0~6岁儿童非故意伤害风险评估工具的系统性文献分析

Risk assessment tools for 0-6 years old children unintentional injuries: A systematic literature analysis

摘要

目的 伤害是儿童和青少年死亡的首位原因。尽管国内外学者已发表数十个儿童非故意伤害风险评估工具，但目前全球并未就已有工具的规范使用形成共识。本研究旨在系统阐明当前国内外涉及0~6岁儿童非故意伤害风险评估工具的特点，以期为工具的科学选择和优化提供参考。 方法 在中国知网、万方、PubMed、Web of Science中检索并筛选从建库至2025年1月收录的与儿童非故意伤害风险评估相关的文献。建立资料信息提取表，从文献中提取儿童非故意伤害评估工具的基本特征、评估形式、定量计分方法和评判标准、评估维度、信度和效度，以及涉及的非故意伤害类型等。 结果 共纳入50个涉及0~6岁儿童非故意伤害风险的评估工具，其中35个评估工具评估2种及以上的非故意伤害类型。分别有38、2、3及7个评估工具采取儿童照护人自我报告、调查员询问、调查员现场观察及结合多种方式实施风险评估。评估工具涉及的4个维度为知识、态度、行为、环境，11个工具涵盖3个维度，仅1个工具全面涵盖4个维度。19个评估工具有明确的计分方法，14个评估工具有风险判定标准，11个评估工具同时有计分方法及风险判定标准，28个评估工具既无计分方法又无风险判定标准。22个评估工具已有信度和/或效度方面的评价。25个英文评估工具中，仅有3个有汉化版本。 结论 目前暂无工具能同时满足6岁以下儿童所有常见非故意伤害类型风险评估的需要，建议在实践中结合具体用途选择恰当的工具。此外，针对现有工具的不足，建议开展优化工作，如翻译英文工具并评估其信效度、对缺乏评分方法和判断标准的工具制订相应的量化评估方法和评判标准、针对现有工具涉及不足的重要非故意伤害类型(如道路交通伤害、溺水)开发适用于中国儿童的风险评价工具。

Abstract

Objective Injuries are the leading cause of death among children and adolescents. Although numerous risk assessment tools for unintentional injuries in children have been developed and published both domestically and internationally, there is currently no global consensus on standardized use. This study aims to systematically characterize existing unintentional injury risk assessment tools for children aged 0-6 years, with the goal of informing scientific tool selection and optimization. Methods Relevant literature published up to January 2025 was retrieved from CNKI, Wanfang, PubMed, and Web of Science. An information extraction form was developed to gather data on the basic features of each assessment tool, assessment format, scoring methods and criteria, dimensions assessed, reliability and validity, and types of unintentional injuries covered. Results A total of 50 risk assessment tools for unintentional injuries among children aged 0-6 years were included. Among them, 35 tools assessed two or more types of unintentional injuries. Regarding assessment format, 38 tools relied on caregiver self-report, 2 on investigator interviews, 3 on direct observation by investigators, and 7 used multiple methods. The tools covered four major dimensions: knowledge, attitude, behavior, and environment. Eleven tools covered 3 dimensions, while only one tool addressed all 4. Nineteen tools provided clear scoring methods, 14 included criteria for risk determination, and only 11 had both scoring methods and risk criteria. Twenty-eight tools lacked both. Twenty-two tools had been evaluated for reliability and/or validity. Among the 25 English-language tools, only 3 had been translated into Chinese. Conclusion Currently, no existing tool comprehensively assesses all major types of unintentional injuries for children under six years of age. It is recommended that practitioners select appropriate tools based on specific needs. In addition, improvements should be pursued, such as translating and validating English-language tools, developing quantitative scoring methods and criteria for tools tailored to Chinese children for important but underrepresented injury types (e.g., road traffic injuries, drowning).

关键词

儿童 / 非故意伤害 / 风险评估工具 / 道路交通伤害 / 溺水

Key words

children / unintentional injury / risk assessment tools / road traffic injuries / drowning

2021年，全球有20万0~4岁儿童死于伤害，病死率高达30.38/10万，已超过恶性肿瘤的病死率(5.19/10万)^[1]。在中国，伤害是儿童和青少年死亡的第1位原因^[2-3]。非故意伤害指无目的造成的伤害，常见类型包括道路交通伤害、中毒、跌倒、溺水、烧烫伤等^[4]。准确地评价儿童非故意伤害风险可用于制订针对性的预防措施，有效减少非故意伤害事件发生。尽管目前国内外学者已开发了儿童非故意伤害风险评估工具，但不同评估工具的适用年龄、评估维度、所适用的非故意伤害类型等存在差异。目前尚缺乏文献系统梳理已发表的儿童非故意伤害风险评估工具的特点，也未就规范使用已发表儿童非故意伤害风险评估工具给出建议，严重影响儿童非故意伤害风险评估和伤害预防工作的开展。因此，本研究全面梳理了国内外0~6岁儿童非故意伤害风险评估工具，分析其适用范围、评估维度、评估形式、评价方法、信度和效度及局限性等，旨在为实际工作中科学选择儿童非故意伤害风险评估工具，以及后续的工具改良与研发提供参考。

