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Article(id=1240395009371984237, tenantId=1146029695717560320, journalId=1227665162245664772, issueId=1240395006914130733, articleNumber=null, orderNo=null, doi=10.20043/j.cnki.MPM.202502056, pmid=null, cstr=null, oa=null, hot=null, price=null, onlineType=0, articleFormat=0, articleType=null, articleTypeStr=null, receivedDate=1738857600000, receivedDateStr=2025-02-07, revisedDate=null, revisedDateStr=null, acceptedDate=null, acceptedDateStr=null, onlineDate=1773662815659, onlineDateStr=2026-03-16, pubDate=1753372800000, pubDateStr=2025-07-25, doiRegisterDate=null, doiRegisterDateStr=null, onlineIssueDate=1773662815659, onlineIssueDateStr=2026-03-16, onlineJustAcceptDate=null, onlineJustAcceptDateStr=null, onlineFirstDate=null, onlineFirstDateStr=null, sourceXml=null, magXml=null, createTime=1773662815659, creator=13701087609, updateTime=1773662815659, updator=13701087609, issue=Issue{id=1240395006914130733, tenantId=1146029695717560320, journalId=1227665162245664772, year='2025', volume='52', issue='14', pageStart='2497', pageEnd='2688', issueExtLink='null', onlineDate='null', pubDate='null', beforeIssueId=null, nextIssueId=null, price=null, status=1, issueComplete=1, articleOrder=1, issueType=-1, specialIssue=0, createTime=1773662815073, creator=13701087609, updateTime=1773662858015, updator=13701087609, preIssue=null, nextIssue=null, ext={EN=IssueExt(id=1240395187109810535, tenantId=1146029695717560320, journalId=1227665162245664772, issueId=1240395006914130733, language=EN, specialIssueTitle=, coverIllustrator=null, specialIssueEditor=, specialIssueAbout=), CN=IssueExt(id=1240395187109810536, tenantId=1146029695717560320, journalId=1227665162245664772, issueId=1240395006914130733, language=CN, specialIssueTitle=, coverIllustrator=null, specialIssueEditor=, specialIssueAbout=)}, issueFiles=null}, startPage=2569, endPage=2574, ext={EN=ArticleExt(id=1240395009665585521, articleId=1240395009371984237, tenantId=1146029695717560320, journalId=1227665162245664772, language=EN, title=Influence of family parenting style on two-week illness in children under 6 years of age——Based on the seventh health service survey of Sichuan Province, columnId=1228016572892119056, journalTitle=Modern Preventive Medicine, columnName=Primary Health Services, runingTitle=null, highlight=null, articleAbstract=
Objective

To analyze the current situation and influencing factors of two-week illness among children aged 0-6 years in Sichuan Province, and to explore the influence of family parenting styles on children’s two-week illness, so as to provide reference for improving the quality of children’s health services.

Methods

Based on data from the seventh health service survey of Sichuan Province, the relationship between family parenting style and children’s two-week illness was explored using logistic modeling.

Results

Rural (OR=0.554, 95% CI: 0.311-0.985), left-behind families (where parents do not live permanently or are primarily cared for by someone other than the parents) (OR=1.775, 95% CI: 1.028-3.067) are more sensitive to children’s two-week illness. Indicators such as whether a parent is a permanent resident, the child’s primary caregiver, whether they have commercial insurance, whether they are placed in a childcare facility, and the number of toys they own vary among children’s two-week illness rates (P<0.05).

Conclusion

Different family parenting styles have a great impact on children’s two-week illness. It is recommended to further improve the mechanism of primary children’s health care services, emphasize the role of family in children’s health, and create a child-friendly environment for children to grow up.

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目的

分析四川省0~6岁儿童两周患病的现状及影响因素，探索家庭教养方式对儿童两周患病的影响，为提升儿童卫生服务质量提供参考。

方法

基于四川省第七次卫生服务调查数据，采用logistic模型探索了家庭教养方式与儿童两周患病之间的关系。

结果

农村（OR=0.554，95% CI：0.311~0.985）、留守家庭（父母不常住或者主要由父母之外的人员照顾）（OR=1.775，95% CI：1.028~3.067）对儿童两周患病更为敏感。父母亲是否为常住人口、儿童主要照料人、是否购买商业保险、是否被送入托育机构、拥有的玩具数量等指标在儿童两周患病率间存在差异（P<0.05）。

