The Status Of Emotional And Physical Abuse And Its Influence On Emotional And Behavioral Problems Among Preschool Children In Rural Anhui Province

Objective Preschool age is a critical period in life,and emotional abuse(EA)and physical abuse(PA)of preschool children can have a series of adverse effects in the future.Through the survey of preschool children in rural area of Anhui Province,we aimed to understand the current situation of EA and PA in preschool children and related influencing factors based on cross-sectional study;meanwhile,in order to provide evidence of the association between child abuse(CA)and emotional and behavioral problems(EBP),we analyzed the effects of EA,PA,forms of CA exposure,and patterns of CA change on children’s EBP based on follow-up study.So as to provide a theoretical basis for early identification and intervention of EA,PA and EBP in preschool children.Methods This study contains two parts:the cross-sectional study and the follow-up study.The cross-sectional survey was employed to investigate the present status of EA and PA and their influencing factors in preschool children,and the follow-up survey was used to analyze the influence of EA,PA,forms of CA exposure and patterns of CA change on EBP.The cross-sectional survey was conducted in September 2019 to January 2020,and 26 kindergartens were selected by using convenience sampling.The preschool children in junior class and middle class of kindergarten in the cross-sectional survey were selected as the follow-up subjects,and the follow-up survey was carried out in October 2020 to January 2021.Caregivers of preschool children were investigated for basic demographic characteristics,EA and PA,EBP,family function,caregivers’anxiety symptoms,etc.Statistical descriptions and statistical analyses were performed using SPSS 23.0 software.Results The cross-sectional survey showed that:(1)Among 3636 preschool children,2244(61.72%)children suffered EA in the past year,and 774(21.29%)suffered PA.(2)The results ofχ~2test showed that there were significant differences in monthly household income,family type,family function,caregiver type,and caregivers’anxiety between preschoolers who suffered EA and those who did not.There were significant differences in gender,only children,current left-behind,mother’s age,parents’education level,monthly household income,family type,family function,caregiver type and caregivers’anxiety between preschoolers who experienced PA and those who did not.(3)Multivariate logistic regression analysis showed that the mother’s age 30 years and older,and non-parent as caregiver reduced the risk of EA,whereas the family dysfunction and caregivers’anxiety increased the risk of EA.Mother’s age 30 years and older,fathers with high school education level,and non-parent as caregiver reduced the risk of PA;while older children,boys,non-only children,monthly household income less than 5000 yuan,family dysfunction,and caregivers’anxiety increased the risk of PA.The follow-up survey showed that:(1)2340 children in the junior and middle classes of kindergartens were taken as the follow-up study subjects.1595 preschool children were followed up after an interval of one year,the follow-up rate was 68.16%.The detection rate of EA was 61.88%and 55.86%,PA was 20.19%and 16.11%,and EBP was 15.80%and 11.22%for follow-up subjects at baseline and follow-up surveys,respectively.(2)The respective percentages of CA exposure forms for follow-up subjects at baseline and follow-up survey were 35.67%and 41.94%for no abuse,46.58%and 44.14%for single abuse,and 17.74%and 13.92%for double abuse.(3)Of the changing patterns of EA,22.32%were persistent no EA pattern,21.82%were decreasing EA pattern,15.80%were increasing EA pattern,and 40.06%were persistent EA pattern.Of the changing patterns of PA,70.66%were persistent no PA pattern,13.23%were decreasing PA pattern,9.15%were increasing PA pattern,and 6.96%were the persistent PA pattern.Of the changing patterns of CA exposure forms,20.63%were persistent no abuse pattern,28.46%were decreasing abuse exposure pattern,20.82%were increasing abuse exposure pattern,24.51%were persistent single abuse pattern,and 5.58%were persistent double abuse pattern.(4)The results of the GEE indicated that EA and PA were positive predictors of EBP in preschool children(P<0.01);single abuse and double abuse were positive predictors of EBP(P<0.01).The results of generalized linear regression analysis indicated that increased EA,persistent exposure to EA,increased PA,and persistent exposure to PA were positive predictors of EBP(P<0.001);increased CA exposure,persistent single abuse,and persistent double abuse were positive predictors of EBP(P<0.001).Conclusion(1)This study shows that EA and PA of preschool children are more common in rural areas of Anhui Province,especially EA.(2)The occurrences of EA and PA are related to the children themselves(age,gender,only children,etc.),parents(age,education level,etc.)and family(monthly household income,family function,caregivers’anxiety,etc.)factors.The prevention and intervention of CA should be carried out according to the relevant factors.(3)EA and PA are related to the EBP of preschool children,so some certain measures need to be taken to reduce the occurrence of CA and its adverse effects.