1 资料与方法

1.1 数据来源和文献检索策略

在中国知网、万方、PubMed和Web of Science数据库，选择发生率及病死率较高的非故意伤害类型作为检索词进行文献检索。中文检索词包括：“儿童”“伤害”“道路交通”“烧烫伤”“溺水”“窒息”“动物咬伤/抓伤”“中毒”“跌倒”“问卷/调查/量表/评价”“风险”。英文检索词包括：“children/child/toddler”“injury”“road/traffic”“burn”“drowning”“suffocate”“bite/scratch”“poison”“fall”“questionnaire/survey/scale/evaluate/assessment”。采用布尔逻辑运算符“AND”与“OR”进行组合。检索时间为建库至2025年1月。同时采用“滚雪球”方法检索，对符合纳入和排除标准的文献，进一步检索其参考文献和引用文献。

1.2 文献纳入和排除标准

纳入标准：1)公开发表的儿童非故意伤害风险评估相关文献；2)适用于0~6岁儿童和/或其照护人，或针对儿童居住或活动的环境；3)阐明所使用评估工具的具体内容及指标数量；4)语言为中文或英文。排除标准：1)采用开放式条目评估非故意伤害风险的工具；2)评估对象为患有严重疾病或住院需特殊的照顾儿童，含有不适用于普通儿童的指标(如儿童疾病诊断、认知受损程度等)；3)无法获取全文(经数据库、馆际互借、联系作者后仍无法获取)。

1.3 资料提取

建立资料信息提取表，从纳入文献中提取儿童非故意伤害评估工具的以下信息：1)基本特征，包括研究题目、第一作者、语言、英文评估工具的汉化情况、指标数量、适用年龄等；2)评估形式、定量计分方法和评判标准；3)评估维度；4)涉及的非故意伤害类型；5)信度、效度。采用双人提取、交叉核对的方式，确保信息提取的准确性和可靠性。

2 结 果

2.1 文献检索结果

根据检索策略，通过阅读文献标题和摘要，去除重复文献后剩余76篇。排除无法获取全文的文献，进一步阅读全文进行复筛，依据纳入和排除标准，最终从符合要求的文献中纳入50个儿童非故意伤害风险评估工具。

2.2 评估工具的基本特征

50个符合标准的儿童非故意伤害风险评估工具中，25个为中文工具，25个为英文工具。其中，仅有3个英文工具有中文版本，即伤害态度问卷(Injury Attitudes Questionnaire，IAQ)^[5-6]，伤害行为量表(Injury Behavior Checklist，IBC)^[7-8]和家长监督属性概况问卷(Parent Supervision Attributes Profile Questionnaire，PSAPQ)^[9-10]。50个评估工具所包括的指标数量介于5~61不等。就评估工具的适用年龄而言，6个评估工具可用于评估0~3岁的儿童，20个工具可用于评估3~6岁的儿童，14个评估工具可用于评估0~6岁的儿童，1个评估工具未提及所适用的年龄范围，其余评估工具的适用年龄范围不适于上述分类。

2.3 评估工具的评估形式、计分方法及评判标准

就评估形式而言，分别有38、2、3及7个工具采取儿童照护人自我报告、调查员询问、调查员现场观察及结合多种方式实施风险评估。

就评价方法而言，有19个评估工具有明确的计分方法，14个评估工具有风险判定标准，11个评估工具同时有计分方法和风险判定标准，28个评估工具既无计分方法又无风险判定标准^{[5, 7-9, 11-55]}(表1)。

2.4 评估工具的评估维度

50个纳入研究的儿童非故意伤害风险评估工具评估包含知识(家长/照护人的相关知识)、态度(家长/照护人的态度)、行为(家长/照护人、儿童的行为)、环境(家庭内外环境)4个维度。其中，11个工具涵盖3个维度，仅1个工具全面涵盖知识、态度、行为、环境4个维度^[30]。就评估工具涉及的维度而言，涵盖维度最多的评估工具为高华等^[30]从家长的非故意伤害有关知识、态度、行为及环境4个维度开发的学龄前儿童伤害及家长认知调查表(Preschool Children’s Injury and Parental Perception Survey，PCIPPS)。在环境维度评估方面，国内学者开展的研究较少，仅王孜宇等^[18]开发了中国城区0~6岁儿童家庭内意外伤害环境量表(Environment Scale of Unintentional Injury in the Home for Children Aged 0-6 Years Old in Urban Area of China，ESUI)。有6个工具只在行为维度上评估儿童非故意伤害发生风险，其中4个工具[中国城区0~6岁儿童家庭内意外伤害危险行为量表(Risk Behavior Scale for In-Home Unintentional Injury in Urban Children Aged 0-6 years in China，RBSUI)、IBC、婴幼儿伤害相关行为问卷(Infant/Toddler-Injury Behavior Questionnaire，IT-IBQ)、道路安全行为指数(Road Safety Behavior Index，RSBI)^{[7, 27, 47, 49]}]从儿童相关行为维度评估风险，而2个工具[家长防护儿童非故意伤害行为问卷(Parents’ Protection Against Unintentional Injury Behavior Questionnaire，PAUIB)、儿童乘车安全调查表(Child Passenger Safety Survey，CPSS)^{[8, 17]}]从照护人的照护行为维度评估风险(表2)。