结论

不同家庭教养方式对儿童两周患病影响较大。建议进一步完善基层儿童医疗服务机制，重视家庭在儿童健康中发挥的作用，营造儿童友好成长环境。

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张菊英，E-mail：
, copyrightStatement=本刊刊出的所有文章不代表中华预防医学会和本刊编委会的观点，除非特别声明。, copyrightOwner=中华预防医学会和四川大学华西公共卫生学院, extLink=null, articleAbsUrl=null, sourceXml=ygW9+LJlquf7eg3JBvEw8Q==, magXml=3EEAN2X5rlmW59t1s/xvPA==, pdfUrl=null, pdf=6ww732ywdtvq+xI1oOSyVw==, pdfFileSize=734008, pdfExtLink=null, richHtmlUrl=null, mobilePdfUrl=null, reviewReport=null, pdfFirstPage=null, abstractGraph=MCo0lzYgOxTmoyFe8p7wdQ==, abstractGraphContent=null, abstractVideo=null, citation=null, cebUrl=null, magXmlContent=ah5Ecj/KwQL68i6NbJLv8g==, mapNumber=null, authorCompany=null, fund=null, authors=

邱汐茵（2000—），女，硕士在读，研究方向：卫生统计方法与应用

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邱汐茵（2000—），女，硕士在读，研究方向：卫生统计方法与应用

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Analysis on utilization and influencing factors of health services for left behind children in rural areas[J]. Smart Healthcare, 2019, 5(36): 28-29, 32. (In Chinese), articleTitle=Analysis on utilization and influencing factors of health services for left behind children in rural areas, refAbstract=null), Reference(id=1240413554273210905, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1240395009371984237, doi=null, pmid=null, pmcid=null, year=2019, volume=46, issue=2, pageStart=270, pageEnd=273, url=null, language=null, rfNumber=［14］, rfOrder=23, authorNames=郭建花, 翟俊霞, 阎香娟, journalName=现代预防医学, refType=null, unstructuredReference=郭建花，翟俊霞，阎香娟．农村地区5岁以下留守儿童卫生服务需求及影响因素[J].现代预防医学，2019,46(2):270-273., articleTitle=农村地区5岁以下留守儿童卫生服务需求及影响因素, refAbstract=null), Reference(id=1240413554390651421, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1240395009371984237, doi=null, pmid=null, pmcid=null, year=2019, volume=46, issue=2, pageStart=270, pageEnd=273, url=null, language=null, rfNumber=［14］, rfOrder=24, authorNames=Guo JH, Zhai JX, Yan XJ, journalName=Modern Preventive Medicine, refType=null, unstructuredReference=Guo JH, Zhai JX, Yan XJ. Influencing factors for health demand of ill rural left-behind children under 5 years old[J]. Modern Preventive Medicine, 2019, 46(2): 270-273. (In Chinese), articleTitle=Influencing factors for health demand of ill rural left-behind children under 5 years old, refAbstract=null), Reference(id=1240413554461954590, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1240395009371984237, doi=null, pmid=null, pmcid=null, year=2019, volume=47, issue=null, pageStart=418, pageEnd=431, url=null, language=null, rfNumber=［15］, rfOrder=25, authorNames=Bernal R, Attanasio O, Peña X, journalName=Early Childhood Research Quarterly, refType=null, unstructuredReference=Bernal R, Attanasio O, Peña X, et al. The effects of the transition from home-based childcare to childcare centers on children’s health and development in Colombia[J]. Early Childhood Research Quarterly, 2019, 47: 418-431., articleTitle=The effects of the transition from home-based childcare to childcare centers on children’s health and development in Colombia, refAbstract=null), Reference(id=1240413554600366627, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1240395009371984237, doi=null, pmid=null, pmcid=null, year=2016, volume=35, issue=8, pageStart=923, pageEnd=924, url=null, language=null, rfNumber=［16］, rfOrder=26, authorNames=Bearden RL, Casanova LM, journalName=Pediatric Infectious Disease Journal, refType=null, unstructuredReference=Bearden RL, Casanova LM. Survival of an enveloped virus on Toys[J]. Pediatric Infectious Disease Journal, 2016, 35(8): 923-924., articleTitle=Survival of an enveloped virus on Toys, refAbstract=null)], funds=[Fund(id=1240413549923717531, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1240395009371984237, awardId=81973151; 82103943; 82073667, language=CN, fundingSource=国家自然科学基金(81973151; 82103943; 82073667), fundOrder=null, country=null), Fund(id=1240413550045352356, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1240395009371984237, awardId=null, language=CN, fundingSource=四川省2023年卫生服务专项调查, fundOrder=null, country=null)], companyList=[AuthorCompany(id=1240413540973072389, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1240395009371984237, xref=1., ext=[AuthorCompanyExt(id=1240413540985655303, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1240395009371984237, companyId=1240413540973072389, language=EN, country=null, province=null, city=null, postcode=null, companyName=null, departmentName=null, remark=Department of Epidemiology and Biostatistics, West China School of Public Health and West China Fourth Hospital, Sichuan University, Chengdu, Sichuan 610044, China), AuthorCompanyExt(id=1240413540989849608, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1240395009371984237, companyId=1240413540973072389, language=CN, country=null, province=null, city=null, postcode=null, companyName=null, departmentName=null, remark=1.四川大学华西公共卫生学院/四川大学华西第四医院，流行病与卫生统计学系，四川 成都 610041)]), AuthorCompany(id=1240413541086318612, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1240395009371984237, xref=2., ext=[AuthorCompanyExt(id=1240413541090512917, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1240395009371984237, companyId=1240413541086318612, language=CN, country=null, province=null, city=null, postcode=null, companyName=null, departmentName=null, remark=2.四川省卫生信息中心/四川省医疗大数据中心)])], figs=[ArticleFig(id=1240413548682203495, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1240395009371984237, language=EN, label=Fig.1, caption=Types of diseases for which children are sick for two weeks, figureFileSmall=4oj+koWiBqY8lC84YRuLmA==, figureFileBig=Hp9DY4DlUkgLYZutWqST1g==, tableContent=null), ArticleFig(id=1240413548808032620, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1240395009371984237, language=CN, label=图1, caption=儿童两周患病疾病类型

