文章摘要
王建敏,李侠,农铮,黄燕,凌子羽,覃媛媛,杨森焙,张静.监护人重视的首个儿童孤独症异常特征及与就诊时间关系的分析[J].中华流行病学杂志,2015,36(10):1077-1080
监护人重视的首个儿童孤独症异常特征及与就诊时间关系的分析
Association between guardian's first notice of autism symptom of children and time to seek medical care
收稿日期:2015-02-16  出版日期:2015-10-14
DOI:10.3760/cma.j.issn.0254-6450.2015.10.009
中文关键词: 儿童孤独症;发现时间;就诊时间;关联性;影响因素
英文关键词: Children autism;Discovery time;Visiting time;Correlation;Influence factors
基金项目:国家自然科学基金(81273084)
作者单位E-mail
王建敏 430030 武汉, 华中科技大学同济医学院公共卫生学院儿少卫生与妇幼保健学系  
李侠 430030 武汉, 华中科技大学同济医学院公共卫生学院儿少卫生与妇幼保健学系  
农铮 广西壮族自治区柳州市妇幼保健院  
黄燕 海南省妇幼保健院  
凌子羽 430030 武汉, 华中科技大学同济医学院公共卫生学院儿少卫生与妇幼保健学系  
覃媛媛 430030 武汉, 华中科技大学同济医学院公共卫生学院儿少卫生与妇幼保健学系  
杨森焙 430030 武汉, 华中科技大学同济医学院公共卫生学院儿少卫生与妇幼保健学系  
张静 430030 武汉, 华中科技大学同济医学院公共卫生学院儿少卫生与妇幼保健学系 fyebzj@126.com 
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中文摘要:
      目的 了解监护人重视的首个儿童孤独症异常特征分布情况及其影响因素,并分析其对就诊时间的影响。方法 2012年9月至2014年4月使用自拟《儿童心理行为发育及相关因素》问卷,选取就诊于武汉、海口、柳州和长沙市儿童孤独症康复机构5岁以下孤独症患儿主要监护人进行问卷调查,采用EpiData软件录入数据,使用SPSS 13.0软件进行统计分析。结果 415名孤独症患儿男童占85.54%(355人),女童占14.46%(60人),男女性别比为5.9:1;引起监护人重视的首个异常特征出现概率前3位的是语言发育不良、不理人或缺乏与他人交往和重复、怪异或固定动作,分别占20.72%、18.55%和14.94%;首个异常特征出现时间的M值为8~28个月,不同异常特征引起监护人重视的时间不同(χ2=46.64,P<0.000 1);监护人年龄、文化程度、与儿童接触时间及亲密程度、家庭类型、家庭关系等与监护人重视的首个儿童孤独症异常特征无统计学关联。孤独症患儿就诊时间的M值为10.5~33个月,且不同异常特征就诊时间存在差异(χ2=46.10,P<0.000 1);90.74%的监护人延迟患儿就诊,但不同异常特征就诊延迟时间的差异无统计学意义(χ2=9.46,P=0.579 6)。结论 孤独症患儿监护人重视的首个异常特征主要集中在语言交往交流障碍、社交交往交流障碍和刻板兴趣及行为3个类别,监护人文化程度、与儿童亲密程度等对引起其重视的首个异常特征无影响,监护人重视的首个异常特征对孤独症患儿引起监护人重视和就诊的时间有影响。
英文摘要:
      Objective To understand the symptoms of autism of children that caused the first notice of guardian,related risk factors and the influence on the time to seek medical care. Methods The children with autism aged <5 years were selected from autism rehabilitation centers in Wuhan,Changsha,Haikou,Liuzhou and Changsha between September 2012 and April 2014,and their guardians were retrospectively surveyed by using questionnaire. SPSS 13.0 software was used for statistical analysis. Results A total of 415 children with autism were included in the study. Including 355 boys (85.54%) and 60 girls (14.46%),the sex ratio was 5.9:1. The most common concern of guardian were: language dysplasia (20.72%);ignoring of people or lack of interaction with others (18.55%);repeat and weird action pattern (14.94%). The age when the first symptom occurred,which causing guardians' concern,ranged from 8 months to 28 months,the time when guardian began to concern varied with symptom(χ2=46.64,P<0.000 1). Guardian's educational level,guardian's contact time with the children,guardian's intimate degree with the children,the age of guardian,family type and tie had no statistical association with the fist autism symptom that caused guardian's concern. The age of the children at first medical care seeking ranged from 10.5 months to 33 months,the time of the first medical care seeking varied with symptom (χ2=46.10,P<0.000 1). Up to 90.74% of the guardians delayed the medical care seeking of the children with autism,but the symptom specific differences in medical care delay had no statistical significance(χ2=9.46,P=0.579 6). Conclusion The symptom of the children with autism causing guardian's first notice were mainly verbal communication barrier,social interaction barrier and restricted interests and behaviors. Guardian's educational level and intimate degree with children had no correlation with the symptom which caused guardian's first notice. The time when guardian began to concern and the time for children's medical care varied with guardian's first notice.
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