2.5 评估工具涉及的非故意伤害类型

在50个纳入研究的儿童非故意伤害风险评估工具中，15个评估工具仅评估1种非故意伤害类型的发生风险，其中7个^{[23, 35-36, 39-40, 42-43]}、3个^{[11, 17, 49]}、2个^{[12, 16]}、2个^{[13, 22]}、1个^[44]工具分别评估儿童发生铅中毒、道路交通伤害、烫烧伤、跌倒、溺水的风险。

35个评估工具评估2种及以上的非故意伤害类型，包括道路交通伤害、窒息、烧烫伤、跌倒坠落、溺水、中毒、锐器伤、动物抓咬伤、异物伤、挤压伤、机械伤、触电、火器伤等。其中，涉及伤害类型最多的评估工具为宋娟等^[47]开发的RBSUI(11种)，涉及伤害类型较少的评估工具为儿童意外伤害知识问卷(Questionnaire on Knowledge of Unintentional Injuries of Pre-school Children，QKUI-L)^[45]及低收入国家儿童非故意伤害风险评估工具(Unintentional Injuries in Young Children in Low-income Settings Questionnaire，UIYCLSQ)^[55]，均仅3种(表3)。

2.6 评估工具的信度和效度

在50个纳入研究的儿童非故意伤害风险评估工具中，22个评估工具已有信度和/或效度方面的评价。

在信度评价方面，检验了内部一致性的工具有18个，报告了克龙巴赫α系数的工具有18个(克龙巴赫α系数介于0.42~0.95)，报告了分半信度的工具有8个(分半信度介于0.72~0.94)，报告了重测信度的工具有6个(重测信度介于0.13~0.98)，报告了不同评分者间信度的工具有1个(信度为0.70)。按照第5版《医学统计学》^[57]推荐的标准(克龙巴赫α系数>0.7，重测信度>0.7)，仅IAQ^[5]、IBC^[7]、家长监督属性概况问卷(Parent Supervision Attributes Profile Questionnaire，PSAPQ)^[9]和幼儿意外伤害家庭急救技能问卷(Family First Aid Skills Questionnaire for Children’s Unintentional Injuries，FFASQ)^[19]4个评估工具拥有较好的内部一致性及重测可信度(表4)。

在效度评价方面，采用专家咨询法或相关性分析评价10个工具的内容效度；采用专家咨询法评价4个工具的表面效度；15个工具有结构效度的评价，其中12个工具采用因子分析或相关性分析，4个工具采用t检验评价其区分效度；7个工具有校标效度的评价；仅5个工具同时具备结构效度及校标效度的评价(表4)。除表4列出的结果外，儿童铅中毒风险筛查问卷(Childhood Lead Screening Questionnaire，CLSQ)的测量学性能评价结果包括：灵敏度为0.46，特异度为0.74，阳性预测值为0.03，阴性预测值为0.99^[39]。儿童溺水潜在风险评估指数(Potential Risk Estimation Drowning Index for Children，PREDIC)的受试者操作特征(receiver operator characteristic，ROC)曲线下面积为0.662^[44]。

总体而言，国外学者Jordaan等^[55]研制的UIYCLSQ中“石蜡和电器维度”的内部一致性(克龙巴赫α系数=0.42)和重测信度(Kappa系数=0.13)不甚理想。宋娟等^[47]研制的RBSUI具有较高的信度和效度(克龙巴赫α系数=0.94，分半信度=0.87)。3个英文工具被汉化，且拥有中国人群样本的信度和/或效度，其中汉化版IBC仅有信度评价结果(克龙巴赫α系数=0.90)^[8]，汉化版PSAPQ信度较高但区分效度不甚理想[克龙巴赫α系数=0.84，分半信度=0.92，监督信念及保护信念2个维度的平均方差提取量(average variance extracted，AVE)<0.5]^[10]，汉化版IAQ具有良好的信度和效度[克龙巴赫α系数=0.91，分半信度=0.75，重测信度=0.87，内容效度指数(content validity index，CVI)=0.93]^[6]。

3 讨 论

本研究选取发生率及病死率较高的非故意伤害类型作为检索词，在多个数据库中全面检索了建库至2025年1月期间发表的涉及0~6岁儿童非故意伤害风险的评估工具，确保检索策略充分覆盖现有的评估工具，极大程度地避免了遗漏。对纳入研究的评估工具进行系统梳理后，发现不同评估工具采用的评估形式、维度、指标数量、覆盖的儿童年龄及非故意伤害类型具有较大差异。

本研究共检索到50个评估工具，指标数量从5到61不等，评估维度涵盖儿童家长/照护人非故意伤害预防相关知识、态度和行为，儿童非故意伤害相关行为，以及家庭内/外环境安全，11个工具涵盖3个维度，仅1个工具全面涵盖知识、态度、行为、环境4个维度。就评价方法而言，仅有11个评估工具同时具有计分方法及风险判定标准，28个评估工具既无计分方法又无风险判定标准。就信效度检验而言，22个评估工具已有信度和/或效度方面的评价，其中4个工具有较好的内部一致性及重测信度，5个工具具备结构效度及校标效度方面的评价。此外，15个评估工具仅评估1种非故意伤害类型的发生风险，35个工具评估多种非故意伤害类型的整体发生风险。

