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Article(id=1325501724403835729, tenantId=1146029695717560320, journalId=1256213402557890569, issueId=1325501647736156411, articleNumber=null, orderNo=null, doi=10.16835/j.cnki.1000-9817.2025069, pmid=null, cstr=null, oa=null, hot=null, price=null, onlineType=0, articleFormat=0, articleType=null, articleTypeStr=null, receivedDate=1727193600000, receivedDateStr=2024-09-25, revisedDate=1736179200000, revisedDateStr=2025-01-07, acceptedDate=null, acceptedDateStr=null, onlineDate=1793953837728, onlineDateStr=2026-11-06, pubDate=1742832000000, pubDateStr=2025-03-25, doiRegisterDate=null, doiRegisterDateStr=null, onlineIssueDate=1793953837728, onlineIssueDateStr=2026-11-06, onlineJustAcceptDate=null, onlineJustAcceptDateStr=null, onlineFirstDate=null, onlineFirstDateStr=null, sourceXml=null, magXml=null, createTime=1793953837728, creator=13701087609, updateTime=1793953837728, updator=13701087609, issue=Issue{id=1325501647736156411, tenantId=1146029695717560320, journalId=1256213402557890569, year='2025', volume='46', issue='3', pageStart='305', pageEnd='456', issueExtLink='null', onlineDate='null', pubDate='1742832000000', pubDateStr='2025-03-25', beforeIssueId=null, nextIssueId=null, price=null, status=1, issueComplete=1, articleOrder=1, issueType=-1, specialIssue=null, createTime=1793953819450, creator='13701087609', updateTime=1793953819450, updator='13701087609', preIssue=null, nextIssue=null, articleTotal=null, ext=null, issueFiles=null, downloadFileDto=null}, startPage=353, endPage=357, ext={EN=ArticleExt(id=1325501724638716754, articleId=1325501724403835729, tenantId=1146029695717560320, journalId=1256213402557890569, language=EN, title=Propensity score matching analysis of the impact of left behind experience on the mental health of secondary vocational school students, columnId=1259565855189418448, journalTitle=Chinese Journal of School Health, columnName=Mental Health, runingTitle=null, highlight=null, articleAbstract=
Objective

To understand the impact of left behind experience on the mental health of secondary vocational school students, so as to provide theoretical basis for the psychological health education of secondary vocational school students.

Methods

From September to December in 2019, a total of 3 401 students from Duyun, Guiding and Pingtang County were selected by multi-stage cluster random sampling method. Self-designed questionnaire and Symptom Check List-90(SCL-90) were used to investigate mental health status. A total of 1 415 left behind students and 1 415 non left behind students were matched by using propensity score matching (PSM). Wilcoxon test and Logistic regression analysis were conducted.

Results

Before the matching of propensity score, there were statistically significant differences in the distribution of family structure, mother's educational level, family residence, family harmony and children's past health among the students with or without left behind experience (χ2=28.17, 52.40, 96.31, 29.75, 19.10, P < 0.05). After the matching, there were no statistically significant differences in the distribution of the above variables among the students with or without left-behind experience (χ2=0.02-4.32, P>0.05). Before the matching of propensity scores, there were significant differences in the scores of 10 dimensions of SCL-90, including somatization (1.67, 1.58), interpersonal sensitivity (2.00, 1.89), anxiety (1.90, 1.70), obsessive-compulsive symptoms (2.20, 2.10), depression (2.00, 1.85), hostility (1.83, 1.67), terror (1.85, 1.71), paranoia (1.83, 1.67), psychotic (1.70, 1.60) and other (1.85, 1.71) dimensions among secondary vocational school students with or without left behind experience (Z=-5.15 to -2.84, P < 0.05). After propensity score matching, there were significant differences in scores remained only in three factors for interpersonal sensitivity [(2.00(1.56, 2.67), 2.00(1.44, 2.56)], paranoia [1.83(1.33, 2.50), 1.83(1.33, 2.33)] and psychoticism [1.70(1.30, 2.30), 1.70(1.20, 2.20)] in SCL-90 among secondary vocational students with or without left behind experience (Z=-2.45, -2.12, -2.23, P < 0.05).

Conclusion

The impact of left behind experience on the mental health of vocational school students is mainly reflected in interpersonal sensitivity, paranoia, and psychoticism, which should be identified as key areas of psychological education for secondary vocational school students.

