Liphuputso tse fetileng li tlalehiloe ka kamano lipakeng tsa taolo ea lipapali tsa inthanete (IGD) le khatello ea maikutlo, empa kamano ea kamano e ntse e sa hlaka. Ka hona, re ile ra hlahloba kamano ea ho khutlisetsa lipakeng tsa lipontšo tsa khatello ea maikutlo le IGD har'a bana thutong e telele.
mekhoa
Likarolo tsa lipatlisiso tsa boithuto bona li ne li na le baithuti ba sekolo sa mathomo ba 366 thutong ea iCURE. Barupeluoa bohle e ne e le basebelisi ba inthanete ba hona joale, ka hona ba ka nkuoa e le baahi ba kotsing ea IGD. Boima ba boits'oaro ba likarolo tsa IGD le boemo ba khatello ea maikutlo bo ile ba lekoa ke Internet Use-Elicited Syndromeom Screen le Children's Depression Inventory, ka ho latellana. Tekolo ea tlhahlobo e phethetsoe kamora likhoeli tse 12 Re kentse mefuta ea mekhahlelo e nang le mekhahlelo e mengata ho lekola botsoalle lipakeng tsa mefuta e 'meli ka linako tse peli ka nako e le ngoe.
Tlhahlobo e nang le sefapano se senotseng boemo boo ba khatello ea maikutlo qalong e ile ea bolela esale pele botebo ba litšobotsi tsa IGD ho latela-pele likhoeli tse 12 (β = 0.15, p = .003). Bokhabane ba likarolo tsa IGD maemong a mantlha le tsona li ile tsa bolela esale pele hore na boemo ba khatello ea maikutlo e tla ba bofe ha ho latela khoeli ea 12 (β = 0.11, p = .018), ho laola lintho tse ka ferekanyang.
Tlhahlobo ea tsela ea mahlakore a mahlano e bonts'a kamano ea ho iphetetsa lipakeng tsa ho teba ha likarolo tsa IGD le boemo ba matšoao a nyahamisang. Ho utloisisa kamano ea boiphetetso lipakeng tsa matšoao a sithabetsang le ho teba ha likarolo tsa IGD ho ka thusa lipuisanong ho thibela maemo ana ka bobeli. Liphumano tsena li fana ka tšehetso ea theoretical bakeng sa merero ea thibelo le khalemelo bakeng sa IGD le matšoao a nyahamisang ho bana.
Selelekela
Bana ba ntse ba tsoela pele mehleng ea theknoloji ea dijithale le ho tloaela lik'homphieutha, lisebelisoa tsa mohala le inthanete ba sa le banyenyane. Boloetse ba lipapali bo hlaha e le bothata bo boholo ba bophelo ba kelello ho bana le bacha lefatšeng ka bophara (Ioannidis et al., 2018), leha ho ntse ho na le ngangisano ea hore na papali ea lipapali e na le molemo kapa e kotsi ho bana le bacha.
Halofo ea maloetse 'ohle a kelello e qala ha a le lilemo li 14,' me ka linako tse ling mathata a ho feto-fetoha ha maikutlo a kelello a qala ha a le lilemo li 11, pele a kena bonngoeng (Forbes & Dahl, 2010; Guo et al., 2012). Mathata a bophelo bo botle ba kelello a emela moroalo o moholo oa mafu har'a bacha. Liphuputso tse fetileng li tlalehile kamano lipakeng tsa bokhoba ba marang-rang le matšoao a kelello, a joalo ka khatello ea maikutlo, ho tšoenyeha le ho jeoa ke bolutu har'a bacha. Har'a mekhahlelo ea matšoao a kelello, matšoao a sithabetsang a bonts'a tšusumetso e matlahali nts'etsopele ea temallo ea inthanete ho bana le bacha (Erceg, Flander, & Brezinšćak, 2018; Niall McCrae, Gettings, le Purssell, 2017; Piko, Milin, O'Connor, & Sawyer, 2011).