不同评估工具的适用性(适用年龄、评估的伤害类型、评估维度)、实用性(指标数量、评价方法)、可操作性(评估形式)、可推广性(语种)及科学性(信度和效度)不尽相同，在研究和实践中应根据研究的对象、目的等选择适当的儿童非故意伤害风险评估工具。

尧依莹^[34]制订的乌鲁木齐市0~6岁儿童伤害防控中家长防控知识、信念和行为调查表(Parental Knowledge and Belief Behavior Scale for Prevention and Control，KBBS)从家长的儿童非故意伤害防控知识、态度和行为维度进行评价，有明确的计分方法和风险判定标准，信度和效度均良好，适用于量化评估0~6岁儿童家长的非故意伤害防控能力。但儿童非故意伤害的发生同时受儿童个人因素、家庭及社会环境因素多种因素影响^[58]，该问卷仅从家长伤害防控知信行出发，缺乏对儿童非故意伤害相关行为的评估。除此之外，该问卷包含难以区分伤害类型的综合条目，不适用于特定伤害类型的评估。

RBSUI^{[47, 59]}、PAUIB^[8]及ESUI^{[18, 60]}具有较好的信度和效度，以及明确的计分方法和风险判定标准，但评估维度各有侧重，分别从儿童非故意伤害相关行为、家长非故意伤害防护行为、环境安全维度评估儿童非故意伤害的发生风险。同时，这3个评估的非故意伤害类型不同。然而，PAUIB的信度和效度未被全面评价，有待未来研究提供全面的信度和效度评价结果。

城市学龄前3~6岁儿童烧烫伤简易风险评估问卷(Brief Risk Questionnaire for Burns of Urban Preschoolers Aged 3~6 years，BRQB)^{[12, 61]}和城市3~6岁学龄前儿童跌倒伤害简易风险评估问卷(Brief Risk Questionnaire for Falls of Urban Preschoolers Aged 3-6 years，BRQF)^{[13, 62]}分别从家长行为和环境维度进行评价，适用年龄为3~6岁，信度和效度均良好，有明确的计分方法和风险判定标准，可用于评价3~6岁儿童的常见风险(烧烫伤、跌倒)；但不适用于农村和0~3岁儿童，且采用不记名调查方式评价评估工具的信度和效度，缺乏对重测信度的评价。

国内外儿童非故意伤害评估工具的研究起步时间存在显著差异，国外始于1990年，而国内始于2006年，起步较晚。从评估方法来看，国外工具多通过单一条目的问答直接评估风险，而国内工具则较多采用量化评分体系，对得分进行综合评估。在评估维度上，国外工具更侧重行为和环境因素，国内工具则主要关注知识、行为和态度，较少涉及环境因素。建议国内科研工作者在未来工具研发中加强对环境因素的评估。

现有0~6岁儿童非故意伤害风险评估工具存在以下局限性：首先，大部分工具缺乏评价方法，仅少数工具有计分方法及风险判定标准。缺乏量化评分或风险等级判定标准的工具在实践中可操作性较差，限制了其在后续研究中的推广和使用。其次，现有工具大多侧重综合评估整体非故意伤害风险，无法精准判断单一伤害类型的风险。然而，不同伤害类型的环境风险有较大差异，若评估工具可依据伤害类型进行评估，将提高工具的实用性和针对性，未来研究应考虑开发针对特定伤害类型风险的评估工具，增强其精准性。此外，儿童非故意伤害的发生受儿童个人、家庭及社会环境因素等多重因素综合影响^[63]，但现有工具评估维度较为单一，多集中在家庭因素的家长/照护人知识、态度、行为的一个或多个方面^[64]，缺乏全面评估框架。最后，儿童非故意伤害风险工具定量评估的有效性是确保风险评估科学性的基础，目前仅少部分工具开展了完整的信度和效度分析。因此，未来开发及使用儿童非故意伤害风险评估工具时，应进行信度和效度检验，确保研究的科学性和严谨性。

综上，现有涉及0~6岁儿童非故意伤害风险评估工具包含多种伤害类型，涵盖儿童行为、家长知识、态度和照护行为以及相关环境因素。然而，目前暂未发现任何一种工具可以同时满足科学、全面且便捷地评价儿童非故意伤害发生风险的需求。建议根据不同的研究目的和人群特征，选择评价方法明确、信度和效度较高的儿童非故意伤害风险评估工具。此外，在未来儿童非故意伤害风险评估工具研发和改良的过程中，应开展科学严谨的有效性分析，从儿童、家庭、社会、环境等多维度综合评估，并明确具体的计分方法和风险判定标准。

参考文献

[1] Institute for Health Metrics and Evaluation, University of Washington. GBD results[EB/OL]. (2024-02-15)[2024-03-20].