, authors=Quanxiang ZHOU1, Fuqiang SHE1, Yan WAN1, Xuehua HE1, Jingyuan YANG2, Xianming CAO1, Xiangyang XU1, authorsList=Quanxiang ZHOU, Fuqiang SHE, Yan WAN, Xuehua HE, Jingyuan YANG, Xianming CAO, Xiangyang XU, authorCompany=null, correspAuthors=null, authorNote=null, correspAuthorsNote=null, copyrightStatement=Copyright ©2025 Chinese Journal of School Health. All rights reserved., copyrightOwner=null, extLink=null, articleAbsUrl=null, sourceXml=null, magXml=null, pdfUrl=null, pdf=null, pdfFileSize=null, pdfExtLink=null, richHtmlUrl=null, mobilePdfUrl=null, reviewReport=null, pdfFirstPage=null, abstractGraph=null, abstractGraphContent=null, abstractVideo=null, citation=null, cebUrl=null, magXmlContent=null, mapNumber=null, fund=null), CN=ArticleExt(id=1325501726941389651, articleId=1325501724403835729, tenantId=1146029695717560320, journalId=1256213402557890569, language=CN, title=留守经历对中等职业学校学生心理健康影响的倾向匹配得分分析, columnId=1259565858817491410, journalTitle=中国学校卫生, columnName=心理卫生, runingTitle=null, highlight=null, articleAbstract=
目的

了解留守经历对中等职业学校(以下简称“中职”)学生心理健康的影响，以期为中职学生心理健康教育提供理论依据。

方法

2019年9—12月，采用多阶段整群随机抽样方法，在黔南地区都匀市、贵定县和平塘县共抽取3 401名中职学生，采用自行设计问卷和症状自评量表(SCL-90)进行一般情况和心理健康状况调查，采用倾向匹配得分法(PSM)匹配是否有留守经历学生各1 415名，并对数据进行Wilcoxon检验及Logistic回归分析。

结果

倾向得分匹配前，家庭结构、母亲文化程度、家庭居住地、家庭和睦情况及子女过去健康状况在是否有留守经历的学生间分布差异均有统计学意义(χ2值分别为28.17，52.40，96.31，29.75，19.10，P值均＜0.05)；匹配后，以上变量在两者间分布差异均无统计学意义(χ2=0.02~4.32，P值均＞0.05)。倾向得分匹配前，有无留守经历的中职学生在SCL-90中躯体化(1.67，1.58)、人际关系敏感(2.00，1.89)、焦虑(1.90，1.70)、强迫症状(2.20，2.10)、抑郁(2.00，1.85)、敌对(1.83，1.67)、恐怖(1.85，1.71)、偏执(1.83，1.67)、精神病性(1.70，1.60)、其他(1.85，1.71)10个维度得分中位数差异均有统计学意义(Z=-5.15~-2.84，P值均＜0.05)。倾向得分匹配后，有无留守经历中职生仅在SCL-90中人际关系敏感[(2.00(1.56, 2.67)，2.00(1.44, 2.56)]、偏执[1.83(1.33, 2.50)，1.83(1.33, 2.33)]、精神病性[1.70(1.30, 2.30)，1.70(1.20, 2.20)]3个维度得分中位数差异有统计学意义(Z值分别为-2.45，-2.12，-2.23，P值均＜0.05)。

结论

留守经历对中职学生心理健康的影响主要在人际关系敏感、偏执、精神病性等方面，应将其作为留守经历中职学生心理教育的重点领域。

, authors=周全湘1, 佘福强1, 万雁1, 何学华1, 杨敬源2, 曹显明1, 许向阳1, authorsList=周全湘, 佘福强, 万雁, 何学华, 杨敬源, 曹显明, 许向阳, authorCompany=null, correspAuthors=null, authorNote=