Bothata ba lipapali tsa inthanete (IGD) le khatello ea maikutlo li sebelisana 'me li arolelana mekhoa ea neural (Choi et al., 2017; Liu et al., 2018). Likarolo tse tšoanang tsa boko li bonts'a ts'ebetso e sa tloaelehang ho khatello ea maikutlo le IGD. Amygdala, preortal cortex, gyrus, le khokahano lipakeng tsa frontoparietal lobe le amygdala le tsona li bonahala li senyeha ho batho ba nang le mathata a lipapali le ba nang le khatello ea maikutlo.
Tlhahlobo e hlophisehileng e bonts'itse hore batho ba nang le matšoao a sithabetsang ba batla ba hlaolela makhetlo a mararo ho feta ba se nang matšoao a sithabetsang (Carli et al., 2013). Leha ho le joalo, lithuto tse 19 ho tse 20 tse hlahlobisisong e ne e le lithuto tse sa sebetsaneng tse neng li sa khone ho khetholla kamano lipakeng tsa khatello ea maikutlo le bokhoba ba marang-rang. Leha ho le joalo, 75% ea liphuputso e tlaleha khokahano ea bohlokoa lipakeng tsa ts'ebeliso e mpe ea inthanete le khatello ea maikutlo.
Palo e lekanyelitsoeng ea lithuto tsa nako e telele li lekolile likamano lipakeng tsa IGD le sephetho sa bophelo bo botle ba kelello har'a bacha. Phuputso e tlang ho ba teng naheng ea China e fumane hore baithuti ba koleche bao qalong ba neng ba se na mathata a bophelo bo botle ba mantlha, joalo ka ha ho hlahlojoa ke tlaleho ea khatello ea maikutlo, ba na le menyetla e fetang 2.5 ea ho ba le khatello ea maikutlo nakong ea ho latela ha likhoeli tse 9 ha ba bontša. ts'ebeliso e mpe ea marang-rang sebakeng sa mantlha (Lam, Peng, Mai, & Jing, 2009). Thutong ea lilemo tse 2 ea bana le bacha, Moditjhaba et al. (2011) e fumane hore papali ea mathata a lipalo e boletsoe esale pele ka maemo a holimo a tlang a khatello ea maikutlo, phobia ea sechaba, le matšoenyeho joalo ka ha ho lekantsoe ke boemo ba bophelo ba kelello bo ikhethileng (Molichaba et al., 2011). Maemo a phahameng a khatello ea maikutlo a 'nile a amahanngoa le boitšoaro bo phahameng ba ho lemalla Inthanete (Stavropoulos & Adams, 2017).
Le ha lithuto tse fetileng li ka thusa ho tseba lintlha tse amanang le tatellano ea nakoana ea likamano lipakeng tsa khatello ea maikutlo le IGD, ha ho ntse ho sa hlaka hore na IGD e amana le nts'etsopele ea khatello ea maikutlo kapa hore na kamano e fapaneng hape le eona. Ka hona, re ile ra hlahloba botsitso le likamano lipakeng tsa matšoao a sithabetsang le IGD ka nako ho utloisisa hantle hore na lintho tsena tse peli li fapana joang ha nako e ntse e feta re sebelisa mohlala oa tsela e tšesaane. Re hlahlobe kamano ea ho khutlisetsa lipakeng tsa matšoao a nyahamisang le ho teba ha likarolo tsa IGD ho bana ba tlang pele ho nako ho fokotsa tšusumetso ea liphetoho tsa maikutlo nakong ea ho kena bohlankaneng.
