| ObjectiveTo evaluate the use of Multidimensional Sub-health Questionnaire of Adolescents (MSQA) in Chongqing middle school students, to investigate the status and influencing factors of sub-health, to find the relationship between sub-health of middle school students and health risk behaviors of tobacco and alcohol abuse, suicidal behavior and psychological behavior, and internet addiction, and to evaluate the predictive value of sub-health of middle school students for tobacco and alcohol abuse, suicidal behavior and psychological behavior and internet addiction within 3 months.MethodA stratified cluster random sampling method was used. Firstly, two urban and rural middle schools were selected from two districts of Chongqing as the primary unit, then, 4-5 classes were selected randomly from every school as the second unit, at last, all the students in every class as our the least unit. Finally, a total of 3100 students were selected as our study subjects to conduct a questionnaire survey. The survey included basic information of students, MSQA, tobacco and alcohol abuse within one month, suicidal psychology and behaviors within one year and internet addiction behaviors. After that, 1548 students were followed up for 3 months, and 1310 questionnaires were analyzed. Then, tobacco and alcohol abuse within three month, suicidal psychology and behaviors within three month and internet addiction behaviors within three month were investigated. SPSS 13.0 statistical software was used for analysis by using t test, x2 test, Pearson correlation and logistic regression analysis.ResultsThe correlation coefficients among the various dimensions of MSQA questionnaire were 0.403-0.908 (P<0.01), and the correlation coefficients between the dimensions scores and the total scores of MSQA were 0.450-0.952 (P<0.01). The correlation coefficient between the scores of psychiatric part of SCL-90 and the scores of mental sub-health domain was 0.766 (P<0.01), the range of correlation coefficients between psychiatric part of SCL-90 questionnaire and each dimensions of MSQA was 0.442-0.765 (P<0.01). The correlation coefficient between the scores of physical part of CMI and the score of somatic sub-health domain was 0.575 (P<0.01), the range of correlation coefficients between physical part of CMI questionnaire and each dimension of MSQA was 0.236-0.575(P<0.01). The retest reliability coefficients of whole questionnaire, somatic sub-health domain, mental sub-health domain and each dimension were 0.941,0.926, 0.901, 0.838, 0.822, 0.831, 0.923, 0.913, 0.934 (P<0.01). The Cronbach'sαcoefficient of MSQA was 0.961, split-half reliability coefficient was 0.938, the Cronbach'sαcoefficients of each dimensions and each domains of MSQA were 0.711-0.921, while split-half reliability coefficient were 0.697-0.915.The score of total Sub-health in Chongqing middle school students was 392.20±36.44, in which the somatic sub-health score was 181.53±13.53, mental sub-health score was 210.67±26.16. The detection rate of sub-health symptoms was 56.9%, of which somatic symptoms of sub-health was 36.4%, psychological symptoms of sub-health was 48.9%. The detection rate of sub-health state was 14.4%, of which the somatic sub-health state detection rate was 14.0%, and the mental sub-health detection rate of 15.5%. Overall, boys got higher score than girls on sub-health (P<0.05), while the junior high school students score higher than high school students on sub-health (P<0.05), however, there is no difference between urban and rural middle school students (P>0.05). For somatic sub-health, the boys'score was higher than girls'(P<0.05), the junior high school students'score was higher than high school students'on sub-health (P<0.05), but there was a statistically significance only in the dimension of the lack of physical activity (P<0.05). There is no difference between urban and rural middle school students (P>0.05). For mental sub-health, the boys'score was higher than girls (P<0.05), the junior high school students'score was higher than high school students'on sub-health (P<0.05), but there was a statistically significance only in the dimension of conduct problem (P<0.05). There was no difference between urban and rural middle school students (P>0.05). There was no difference in detection rate of sub-health symptoms between different gender (P>0.05), but the detection rate of sub-health state in girls was higher than in boys (P<0.05). The detection rate of sub-health symptoms and state in high school was higher than junior high school students, the difference is statistically significance (P<0.05). There was no difference in detection rate of sub-health symptoms between urban and rural school students (P>0.05).Sex, age, weight, BMI index, home location, learning burden, high-intensity exercise, low-intensity exercise, smoking, alcohol abuse, interpersonal relationships, self-assessment economic level, sleeping time, self-assessment body style, physical development status, grade were found difference in sub-health (symptom or state) by using univariate logistic regression analysis(P<0.05). Multivariate non-conditional logistic regression analysis found relevant factors which were statistically significant, which were sex, age, home location, learning burden, high-intensity exercise, smoking history, alcohol abuse, interpersonal relationships, sleeping time, self-assessment body style and grade.Last 1 month, the detection rate of smoking and drinking and drunkenness in Middle School Students of Chongqing was 10.4%, 15.7%, 2.3%, and the rate for boys was significantly higher than girls (P<0.01). There was no difference for the rate between urban and rural school