注：图1(a)展示了儿童两周患病的疾病系统类型及患儿数量分布情况；(b)展示了儿童两周患病的详细疾病病种类型及患儿数量分布情况。

, figureFileSmall=4oj+koWiBqY8lC84YRuLmA==, figureFileBig=Hp9DY4DlUkgLYZutWqST1g==, tableContent=null), ArticleFig(id=1240413548954833265, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1240395009371984237, language=EN, label=Table 1, caption=

Basic characteristics of two-week illness in children［n(%)］

, figureFileSmall=null, figureFileBig=null, tableContent=
基本特征总人数
（n=631)		是否两周患病χ2P
否
(n)=472		是
(n)=159
性别0.0450.832
男童332(52.6)250(53.0)82(51.6)
女童299(47.4)222(47.0)77(48.4)
年龄（岁）0.9440.624
≤1118(18.7)92(19.5)26(16.4)
2~3170(26.9)124(26.3)46(28.9)
4~6343(54.4)256(54.2)87(54.7)
居住地5.615<0.05
城市300(47.5)211(44.7)89(56.0)
农村331(52.5)261(55.3)70(44.0)
民族5.254<0.05
汉族529(83.8)386(81.8)143(89.9)
少数民族102(16.2)86(18.2)16(10.1)
家庭年收入（元）2.2080.137
≤60 000347(55.0)251(53.2)96(60.4)
>60 000284(45.0)221(46.8)63(39.6)
家庭人口数（人）7.249<0.01
≤4394(62.4)280(59.3)114(71.7)
>4237(37.6)190(40.7)45(28.3)
医疗服务可及性1.4880.223
好385(61.0)281(59.5)104(65.4)
一般246(39.0)191(40.5)55(34.6)
家庭饮用水0.2070.649
安全580(91.9)432(91.5)148(93.1)
不安全51(8.1)40(8.5)11(6.9)
家庭厕所类型0.1250.723
卫生厕所573(90.8)427(90.5)146(91.8)
其他厕所58(9.2)45(9.5)13(8.2)
低保户0.0450.833
是44(7.0)34(7.2)10(6.3)
否587(93.0)438(92.8)149(93.7)
是否购买商业保险4.948<0.05
是155(24.6)105(22.2)40(31.4)
否476(75.4)367(77.8)109(68.6)
是否建立健康档案1.2890.525
是491(77.8)371(78.6)120(75.5)
不知道90(14.3)63(13.3)27(17.0)
否，但知道有此服务50(7.9)38(8.1)12(7.5)
一年内是否接受健康体检1.9530.162
是521(82.6)396(83.9)125(78.6)
否110(17.4)76(16.1)34(21.4)
母亲是否为常住人口a7.680<0.01
是416(65.9)326(69.1)90(56.6)
否215(34.1)146(30.9)69(43.4)
父亲是否为常住人口a15.769<0.001
是391(62.0)314(66.5)77(48.4)
否240(38.0)158(33.5)82(51.6)
儿童主要照顾人员10.808<0.001b
父亲或母亲422(66.9)331(70.1)91(57.2)
（外）祖父母206(32.6)140(29.7)66(41.5)
其他人员3(0.5)1(0.2)2(1.3)
主要照护方式0.0060.939
居家照护444(70.4)333(70.6)111(69.8)
其他照护（社区等）187(29.6)139(29.4)48(30.2)
是否送孩子入托5.353<0.05
是394(62.4)282(59.7)112(70.4)
否247(27.6)190(40.3)47(29.6)
拥有玩具数量（件）9.706<0.01
036(5.7)27(5.7)9(5.7)
1~10134(21.2)114(24.2)20(12.6)
>10461(73.1)331(70.1)130(81.8)
), ArticleFig(id=1240413549089050998, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1240395009371984237, language=CN, label=表1, caption=

