Childhood Psychological Problems in School Settings in Rural Southern Africa
Childhood Psychological Problems in School Settings in Rural Southern Africa
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DOI：
10.1371/journal.pone.0065041
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发表时间：
2013-06-12
期刊：
影响因子：
3.7
通讯作者：
Stein, Alan
中科院分区：
文献类型：
--
作者：
Cortina, Melissa A.;Fazel, Mina;Stein, Alan
背景：低收入和中等收入国家（LMIC）的许多儿童可能面临多种逆境，使他们面临出现心理问题的潜在风险。然而，很少有研究利用大型代表性队列来考察这些国家学校环境中儿童的心理适应情况。儿童的心理调整已被证明会影响教育进步，这对他们的未来至关重要。这项研究以南非社会经济贫困的农村地区为基础，旨在调查儿童心理问题的患病率以及可能的风险和保护因素。方法：使用教师和儿童报告问卷调查 10-12 岁儿童的心理问题发生率。通过分层随机抽样选出的 10 所农村小学的儿童数据，与阿金库尔健康和社会人口监测系统从 15 年以上家庭收集的个人和家庭数据相关联。 结果：总共对 1,025 名儿童进行了评估。教师发现存在严重的行为和情绪问题（41%）。儿童报告的焦虑/抑郁比例较低，但比例较高（14%），以及显着的创伤后应激症状（24%）；近四分之一的人在学校感到不安全。风险因素包括作为第二代前难民和来自一个大家庭。保护性因素凸显了母亲因素的重要性，例如受更多教育和稳定的伙伴关系。结论：教师发现的高水平心理问题是一个严重的公共卫生问题，因为它们可能对儿童教育产生负面影响，特别是考虑到农村中低收入国家班级规模大且资源有限。尽管风险很高，但仍有一部分儿童表现良好，了解复原力的研究可以为干预措施提供信息。
Background: Many children can be exposed to multiple adversities in low and middle-income countries (LMICs) placing them at potential risk of psychological problems. However, there is a paucity of research using large representative cohorts examining the psychological adjustment of children in school settings in these countries. Children's psychological adjustment has been shown to affect educational progress which is critical for their future. This study, based in a rural, socio-economically disadvantaged area of South Africa, aimed to examine the prevalence of children's psychological problems as well as possible risk and protective factors.Methods: Rates of psychological problems in 10-12 year olds were examined using teacher-and child-report questionnaires. Data on children from 10 rural primary schools, selected by stratified random sampling, were linked to individual and household data from the Agincourt health and socio-demographic surveillance system collected from households over 15 years.Results: A total of 1,025 children were assessed. Teachers identified high levels of behavioural and emotional problems (41%). Children reported lower, but substantial rates of anxiety/depression (14%), and significant post-traumatic stress symptoms (24%); almost a quarter felt unsafe in school. Risk factors included being a second-generation former refugee and being from a large household. Protective factors highlight the importance of maternal factors, such as being more educated and in a stable partnership.Conclusion: The high levels of psychological problems identified by teachers are a serious public health concern, as they are likely to impact negatively on children's education, particularly given the large class sizes and limited resources in rural LMIC settings. Despite the high levels of risk, a proportion of children were managing well and research to understand resilience could inform interventions.