mekhoa
Palo ea batho ba ithutoang e nkiloe thutong ea iCURE, e 'nileng ea hlalosoa ka botlalo libakeng tse ling (Jeong et al., 2017). Ka bokhutšoanyane, thuto ea iCURE ke thuto e tsoelang pele e thehiloeng ho sekolo ho ithuta nalane ea tlhaho ea IGD har'a baithuti ba mathomo sehlopheng sa 3 le 4 le baithuti ba sekolo se mahareng ba sehlopha sa 7 Korea. Barupeluoa bohle ba tlalehile hore ke basebelisi ba marang-rang ba marang-rang, kahoo ba ile ba nkuoa e le baahi ba kotsing ea IGD. Tlhahlobo ea pele ea ho phethela e phethetsoe likhoeli tse 12 kamora tlhahlobo ea motheo. Ho fokotsa litlamorao tse ka bang teng tsa liphetoho tse bang teng lipapaling tsa thuto ea bophelo bo botle liphetho tsa lipatlisiso, liphanelelo tsa lipatlisiso tsa thuto ena li ne li kenyelletsa baithuti ba sehlopha sa 3 le sa 4 feela bao e neng e le karolo ea thuto ea iCURE. Ho ba 399 baithuti ba sekolo sa mathomo ba ngolisitseng thupelong ea iCURE motheong oa motheo, ba 366 (91.5%) ba qetile tlhahlobo ea ho latela ea likhoeli tse 12 mme ba kenyelelitsoe thutong ena.
Thutong ea mantlha, barupeluoa bohle ba ile ba tlatsa lipotso ka sethaleng; mothusi ea lipatlisiso o bala lipotso ka mongolo o tloaelehileng ho thusa ho utloisisa. Bakeng sa tlhahlobo ea tlhahlobo ea likhoeli tse 12, barutoana bohle ba ile ba qeta ho ngola lipotso ba le bang, ba sebelisa mokhoa o ikemetseng oa ho itšebelletsa marang-rang, ba nang le mothusi ea tsamaisang lipatlisiso ea fumanehang ho araba lipotso.
Bokhabane ba likarolo tsa IGD bo ile ba lekoa ke Sesebelisoa sa Marang-rang sa Matsoho a Inthanete (IGUESS). Sesebelisoa sena se thehiloe ho latela litekanyetso tse robong tsa DSM-5 IGD, ntho ka 'ngoe e lekantsoe sekaleng sa 4-point (1 = ha e lumellane ka matla, 2 = ba bang ha ba lumellane, 3 = ba bang ba lumela, 4 = ka matla lumela). Pholo e phahameng e supa ho teba ha likarolo tsa IGD. Sekala sena sea tšeptjoa, 'me se na le Cronbach's α ea .85 thutong ena. Botebo ba IGD bo ne bo nkuoa e le bophahamo bo tsoelang pele, moo lintlha tse phahameng ho IGUESS li bonts'itseng ho teba ha sekaseka le mohlala oa tsela e sefapanong. Mohato o motle ka ho fetisisa oa ho khaoloa e ne e le 10 e lokelang ho nkuoa kotsing e phahameng ea IGD (Jo et al., 2017). Re sebelisitse sekhahla sena sa tlhahlobo ea dichotomous.
Boemo ba khatello ea maikutlo bo ile ba hlahlojoa ke Children's Depression Inventory (CDI). CDI e na le lintho tse 27 tse lekanyang matšoao a joalo ka maikutlo a sithabetsang, matla a hedonic, mesebetsi ea limela, boitlhahlobo le boits'oaro ba batho. Ntho e ngoe le e ngoe e na le lipolelo tse tharo tse hlophisitsoeng ho eketsa matla ho tloha 0 ho ea 2; bana ba khetha e khethollang matšoao a bona hantle nakong ea libeke tse 2 tse fetileng. Lintlha tsa lintlha li kopantsoe ho ba palo e felletseng ea khatello ea maikutlo, e pakeng tsa 0 le 54. Re sebelisitse mofuta oa Korea oa CDI, o nang le ts'epahalo e nepahetseng le bonnete ba tlhahlobo ea matšoao a tepeletseng (Cho & Choi, 1989). Boemo ba matšoao a sithabetsang a ne a nkuoa e le bophahamo bo sa khaotseng, moo lintlha tse phahameng ho CDI li bonts'itseng ho teba ha matšoao a sithabetsang bakeng sa ho sekaseka le mohlala oa tsela e sefapanong. Kakaretso ea 22 kapa ho feta e ile ea nkuoa ho bontša matšoao a nyahamisang ho tlhahlobisong ea dichotomous. Matšoao a mabeli a likarolo tsa IGD le boemo ba khatello ea maikutlo li ile tsa hlahlojoa ho latela motheo le tlhahlobo ea likhoeli tse 12 ho sebelisoa tlhahlobo ea tlhahlobo ea lipotso tseo motho a li entseng.