周全湘(1987-)，女，贵州龙里人，硕士，副教授，主要研究方向为预防医学教育教学及人群健康状况

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(in Chinese), articleTitle=null, refAbstract=null), Reference(id=1325501740631597995, tenantId=1146029695717560320, journalId=1256213402557890569, articleId=1325501724403835729, doi=null, pmid=null, pmcid=null, year=null, volume=null, issue=null, pageStart=null, pageEnd=null, url=null, language=null, rfNumber=16, rfOrder=29, authorNames=null, journalName=null, refType=null, unstructuredReference=左静, 王东方, 陈曦, 等. 有留守经历大学生社会支持与精神病性体验的关系及乐观和自尊的链式中介效应[J]. 中国临床心理学杂志, 2020, 28(4): 705-712., articleTitle=null, refAbstract=null), Reference(id=1325501740694512556, tenantId=1146029695717560320, journalId=1256213402557890569, articleId=1325501724403835729, doi=null, pmid=null, pmcid=null, year=null, volume=null, issue=null, pageStart=null, pageEnd=null, url=null, language=null, rfNumber=16, rfOrder=30, authorNames=null, journalName=null, refType=null, unstructuredReference=ZUO J, WANG D F, CHEN X, et al. Effect of optimism and self-esteem between social support and psychotic-like experiences college students with left-behind experiences[J]. Chin J Clin Psychol, 2020, 28(4): 705-712. (in Chinese), articleTitle=null, refAbstract=null)], funds=[Fund(id=1325501736282104717, tenantId=1146029695717560320, journalId=1256213402557890569, articleId=1325501724403835729, awardId=null, language=CN, fundingSource=2019年贵州省教育科学规划课题(2019C040)；2020年贵州省教育科学规划课题(2020C008)；民族地区健康乡村建设科研创新团队项目(QNYZ2024005), fundOrder=null, country=null)], companyList=[AuthorCompany(id=1325501728136766293, tenantId=1146029695717560320, journalId=1256213402557890569, articleId=1325501724403835729, xref=1, ext=[AuthorCompanyExt(id=1325501728153543510, tenantId=1146029695717560320, journalId=1256213402557890569, articleId=1325501724403835729, companyId=1325501728136766293, language=EN, country=null, province=null, city=null, postcode=null, companyName=null, departmentName=null, remark=1Department of Medicine, Qiannan Medical College for Nationalities, Duyun (558000), Guizhou Province, China), AuthorCompanyExt(id=1325501728161932119, tenantId=1146029695717560320, journalId=1256213402557890569, articleId=1325501724403835729, companyId=1325501728136766293, language=CN, country=null, province=null, city=null, postcode=null, companyName=null, departmentName=null, remark=1黔南民族医学高等专科学校医学系，贵州 都匀 558000)]), AuthorCompany(id=1325501728279372632, tenantId=1146029695717560320, journalId=1256213402557890569, articleId=1325501724403835729, xref=2, ext=[AuthorCompanyExt(id=1325501728291955545, tenantId=1146029695717560320, journalId=1256213402557890569, articleId=1325501724403835729, companyId=1325501728279372632, language=CN, country=null, province=null, city=null, postcode=null, companyName=null, departmentName=null, remark=2贵州医科大学公共卫生学院流行病与卫生统计学系)])], figs=[ArticleFig(id=1325501735413883781, tenantId=1146029695717560320, journalId=1256213402557890569, articleId=1325501724403835729, language=EN, label=Tab.1, caption=

Comparison of SCL-90 scores of vocational school students with or without left behind experience in Qiannan Area before matching[M(P25, P75)]

, figureFileSmall=null, figureFileBig=null, tableContent=
留守经历人数躯体化强迫症状人际关系敏感抑郁焦虑
有1 5931.67(1.25, 2.25)2.20(1.80, 2.70)2.00(1.56, 2.67)2.00(1.46, 2.69)1.90(1.40, 2.50)
无1 8081.58(1.17, 2.08)2.10(1.70, 2.60)1.89(1.44, 2.44)1.85(1.38, 2.54)1.70(1.30, 2.40)
Z值-2.84-3.93-5.15-3.83-4.08
P值0.01< 0.01< 0.01< 0.01< 0.01
留守经历人数敌对恐怖偏执精神病性其他
有1 5931.83(1.33, 2.50)1.85(1.29, 2.57)1.83(1.33, 2.50)1.70(1.30, 2.30)1.85(1.14, 2.43)
无1 8081.67(1.33, 2.33)1.71(1.14, 2.29)1.67(1.33, 2.33)1.60(1.20, 2.10)1.71(1.29, 2.29)
Z值-2.85-4.13-4.28-4.90-4.53
P值< 0.01< 0.01< 0.01< 0.01< 0.01
), ArticleFig(id=1325501735522935686, tenantId=1146029695717560320, journalId=1256213402557890569, articleId=1325501724403835729, language=CN, label=表1, caption=

匹配前黔南地区是否有留守经历中职学生SCL-90得分比较[M(P25, P75)]

, figureFileSmall=null, figureFileBig=null, tableContent=
留守经历人数躯体化强迫症状人际关系敏感抑郁焦虑
有1 5931.67(1.25, 2.25)2.20(1.80, 2.70)2.00(1.56, 2.67)2.00(1.46, 2.69)1.90(1.40, 2.50)
无1 8081.58(1.17, 2.08)2.10(1.70, 2.60)1.89(1.44, 2.44)1.85(1.38, 2.54)1.70(1.30, 2.40)
Z值-2.84-3.93-5.15-3.83-4.08
P值0.01< 0.01< 0.01< 0.01< 0.01
留守经历人数敌对恐怖偏执精神病性其他
有1 5931.83(1.33, 2.50)1.85(1.29, 2.57)1.83(1.33, 2.50)1.70(1.30, 2.30)1.85(1.14, 2.43)
无1 8081.67(1.33, 2.33)1.71(1.14, 2.29)1.67(1.33, 2.33)1.60(1.20, 2.10)1.71(1.29, 2.29)
Z值-2.85-4.13-4.28-4.90-4.53
P值< 0.01< 0.01< 0.01< 0.01< 0.01
), ArticleFig(id=1325501735652959111, tenantId=1146029695717560320, journalId=1256213402557890569, articleId=1325501724403835729, language=EN, label=Tab.2, caption=

Logistic regressiojn analysis of mixed factors of left behind experience of vocational school students(n=3 401)

