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Qiu Y, Li M, Shi H, Zhao C, Du Y, Wang X, Zhang J. Depressive symptoms, parenting attitude, and violent discipline among caregivers of left-behind children in rural China: a cross-sectional study. BMC Public Health 2024; 24:994. [PMID: 38594654 PMCID: PMC11005119 DOI: 10.1186/s12889-024-18394-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/10/2023] [Accepted: 03/20/2024] [Indexed: 04/11/2024] Open
Abstract
BACKGROUND The situation of mental health and discipline behaviors of left-behind children's caregivers were not optimistic in rural China. Caregivers' depression might increase the risk of using violent discipline. However, the specific ways in which depressive symptoms impact violent discipline have rarely been explored in rural areas. This study aims to assess the prevalence of violent discipline among left-behind children under 6 years of age in rural China and explore the potential mechanisms of how caregivers' depressive symptoms affect violent discipline. METHODS We enrolled a total of 396 pairs of left-behind children and their caregivers in our study, which was conducted in 5 counties of Hebei, Henan, Jiangxi, Guizhou, and Sichuan provinces in China. The depressive symptoms of caregivers were measured by using Zung Self-rating Depression Scale (ZSDS) and violent discipline was assessed by the Child Discipline Module of Multiple Indicator Cluster Surveys (MICS). A self-designed questionnaire was utilized to measure caregiver's parenting attitude. Based on the cross-sectional data, controlling for potential confounders, structural equation modeling (SEM) was used to assess the direct and indirect effects of the mediation models by applying the weighted least squares with mean and variance adjusted (WLSMV) estimate. RESULTS The prevalence of violent discipline, psychological aggression, and physical punishment was 72.7%, 59.3%, and 60.4% respectively of left-behind children under 6 years of age. According to the results of SEM, parenting attitude acted as a suppressor, suppressing the association between caregivers' depressive symptoms and physical punishment/psychological aggression/violent discipline. The caregivers' depressive symptoms positively influenced all the outcome variables by affecting parenting attitudes (p = 0.002, p = 0.013, p = 0.002). CONCLUSIONS The presence of depressive symptoms in caregivers increases the use of violent discipline through negative parenting attitudes. The mental health status of primary caregivers of left-behind children in rural China needed emphasis and improvement.
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Grants
- 860/A0/05/502/001/032 Grant United Nations Children's Fund, Beijing, China
- 860/A0/05/502/001/032 Grant United Nations Children's Fund, Beijing, China
- 860/A0/05/502/001/032 Grant United Nations Children's Fund, Beijing, China
- 860/A0/05/502/001/032 Grant United Nations Children's Fund, Beijing, China
- 860/A0/05/502/001/032 Grant United Nations Children's Fund, Beijing, China
- 860/A0/05/502/001/032 Grant United Nations Children's Fund, Beijing, China
- 860/A0/05/502/001/032 Grant United Nations Children's Fund, Beijing, China
- United Nations Children’s Fund, Beijing, China
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Affiliation(s)
- Yunfei Qiu
- Department of Maternal and Child Health, School of Public Health, Peking University, 38 Xueyuan Road, Haidian District, 100191, Beijing, PR China
| | - Mengshi Li
- Department of Maternal and Child Health, School of Public Health, Peking University, 38 Xueyuan Road, Haidian District, 100191, Beijing, PR China
| | - Huifeng Shi
- Department of Maternal and Child Health, School of Public Health, Peking University, 38 Xueyuan Road, Haidian District, 100191, Beijing, PR China
- Department of Obstetrics and Gynecology, Peking University Third Hospital, 49 North Garden Road, Haidian District, 100191, Beijing, PR China
| | - Chunxia Zhao
- Department of Maternal and Child Health, School of Public Health, Peking University, 38 Xueyuan Road, Haidian District, 100191, Beijing, PR China
- Child Development Research Center, China Development Research Foundation, 136 Andingmenwai Street, Dongcheng District, 100010, Beijing, PR China
| | - Yufeng Du
- Department of Epidemiology and Statistics, School of Public Health, Lanzhou University, 730000, Lanzhou, PR China
| | - Xiaoli Wang
- Department of Maternal and Child Health, School of Public Health, Peking University, 38 Xueyuan Road, Haidian District, 100191, Beijing, PR China
- Institute of Reproductive and Child Health/Key Laboratory of Reproductive Health, National Health Commission of the People's Republic of China, Peking University, 100191, Beijing, PR China
| | - Jingxu Zhang
- Department of Maternal and Child Health, School of Public Health, Peking University, 38 Xueyuan Road, Haidian District, 100191, Beijing, PR China.
