| Objective:Although the importance of how temperament directly influences unintentional injury is well awared of;however,few studies have examined whether temperament can also affect unintentional injury indirectly,mediated through parenting styles.The purpose of this study is to investigate the status of unintentional injury of children aged 8-12 years old,then find out the children who have unintentional injury proneness and analyze its temperament characteristics,finally examine direct and indirect effects of temperament on injury proneness of children.In order to provide the theory basis for personalized unintentional injury intervention in the high-risk group in children.Methods:In this cross-sectional study,a representative sample of 2875 primary school children(8-12 years)in Taiyuan city was investigated.The method of multistage random cluster sampling was adopted,a total of 2875 school children of grade 4 and 5 in 10 primary schools in Taiyuan were selected.The questionnaires included characteristic of unintentional injury in past year;parenting styles and the middle childhood temperament questionnaire.2850 effective injury questionnaires were taken back,and corresponding to a response rate of 99.1%.Three effective questionnaires of 2614 children were taken back,and corresponding to a response rate of 90.9%.Epidata 3.1 software was used with the method of parallel double input data to construct the database for qualified questionnaire after unified coding.Statistical description and analysis the data were conducted using SPSS version 22.0 software.Confirmatory factor analyses on continuous variables were conducted using Mplus version 6.12 to construct each known latent variable.The structural equation modeling(SEM)and Bootstrap test was used to examine the possible mediating effect of parenting styles between childhood temperament and unintentional injury proneness.Results:1.The basic characteristics of childrenThe children of 2850 were collected in this study,including 52.2%(n = 1488)boys and 53.6%(n = 1529)children from fourth grade,and 33.6%(n = 958)children were the only child in family and 94(3.3%)parents divorced.Children age ranged from 8 to 12 years(mean = 9.66,SD = 0.78).2.The characteristics of unintentional injuries in childrenThe incidence rate of unintentional injury of 8-12 years old children in the Taiyuan was 23.1%(n = 658).The incidence rate of unintentional injury proneness of children was 3.8%(n = 109).A total of 278 injury events were reported from 109 injury-prone children,of all the injuries observed,72(25.9%)involved falls.Unintentional injury proneness has correlation with age,suggesting with the increase of age,the proportion of injury proneness declined.The proportion of injury proneness in boys was more than that in girls.Moreover,we found that the proportion of injury proneness in fourth grade was more than that in fifth grade.The difference was found in the distribution of injury proneness by gender and grade groups have statistically significant(P < 0.05).3.The analysis of characteristics of child temperament(1)A total of 2662 valid questionnaires of child temperament were retrieved in this survey.The three highest average score of children's temperament dimensions from high to low were: distractibility(3.97±0.69)points,sensory threshold(3.54±0.75)points,approach or withdrawal(3.31±)0.65)points.The three highest composition ratios of the temperament types from high to low were: The intermediate-low type 994(37.3%),the easy type 889(33.4%)and the difficult type 355(13.3%).(2)The variance analysis showed that the activity level of children in injury group was higher than that children of non-injury group;the rhythmicity,adaptability,mood and persistence were weaker than that children of non-injury group.The injury proneness group had higher activity level than children in the non-injury proneness group;the injury proneness group had lower rhythmicity and persistent than children in the non-injury proneness group.These differences were statistically significant(P < 0.05).(3)The distribution difference of children's temperament types between the injury group and the non-injury group was statistically significant by the ?2 test(?2=11.692,P < 0.05).Of the children who had injuries in the past year,children with the difficult rear type temperament accounted for the highest proportion(27.3%).The distribution difference of children's temperament types between children with injury proneness group and non-injury proneness group was statistically significant by ?2 test(?2=10.156,P < 0.05).Among the children who had suffered from injury proneness in the past year,the proportion of children who had the slow start type temperament was the highest(5.7%).4.The analysis of characteristics of parenting styles(1)Among the 2850 children aged 8 to 12 years old,the overall scores of the three main maternal parenting style factors from high to low were: MFI(54.83±9.81),MFII(36.18±7.01)and MFIV(13.80±5.21).The overall scores of the three main paternal parenting style factors from high to low were: FFI(51.36±10.02),FFIII(19.87±4.38)and FFII(18.87±6.47).(2)The scores of FFI and FFIII factors in children with injury proneness group were different among age groups,and there was statistical significance by using the variance analysis(P < 0.05).The scores of MFI,FFI and FFIII in the fourth-grade children were higher than those in the fifth-grade children,and the difference was statistically significant by using the two independent samples t-test(P < 0.05).5.The impact of children temperament and parenting styles on unintentional injury among children aged 8 to 12 years old(1)The Spearman rank correlation analysis results showed that children's age,sex,grade were negatively related to unintentional injury;the activity level/ rhythmicity/ adaptability/ mood/ persistence,and MFII/ MFIII/ MFIV/ MFV of maternal rearing manner factors,and FFII/ FFIII/ FFIV/ FFV/ FFVI of paternal rearing manner factors were positive related to unintentional injury(P < 0.05).Children's age,gender and grade were negatively correlated with the occurrence of injury-proneness;the activity level/ rhythmicity/ persistence and MFII/ MFIII/ MFIV/ MFV of maternal rearing manner factors,and FFII/ FFIII/ FFV/ FFVI of paternal rearing manner factors were positive related to unintentional injury-proneness(P < 0.05).(2)The Logistic regression analysis showed that boys,fourth graders,high activity levels,maternal excessive intervention/ protection and severe punishment were the risk factors for unintentional injury.Boys,fourth graders,low persistence,paternal parenting styles such as punished severely and excessive intervening were the risk factors for the occurrence of injury proneness.(3)The confirmatory factor analysis showed that two dimensions of the maternal refuse/ deny and punish/ strict to measure negative maternal parenting style;and two dimensions of the paternal punished severely and refuse/ deny to measure negative paternal parenting styles;and five temperament dimension of activity level,rhythmicity,adaptability,mood and persistence to measure children temperament.(4)The mediating effect of parenting style between children's temperament and unintentional injuryTo test whether temperament is indirectly related to children's unintentional injury through negative maternal parenting styles,mediation analyses were conducted.The structural equation modelling was used to create the model,the result of the Bootstrap test confirmed the significance of the mediating effect of maternal parenting styles(standardized ? = 0.060,P < 0.01).Creating the model to test whether temperament is indirectly related to children's unintentional injury through negative paternal parenting styles,the result of the Bootstrap test confirmed the significance of the mediating effect of paternal parenting styles(standardized ?= 0.052,P < 0.01).Creating the model to test whether temperament is indirectly related to children's injury proneness through negative maternal parenting styles,the result of the Bootstrap test confirmed the significance of the mediating effect of maternal parenting styles(standardized ? = 0.054,P < 0.01).Creating the model to test whether temperament is indirectly related to children's injury proneness through negative paternal parenting styles,the result of the Bootstrap test confirmed the significance of the mediating effect of paternal parenting styles(standardized ? = 0.060,P < 0.01).Conclusions: 1.The children with injury proneness have temperamental characteristics of high activity level,weak rhythmicity and low persistence.2.Boys,lower grades,weak persistence of temperament and negative paternal parenting styles increase the risk of the occurrence of unintentional injury proneness.Boys,lower grades,high levels of activity,and negative maternal parenting styles increase the risk of the occurrence of unintentional injuries.3.Children's temperament can affect the occurrence of unintentional injury or unintentional injury proneness through negative parenting styles. |
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