, figureFileSmall=null, figureFileBig=null, tableContent=
自变量与常数β值标准误Wald χ2值P值OR值(95%CI)
家庭结构0.090.038.070.011.09(1.03~1.16)
家庭居住地0.620.0853.65< 0.011.85(1.57~2.18)
母亲文化程度-0.220.0612.59< 0.010.80(0.71~0.91)
家庭和睦情况-0.310.0626.78< 0.010.74(0.65~0.83)
子女过去健康情况0.160.0414.79< 0.011.18(1.08~1.28)
常数-0.300.281.150.280.74
), ArticleFig(id=1325501735770399624, tenantId=1146029695717560320, journalId=1256213402557890569, articleId=1325501724403835729, language=CN, label=表2, caption=

中职学生留守经历混杂因素的Logistic回归分析(n=3 401)

, figureFileSmall=null, figureFileBig=null, tableContent=
自变量与常数β值标准误Wald χ2值P值OR值(95%CI)
家庭结构0.090.038.070.011.09(1.03~1.16)
家庭居住地0.620.0853.65< 0.011.85(1.57~2.18)
母亲文化程度-0.220.0612.59< 0.010.80(0.71~0.91)
家庭和睦情况-0.310.0626.78< 0.010.74(0.65~0.83)
子女过去健康情况0.160.0414.79< 0.011.18(1.08~1.28)
常数-0.300.281.150.280.74
), ArticleFig(id=1325501735841702793, tenantId=1146029695717560320, journalId=1256213402557890569, articleId=1325501724403835729, language=EN, label=Tab.3, caption=

Comparison of distribution of general characteristics of vocational school students with or without left behind experience before and after matching

, figureFileSmall=null, figureFileBig=null, tableContent=
匹配前后留守经历人数统计值家庭结构母亲文化程度
核心家庭单亲家庭主干家庭联合家庭其他小学及以下初中高中及以上
匹配前有1 593941(59.07)198(12.43)319(20.03)73(4.58)62(3.89)1 111(69.74)418(26.24)64(4.12)
无1 8081 190(65.82)209(11.56)246(13.61)84(4.64)79(4.37)1 085(60.01)556(30.75)167(9.24)
χ2值28.1752.40
P值< 0.01< 0.01
匹配后有1 415901(63.67)166(11.73)221(15.62)70(4.95)57(4.03)941(66.50)410(28.98)64(4.52)
无1 415927(65.51)147(10.39)205(14.49)65(4.59)71(5.02)955(67.49)376(26.57)84(5.94)
χ2值3.844.28
P值0.430.12
匹配前后留守经历人数统计值家庭居住地子女过去健康情况家庭和睦情况
城镇农村较好一般较差和睦比较和睦不和睦
匹配前有1 593369(23.16)1 224(76.84)696(43.69)409(25.67)488(30.64)974(61.14)493(30.95)126(7.91)
无1 808702(38.83)1 106(61.17)896(49.56)474(26.22)438(24.22)1 244(68.81)484(26.77)80(4.42)
χ2值96.3119.1029.75
P值< 0.01< 0.01< 0.01
匹配后有1 415369(26.08)1 046(73.92)613(43.32)370(26.15)432(30.53)963(68.06)375(26.50)77(5.44)
无1 415372(26.29)1 043(73.71)646(45.65)387(27.35)382(27.00)921(65.09)420(29.68)74(5.23)
χ2值0.024.323.54
P值0.900.120.17
), ArticleFig(id=1325501735946560394, tenantId=1146029695717560320, journalId=1256213402557890569, articleId=1325501724403835729, language=CN, label=表3, caption=

匹配前后有无留守经历中职学生一般特征分布比较

, figureFileSmall=null, figureFileBig=null, tableContent=
匹配前后留守经历人数统计值家庭结构母亲文化程度
核心家庭单亲家庭主干家庭联合家庭其他小学及以下初中高中及以上
匹配前有1 593941(59.07)198(12.43)319(20.03)73(4.58)62(3.89)1 111(69.74)418(26.24)64(4.12)
无1 8081 190(65.82)209(11.56)246(13.61)84(4.64)79(4.37)1 085(60.01)556(30.75)167(9.24)
χ2值28.1752.40
P值< 0.01< 0.01
匹配后有1 415901(63.67)166(11.73)221(15.62)70(4.95)57(4.03)941(66.50)410(28.98)64(4.52)
无1 415927(65.51)147(10.39)205(14.49)65(4.59)71(5.02)955(67.49)376(26.57)84(5.94)
χ2值3.844.28
P值0.430.12
匹配前后留守经历人数统计值家庭居住地子女过去健康情况家庭和睦情况
城镇农村较好一般较差和睦比较和睦不和睦
匹配前有1 593369(23.16)1 224(76.84)696(43.69)409(25.67)488(30.64)974(61.14)493(30.95)126(7.91)
无1 808702(38.83)1 106(61.17)896(49.56)474(26.22)438(24.22)1 244(68.81)484(26.77)80(4.42)
χ2值96.3119.1029.75
P值< 0.01< 0.01< 0.01
匹配后有1 415369(26.08)1 046(73.92)613(43.32)370(26.15)432(30.53)963(68.06)375(26.50)77(5.44)
无1 415372(26.29)1 043(73.71)646(45.65)387(27.35)382(27.00)921(65.09)420(29.68)74(5.23)
χ2值0.024.323.54
P值0.900.120.17
), ArticleFig(id=1325501736084972427, tenantId=1146029695717560320, journalId=1256213402557890569, articleId=1325501724403835729, language=EN, label=Tab.4, caption=