儿童两周患病基本特征［n(%)］

, figureFileSmall=null, figureFileBig=null, tableContent=
基本特征总人数
（n=631)		是否两周患病χ2P
否
(n)=472		是
(n)=159
性别0.0450.832
男童332(52.6)250(53.0)82(51.6)
女童299(47.4)222(47.0)77(48.4)
年龄（岁）0.9440.624
≤1118(18.7)92(19.5)26(16.4)
2~3170(26.9)124(26.3)46(28.9)
4~6343(54.4)256(54.2)87(54.7)
居住地5.615<0.05
城市300(47.5)211(44.7)89(56.0)
农村331(52.5)261(55.3)70(44.0)
民族5.254<0.05
汉族529(83.8)386(81.8)143(89.9)
少数民族102(16.2)86(18.2)16(10.1)
家庭年收入（元）2.2080.137
≤60 000347(55.0)251(53.2)96(60.4)
>60 000284(45.0)221(46.8)63(39.6)
家庭人口数（人）7.249<0.01
≤4394(62.4)280(59.3)114(71.7)
>4237(37.6)190(40.7)45(28.3)
医疗服务可及性1.4880.223
好385(61.0)281(59.5)104(65.4)
一般246(39.0)191(40.5)55(34.6)
家庭饮用水0.2070.649
安全580(91.9)432(91.5)148(93.1)
不安全51(8.1)40(8.5)11(6.9)
家庭厕所类型0.1250.723
卫生厕所573(90.8)427(90.5)146(91.8)
其他厕所58(9.2)45(9.5)13(8.2)
低保户0.0450.833
是44(7.0)34(7.2)10(6.3)
否587(93.0)438(92.8)149(93.7)
是否购买商业保险4.948<0.05
是155(24.6)105(22.2)40(31.4)
否476(75.4)367(77.8)109(68.6)
是否建立健康档案1.2890.525
是491(77.8)371(78.6)120(75.5)
不知道90(14.3)63(13.3)27(17.0)
否，但知道有此服务50(7.9)38(8.1)12(7.5)
一年内是否接受健康体检1.9530.162
是521(82.6)396(83.9)125(78.6)
否110(17.4)76(16.1)34(21.4)
母亲是否为常住人口a7.680<0.01
是416(65.9)326(69.1)90(56.6)
否215(34.1)146(30.9)69(43.4)
父亲是否为常住人口a15.769<0.001
是391(62.0)314(66.5)77(48.4)
否240(38.0)158(33.5)82(51.6)
儿童主要照顾人员10.808<0.001b
父亲或母亲422(66.9)331(70.1)91(57.2)
（外）祖父母206(32.6)140(29.7)66(41.5)
其他人员3(0.5)1(0.2)2(1.3)
主要照护方式0.0060.939
居家照护444(70.4)333(70.6)111(69.8)
其他照护（社区等）187(29.6)139(29.4)48(30.2)
是否送孩子入托5.353<0.05
是394(62.4)282(59.7)112(70.4)
否247(27.6)190(40.3)47(29.6)
拥有玩具数量（件）9.706<0.01
036(5.7)27(5.7)9(5.7)
1~10134(21.2)114(24.2)20(12.6)
>10461(73.1)331(70.1)130(81.8)
), ArticleFig(id=1240413549240045949, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1240395009371984237, language=EN, label=Table 2, caption=

Variable assignment table

, figureFileSmall=null, figureFileBig=null, tableContent=
变量纳入方式赋值及意义
因变量
是否两周患病分类变量0=否，1=是
自变量
居住地分类变量0=城市，1=农村
民族分类变量0=汉族，1=少数民族
家庭人口数分类变量0=≤4人，1=>4人
是否购买商业保险分类变量0=是，1=否
母亲是否常住人口分类变量0=是，1=否
父亲是否常住人口分类变量0=是，1=否
儿童主要照顾人员分类变量0=主要由父亲或母亲照顾
1=主要由(外)祖父母照顾
2=主要由其他人照顾
是否送孩子入托分类变量0=是，1=否
拥有玩具数量分类变量0=0，1=≤10，2=>10
), ArticleFig(id=1240413549353292162, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1240395009371984237, language=CN, label=表2, caption=

变量赋值表

, figureFileSmall=null, figureFileBig=null, tableContent=
变量纳入方式赋值及意义
因变量
是否两周患病分类变量0=否，1=是
自变量
居住地分类变量0=城市，1=农村
民族分类变量0=汉族，1=少数民族
家庭人口数分类变量0=≤4人，1=>4人
是否购买商业保险分类变量0=是，1=否
母亲是否常住人口分类变量0=是，1=否
父亲是否常住人口分类变量0=是，1=否
儿童主要照顾人员分类变量0=主要由父亲或母亲照顾
1=主要由(外)祖父母照顾
2=主要由其他人照顾
是否送孩子入托分类变量0=是，1=否
拥有玩具数量分类变量0=0，1=≤10，2=>10
), ArticleFig(id=1240413549479121287, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1240395009371984237, language=EN, label=Table 3, caption=