- Institute of Reproductive and Child Health/Key Laboratory of Reproductive Health, National Health Commission of the People's Republic of China, Peking University, 100191, Beijing, PR China.
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Gao Y, Sheng J, Mi X, Zhou M, Zou S, Zhou H. Household Water Access, Dietary Diversity and Nutritional Status among Preschoolers in Poor, Rural Areas of Central and Western China. Nutrients 2022; 14:nu14030458. [PMID: 35276816 PMCID: PMC8840283 DOI: 10.3390/nu14030458] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/13/2021] [Revised: 01/14/2022] [Accepted: 01/18/2022] [Indexed: 12/28/2022] Open
Abstract
Poor child feeding and childhood malnutrition are major public health problems in rural central and western China, with little evidence about their environmental determinants. This study aimed to investigate whether household water access is associated with dietary diversity and nutritional outcomes. We analyzed the cross-sectional data of 3727 children aged 6 to 59 months in rural central and western China, applying multivariate linear and logistic models to estimate the effect of water access on children’s anthropometric indices, hemoglobin, and dietary diversity. We found that unimproved water access was linked to a lower likelihood of achieving dietary diversity (OR = 0.65, 95% CI 0.44 to 0.98, p = 0.039); lower height-for-age z-score (β = −0.34, 95% CI −0.49 to −0.19, p < 0.001) and hemoglobin concentration (β = −2.78, 95% CI −5.16 to −0.41, p = 0.022); higher odds of stunting (OR = 1.50, 95% CI 1.01 to 2.25, p = 0.047) and anemia (OR = 1.34, 95% CI 1.02 to 1.77, p = 0.037). The associations between water access and nutritional outcomes were not explained by dietary diversity and were stronger in children who did not receive iron supplementation. These findings provide evidence for designing water-based nutritional interventions in China.
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Affiliation(s)
- Yaqing Gao
- Department of Maternal and Child Health, School of Public Health/National Health Commission Key Laboratory of Reproductive Health, Peking University, Beijing 100191, China; (Y.G.); (X.M.); (M.Z.); (S.Z.)
| | - Jie Sheng
- Department of Biochemistry and Molecular Biology, School of Basic Medical Sciences, Peking University, Beijing 100191, China;
| | - Xiaoyi Mi
- Department of Maternal and Child Health, School of Public Health/National Health Commission Key Laboratory of Reproductive Health, Peking University, Beijing 100191, China; (Y.G.); (X.M.); (M.Z.); (S.Z.)
| | - Mo Zhou
- Department of Maternal and Child Health, School of Public Health/National Health Commission Key Laboratory of Reproductive Health, Peking University, Beijing 100191, China; (Y.G.); (X.M.); (M.Z.); (S.Z.)
| | - Siyu Zou
- Department of Maternal and Child Health, School of Public Health/National Health Commission Key Laboratory of Reproductive Health, Peking University, Beijing 100191, China; (Y.G.); (X.M.); (M.Z.); (S.Z.)
| | - Hong Zhou
- Department of Maternal and Child Health, School of Public Health/National Health Commission Key Laboratory of Reproductive Health, Peking University, Beijing 100191, China; (Y.G.); (X.M.); (M.Z.); (S.Z.)
- Correspondence: ; Tel.: +86-10-8280-1222
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