农村初中生身心健康状况、群体差异及其关联

Physical and Mental Health Status, Group Differences, and Their Association among Rural Junior High School Students

摘要: 目的：了解广东省惠州、河源两市农村初中生身心健康状况，分析不同性别、年级学生的群体差异，并考察体质健康与心理健康之间的关联。方法：采用横断面研究设计，将广东省惠州市和河源市6所农村中学初中生体质健康测试与心理健康诊断测验(Mental Health Test, MHT)数据进行个体匹配，最终纳入4048名学生。采用独立样本t检验、单因素方差分析、χ²检验、Pearson相关分析和多元线性回归进行统计分析，并通过BMI二次项检验其与MHT总分的潜在非线性关系。结果：学生体测标准分为(75.79 ± 10.68)分，体质健康达标率为94.3%，MHT总分为(35.81 ± 17.69)分。男、女生体测标准分差异无统计学意义，但女生MHT总分及8个维度得分均高于男生(均P < 0.001)。不同年级学生体测标准分、MHT总分及部分心理维度得分差异有统计学意义。体测标准分与MHT总分及部分心理维度呈极弱负相关；控制性别、年级和体重状态后，体测标准分与MHT总分的独立关联未达统计学意义(B = −0.048, P = 0.086)。BMI二次项亦不显著(P = 0.982)。结论：广东省惠州、河源两市农村初中生的体质健康总体处于达标水平，心理健康连续得分存在一定性别和年级差异。体质健康与心理健康的总体关联较弱，控制基本协变量后体测标准分未显示显著独立关联。农村学校应分别开展体质健康促进与心理健康教育，不宜以体测表现替代心理健康评估，并加强对重点群体的分层支持。

Abstract: Objective: To examine physical and mental health status, group differences, and the association between physical fitness and mental health among rural junior high school students in Huizhou and Heyuan, Guangdong Province. Methods: A cross-sectional design was used. Physical fitness test records and Mental Health Test (MHT) data from six rural junior high schools in Huizhou and Heyuan were matched at the individual level, yielding 4,048 valid cases. Independent-samples t tests, one-way analysis of variance, chi-square tests, Pearson correlation analyses, and multivariable linear regression were conducted. A quadratic BMI term was additionally tested for a potential nonlinear association with the total MHT score. Results: The mean physical fitness standard score was 75.79 ± 10.68, 94.3% of students met the national standard, and the mean total MHT score was 35.81 ± 17.69. Boys and girls did not differ significantly in physical fitness standard scores, whereas girls had higher total MHT scores and scores on all eight dimensions than boys (all P < 0.001). Significant grade differences were found in physical fitness scores, total MHT scores, and several MHT dimensions. Physical fitness scores were very weakly and negatively correlated with the total MHT score and several dimensions. After adjustment for sex, grade, and weight status, the independent association between physical fitness score and total MHT score was not statistically significant (B = −0.048, P = 0.086). The quadratic BMI term was also nonsignificant (P = 0.982). Conclusion: Physical fitness was generally at a qualified level in this sample, while continuous mental health scores showed sex and grade differences. The overall association between physical fitness and mental health was weak, and no significant independent association remained after adjustment for basic covariates. Rural schools should promote physical fitness and mental health education in parallel rather than use physical fitness performance as a proxy for mental health assessment.