我国4岁以下儿童看电视行为对睡眠质量影响的多中心研究
Multi-center study on the effects of television viewing on sleep quality among children under 4 years of age in China
目的 了解我国4岁以下儿童看电视现状并探讨其对睡眠质量的影响.方法 按照"省—市—县—医院"的抽样技术路线,于2012年11月至2013年3月采用多中心横断面研究,抽取来自中国8个省或自治区1 046名4 ~48月龄足月、健康儿童作为研究对象.通过家长填写"儿童个人及家庭社会环境问卷"收集儿童看电视情况、个人及家庭基本信息;利用简明婴儿睡眠问卷(BISQ)和简明儿童睡眠问卷(BCSQ)分别评估3岁以下婴幼儿及3岁以上学龄前儿童睡眠情况;采用多元线性回归分析儿童看电视对睡眠质量的影响.结果入选儿童平均(20±13)月龄,其中男孩558人,占总数的53.3%;4岁以下儿童看电视率为70.3%(735/1 046),其中2岁以下婴幼儿看电视率为58.7%(408/695),≥2岁儿童中看电视时间≥2 h/d的占19.9%(70/351),随着年龄的增长儿童看电视率逐渐增高.不同性别、城乡、父母受教育程度、家庭成员结构之间儿童看电视时间差异均无统计学意义(P均> 0.05);然而,卧室内有电视(x2=13.682,P=0.001)以及母亲全职工作(x2=15.053,P=0.005)的儿童电视使用时间明显偏高;在校正了儿童年龄、性别、母亲教育程度、母亲工作状况等因素后,经多元线性回归分析显示:与不看电视的儿童相比,看电视时间≥1 h/d儿童的就寝时间更晚(t=5.49,P<0.001),入睡潜伏期更长(t=2.63,P=0.009),夜间睡眠时间更短(t=-3.49,P=0.001).结论我国4岁以下儿童看电视比例较高,且很多婴儿6个月以下就暴露在电视环境中;卧室内有电视以及母亲全职工作的儿童看电视的比例明显偏高.在年幼儿中,看电视已经可以使其就寝时间延迟、入睡潜伏期延长、夜间睡眠时间缩短,需要引起家长及儿科医生的高度重视.
更多Objective To explore the current television viewing situation among children less than 4 years of age in our country and investigate effects of television viewing on sleep quality.Method According to the "Hospital of Province—City—County" sampling technical route, a total of 1 046 full term healthy children at the age of 4-48 months were sampled by stratified cluster random sampling method from 8 provinces in China from 2012-2013.The information of television viewing and family and personal information was investigated by Shanghai Children's Medical Center Socio-demographic Questionnaire.Brief Infant Sleep Questionnaire (BISQ) and Brief Child Sleep Questionnaire (BCSQ) were employed to assess the sleep behaviors of children 0-3 years old and over 3 years old respectively.The effects of television viewing on sleep quality were analyzed by multiple linear regression analysis.Result The children's average age was (20 ± 13) months, with boys accounted for 53.3% (558/1 046).The percentage of children who viewed television was 70.3% (735/1 046).Moreover, 58.7% (408/695) of infants and young children under the age of 2 viewed TV per day, and 19.9% (70/351) of 2 years and older infants and young children viewed television ≥2 hours per day.With the increase of age, the percentage of children who viewed television time gradually increased(P < 0.001).Child sex, geographic area, paternal education, and family structure were not associated with television viewing time among children aged 4-48 months.However, the presence of a bedroom TV (x2 =13.682, P =0.001) and maternal employment (x2 =15.053, P =0.005) were commonly correlated with long screen-watching time among children.After adjusting for age, gender, mother' education level, and working state, it was revealed by multiple linear regression analysis that television viewing was not only positively correlated with later bedtime (t =5.49, P < 0.001) and shorter night sleep duration (t =-3.49, P =0.001) but also significantly associated with longer sleep onset latency (t =2.63, P =0.009).Conclusion The percentage of children under 4 years of age who viewed television is very high in our country, and many infants under 6 months of age exposed to TV environment.Bedroom TV and mother full-time job were associated with higher proportion of children viewing TV.In early childhood, television viewing was positively correlated with later bedtime, shorter sleep duration and longer sleep onset latency.There is a need for parents and pediatricians to pay more attention to the behavior of children viewing TV and improve sleep quality.
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