Comparison of SCL-90 scores of vocational school students with or without left behind experience in Qiannan Area after matching[M(P25, P75)]

, figureFileSmall=null, figureFileBig=null, tableContent=
留守经历人数躯体化强迫症状人际关系敏感抑郁焦虑
有1 4151.67(1.25, 2.25)2.20(1.80, 2.70)2.00(1.56, 2.67)2.00(1.46, 2.62)1.90(1.40, 2.50)
无1 4151.58(1.25, 2.08)2.20(1.70, 2.70)2.00(1.44, 2.56)1.92(1.46, 2.54)1.80(1.30, 2.50)
Z值-1.13-1.88-2.45-1.22-1.68
P值0.260.060.010.220.09
留守经历人数敌对恐怖偏执精神病性其他
有1 4151.83(1.33, 2.50)1.86(1.29, 2.43)1.83(1.33, 2.50)1.70(1.30, 2.30)1.85(1.43, 2.43)
无1 4151.67(1.33, 2.33)1.71(1.29, 2.43)1.83(1.33, 2.33)1.70(1.20, 2.20)1.85(1.43, 2.29)
Z值-1.26-1.54-2.12-2.23-2.29
P值0.210.120.030.030.02
), ArticleFig(id=1325501736156275596, tenantId=1146029695717560320, journalId=1256213402557890569, articleId=1325501724403835729, language=CN, label=表4, caption=

匹配后黔南地区是否有留守经历中职学生SCL-90得分比较[M(P25, P75)]

, figureFileSmall=null, figureFileBig=null, tableContent=
留守经历人数躯体化强迫症状人际关系敏感抑郁焦虑
有1 4151.67(1.25, 2.25)2.20(1.80, 2.70)2.00(1.56, 2.67)2.00(1.46, 2.62)1.90(1.40, 2.50)
无1 4151.58(1.25, 2.08)2.20(1.70, 2.70)2.00(1.44, 2.56)1.92(1.46, 2.54)1.80(1.30, 2.50)
Z值-1.13-1.88-2.45-1.22-1.68
P值0.260.060.010.220.09
留守经历人数敌对恐怖偏执精神病性其他
有1 4151.83(1.33, 2.50)1.86(1.29, 2.43)1.83(1.33, 2.50)1.70(1.30, 2.30)1.85(1.43, 2.43)
无1 4151.67(1.33, 2.33)1.71(1.29, 2.43)1.83(1.33, 2.33)1.70(1.20, 2.20)1.85(1.43, 2.29)
Z值-1.26-1.54-2.12-2.23-2.29
P值0.210.120.030.030.02
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留守经历对中等职业学校学生心理健康影响的倾向匹配得分分析
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周全湘 1 , 佘福强 1 , 万雁 1 , 何学华 1 , 杨敬源 2 , 曹显明 1 , 许向阳 1
中国学校卫生 | 心理卫生 2025,46(3): 353-357
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中国学校卫生 |心理卫生 2025 , 46 (3) : 353 -357
留守经历对中等职业学校学生心理健康影响的倾向匹配得分分析
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周全湘1, 佘福强1, 万雁1, 何学华1, 杨敬源2, 曹显明1, 许向阳1
作者信息
  • 1黔南民族医学高等专科学校医学系，贵州 都匀 558000
  • 2贵州医科大学公共卫生学院流行病与卫生统计学系
作者简介:

周全湘(1987-)，女，贵州龙里人，硕士，副教授，主要研究方向为预防医学教育教学及人群健康状况

Propensity score matching analysis of the impact of left behind experience on the mental health of secondary vocational school students
Quanxiang ZHOU1, Fuqiang SHE1, Yan WAN1, Xuehua HE1, Jingyuan YANG2, Xianming CAO1, Xiangyang XU1
Affiliations
  • 1Department of Medicine, Qiannan Medical College for Nationalities, Duyun (558000), Guizhou Province, China
出版时间: 2025-03-25 doi: 10.16835/j.cnki.1000-9817.2025069
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摘要
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目的

了解留守经历对中等职业学校(以下简称“中职”)学生心理健康的影响，以期为中职学生心理健康教育提供理论依据。

方法

2019年9—12月，采用多阶段整群随机抽样方法，在黔南地区都匀市、贵定县和平塘县共抽取3 401名中职学生，采用自行设计问卷和症状自评量表(SCL-90)进行一般情况和心理健康状况调查，采用倾向匹配得分法(PSM)匹配是否有留守经历学生各1 415名，并对数据进行Wilcoxon检验及Logistic回归分析。

