新冠肺炎疫情对儿童心理健康负面影响的主要因素

S. Hozak, O. Yelizarova, T.V. Stankevych, A. Parats
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引用次数: 0

摘要

关联人们普遍认识到,新冠肺炎是公共卫生面临的重大问题。新冠肺炎大流行正在演变,对健康的长期影响不断增加,儿童健康尤其令人担忧。暴露的持续时间、异质性和多种生物心理社会因素对儿童和青少年等弱势群体的心理健康产生了不可预测的影响。客观的确定疫情期间影响学童心理健康的重要因素,以进一步制定健康挽救措施。方法。在因新冠肺炎大流行而实施隔离措施期间,我们研究了2020-2021年乌克兰所有地区(n=1393)学童的生活和心理健康特点。采用Q-RAPH、GPAQ、RCADS-P-25问卷。在新冠疫情之前,MH使用“儿童神经系统问卷”方法对500名学童进行了调查。使用描述性统计、Student系数、单变量和多变量方差分析,然后根据Bonferroni检验、共轭表、逻辑和线性回归模型对平均差异进行后验估计。后果在隔离期间,住在公寓里会导致焦虑抑郁障碍的几率平均增加2.5倍。在观察期的疫情期间,患有精神障碍的儿童散步的持续时间和频率都明显较低。在没有互动学习的学龄儿童中,焦虑和抑郁发生病理性增加的可能性是正常儿童的1.8倍。使用Bonferroni检验对调整平均值进行的成对比较表明,BMI越高-睡眠时间越短(β=-1.9;p=0.004),久坐行为持续时间越长(β=3.4;p=0.001)-MVPA越短(α=-1.4;p=0.005)。研究表明,慢性病儿童中抑郁障碍的发生率是健康儿童的2.4倍(χ2=51.1;p<0.001)。在标准化指标的三维线性建模过程中,我们可以看到,轻度体力活动(LPA)和MVPA的减少会导致儿童心理健康指标的恶化。结论。新冠肺炎大流行期间对儿童心理健康产生负面影响的主要因素是:长期呆在家里(OR=2.02;CI 1.39-2.93),每周散步次数少于4次,每周持续时间少于220分钟(OR=1.96;CI 1.12-3.45),非交互式远程学习(OR=1.78;CI 1.17-2.69),学童超重和肥胖(OR=1.52;CI 1.11-2.08),存在慢性疾病(OR=2.79;CI 1.99-3.91)、父母的焦虑障碍(OR=3.67;CI 1.02-13,25)以及他们缺乏高等教育(OR=1,27;CI 1,03-1,56)。在制定进一步的预防战略和策略以克服疫情后果时,必须考虑到所取得的结果。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
MAIN FACTORS OF THE NEGATIVE IMPACT OF THE COVID-19 PANDEMIC ON MENTAL HEALTH OF CHILDREN
Relevance. It is widely recognized that COVID-19 disease is significant problem for public health. The COVID-19 pandemic evolves, the long-term health impacts are continually increasing and children health is particular concern.  The duration of exposure, heterogeneity and plurality of biopsychosocial factors  have to unpredictable consequences on the mental health of vulnerable populations such as children and adolescents. Objective. Determination the significant factors affecting the mental health of schoolchildren during the pandemic in order to further develop the health-saving measures. Methods. During implementation of quarantine measures due to COVID-19 pandemic, we studied the peculiarities of schoolchildren’s life and mental health in 2020-2021 (n=1393) from all regions of Ukraine. Q-RAPH, GPAQ, RCADS-P-25 questionnaires were used. Prior to the pandemic, MH survey of 500 schoolchildren was conducted using “Children’s Neuroses Questionnaire” method. Descriptive statistics, Student's coefficients, univariate and multivariate analysis of variance, followed by a posteriori estimation of mean differences according to the Bonferroni test, conjugation tables, logistic and linear regression models were used. Results. Сonstant stay in an apartment during quarantine leads to an increase in the chances of anxiety-depressive disorders on average by 2.5 times. During the pandemic for the observation period, both duration and frequency of walks were significantly lower for the children with mental disorders. The likelihood of pathological increases in anxiety and depression in school age children without interactive learning is 1.8 times greater. Pairwise comparisons of adjusted means using the Bonferroni test demonstrated that the higher is the BMI - the shorter is the sleep (β=-1.9; p=0.004), the longer is the sedentary behavior duration (β=3.4; p=0.001) - the shorter is MVPA (β =-1,4; p=0,005). It was established that depressive disorders are 2.4 times more common among the children with chronic diseases than among the healthy children (χ2 =51.1; p<0.001). In the course of 3d linear modeling of normalized indicators we can see that a decrease in both light physical activity (LPA) and MVPA leads to deterioration in mental health indicators of the children. Conclusions. Main factors of the negative impact on children's mental health during the COVID-19 pandemic are: permanent stay at home (OR=2.02; CI 1.39-2.93), frequency of walks less than 4 times a week and duration less than 220 minutes per week (OR=1.96; CI 1.12-3.45), non-interactive remote learning (OR=1.78; CI 1.17-2.69), overweight and obesity of schoolchildren (OR=1 .52; CI 1.11-2.08), presence of chronic diseases (OR=2.79; CI 1.99-3.91), anxiety disorders in parents (OR=3.67; CI 1.02-13,25) and their lack of higher education (OR=1,27; CI 1,03-1,56). The obtained results must be taken into account when developing further preventive strategies and tactics for overcoming the pandemic consequences.
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