| Part Ⅰ Mental resilience among Chinese children:a systematic reviewObjective:To do a systematic review on the mental resilience of Chinese children to know its status as well as the status of the studies in the field.Methods:Four electronic databases (CBM, VIP, CNKI and WF) were searched to February2013. References of included studies were reviewed for missing information. Studies that reported the results of mental resilience status of Chinese children were included. Two reviewers independently screened and extracted data and relevant information. Disagreements were resolved by discussion. A third party was involved when necessary. Statistical formula was used to synthesize means and standard deviations of each study to calculate a total score; meta-analysis was conducted using Review Manager software for comparison between different groups; and qualitative method was used to summarize the information not suitable for quantitative synthesis.Results:Of the1028papers,79papers including77studies were included for the final analysis. The target population were common students in middle school, children in kindergarten, left-behind children, street children, HIV-infected children, offspring of drug addicts, and children with nanism or epilepsy in24provinces/municipality/autonomous region. A total of24questionnaires were used, among which the Resilience Scale for Chinese Adolescents was most popular. Quantitative synthesis results showed that the mental resilience of Chinese children was modest, not high or not low. There were meta-analysis for4scales. Meta-analysis results of RSCA and ER89showed that girls’total resilience score were significantly higher than that of boys’while results of HKRA showed the opposite results. Meta-analysis results of RSCA showed that total resilience score of students in Grade7was higher than that in Grade8while results of ER89showed the opposite results. Besides gender and grade, the included studies also compared resilience among different groups, such as different rural/urban, minority, providence, number of brothers or sisters, addiction to internet, influence of HIV, education background of parents, family income, divorce of parents, temperament, communication skill, physical exercise, whether left-behind, disaster severity and so on.Conclusion:The resilience of Chinese children is modest with differences among different groups. There are difference between synthesis results of different scales. The number of studies has been increasing sharply in the last five years. The most studied subjects are students in primary or middle schools. Compared with questionnaires that proposed and revised by researchers themselves, the ones that have been modified and revised by other experts or scholars in China before are used more often. The questionnaires are various with different standard without clear description in the papers, which is a barrier for other scholars to apply the results. Part II Reliability and validity of Mental Health Test and Resilience Youth Development Module among children in rural Three Gorges AreaObjective:To analyze the reliability and validity of two scales, Mental Health Test and Resilience Youth Development Module, among children in rural Three Gorges Area.Methods:Using the multistage clustering sampling method,964students from Grade7to12in two middle schools in two towns were selected and investigated using the Mental Health Test and Resilience Youth Development Module.218of them were re-investigated after half a month. The software of Epidata3.0and SPSS17.0were used for data management and analysis. The reliability analyzed included the Cronbach alpha coefficient, Spearman Brown Split-half coefficient and test-retest coefficient and the validity analyzed was the criterion-related validity.Results:A total of922and214valid questionnaires were included for the final analysis. The reliability and validity of the two scales were as the following:1) Mental Health Test:The Cronbach’s a of the total scale was0.897and that of the sub scales were between0.520and0.788. The split-half coefficient of the total scale was0.834and that of the sub scales were between0.506and0.769. The test-retest coefficient of the total scale was0.801and that of the sub scales were between0.500and0.791. The correlations between the total scale and sub-scales were between0.504and0.769. The correlation between the sub scales were between0.251and0.442.2) The Cronbach’s α of the total scale was0.949and that of the sub scales were between0.524and0.874. The split-half coefficient of the total scale was0.869and that of the sub scales were between0.512and0.799. The test-retest coefficient of the total scale was0.832and that of the sub scales were between0.504and0.771. The correlations between the total scale and sub-scales were between0.584and0.836. The correlation between the sub scales were between0.314and0.696.Conclusion:Reliability and validity of the two scales are psychometrically qualified. They are suitable tool for analyzing the mental health and mental resilience among children in rural Three Gorges Area. Part III Mental health and resilience among children in rural Three Gorges AreaObjective:1) To know the mental health and mental resilience status of the left-behind children in rural Three Gorges Area as well as their sociology and left-behind information.2) To analyze protective and risk factors of mental health and resilience, the relationships between them and the prediction of resilience to mental health.Methods:Using the multistage clustering sampling method,1000left-behind children and non-left-behind children from Grade7and Grade10in three middle schools in three towns were selected and investigated using the Mental Health Test and Resilience Youth Development Module. The information of the questionnaires was double-entered into the software of Epidata3.0and SPSS17.0was used to analyze the data. The main statistical methods used were chi-square test, independent-samples T test, multiple linear regression, uni-variable logistic regression and multi-variable logistic regression.Results:The detection rate of mental problem among the left-behind children was11.5%. The detection rates of the sub scales were listed from the highest one to the smallest as the following:learning anxiety, superresponse tendency, physical symptom, self-accusation tendency, fear tendency, anxiety with people, loneliness tendency and impulse tendency. The total score of the Mental Health Test was38.64±13.27and there was no significant difference between left-behind children and non-left-behind children (p>0.05). For sub scales, the scores of anxiety with people and loneliness tendency among the left-behind children were significantly higher than that of the non-left-behind children (p<0.05). The total score of mental resilience among the left-behind children was2.89±0.42, which was significantly lower than that of the non-left-behind children (p<0.05). For sub scales, the scores of the school meaningful participation, peer caring relationship, community meaningful participation, cooperation and communication and problem solving were significantly lower than that of the non-left-behind children (p<0.05). The impact factors of mental health among the left-behind children were gender, family income, impact of parents’working out on personality while the factors for mental resilience were grade at school, reaction to conflict with the guardian (keep quiet; extreme reaction such as quarrel) and support for parents’working out. Except for the peer high expectation, family high expectation and self-self-efficacy, there was obvious negative relationship between the scores of other sub scales and the total score of resilience and the total score of mental health. The score of the mental resilience could predict the score of mental health. For the sub scale of the mental resilience, the predictive factors included the add school connectedness scale, school meaningful participation, peer high expectation, self-efficacy, empathy, problem-solving and self-awareness.Conclusion:There is no difference in mental health between left-behind and non-left-behind children. But they are different in some specific aspect. The mental resilience of the left-behind children is lower than that of the non-left-behind children. The factors of sociology and left-behind information that influence the mental health and resilience include gender, grade, conflict with guardians, reaction to conflict, family income and impact of parents’ working out. There is obvious relationship between resilience and mental health. Resilience as well as some of its specific aspects are the predictive factors for mental health. |
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