Litšobotsi tse akaretsang, ho kenyeletsoa lilemo, thobalano, mofuta oa lelapa, le nako e sebelisoang letsatsi le letsatsi ea ho bapala lipapali tsa inthanete li fumanoe data ea motheo e fumanoeng ke tlaleho ea bana ea tlhahlobo ea lipotso. Bakeng sa mofuta oa lelapa, lelapa le tsitsitseng le ne le hlalosoa e le bana ba lulang le batsoali ka bobeli; tseo tse hlalosoang e se tse se nang morero li kenyelletsa bana ba lulang le bo-mme kapa ntate feela kapa ba se na motsoali ka lebaka la tlhalo, lefu kapa karohano ea batsoali ba bona. Bokhachane bo ile ba khethoa ho latela karabelo ea barupeluoa lipotsong tse peli: ebang "Na u se u qalile nako ea hau?" Bakeng sa banana kapa "Na u se u qalile ho hola moriri oa hau o tlasa thekiso?" bakeng sa bashanyana. Haeba barupeluoa ba arabela "e," re ile ra ba nka ba se ba kena lilemong tsa bocha. Ts'ebetso ea bobeli ea thuto ea bana ba bona le boemo ba boiketlo ba sechaba (SES) e fumanoe tlhahlobong ea batsoali ea ho itlaleha.
Lipalopalo tse hlalosang le ho hokahana pakeng tsa lintho tse ithutoang li entsoe le SAS 9.4 (SAS Institute Inc., Cary, NC, USA). Moetso oa likamore tse nang le sefapano se sefapanong se entsoe ka mokhoa oa sebopeho sa sebopeho sa sebopeho (SEM) ka thuso ea Ts'ebetso ea lipalo tsa lipalo tsa Moment Structures, phetolelo ea 23.0. (IBM Inc., Chicago, IL, USA). Lintlha tse hlalosang li akaretsoa ka lipalo le liperesente bakeng sa likarolo tsa mekhahlelo, kapa li bolela ± SD kapa Median (li-range) bakeng sa lipapatso tse tsoelang pele. Kamano e telele pakeng tsa ho teba ha likarolo tsa IGD le boemo ba khatello ea maikutlo li ile tsa hlahlojoa ka mehlala ea likhaohano tse tšekaletseng. Pele o etsa tlhahlobo, maemo a mabeli a khatello ea maikutlo le ho teba ha likarolo tsa IGD li ile tsa fetoloa hore li lekane ho lekana.
Meetso ea likhutlo tse chitja e lumella likamano pakeng tsa tse peli kapa ho feta tse lekantsoeng khafetsa ho fuputsoa ka mokhoa o tšoanang. Ka hona, likhokahano tse koahetsoeng ka sefapano li bonts'a tšusumetso ea nako e fapaneng ka nako linthong tse ling tsa boleng bo bong bo fetohileng kamora nako, e laolang ho hokahana ha likarolo le litšebelisano tsa mantlha.
