卫生研究

目的 探讨湖南省中小学生校园欺凌受害的特征及其相关因素的可能作用路径。方法 于2022年9—12月,采用多阶段分层整群随机抽样方法,抽取湖南省14个地州市209 096名中小学生(小学四年级至高中三年级)作为调查对象。采用中国疾病预防控制中心编制的《学生健康状况及影响因素调查表》进行现场调查(内容包括欺凌受害、个人特征、不良生活习惯、伤害相关行为及家庭暴力等),并开展体格检查(身高、体重)。共回收有效问卷200 735份。采用结构方程模型分析各相关因素与校园欺凌受害之间的作用路径,拟合指标包括近似误差均方根(root mean square error of approximation,RMSEA)、比较拟合指数(comparative fit index,CFI)和Tucker-Lewis指数(Tucker-Lewis index,TLI)、增量拟合指数(incremental fit index,IFI)等。结果 200 735名调查对象中,男生104 327人(52.0%),女生96 408人(48.0%);小学生73 117人(36.4%),中学生127 618人(63.6%);城市73 651人(36.7%),郊县127 084人(63.3%);汉族163 644人(81.5%),少数民族37 091人(18.5%);住校生64 888人(32.3%),非住校生135 847人(67.7%)。校园欺凌受害总检出率为5.6%(1152人),其中言语欺凌受害检出率最高(8226人,4.1%),其次为身体欺凌受害检出率(5304人,2.6%)和关系欺凌受害检出率(3388人,1.7%)。结构方程模型拟合良好(RMSEA=0.06,CFI=0.93,TLI=0.91,IFI=0.93)。据结构方程中标准化直接效应结果,伤害相关行为系数最大(0.77,P<0.001)、其次为不良生活习惯(0.19,P<0.001)、个人特征(-0.11,P<0.001)、家庭暴力(0.05,P<0.001);此外,个人特征通过伤害相关行为对欺凌受害产生间接效应为0.11。结论 2022年湖南省中小学生校园欺凌受害检出率较高,言语欺凌最为常见。个人特征、不良生活习惯、伤害相关行为及家庭暴力是校园欺凌受害的主要相关因素。

OBJECTIVE To describe the characteristics of school bullying victimization among primary and secondary school students in Hunan Province and to explore the possible pathways of associated factors.METHODS From September to December 2022, a multistage stratified cluster random sampling method was used to recruit 209 096 students(from grade 4 of primary school to grade 3 of senior high school) across 14 prefectures and cities in Hunan Province. A self-administered questionnaire, developed by the Chinese Center for Disease Control and Prevention, was employed to collect data on bullying victimization, personal characteristics, unhealthy lifestyle habits, injuryrelated behaviors, and domestic violence. Anthropometric measurements( height and weight) were also taken. A total of 200 735 valid questionnaires were returned(response rate 96. 0%). Structural equation modeling was applied to examine the pathways between various factors and bullying victimization, with model fit assessed by root mean square error of approximation(RMSEA), comparative fit index(CFI), Tucker-Lewis index(TLI), and incremental fit index(IFI).RESULTS Among the 200 735 participants, 52. 0%(n = 104 327) were boys and 48. 0%(n = 96 408) were girls; 36. 4%(n = 73 117) were from primary schools and 63. 6%(n = 127 618) from secondary schools; 36. 7%(n = 73 651) resided in urban areas and 63. 3%(n = 127 084) in suburban county areas; 81. 5%(n = 163 644) were of Han ethnicity and 18. 5%(n =37 091) were ethnic minorities; and 32. 3%(n = 64 888) were boarders. The overall prevalence of bullying victimization was 5. 6%(n = 1152), with verbal bullying being the most common(4. 1%, n = 8226), followed by physical bullying(2. 6%, n = 5304) and relational bullying(1. 7%, n = 3388). The structural equation model demonstrated a good fit(RMSEA = 0. 06, CFI = 0. 93, TLI = 0. 91, IFI = 0. 93). The standardized direct effects were as follows: injury-related behaviors had the largest coefficient(0. 77, P<0. 001), followed by unhealthy lifestyle habits( 0. 19, P<0. 001), personal characteristics(-0. 11, P<0. 001), and domestic violence( 0. 05, P<0. 001). In addition, the indirect effect of personal characteristics on bullying victimization through injury-related behaviors was 0. 11.CONCLUSION The detection rate of school bullying victimization among primary and secondary school students in Hunan Province is relatively high, with verbal bullying being the most common form. Personal characteristics, unhealthy lifestyle habits, injury-related behaviors, and domestic violence are major associated factors.