[2] Zhou J, Zhao M, Huang H, et al. Injury mortality of children and adolescents aged 0-19 years-China, 2010-2021[J]. China CDC Wkly, 2024, 6(14): 294-299.

[3] 国家卫生健康委统计信息中心. 中国死因监测数据集2021[M]. 北京: 中国科学技术出版社, 2022.

[4] National Health Commission Statistical Information Center. China cause of death surveillance dataset 2021[M]. Beijing: China Science and Technology Press, 2022.

[5] Regional workshop on trainers on the international classification of diseases (ICD)[EB/OL]. (2022-01-09)[2024-03-20].

[6] Lewis T, DiLillo D, Peterson L. Parental beliefs regarding developmental benefits of childhood injuries[J/OL]. Am J Health Behav, 2004, 28(): S61-S68[2024-03-20].

[7] 孙孟珂, 冉霓, 胡晓雯, 等. 儿童家长伤害态度问卷的汉化及信效度研究[J]. 现代预防医学, 2021, 48(10): 1809-1812.

[8] SUN Mengke, RAN Ni, HU Xiaowen, et al. Reliability and validity of Injury Attitude Questionnaire for Chinese Parents[J]. Modern Preventive Medicine, 2021, 48(10): 1809-1812.

[9] Speltz ML, Gonzales N, Sulzbacher S, et al. Assessment of injury risk in young children: a preliminary study of the injury behavior checklist[J]. J Pediatr Psychol, 1990, 15(3): 373-383.

[10] 孙孟珂. 1~6岁儿童非故意伤害危险因素分析及风险预测模型的构建[D]. 山东: 青岛大学, 2021.

[11] SUN Mengke. Study on risk factors and construction a risk prediction model for unintentional injury of 1-6 years old children[D]. Shandong: Qingdao University, 2021.

[12] Morrongiello BA, Corbett M. The Parent Supervision Attributes Profile Questionnaire: a measure of supervision relevant to children’s risk of unintentional injury[J]. Inj Prev, 2006, 12(1): 19-23.

[13] Yang J, Lee SY, Zhou Y, et al. Parent Supervision Attributes Profile Questionnaire (PSAPQ) for young children: psychometric properties of the Chinese version[J]. BMC Public Health, 2019, 19(1): 1073.

[14] Koppel S, Muir C, Budd L, et al. Parents’ attitudes, knowledge and behaviours relating to safe child occupant travel[J]. Accid Anal Prev, 2013, 51: 18-26.

[15] 朱松林, 王琦琦, 廖先珍, 等. 城市学龄前 3~6岁儿童烧烫伤简易风险评估问卷的研制[J/OL]. 伤害医学(电子版), 2015, 4(1): 27-31[2024-03-20].

[16] ZHU Songlin, WANG Qiqi, LIAO Xianzhen, et al. Development of a Brief Risk Questionnaire for Burns of Urban Preschoolers Aged 3-6 Years[J/OL]. Injury Medicine: Electronic Edition, 2015, 4(1): 27-31[2024-03-20].

[17] 王琦琦, 朱松林, 何琼, 等. 城市3~6岁学龄前儿童跌倒伤害简易风险评估问卷的研制[J]. 中国卫生统计, 2014, 31(1): 74-77.

[18] WANG Qiqi, ZHU Songlin, HE Qiong, et al. Development of a Brief Risk Assessment Questionnaire for Fall Injury of Preschool Children Aged 3-6 in Urban Areas[J]. Chinese Journal of Health Statistics, 2014, 31(1): 74-77.

[19] 黄巧宇, 吴擢春, 吕军, 等. 上海市嘉定区家长对0~3岁儿童意外伤害的认知与预防行为调查[J]. 医学与社会, 2020, 33(4): 1-5.

[20] HUANG Qiaoyu, WU Zhuochun, Jun LÜ, et al. Investigation on the cognition and prevention behaviors of unintentional injuries in parents of children aged 0-3 years in Jiading, Shanghai[J]. Medicine and Society, 2020, 33(4): 1-5.

[21] Shields WC, Gielen AC, Frattaroli S, et al. Child Housing Assessment for a Safe Environment (CHASE): A new tool for injury prevention inside the home[J]. Inj Prev, 2020, 26(3): 215-220.

[22] 于庆, 肖永强, 胡晓燕, 等. 2 723名上海市儿童看护人对小面积烧伤急救知识认知水平的横断面调查与分析[J]. 中华烧伤杂志, 2019, 35(3): 198-204.

[23] YU Qing, XIAO Yongqiang, HU Xiaoyan, et al. Cognitive level of first aid knowledge regarding small area burn among 2 723 child caregivers in Shanghai: a cross-sectional survey and analysis[J]. Chinese Journal of Burns, 2019, 35(3): 198-204.

[24] Uherick L, Gorelick MH, Biechler R, et al. Validation of two child passenger safety questionnaires[J]. Inj Prev, 2010, 16(5): 343-347.

[25] 王孜宇, 冉昱, 粘惠瑜, 等. 中国城区0~6岁儿童家庭内意外伤害环境量表的研制与性能测试[J]. 中华预防医学杂志, 2020, 54(2): 139-143.

