b4da70d5195f312b3169a5cf.html?from=related &hasrec=1
[48]李辉,季成叶,宗心南,等.中国0~18岁儿童、青少年身高、体重的标准化生长曲线[J].中华儿科杂志,2009,47(7):487-492.
[49]季成叶.中国学龄儿童青少年1985-2000年超重、肥胖流行趋势动态分析[J]. 中华流行病学杂志2004,25(2):103-108.
[50]林崇德,李庆安.青少年期身心发展特点[J].北京师范大学学报(社会科学版),2005(1):48-56.
[51]唐永云,潘尧云,臧渝梨,等.青少年身心发展状况及趋势分析[J].中国妇幼保健,2011,26(31):4881-4883.
[52]马颖.鄂州市青少年生活满意度与心理亚健康状态的关系[D],广州:华中科技大学,2009.
[53]彭昭宣,陈建.在校大学生家庭关怀度及家庭功能状况调查[J].四川生殖卫生学院学报,2009,4(9):67-68.
[54]徐松泉,王东波,林美琴,等.中学生网络成瘾的家庭关怀和应对方式研究[J].中国学校卫生,2010,22(8):4-6.
[55]韦文洁,蓝忠.学生家庭功能筛检和健康促进的探讨[J].中国学校卫生,2007,28(2):160.
[56]周芹.青少年及其家长应付方式、心健康状况的相关研究[J].心理科学,2004,27(5):1251-1253.
[57]张天亮,翟静,王成关,等.初中生心理问题与父母教养方式的相关性研究[J].中国行为医学科学,2005,14:844-846.
[58]杨新华,屈正良,朱翠英,等.大学新生自尊、生活事件、家庭环境与心理健康的相关性研究[J].中国行为医学科学,2008,17:65-66.
[59]叶曼,张静平.农村留守初中生心理健康状况影响因素研究:家庭关怀度与社会支持[J].中国行为医学科学,2008,17(11):1044-1047.
[60]唐慧琴,张志雄,程志屏,等.全国22个省市26个单位24013名城市在校少年儿童行为问题调查.独生子女精神卫生问题的调查、防治和Achenbach'S儿童行为量表中国标准化[J].上海精神医学,1992,4(1):47-55.
[61]Rutter M. Twenty-five years of child psychiatric Epidemiology[J]. J Am. Acad child Adolesc Psychiatry,1989,28(5):633-653.
[62]苏亚玲,谢晋晓.大学新生的大学生人格问卷(UPI)心理健康调查研究[J].中国健康心理学杂志,2008,16(10):1133-1135.
[63]张朝,于宗富.非独生子女大学生心理健康状况的调查研究[J].现代预防医 学,2008,35(7):1308-1310.
[64]张晓庆,王克明,李泽爱.合肥市儿童青少年焦虑障碍调查分析[J].中国心理卫生杂志,2004,189(10):100-105.
[65]刘媛,姜潮,林媛.单亲大学生领悟社会支持及心理健康状况的研究[J].中国健康心理学杂志,2009,17(5):604-606.