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目的了解北京市城区婴儿养育现状及其影响因素,为制定适合社区应用的促进依恋关系发展的保健模式提供依据。方法采用自编儿童养育现状调查问卷对北京市2个城区4家社区卫生服务中心的270名4~11月龄婴儿家庭进行基线研究,分析养育行为与养育态度的影响因素。结果 1)婴儿母亲平均生育年龄为(30.46±3.56)岁;父母文化程度以大学及以上者为主(父88.52%、母89.63%);婴儿主要带养人以祖辈为主(57.99%)。2)68.20%和35.34%的家庭不能满足婴儿接触大自然和与他人交往的需求;53.76%的家庭很少陪婴儿看书;51.36%很少鼓励子女做稍有难度的活动;84.82%急于帮子女解决问题。3)母亲文化程度越高,陪伴子女时间越少(P=0.003),但养育敏感性和一致性(OR=3.51,95%CI:1.55~7.94)越高;生育年龄越大的母亲对婴儿哭闹更敏感(趋势χ2=7.42,P=0.010)、更为关注婴儿健康(χ2=6.94,P=0.008)和饮食(χ2=4.23,P=0.039);核心家庭经常带婴儿接触大自然(OR=1.95,95%CI:1.10~3.46)和家庭养育态度一致(OR=3.91,95%CI:1.26~12.14)的比例更高;主要带养人为祖辈的家庭经常与婴儿亲密接触(χ2=5.14,P=0.023)、定期带婴儿体检(χ2=5.17,P=0.026)的比例更高,而经常带子女接触大自然的比例低(OR=0.46,95%CI:0.26~0.83)。结论目前北京市城区婴儿家庭存在不利于亲子关系发展的养育态度及行为,表现为给婴儿提供接触大自然和同伴交往的机会较少、陪伴婴儿阅读少、过度保护与过分限制等问题。应针对不同家庭类型、母亲生育年龄、文化程度特点和主要带养人等因素进行咨询指导,摸索适宜的促进婴儿期良好亲子关系发展的保健模式。
Objective To understand the status quo and influencing factors of infant feeding in urban areas of Beijing and provide evidences for formulating health care models that can promote the development of attachment relationships suitable for community use. Methods A total of 270 4-to-11-month-old infants from 4 community health service centers in 2 urban districts of Beijing were investigated by using self-compiled questionnaire. The influencing factors of parenting behavior and attitude were analyzed. Results 1) The average age at birth of infants and mothers was (30.46 ± 3.56) years old. The parents’ education level was mainly at university and above (88.52% for parents and 89.63% for mothers). The main support for an infant was ancestry (57.99%). 2) 68.20% of families and 35.34% of families can not meet the needs of infants in contact with nature and others; 53.76% of them rarely read books with infants; 51.36% rarely encourage children to do slightly difficult activities; 84.82% Solve the problem. 3) The higher the educational level of mother, the less time spent with children (P = 0.003), but the higher the sensitivity and consistency of parenting (OR = 3.51,95% CI: 1.55 ~ 7.94) (Χ2 = 6.92, P = 0.008) and diet (χ2 = 4.23, P = 0.039). The nuclear family often brought babies to contact with nature (χ2 = 7.42, P = 0.010) OR = 1.95, 95% CI: 1.10-3.46) were more likely to be associated with family rearing (OR = 3.91,95% CI: 1.26-12.14). Families with the main dependents were often intimately exposed to infants (χ2 = 5.14, P = 0.023). The proportion of infants with periodic physical examination (χ2 = 5.17, P = 0.026) was higher than that of regular physical contact with children (OR = 0.46,95% CI: 0.26-0.83). Conclusions Infant families in urban areas of Beijing presently have parenting attitudes and behaviors that are not conducive to the development of parent-child relationships. They are characterized by fewer opportunities for infants to have contact with nature and their peers, fewer problems with accompanying infants, excessive protection and excessive restrictions. Counseling should be conducted based on factors such as family type, mother’s childbearing age, education level and main dependents, so as to find suitable health care mode to promote the development of good parent-child relationship in infancy.