[26] WANG Ziyu, RAN Yu, NIAN Huiyu, et al. Development and performance test of the Environment Scale of Unintentional Injury in the Home for Children Aged 0-6 Years Old in Urban Area of China[J]. Chinese Journal of Preventive Medicine, 2020, 54(2): 139-143.

[27] 苏醒. 幼儿意外伤害家庭急救技能问卷的编制及应用[D]. 承德: 承德医学院, 2021.

[28] SU Xing. Development and application of the Family First Aid Skills Questionnaire for Children’s Unintentional Injuries[D]. Chengde: Chengde Medical College, 2021.

[29] 周凡. 0~3岁婴幼儿意外伤害家庭急救能力量表的编制与信效度检验[D]. 海口: 海南医科大学, 2024.

[30] ZHOU Fan. Development, reliability and validity test of Family First Aid Ability Scale for Accidental Injury of Infants Aged 0-3 Years[D]. Haikou: Hainan Medical University, 2024.

[31] Hansen K, Wong D, Young PC. Do the Framingham Safety Surveys improve injury prevention counseling during pediatric health supervision visits[J]. J Pediatr, 1996, 129(4): 494-498.

[32] McWilliams JR. An evidence-based pediatric fall risk assessment tool for home health practice[J]. Home Healthc Nurse, 2011, 29(2): 98-105.

[33] Hyder AA, Chandran A, Khan UR, et al. Childhood unintentional injuries: Need for a community-based home injury risk assessments in Pakistan[J]. Int J Pediatr, 2012, 2012: 203204.

[34] Parmeswaran GG, Kalaivani M, Gupta SK, et al. Assessment of home hazards for childhood injuries in an urban population in new Delhi[J]. Child Care Health Dev, 2016, 42(4): 473-477.

[35] Phelan KJ, Khoury J, Xu Y, et al. Validation of a HOME Injury Survey[J]. Inj Prev, 2009, 15(5): 300-306.

[36] 王虹, 刘筱娴, 林艳, 等. 深圳市横岗镇幼儿园儿童家长伤害认知状况调查[J]. 中国初级卫生保健, 2009, 23(5): 42-43.

[37] WANG Hong, LIU Xiaoxian, LIN Yan, et al. A study on the injury knowledge and attitude of kindergarten children’s parents in Henggang Town of Shenzhen City[J]. Chinese Primary Health Care, 2009, 23(5): 42-43.

[38] Morrongiello BA, Bryant L, Cox A. Validation of a measure of injury-risk behaviors in the first 2 years of life: Infant/Toddler-Injury Behavior Questionnaire (IT-IBQ)[J]. Infant Behav Dev, 2021, 63: 101561.

[39] 杨桂涛, 黄碧玲, 刘子健, 等. 学龄前儿童家长对非故意伤害发生的知信行调查[J/OL]. 伤害医学(电子版), 2019, 8(3): 16-23[2024-03-20].

[40] YANG Guitao, HUANG Biling, LIU Zijian, et al. Research on the Knowledge, Attitude and Practice in Parents of Preschool Children Regarding the Occurrence of Unintentional Injury [J/OL]. Injury Medicine (Electronic Edition), 2019, 8(3): 16-23[2024-03-20].

[41] Liu WY, Tung TH, Zhou Y, et al. The relationship between knowledge, attitude, practice, and fall prevention for childhood in Shanghai, China[J]. Front Public Health, 2022, 10: 848122.

[42] 高华, 张涛, 丁可, 等. 宁波市城乡结合部学龄前儿童伤害及家长认知调查[J]. 中国农村卫生事业管理, 2010, 30(11): 945-946.

[43] GAO Hua, ZHANG Tao, DING Ke, et al. Investigation on preschool children’s injury and parents’ cognition survey in Ningbo urban-rural fringe[J]. Chinese Rural Health Service Administration, 2010, 30(11): 945-946.

[44] 周卫国, 周德定, 张胜冰, 等. 花木社区学龄前儿童伤害及家长知信行调查[J]. 环境与职业医学, 2008, 25(6): 586-588.

[45] ZHOU Weiguo, ZHOU Deding, ZHANG Shengbing, et al. Analysis of prevalence of pre-school children’s injuries and the status of their parents/guardians’ KAP in Huamu community, Pudong district, Shanghai[J]. Journal of Environmental & Occupational Medicine, 2008, 25(6): 586-588.

[46] 刘玉玲, 付四毛, 陈昂, 等. 儿童看护人对儿童意外伤害知识、行为和态度的调查研究[J]. 国际医药卫生导报, 2019, 25(8): 1206-1210.

[47] LIU Yuling, FU Simao, CHEN Ang, et al. The Children Carers’ Knowledge, Behavior and Attitudes Towards Accidental Injuries of Children[J]. International Medicine and Health Guidance News, 2019, 25(8): 1206-1210.

[48] 赵婷, 桂莉, 张静, 等. 儿童意外伤害发生情况及其父母对意外伤害知识、行为和态度的调查[J]. 中华现代护理杂志, 2011, 17(6): 645-647.