结果

倾向得分匹配前，家庭结构、母亲文化程度、家庭居住地、家庭和睦情况及子女过去健康状况在是否有留守经历的学生间分布差异均有统计学意义(χ2值分别为28.17，52.40，96.31，29.75，19.10，P值均＜0.05)；匹配后，以上变量在两者间分布差异均无统计学意义(χ2=0.02~4.32，P值均＞0.05)。倾向得分匹配前，有无留守经历的中职学生在SCL-90中躯体化(1.67，1.58)、人际关系敏感(2.00，1.89)、焦虑(1.90，1.70)、强迫症状(2.20，2.10)、抑郁(2.00，1.85)、敌对(1.83，1.67)、恐怖(1.85，1.71)、偏执(1.83，1.67)、精神病性(1.70，1.60)、其他(1.85，1.71)10个维度得分中位数差异均有统计学意义(Z=-5.15~-2.84，P值均＜0.05)。倾向得分匹配后，有无留守经历中职生仅在SCL-90中人际关系敏感[(2.00(1.56, 2.67)，2.00(1.44, 2.56)]、偏执[1.83(1.33, 2.50)，1.83(1.33, 2.33)]、精神病性[1.70(1.30, 2.30)，1.70(1.20, 2.20)]3个维度得分中位数差异有统计学意义(Z值分别为-2.45，-2.12，-2.23，P值均＜0.05)。

结论

留守经历对中职学生心理健康的影响主要在人际关系敏感、偏执、精神病性等方面，应将其作为留守经历中职学生心理教育的重点领域。

精神卫生  /  倾向评分分配  /  回归分析  /  学生
Objective

To understand the impact of left behind experience on the mental health of secondary vocational school students, so as to provide theoretical basis for the psychological health education of secondary vocational school students.

Methods

From September to December in 2019, a total of 3 401 students from Duyun, Guiding and Pingtang County were selected by multi-stage cluster random sampling method. Self-designed questionnaire and Symptom Check List-90(SCL-90) were used to investigate mental health status. A total of 1 415 left behind students and 1 415 non left behind students were matched by using propensity score matching (PSM). Wilcoxon test and Logistic regression analysis were conducted.

Results

Before the matching of propensity score, there were statistically significant differences in the distribution of family structure, mother's educational level, family residence, family harmony and children's past health among the students with or without left behind experience (χ2=28.17, 52.40, 96.31, 29.75, 19.10, P < 0.05). After the matching, there were no statistically significant differences in the distribution of the above variables among the students with or without left-behind experience (χ2=0.02-4.32, P>0.05). Before the matching of propensity scores, there were significant differences in the scores of 10 dimensions of SCL-90, including somatization (1.67, 1.58), interpersonal sensitivity (2.00, 1.89), anxiety (1.90, 1.70), obsessive-compulsive symptoms (2.20, 2.10), depression (2.00, 1.85), hostility (1.83, 1.67), terror (1.85, 1.71), paranoia (1.83, 1.67), psychotic (1.70, 1.60) and other (1.85, 1.71) dimensions among secondary vocational school students with or without left behind experience (Z=-5.15 to -2.84, P < 0.05). After propensity score matching, there were significant differences in scores remained only in three factors for interpersonal sensitivity [(2.00(1.56, 2.67), 2.00(1.44, 2.56)], paranoia [1.83(1.33, 2.50), 1.83(1.33, 2.33)] and psychoticism [1.70(1.30, 2.30), 1.70(1.20, 2.20)] in SCL-90 among secondary vocational students with or without left behind experience (Z=-2.45, -2.12, -2.23, P < 0.05).

Conclusion

The impact of left behind experience on the mental health of vocational school students is mainly reflected in interpersonal sensitivity, paranoia, and psychoticism, which should be identified as key areas of psychological education for secondary vocational school students.