students (P>0.05). The detection rate for high school students was significantly higher than junior high school students (P<0.01). Last 1 year, the detection rates of suicidal ideation, suicide plans and suicide attempts in middle school students of Chongqing were 15.7%, 8.4%, 3.6%. The rate for girls was higher than boys (P<0.05). There was no difference for the rate between urban and rural school students (P>0.05). Junior high school is higher than the high school students (P<0.05). The detection rate of internet addiction for middle school students of Chongqing was 23.3%. The detection rate of addiction for boys was higher than girls (P<0.01). There was no difference for the rate between urban and rural school students (P>0.05), but score of internet addiction for the urban middle school students was higher than rural school students (P<0.05). The detection rate in internet addiction of high school students was higher than junior high school students (P<0.01).Last 1 month, the detection rate of smoking, alcohol abuse for girls was increased with the number of somatic sub-health symptoms increased (P<0.01), but there was no the trend in drunkenness for girls and in smoking, alcohol abuse and drunkenness for boys (P>0.05). The detection rate of smoking, alcohol abuse for middle school students was increased with the number of mental sub-health symptoms increased (P<0.01), but there was no the trend in drunkenness (P>0.05). The detection rate of suicidal ideation, suicide plans and suicide attempts was increased with the number of somatic sub-health symptoms, mental sub-health symptoms and sub-health symptoms increased (P<0.01), while the detection rate of internet addiction had the same trend for middle school students (P<0.01), and there was a correlation the score of internet addiction and the score of somatic sub-health, mental sub-health and total sub-health (P<0.01).Within 3 months, the detection rate of smoking, alcohol abuse and drunkenness in middle school students of Chongqing was 7.6%, 20.6%, 3.4%, and the rate for boys was significantly higher than girls (P<0.01). There was no difference for the rate between urban and rural school students (P>0.05). The detection rate for high school students was significantly higher than junior high school students (P<0.01), except in drunkenness (P>0.05). The detection rates of suicidal ideation, suicide plans and suicide attempts in middle school students of Chongqing were 7.2%, 3.5%, 2.4%. The rate for girls was higher than boys (P<0.05), except in suicide plans (P>0.05). The detection rate for urban school students was higher than rural school students (P<0.05). Junior high school was higher than the high school students (P<0.05). The detection rate of internet addiction for middle school students of Chongqing was 19.1%. The detection rate of addiction for boys was higher than girls (P<0.01). The detection rate of addiction for urban school students was higher than rural students (P<0.01), and the same as the score for urban and rural students (P<0.01). There was no difference in the detection rate in internet addiction between high school students and junior high school students (P>0.05).Within 3 months, the detection rate of alcohol abuse for all the students and girls and drunkenness for boys was increased with the number of somatic sub-health symptoms increased (P<0.01). The detection rate of smoking, alcohol abuse and drunkenness for middle school students was increased with the number of mental sub-health symptoms increased (P<0.01). The detection rate of smoking, alcohol abuse and drunkenness for middle school students was increased with the number of mental sub-health symptoms increased (P<0.01), except for the rate of smoking and alcohol abuse for boys (P>0.05). Except for the detection rate of suicide attempts for girls, the detection rate of suicidal ideation, suicide plans and suicide attempts was increased with the number of somatic sub-health symptoms, mental sub-health symptoms and sub-health symptoms increased (P<0.01), while the detection rate of internet addiction had the same trend for middle school students (P<0.01), and there was a correlation the score of internet addiction and the score of somatic sub-health, mental sub-health and sub-health (P<0.01).ConclusionWith good criterion validity and construct validity, high test-retest reliability, and well internal consistency, MSQA questionnaire was better suited to evaluate the sub-health status of middle school students in Chongqing .The detection rate of sub-health symptoms and status of Middle school students in Chongqing City detection was a little bit high. There were difference in gender, urban and rural school and different grade with different degrees. The sub-health of middle school students was influenced by their own sub-health factors, family factors, school factors and other factors, therefore, health education and psychological counseling for middle school should be conducted from different aspects.Sub-health, alcohol and tobacco abuse, suicide, internet addiction and other psychological and behavioral problems was very common in middle school. There was a statistically correlation between sub-health of students and tobacco and alcohol abuse, suicide and internet addiction, and sub-health was a better predictive value for tobacco and alcohol abuse, suicide and internet addiction within 3 months. Early screening for sub-health status of middle school students was a right opportunity for health-promoting interventions, which would have a positive impact on the improvement of mental and physical health of middle school students.
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