[49] ZHAO Ting, GUI Li, ZHANG Jing, et al. Investigation on the occurrence of unintentional injury of childhood and their parents’ knowledge, attitude and practice on unintentional injury[J]. Chinese Journal of Modern Nursing, 2011, 17(6): 645-647.

[50] 尧依莹. 乌鲁木齐市0~6岁儿童家长对儿童伤害防控知信行现状及影响因素分析[D]. 乌鲁木齐: 新疆医科大学, 2023.

[51] YAO Yiying. Current status and factors influencing parents’ knowledge and attitudes about child injury prevention and control of children aged 0-6 years in Urumqi[D]. Urumqi: Xinjiang Medical University, 2023.

[52] 杨如兰. 儿保门诊家长儿童铅中毒防治知识问卷调查[J]. 河南预防医学杂志, 2007, 18(4): 270-271.

[53] YANG Rulan. Questionnaire survey on the knowledge of prevention and treatment of lead poisoning among parents and children in child care clinic[J]. Henan Journal of Preventive Medicine, 2007, 18(4): 270-271.

[54] Mahon I. Caregivers’ Knowledge and Perceptions of Preventing Childhood Lead Poisoning[J]. Public Health Nurs, 1997, 14(3): 169-182.

[55] 陈宇. 学龄前儿童意外伤害状况及家长认知水平调查[J]. 家庭医药, 2019(2): 358-359.

[56] CHEN Yu. Investigation on unintentional injuries of preschool children and parents’ cognitive level[J]. Home Medicine, 2019(2): 358-359.

[57] 万姝倩, 粘惠瑜, 杨俊, 等. 中国城市0~6岁儿童家庭内非故意伤害家长监管特质量表的研制与信效度检验[J]. 中国卫生统计, 2021, 38(6): 874-878.

[58] WAN Shuqian, ZHAN Huiyu, YANG Jun, et al. Development, reliability and validity test of parental supervision trait scale for unintentional injuries of children aged 0-6 in China city[J]. Chinese Journal of Health Statistics, 2021, 38(6): 874-878.

[59] United States. Public Health Service. Screening young children for lead poisoning: guidance for state and local public health officials[M]. Atlanta, Ga: Centers for Disease Control and Prevention, National Center for Environmental Health, U S. Dept of Health and Human Services, Public Health Service, 1997.

[60] Rolnick SJ, Nordin J, Cherney LM. A comparison of costs of universal versus targeted lead screening for young children[J]. Environ Res, 1999, 80(1): 84-91.

[61] Sutchritpongsa S, Sangwisit S, Sonjaipanich S. Parental awareness of household injury prevention: adequacy of anticipatory guidance for well childcare[J]. J Med Assoc Thai, 2013, 96(12): 1531-1535.

[62] Burns MS, Shah LH, Marquez ER, et al. Efforts to identify at-risk children for blood lead screening in pediatric clinics—Clark county, Nevada[J]. Clin Pediatr (Phila), 2012, 51(11): 1048-1055.

[63] Nordin J, Rolnick S, Ehlinger E, et al. Lead levels in high-risk and low-risk young children in the Minneapolis-St Paul metropolitan area[J]. Pediatrics, 1998, 101(1Pt1): 72-76.

[64] Borse NN, Hyder AA, Bishai D, et al. Potential Risk Estimation Drowning Index for Children (PREDIC): A pilot study from Matlab, Bangladesh[J]. Accid Anal Prev, 2011, 43(6): 1901-1906.

[65] 刘熹, 张晓燕, 彭中, 等. 成都市儿童家长对儿童意外伤害认知现状调查[J]. 中国卫生事业管理, 2013, 30(7): 550-552.

[66] LIU Xi, ZHANG Xiaoyan, PENG Zhong, et al. A survey on the cognitive status about unintentional injury of pre-school children’s parents in Chengdu[J]. Chinese Health Service Management, 2013, 30(7): 550-552.

[67] 王敏. 临安市学龄前儿童意外伤害现状及相关因素研究[D]. 上海: 复旦大学, 2012.

[68] WANG Min. Study of status and influencing factors of accidental injuries of preschool children in Lin’an[D]. Shanghai: Fudan University, 2012.

[69] 宋娟, 邵凯, 张丙亮, 等. 中国城区0~6岁儿童家庭内非故意伤害危险行为量表编制及考评[J]. 中华流行病学杂志, 2021, 42(9): 1662-1669.

[70] SONG Juan, SHAO Kai, ZHANG Bingliang, et al. Development and validation of risk behavior scale for in-home unintentional injury in urban children aged 0-6 years in China[J]. Chinese Journal of Epidemiology, 2021, 42(9): 1662-1669.

[71] Zabel EW, Falken MC, Sonnabend M, et al. Prevalence of elevated blood lead levels and evaluation of a lead-risk-screening questionnaire in rural Minnesota[J]. J Environ Health, 2005, 68(2): 9-15, 36.

[72] Yu J, Zou N, Liu Y, et al. Childhood road safety behaviors in China: A cross-sectional study of Guangzhou City[J]. Traffic Inj Prev, 2012, 13(6): 620-630.