Two-level logistic regression analysis of two-week illness in children

, figureFileSmall=null, figureFileBig=null, tableContent=
影响因素两周患病
OR (95% CI)P
居住地 （以“城市”为对照）0.044a
农村0.554 (0.311~0.985)
民族（以“汉族”为对照）0.830
少数民族0.918 (0.421~2.004)
家庭人口数（以“≤4人”为对照）0.271
>4人0.736 (0.426~1.271)
是否购买商业保险（以“是”为对照）0.210
否0.694 (0.393~1.228)
母亲是否常住人口（以“是”为对照）0.287
否1.418 (0.745~2.694)
父亲是否常住人口（以“是”为对照）0.040a
否1.775 (1.028~3.067)
儿童主要照顾人员（以“主要由父亲或母亲照顾”为对照）
孩子主要由(外)祖父母照顾1.292 (0.667~2.504)0.447
孩子主要由其他人照顾17.993 (0.619~522.457)0.093
是否送孩子入托（以“已入托”为对照）0.108
未入托0.652 (0.387~1.098)
孩子拥有玩具数量（以“0件”为对照）
≤10件0.369 (0.111~1.223)0.103
>10件0.749 (0.257~2.185)0.596
), ArticleFig(id=1240413549596561805, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1240395009371984237, language=CN, label=表3, caption=

儿童两周患病的两水平logistic回归分析

, figureFileSmall=null, figureFileBig=null, tableContent=
影响因素两周患病
OR (95% CI)P
居住地 （以“城市”为对照）0.044a
农村0.554 (0.311~0.985)
民族（以“汉族”为对照）0.830
少数民族0.918 (0.421~2.004)
家庭人口数（以“≤4人”为对照）0.271
>4人0.736 (0.426~1.271)
是否购买商业保险（以“是”为对照）0.210
否0.694 (0.393~1.228)
母亲是否常住人口（以“是”为对照）0.287
否1.418 (0.745~2.694)
父亲是否常住人口（以“是”为对照）0.040a
否1.775 (1.028~3.067)
儿童主要照顾人员（以“主要由父亲或母亲照顾”为对照）
孩子主要由(外)祖父母照顾1.292 (0.667~2.504)0.447
孩子主要由其他人照顾17.993 (0.619~522.457)0.093
是否送孩子入托（以“已入托”为对照）0.108
未入托0.652 (0.387~1.098)
孩子拥有玩具数量（以“0件”为对照）
≤10件0.369 (0.111~1.223)0.103
>10件0.749 (0.257~2.185)0.596
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家庭教养方式对6岁以下儿童两周患病的影响研究——基于四川省第七次卫生服务调查
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邱汐茵 1 , 许欢 1 , 王乐乐 1 , 郭冰 1 , 张雪莉 2 , 刘秋硕 2 , 赵星 1 , 张菊英 1
现代预防医学 | 基层卫生服务 2025,52(14): 2569-2574
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现代预防医学 | 基层卫生服务 2025, 52(14): 2569-2574
家庭教养方式对6岁以下儿童两周患病的影响研究——基于四川省第七次卫生服务调查
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邱汐茵1, 许欢1, 王乐乐1, 郭冰1, 张雪莉2, 刘秋硕2, 赵星1, 张菊英1
作者信息
  • 1.四川大学华西公共卫生学院/四川大学华西第四医院，流行病与卫生统计学系，四川 成都 610041
  • 2.四川省卫生信息中心/四川省医疗大数据中心

    • 邱汐茵（2000—），女，硕士在读，研究方向：卫生统计方法与应用

通讯作者:

张菊英，E-mail：
Influence of family parenting style on two-week illness in children under 6 years of age——Based on the seventh health service survey of Sichuan Province
Xi-yin QIU1, Huan XU1, Le-le WANG1, Bing GUO1, Xue-li ZHANG2, Qiu-shuo LIU2, Xing ZHAO1, Ju-ying ZHANG1
Affiliations
  • Department of Epidemiology and Biostatistics, West China School of Public Health and West China Fourth Hospital, Sichuan University, Chengdu, Sichuan 610044, China
出版时间: 2025-07-25 doi: 10.20043/j.cnki.MPM.202502056
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摘要
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目的

分析四川省0~6岁儿童两周患病的现状及影响因素，探索家庭教养方式对儿童两周患病的影响，为提升儿童卫生服务质量提供参考。

方法

基于四川省第七次卫生服务调查数据，采用logistic模型探索了家庭教养方式与儿童两周患病之间的关系。

结果

农村（OR=0.554，95% CI：0.311~0.985）、留守家庭（父母不常住或者主要由父母之外的人员照顾）（OR=1.775，95% CI：1.028~3.067）对儿童两周患病更为敏感。父母亲是否为常住人口、儿童主要照料人、是否购买商业保险、是否被送入托育机构、拥有的玩具数量等指标在儿童两周患病率间存在差异（P<0.05）。

结论

不同家庭教养方式对儿童两周患病影响较大。建议进一步完善基层儿童医疗服务机制，重视家庭在儿童健康中发挥的作用，营造儿童友好成长环境。

儿童  /  两周患病  /  影响因素  /  家庭教养方式
Objective

To analyze the current situation and influencing factors of two-week illness among children aged 0-6 years in Sichuan Province, and to explore the influence of family parenting styles on children’s two-week illness, so as to provide reference for improving the quality of children’s health services.

