The Epidemiological Characteristics And Intervention Of Injuries Among The School Aged Children During Holidays In Changning District, Shanghai

Objective:To understand the distribution features and epidemiological characteristics of injuries among the school aged children during holidays and explore the possible risk factors of injuries among the children during holidays. Give suggestions to the further injuries intervention plan to school aged children by carrying out a trail comprehensive injuries interventions which using health education to the children and their parents as the main measures.Methods:4 primary schools and 4 secondary schools in Changning District, Shanghai in 2008 was determined by stratified cluster-sampling method. All students excluding the students of graduating classes was selected as subjects. By using questionnaire, injury information, which happened during 2007 winter holidays, was collected. Then we evaluated the injury awareness rate among the subjects and their parents. The criteria of injury in this study was to meet any of the following situations: 1, made the victim send to hospital or clinic room; 2, made the victim receive emergent treatment or care by their parents or themselves or others; 3, made the victim had to rest or was immobilized for at least half days. Then these 8 schools were divided as intervention group and control group through cluster random sampling method. Each group contained the interviewees from 2 primary schools and 2 secondary schools. We provide one and half year's comprehensive interventions which using health education as main strategy to the intervention group students by the schools and family and evaluated the result.Results:(1) There were 5273 valid questionnaires had been received (among them 2426 are primary school students and 2847 are secondary school). The injury incidence in 2007 winter holiday was high:939 students experienced accumulatively 1734 person-time injuries in 11 types; the injury incidence was 17.81%(cumulative incidence was 32.88%). The injury incidence of primary school students and secondary school students was 17.48%(28.90%) and 18.09%(36.28%), respectively. The top three most common injury types are falling injury, injured by foreign matters and cut/puncture injury, which occupied 62.69% of the total injury. Falling injury was the most common injury types for both primary school student and secondary school student, however the rest ranking was different for these two groups. Meanwhile, no matter in primary school group or in secondary school groups, the injury incidence of key schools students was significantly higher than that of normal school students (P<0.05). There was no significant difference in injury incidence between boys and girls (p>0.05), while difference in injury incidence between different age groups has statistical meaning (p<0.01):the injury incidence grows with the increase of age, but injury incidence great decreased in grade eight compare to that in grade seven. (2) There are many factors which have effect on the injury incidence of school aged children during holidays, such as age, the health conditions of recent one year, school type, attitude of parents facing the bad marks of their children, family type of the students, family relationship, ability of communication, habits related to behaviors (such as restless, like climbing, like playing sticks or scissors, like playing fire, liking fighting, like sport and so on), acknowledge level of parents towards injury prevention skills, the willingness of parents wanting to join the injury prevention training, the anxious level of parents for their children to have injury, the behaves of parents to prevent children from injury, texture of the floor in the house and pet. All these factors put a joint effect on the incidence of injury. (3) Most of the parents heard about injury prevention training and willing to join it. The average marks of injury prevention knowledge was 7.44±1.30(out of 9) and 6.67±1.13 (out of 8) for primary and secondary school students' parents respectively. The marks of those parents whose kids didn't experience injury were significantly higher than that of the parents whose kids did have injury (p<0.05).86.6%,71.3% and 82.0% primary school children's parents can put the edge tools, medicines and hot water in the right place, respectively, while that rate of the secondary school children's' parents are 82.9%,73.2% and 73.5%. There were 81.0% and 77.3% primary and secondary school children's parents, respectively give injury prevention education to their kids frequently, but only 15.8% and 23.3% primary and secondary school children's parents, respectively teach their kids first aids skills frequently. (4) After adopting health education as main intervention methods to the school aged children, the injury accidence during holidays of primary school students and secondary school students were 8.27% and 5.25% respectively, significantly lower that before the intervention and it was also significantly lower that of the control groups (p<0.05). The intervention effect of primary school group was better than that of the secondary groups, the awareness rate and marks of injury prevention knowledge were higher after the interventions and it was also higher in invention group than that in control group. There was no much improvement in behaviors of parents that keep their kids from injuries.Conclusion:The incidence rate of injury happened during holidays is higher among school aged children. The injuries are seriously influencing on their health and learning, it is urgent to reinforce the intervention activities, which requires the participation and corporation of many sections, such as health, education and family. Comprehensive intervention measure with health education play an important role in preventing the school aged children from being injured during holidays, and it requires long-term adherence.