儿童人口样本中不良童年经历的发生率:系统性审查和元分析
Sheri Madigan1,2, Raela Thiemann1, Audrey-Ann Deneault3
1Department of Psychology, University of Calgary, Calgary, Alberta, Canada.
JAMA pediatrics
|November 11, 2024
概括
儿童不良经历 (ACE) 在全球儿童中很常见,在某些群体中患病率更高. 早期识别和干预对于减轻长期健康后果至关重要.
科学领域:
- 公共卫生 公共卫生
- 儿童心理学 儿童心理学
- 流行病学 流行病学
背景情况:
- 童年不良经历 (ACE) 显著增加了全球疾病和残疾负担.
- 了解ACE的患病率和风险因素对于制定有效的公共卫生战略至关重要.
研究的目的:
- 对18岁或以下儿童ACE患病率进行元分析.
- 确定与ACE暴露相关的人口和上下文因素.
- 探索对ACE患病率估计的方法影响.
主要方法:
- 在主要数据库 (MEDLINE,PsycINFO,CINHAL,Embase) 中对1998年至2024年间发表的研究进行了系统的文献搜索.
- 来自65项研究的数据,包括来自18个国家的超过49万名儿童,使用多类流行率元分析进行了综合分析.
- 纳入标准侧重于使用标准化问卷在18岁以下儿童中报告ACE患病率的研究.
主要成果:
- 分析显示,0个ACE的平均患病率为42.3%,1个ACE的平均患病率为22.0%,2个ACE的平均患病率为12.7%,3个ACE的平均患病率为8.1%,4个ACE或更多的ACE的平均患病率为14.8%.
- 在青少年,住院照顾儿童,有犯罪史的儿童和土著儿童中观察到4+ACE的更高患病率.
- 患病率因评估方法而异,档案审查显示的比儿童报告的调查问卷更高.
结论:
- 儿童中ACE普遍存在,根据人口统计和背景存在显著差异.
- ACE对儿童的福祉和未来生活前景构成重大威胁.
- 有针对性的早期识别和社区干预措施对于减少ACE的患病率和减轻不良健康结果至关重要.
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