Methods

Based on data from the seventh health service survey of Sichuan Province, the relationship between family parenting style and children’s two-week illness was explored using logistic modeling.

Results

Rural (OR=0.554, 95% CI: 0.311-0.985), left-behind families (where parents do not live permanently or are primarily cared for by someone other than the parents) (OR=1.775, 95% CI: 1.028-3.067) are more sensitive to children’s two-week illness. Indicators such as whether a parent is a permanent resident, the child’s primary caregiver, whether they have commercial insurance, whether they are placed in a childcare facility, and the number of toys they own vary among children’s two-week illness rates (P<0.05).

Conclusion

Different family parenting styles have a great impact on children’s two-week illness. It is recommended to further improve the mechanism of primary children’s health care services, emphasize the role of family in children’s health, and create a child-friendly environment for children to grow up.

Children  /  Two-week illness  /  Influencing factors  /  Family parenting style
邱汐茵, 许欢, 王乐乐, 郭冰, 张雪莉, 刘秋硕, 赵星, 张菊英. 家庭教养方式对6岁以下儿童两周患病的影响研究——基于四川省第七次卫生服务调查. 现代预防医学, 2025 , 52 (14) : 2569 -2574 . DOI: 10.20043/j.cnki.MPM.202502056
Xi-yin QIU, Huan XU, Le-le WANG, Bing GUO, Xue-li ZHANG, Qiu-shuo LIU, Xing ZHAO, Ju-ying ZHANG. Influence of family parenting style on two-week illness in children under 6 years of age——Based on the seventh health service survey of Sichuan Province[J]. Modern Preventive Medicine, 2025 , 52 (14) : 2569 -2574 . DOI: 10.20043/j.cnki.MPM.202502056
正文
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儿童健康是家庭和社会的重要组成部分，儿童健康也纳入国家和政府的战略目标和责任。截至2020年底，儿童生存、发展环境得到了优化，婴儿、5岁以下儿童死亡率分别从2010年的13.1‰、16.4‰下降到5.4‰、7.5‰[1]。2021年《中国儿童发展纲要（2021—2030年）》[1]提出，“要进一步完善儿童医疗卫生服务体系，更好满足日益增长的多样化儿童医疗卫生服务需求”。0~6岁是儿童生长发育的关键阶段，这一时期患病情况和健康服务的利用对儿童的长期发展至关重要。现有研究表明，儿童的健康状态与其家庭背景、社会经济状况、生活环境等息息相关[2-3]。受到“单独二孩”“全面两孩”等决策部署和政策措施的影响，第七次人口普查中，我国少儿人口的数量比2010年增加了3 092万人，少儿人口比重上升。因此，关注儿童人群的健康至关重要。然而，四川省针对儿童在影响两周患病情况的研究仍显不足。探索影响儿童两周患病率的因素，不仅对改善儿童健康水平有重大意义，也为政策制定和卫生资源的合理配置提供了支持。本研究基于四川省的卫生服务调查数据，重点分析631例6岁以下儿童的两周患病率，探讨主要的影响因素，以期为改善儿童健康提供依据。
1　资料与方法
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1.1　资料来源
本研究数据来自2023年国家第七次卫生服务调查四川省样本点和增扩样本点的调査数据。
1.1.1　研究对象