Mental health  /  Propensity score matching  /  Regression analysis  /  Students
周全湘, 佘福强, 万雁, 何学华, 杨敬源, 曹显明, 许向阳. 留守经历对中等职业学校学生心理健康影响的倾向匹配得分分析. 中国学校卫生, 2025 , 46 (3) : 353 -357 . DOI: 10.16835/j.cnki.1000-9817.2025069
Quanxiang ZHOU, Fuqiang SHE, Yan WAN, Xuehua HE, Jingyuan YANG, Xianming CAO, Xiangyang XU. Propensity score matching analysis of the impact of left behind experience on the mental health of secondary vocational school students[J]. Chinese Journal of School Health, 2025 , 46 (3) : 353 -357 . DOI: 10.16835/j.cnki.1000-9817.2025069
正文
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近年来，随着农村剩余劳动力向城市转移，农村出现大量留守儿童群体，研究显示，长期缺乏父母的正常抚养及关爱，可对留守儿童心理健康造成一定影响[1-2]。然而，随着留守儿童的成长，父母曾经外出务工对其心理健康的远期效应是否存在仍值得进一步研究，尤其是处于青春期向成年期转变的中等职业学校(中职)学生。当前关于留守经历对学生心理健康的影响观点不一，卢芸等[2-3]研究认为，父母曾经外出务工会对学生心理健康产生消极影响，留守学生在童年期长期缺乏与父母沟通交流、亲子关系淡漠，成人后较容易出现人际关系敏感等问题。但赵晨晓等[4]认为留守经历并未对学生心理健康产生影响，并且因父母外出能增加家庭收入，有利于促进学生的营养状况，从而改善身体和心理健康状况[5]。温义媛等[6]研究也认为父母外出务工后为儿童创造了一个独立处理问题的环境，使其在今后的生活及学习中应对方式更为成熟、积极，更能促进心理健康。
由于父母的文化程度、家庭经济水平、子女身心健康状况等在一定程度会影响父母是否外出务工，而这些往往也是子女心理健康的影响因素。在观察性研究中倾向匹配得分法(propensity score matching，PSM)，可以更好地控制混杂因素对结果的影响，使非随机化事件达到随机化效果[7]，由此，本文将个体在16岁之前，父母双方或一方曾经外出务工，有曾留守在家乡半年及以上的在读中职学生[6]定义为有留守经历中职学生，采用PSM获得留守经历对中职学生心理健康状况的“净效应”，以增加结论的可靠性[8]，报道如下。
1　对象与方法
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1.1　对象
于2019年9—12月采用多阶段整群随机抽样方法，在黔南地区采用直接抽选法抽取都匀市、贵定县、平塘县作为一级抽样群，然后采用直接抽选法在都匀市抽取黔南民族职业技术学院中专部、黔南民族卫生学校，在贵定县抽取黔南民族幼儿师范高等专科学校中专部，在平塘县抽取平塘中等职业技术学校作为二级抽样群，对4所学校各年级中等职业院校(以下简称中职)学生开展调查。本次参与问卷调查共3 671人，剔除270份因心理健康状况及留守经历等重要信息缺失的问卷，获得有效问卷3 401份，有效率92.65%。其中有留守经历学生1 593名，无留守经历学生1 808名；汉族学生2 152名，少数民族学生1 249名；男生1 079名，女生2 322名；居住地在农村学生2 330名，城镇学生1 071名；一年级学生1 662名，二年级1 177名，三年级562名。平均年龄(17.42±3.04)岁。调查对象纳入标准：(1)黔南地区注册在籍的中职学生；(2)自愿参与本次调查；(3)沟通理解能力正常，能独立完成问卷者。本研究经黔南民族医学高等专科学校伦理委员会批准(伦理审批号: [2019]65)，所有调查对象均知情同意后进行问卷调查。
1.2　调查方法
(1) 采用自行设计问卷进行一般情况调查，内容主要有：一般人口学特征，包括民族、年龄、性别、年级、家庭所在地等；家庭情况，包括家庭结构、父母文化程度、家庭年收入、家庭氛围是否和谐、父母是否曾外出务工等；学校情况，包括与老师、同学、室友的关系，学习压力、学习成绩、就业前景、学校是否开展心理健康教育活动等。(2)心理健康状况，采用症状自评量表(Symptom Check List-90，SCL-90)[9]测量，该量表的Cronbach α系数为0.983，共90个条目，包含躯体化、人际关系敏感、焦虑、强迫症状、抑郁、敌对、恐怖、偏执、精神病性、其他10个维度，采用5级评分法(“1=没有”~“5=严重”)，总分为90项得分相加所得，即90~450分，得分越高表示心理健康状况越差，各维度得分为所包含题目的总分除以项目数。
1.3　质量控制
调查前组织调查员进行统一培训，后在调查员组织下以班级为单位填写问卷，回收后对问卷的一致性、逻辑性、准确性、完整性等进行核查，剔除不合格问卷。采用EpiData 3.1软件建立数据库双录入数据。
1.4　统计学分析
应用SPSS 25.0软件对数据进行统计分析。由于匹配前后有无留守经历中职学生心理健康得分均不符合正态分布，故采用中位数、四分位数[M(P25，P75)]进行统计描述，采用Wilcoxon秩和检验比较两组心理健康状况得分情况。采用PSM方法评估留守经历对中职学生心理健康的影响，首先确定可能会影响父母外出务工的变量，应用Logistic逐步回归的方法对混杂变量进行筛选，然后将父母是否外出务工作为因变量，将筛选出的混杂因素作为自变量，用Logistic回归模型估计倾向得分。采用最近邻匹配法，容差大小设为0.02，将倾向得分相近的进行一对一匹配，最后计算平均处理效应。匹配完成后建立一个新的数据库，用Wilcoxon秩和检验比较匹配后是否有留守经历中职学生的心理健康得分。P < 0.05为差异有统计学意义。