[73] Mulligan-Smith D, Puranik S, Coffman S. Parental perception of injury prevention practices in a multicultural metropolitan area[J]. Pediatr Emerg Care, 1998, 14(1): 10-14.

[74] Mason M, Christoffel KK, Sinacore J. Reliability and validity of the injury prevention project home safety survey[J]. Arch Pediatr Adolesc Med, 2007, 161(8): 759-765.

[75] 田娟娟. 2015年荣成市城乡学龄前儿童家长意外伤害认知的调查[J]. 预防医学论坛, 2017, 23(12): 939-941.

[76] TIAN Juanjuan. Survey on the cognition of accidental injuries among parents of preschool children in the urban and rural areas, Rongcheng city, 2015[J]. Preventive Medicine Tribune, 2017, 23(12): 939-941.

[77] 曹学龙. 学龄前儿童意外伤害风险评价工具研究[D]. 衡阳: 南华大学, 2017.

[78] CAO Xuelong. Accident risk assessment tool to research in preschool children[D]. Hengyang: University of South China, 2017.

[79] 徐妙珍, 夏庆华, 唐传喜, 等. 上海市长宁区儿童伤害状况及家长认知水平调查[J]. 中国学校卫生, 2006, 27(2): 109-110.

[80] XU Miaozhen, XIA Qinghua, TANG Chuanxi, et al. Children’s injury and parental recognition in Changning district in Shanghai[J]. Chinese Journal of School Health, 2006, 27(2): 109-110.

[81] Jordaan ER, Atkins S, van Niekerk A, et al. The development of an instrument measuring unintentional injuries in young children in low-income settings to serve as an evaluation tool for a childhood home injury prevention program[J]. J Safety Res, 2005, 36(3): 269-280.

[82] Will K, Lorek EJ, Sabo CS, et al. Measuring injury risk perceptions: Feasibility of a risk estimation scale[J]. Am J Health Behav, 2009, 33(6): 639-649.

[83] 孙振球. 医学统计学[M]. 5版. 北京: 人民卫生出版社, 2020．

[84] SUN Zhenqiu. Medical Statistics[M]. 5th ed. Beijing: People’s Medical Publishing House, 2020.

[85] 朱银潮. 伤害预防中儿童照看的研究进展[J]. 中国妇幼保健, 2021, 36(17): 4135-4138.

[86] ZHU Yinchao. Research progress of child care in injury prevention[J]. Maternal and Child Health Care of China, 2021, 36(17): 4135-4138.

[87] 陈沛, 蒲玮榕, 张榕, 等. 城市儿童家庭内环境与居家意外伤害的关联性研究[J]. 健康教育与健康促进, 2023, 18(3): 270-274.

[88] CHEN Pei, PU Weirong, ZHANG Rong, et al. A study on the correlation between family environment and accidental injuries among urban children at home[J]. Health Education and Health Promotion, 2023, 18(3): 270-274.

[89] 孔文瑞, 许梦雪, 贾妮, 等. 婴幼儿家长养育照护实践自评问卷的编制及信效度检验[J]. 中国儿童保健杂志, 2023, 31(8): 825-830.

[90] KONG Wenrui, XU Mengxue, JIA Ni, et al. Development and evaluation of the Caregiver’s Nurturing Care Practice Questionnaire for children aged 0-3 years[J]. Chinese Journal of Child Health Care, 2023, 31(8): 825-830.

[91] 袁凌, 孙同萍, 王明蔓, 等. 遵义市学龄前儿童及家长烧烫伤认知状况及相关因素分析[J]. 遵义医科大学学报, 2024, 47(10): 999-1007.

[92] YUAN Ling, SUN Tongping, WANG Mingman, et al. Cognitive level of burn and scald knowledge among preschool children and parents in Zunyi city and the analysis of influencing factors[J]. Journal of Zunyi Medical University, 2024, 47(10): 999-1007.

[93] 应佳丽, 苏亚娅, 杨琛, 等. 家长行为对儿童跌倒伤害的中介和调节效应[J]. 中国健康教育, 2020, 36(12): 1087-1090.

[94] YING Jiali, SU Yaya, YANG Chen, et al. The moderated and mediating effects of parents’ behavior on children fall injury[J]. Chinese Journal of Health Education, 2020, 36(12): 1087-1090.

[95] 何姗, 伍颖, 陈欣, 等. 中国儿童意外伤害的研究进展及展望[J]. 中国妇幼保健, 2022, 37(8): 1543-1546.

[96] HE Shan, WU Ying, CHEN Xin, et al. Research progress and prospect of accidental injury of children in China[J]. Maternal and Child Health Care of China, 2022, 37(8): 1543-1546.

[97] 殷小雅, 王书梅. 儿童伤害预防家庭监护能力评估研究分析[J]. 中国学校卫生, 2022, 43(8): 1229-1234.

[98] YIN Xiaoya, WANG Shumei. Research progress on assessment of parental ability to prevent child injury[J]. Chinese Journal of School Health, 2022, 43(8): 1229-1234.

基金资助

国家自然科学基金(82204165┫。This work was supported by the National Natural Science Foundation of China ┣82204165)

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