该调查采用多阶段随机整群抽样调查，共抽取156个样本县（市、区），每个样本县（市、区）随机抽取5个样本乡镇（街道），每个样本乡镇（街道）随机抽取2个样本村（居委会），每个样本村（居委会）抽取60户。本次调查四川省总共调查了8 403户，18 035人。本研究选取2016年9月至2023年9月出生的631例儿童为研究对象。本研究经四川大学伦理委员会审查并批准（审查批准号：Gwll2022090）, 所有调查对象参与调查前均签署了知情同意书。
1.1.2　调查内容
本研究采用国家卫生服务调查家庭一般情况调查表、家庭成员个人情况调查表和0~18岁儿童青少年调查表。从调查收集的数据库中，获取所有6岁及以下儿童人口学特征（性别、年龄、民族），家庭基本情况（户口性质、家庭人口数、家庭年收入、是否低保户、是否购买商业保险等），医疗卫生情况（家庭饮用水、家庭卫生厕所、医疗服务可及性、是否建立健康档案等）及反映儿童照护和卫生需要与利用的指标，其中包含两周患病率等信息。
其中，“医疗服务可及性”是指从家到最近医疗卫生机构最快的时间，若时间在30分钟以内，则定义为医疗服务可及性好，若时间超出30分钟，则定义为医疗服务可及性一般。“家庭饮用水”是根据家庭最主要的饮用水类型进行分类，类型为“经过集中净化处理的自来水”或“受保护的井水或泉水”的饮用水被视为安全的家庭饮用水，将饮用水类型为“不受保护的井水或泉水”、“收集雨水”、“江河湖泊沟塘水”以及其他水源视为不安全的家庭饮用水。
1.2　两周患病指标定义
在调查前两周内，（1）因为不舒服看过医生；（2）因为不舒服用过药或采取了自我医疗的措施；（3）因为不舒服通过网络（包括医院网站、App、电话等）咨询过医生（必须咨询的是具有执业资格的正规医生，不包括个人在网上通过搜索引擎直接搜索的疾病诊治信息）；（4）因为不舒服休工、休学或者卧床休息1天及以上（包括婴幼儿异常哭闹、食欲减退等）。若符合上述四个条件的任意一个，则判断为“两周患病”。
两周患病率是衡量卫生服务需要的重要指标之一。两周患病率是指每百人两周内患病人次数。
1.3　统计学分析
本研究根据是否两周患病分别将研究对象分为两组，计数资料采用频数（构成比）描述研究对象的基本情况，并采用χ2检验或Fisher确切概率法比较组间差异。然后以家庭作为水平2、个体作为水平1，采用两水平logistic回归分析探索两周患病指标的影响因素。本研究基于R 4.4.1软件进行数据整理和分析，检验水准为0.05。
2　结果
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2.1　描述性分析及单因素分析结果
本研究纳入了631名儿童，两周内患有疾病的有159名儿童。其中男童82例，女童77例；居住在城市89例，农村70例；医疗服务可及性好有104例；主要由父母照顾的儿童有91例，主要由（外）祖父母照顾的儿童有66例。两周患病率为25.2%。详细信息见表1。
儿童两周患病主要为呼吸系统疾病(84.76%)和消化系统疾病(4.88%)，而且疾病症状多为感冒、上呼吸道感染、其他消化系统疾病等症状。具体两周患病基本类型见图1。
单因素分析结果发现，儿童不同居住地、民族、家庭人口数、是否购买商业保险、母亲或父亲是否为常住人口、儿童主要照顾人、是否送孩子入托、孩子拥有玩具数量的两周患病率差异均有统计学意义。
2.2　两水平logistic回归分析结果
根据单因素分析结果，我们筛选了其中有统计学意义的变量，以是否两周患病为因变量，以居住地、民族、家庭人口数、是否购买商业保险、母亲或父亲是否常住人口、儿童主要照顾人员，是否送孩子入托以及孩子拥有的玩具数为自变量，拟合两水平logistic回归模型。变量赋值情况见表2。
研究结果表明，儿童父亲不是常住人口、儿童由父亲或母亲外的其他人员主要照顾为儿童两周患病的危险因素，农村和未送孩子入托育机构是儿童两周患病的保护因素。相较于城市儿童，农村儿童的两周患病的比值比（Odds ratio，OR）是0.554（95%置信区间（confidence interval，CI）为：0.311~0.985）。父亲不是常住人口与不是常住人口相比，发生两周患病的OR是1.775（95% CI: 1.028~3.067）。儿童由父亲或母亲照顾的两周患病风险低于由（外）祖父母照顾的风险，同时远低于其他人员（如保姆、亲戚等）照顾的风险。两水平logistic回归分析的详细结果见表3。
3　讨论
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本研究基于国家第七次卫生服务调查四川省数据探讨了四川省631名6岁以下儿童的两周患病情况，特别关注其在卫生服务需求和利用上的差异。研究结果显示，儿童的父亲不常住、儿童由其他人员主要照顾是儿童两周患病的危险因素，而生活在农村、未将孩子送入托育机构则被视为保护因素。这些结果不仅揭示了影响儿童健康的多维因素，也为改善儿童健康水平和深化卫生资源的配置提供了重要的理论支持。
据报道，河南省6岁以下儿童的两周患病率为23.3%[4]，全国15省调查显示0~6岁儿童两周患病率为22.35%[5]。而四川省国家第七次卫生服务调查6岁以下儿童的两周患病率25.2%，相比之下患病率略高一点。因此，重点关注四川省低龄儿童的卫生健康，对预防和促进儿童的健康有重要意义。
0~6岁儿童两周患病主要为呼吸系统疾病，其次为消化系统疾病，且症状多为感冒、上呼吸道感染等，这与既往调查结果结论相似[6]。因而，需要多关注儿童的常见基础疾病，提供充足的医疗卫生支持。