2　结果
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2.1　匹配前有无留守经历中职学生SCL-90得分比较
匹配前，有无留守经历的中职学生在躯体化、强迫症状、人际关系敏感、抑郁、焦虑、敌对、恐怖、偏执、精神病性及其他维度得分差异均有统计学意义(P值均 < 0.05)。见表1。
2.2　协变量选择及匹配情况
将民族、性别、家庭结构、家庭子女数、家庭居住地、父母文化程度、父母职业、家庭和睦情况、家庭年收入、子女过去健康状况等作为可能影响父母曾经外出务工的混杂因素。然后采用Logistic逐步回归分析法确定最终的混杂因素，以有无留守经历为因变量，将初选的变量全部纳入回归模型中，根据结果筛选出家庭结构、家庭居住地、母亲文化程度、子女过去健康情况及家庭和睦情况5个变量。见表2。然后以父母是否曾外出务工作为因变量，筛出的5个变量作为自变量建立倾向得分匹配模型，卡钳值为0.02，得到匹配对象共2 830名，有无留守经历中职学生各1 415名。
2.3　样本匹配效果
通过均衡性校验后结果显示，匹配前是否有留守经历的学生在家庭结构、母亲文化程度、家庭居住地、子女过去健康状况及家庭和睦情况等变量分布，两组间差异均有统计学意义(P值均 < 0.05)，而匹配后以上一般特征差异均无统计学意义(P值均>0.05)。见表3。
2.4　匹配后是否有留守经历中职学生SCL-90各维度得分比较
匹配后是否有留守经历的中职学生在人际关系敏感、偏执、精神病性及其他维度上得分差异均有统计学意义(P值均 < 0.05)，在躯体化、强迫症状、抑郁、焦虑、敌对、恐怖维度上得分差异均无统计学意义(P值均>0.05)，见表4。
3　讨论
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PSM是观察性研究中常见的控制混杂因素的方法，将一组混杂因素融合成倾向得分，将处理组和控制组可观测特征相同或相似的样本进行匹配，倾向得分相近的两个个体，其混杂因素分布也趋于一致[7, 10]，即认为有无留守经历的中职学生可观测特征或背景条件相同，若得到结果为两组间心理健康状况有差异则认为这种差异是留守经历产生的效应。
本研究匹配前的结果显示，有无留守经历的中职学生SCL-90各因子得分差异均有统计学意义，而匹配后结果显示，躯体化、强迫症状、抑郁、焦虑、敌对、恐怖维度得分两组间差异均无统计学意义，一方面可能是随着时间推移，留守经历学生逐渐适应了留守带来的变化，并形成稳定的心理应对机制，这种适应过程有助于减轻心理压力和负面情绪，使得两者在躯体化、抑郁、焦虑等方面差异无统计学意义。另一方面可能是有留守经历学生在留守期间培养了生活自理能力和独立处理问题的能力，磨练了意志，使得这些学生具备较强的心理韧性、较好的情绪自我调节能力和更为积极的应对方式[6, 11]。有研究显示良好的心理韧性、积极的应对方式将有利于缓解抑郁、焦虑、孤独感、无助感，使得有留守经历学生在躯体化、抑郁、焦虑等方面与无留守经历学生差异无统计学意义[12]。但是，匹配后人际关系敏感、偏执、精神病性和其他症状得分差异仍有统计学意义，有留守经历学生更易出现人际关系敏感、偏执等心理健康问题，可能是长期留守使依恋行为发展受到干扰，人际关系态度消极[13]，且容易形成敏感、内向的性格特点和较强的心理防御机制，又进一步阻碍人际关系的建立[14]。此外，留守经历的中职学生出现精神病性心理问题可能是因为在成长关键期与父母分离，长期在缺乏社会支持的环境中成长，引发大脑发育过程中某些必要刺激的缺乏，从而诱发精神病性症状出现[15-16]。
由此可见，采用PSM后的分析结果与匹配前不一致，说明匹配前的结果可能受到较多混杂因素的影响，从而在一定程度上不能正确反映留守经历对中职学生心理健康的影响。匹配后有留守经历学生在人际关系敏感、偏执、精神病性等方面与无留守经历学生有差异，说明父母曾经外出务工确实会对子女的心理健康产生远期影响，提示并应将这几方面的内容作为留守经历中职学生心理健康教育的重点领域。
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  • 2019年贵州省教育科学规划课题(2019C040)；2020年贵州省教育科学规划课题(2020C008)；民族地区健康乡村建设科研创新团队项目(QNYZ2024005)
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2025年第46卷第3期
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doi: 10.16835/j.cnki.1000-9817.2025069
  • 接收时间：2024-09-25
  • 首发时间：2026-11-06
  • 出版时间：2025-03-25
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  • 收稿日期：2024-09-25
  • 修回日期：2025-01-07
基金
2019年贵州省教育科学规划课题(2019C040)；2020年贵州省教育科学规划课题(2020C008)；民族地区健康乡村建设科研创新团队项目(QNYZ2024005)
作者信息
    1黔南民族医学高等专科学校医学系，贵州 都匀 558000
    2贵州医科大学公共卫生学院流行病与卫生统计学系
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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
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