调查发现，城市儿童两周患病率为29.67%，显著髙于农村儿童的两周患病率21.15%，提示城市儿童面临的健康问题更加严峻。这与既往研究结论一致[7-8]。随着城市化和工业化的迅速发展，儿童面临的生理问题和心理问题越来越多。一项关于婴儿的研究表明，城市的新生儿和围生儿潜藏的风险最高，农村集群最低[9]。这支持了我们的结论。即使城市拥有便利的医疗卫生服务，但是儿童生长发育阶段会面临城市人口密集导致人均资源不足和环境污染严重等问题。此外，由于两周患病的定义为看过医生或自我治疗，城市居民更容易接触医疗服务，且居民的健康意识较强，可能更加主动进行自我治疗或前往医疗机构诊断[10]。农村居民可能因医疗资源匮乏忽略或未报告患病情况，导致未就诊率升高，统计结果出现偏差。因而，需要注意的是，农村家庭可能面临其他健康隐患，如医疗资源不足和卫生教育缺乏等问题。因此，在制定卫生政策时，政府应考虑农村和城市间健康服务的平等性，以保证所有儿童都能享受到必要的医疗服务。
本研究还发现，儿童的两周患病与其家庭环境密切关联。父母的常住状态及照顾者类型对儿童的两周患病影响显著。父母一方或双方连续半年不在居住地，会影响儿童的生活质量和健康水平。一项基于中国儿童的系统综述表明，与非留守儿童相比，留守儿童的疾病风险显著增加，也更容易患心理方面的疾病[11]。这与我们的结果一致。这可能是由于父母长期不在居住地，会导致儿童在日常生活中缺乏必要的关怀与照护。当儿童的父母一方或双方长期不在居住地时，常住家庭人口数减少, 儿童日常照护者劳作和照顾家庭的压力增大，监护人的精力有限使其无法及时关注儿童的两周健康，进而影响了儿童的卫生需求[12]。在家庭人口数大于4人的大家庭中，儿童能够获得更多的关怀与照顾，提高其免疫力，降低患病风险。此外，父母亲自照顾对6岁以下儿童的健康发展较为重要。很多研究表明[13-14]，留守儿童的两周患病率高于非留守儿童。相较于父母直接照顾，祖父母或其他人员的照顾可能缺乏足够的健康知识和技能，无法及时识别和处理儿童健康问题。因此，政府应加强对流动人口和留守家庭的政策关注，提供必要的健康教育与支持，以保障儿童的健康成长。
未将孩子送入托育机构的家庭和孩子拥有玩具被认为是保护因素。未将孩子送入托育机构可能使儿童获得更多的家庭照护时间，降低集体环境感染的风险，也有研究得出相同的观点，托儿所的基础设施质量虽优于居家照护，但活动质量却相反[15]。有研究发现，病毒可在玩具表面存活24小时[16]，玩具可能增加孩童患病的风险，玩具数量越多，玩具的清洁难度越大、劣质玩具的比例越高。
综上所述，研究发现，城乡差异、家庭因素都有可能影响儿童的两周患病风险。本研究的结果有助于了解不同背景下儿童的健康状况，可以帮助卫生政策的合理制定。可以通过加强对留守儿童家庭的健康教育、改善农村地区的医疗服务等措施保障儿童健康，完善儿童健康服务体系。本研究虽补充了四川省儿童两周患病研究的空白，但仍存在一定的局限性。一是样本量较少，对结果可能产生一定的偏倚，未来可扩大样本范围，考虑社会、环境因素对儿童健康的多维影响。二是研究为横断面分析，缺乏纵向研究来探索儿童健康的其他潜在风险因素。
基金
收起
  • 国家自然科学基金(81973151; 82103943; 82073667)
  • 四川省2023年卫生服务专项调查
文献
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2025年第52卷第14期
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文章信息
doi: 10.20043/j.cnki.MPM.202502056
  • 接收时间：2025-02-07
  • 首发时间：2026-03-16
  • 出版时间：2025-07-25
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  • 收稿日期：2025-02-07
基金
国家自然科学基金(81973151; 82103943; 82073667)
四川省2023年卫生服务专项调查
作者信息
    1.四川大学华西公共卫生学院/四川大学华西第四医院，流行病与卫生统计学系，四川 成都 610041
    2.四川省卫生信息中心/四川省医疗大数据中心

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2种不同金属材料的力学参数
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Family		 属数
Number of
genus		 种数
Number of
species		 占总种数比例
Percentage of
total species (%)		 属
Genus		 种数
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species		 占总种数比例
Percentage of total
species (%)
鹅膏菌科Amanitaceae 2 11 5.26 鹅膏菌属 Amanita 10 4.78
小菇科 Mycenaceae 2 12 5.74 丝盖伞属 Inocybe 5 2.39
多孔菌科 Polyporaceae 8 14 6.70 蜡蘑属 Laccaria 5 2.39
红菇科 Russulaceae 3 23 11.00 小皮伞属 Marasmius 6 2.87
小菇属 Mycena 11 5.26
光柄菇属 Pluteus 5 2.39
红菇属 Russula 17 8.13
栓菌属 Trametes 5 2.39
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