Joalokaha ho bontšitsoe ho Setšoantšo 1A, "ffCL e kopantsoeng ea pele" (a) e bonts'a kamano lipakeng tsa boemo ba khatello ea maikutlo bo lekantsoeng motheong le botebo ba likarolo tsa IGD tse lekantsoeng ketelong e latelang ea likhoeli tse 12. Coeffnty ea bobeli e nang le tšebeliso ea motlakase (b) e emetse kamano lipakeng tsa likarolo tsa IGD tse lekantsoeng motheong oa boemo le khatello ea maikutlo e lekantsoeng kamora khoeli e 12 ea ho latela. Kopano e arolelanang pakeng tsa likarolo tsa IGD le boemo ba khatello ea maikutlo bo emeloa e le motheo oa βCL. Li-coefficients tsa Autoregressive βAR-khatello ea maikutlo le βAR-IGD, tse emelang botsitso ba khatello ea maikutlo le ho teba ha likarolo tsa IGD ho tloha ho tsa pele ho fihlela ho lateloa ha likhoeli tse 12, ka ho latellana, li hlahisoa. Moetso o ile oa fetoloa bakeng sa lintho tse ka 'nang tsa ferekanya, tse kang lilemo, thobalano, mofuta oa lelapa, katleho ea thuto le SES.
Setšoantšo sa 1. (A) Meetso e akaretsang e sebelisetsoang mefuta ea li-panel tse lagged. (B) Moetso oa karolo e nang le marulelo a marang-rang o sekasekang kamano e telele pakeng tsa IGD le khatello ea maikutlo. Litekanyetso tsa linomoro ke li-coefficients tse hlophisitsoeng tse hlophisitsoeng hantle. AR: ho itšireletsa; CL: sefapano; CS: e arohaneng. *p <.05. **p <.01.
Ho leka ts'ebetso ea bobuelli, ho ile ha sebelisoa li-restamples tse 2,000 95 tse se nang bootstrope le nako ea 0% ho theha tsela e sa amaneng. Li-CI tse lokisitsoeng ka Bias tse sa kenyelelitseng 0.01 li nkuoe li le bohlokoa bakeng sa phello e sa tobang. Meetso ea boholo e hlalosoang e le nyane (0.09), mahareng (0.25), le e kholo (XNUMX) ho ipapisitsoe le khothatso e fetileng (Moreri & Kelley, 2011).
Model fit e ile ea hlahlojoa ho sebelisoa li-indices tse lekaneng tse ngata ho kenyelletsa li-indices tse phethahetseng hantle, li-indices tse eketsang boemo bo holimo, le li-indices tsa parimony tse loketseng. Lisebelisoa tse kenang tse lekaneng li ile tsa hlahlojoa ho sebelisoa χ2 tekanyo ea tokoloho (χ2/df) karo-karolelano, molemo oa index e loketseng (GFI), index ea ho bapisoa (CFI), le phoso e bolelang phoso ea boholo ba (RMSEA). Lisebelisoa tse kenyelletsang theko e lekaneng li ile tsa hlahlojoa ho sebelisoa index ea Tucker-Lewis (TLI), index e lumellanang hantle, index index e lekanang (RFI), le index ea fit bapisoa (CFI). GFI e fetotsoeng (AGFI) e sebelisitsoe li-indices tsa parimony fit. Lingoloa tsa SEM li fana ka maikutlo a hore mokhoa oa ho lekana o nepahetse ha χ2/df ≤ 3; CFI ≥ 0.95, TLI ≥ 0.95, GFI ≥ 0.95, NFI ≥ 0.95, RFI ≥ 0.95, AGFI ≥ 0.95, le RMSEA ≤ 0.06 (Kline, 2011).
Bakeng sa tlhahlobo e 'ngoe, kotsi e phahameng ea IGD e hlalosoa e le ho ba le lintlha tse 10 kapa ho feta sekaleng sa IGUESS, mme maemo a phahameng a matšoao a sithabetsang a hlalosoa a na le lintlha tse felletseng ho CDI ea 22 kapa ho feta. Re sebelisitse mofuta oa log-binomial o tsamaeang le PROC GENMOD ho hakanya kotsi e lekanyelitsoeng (RR) bakeng sa kopano lipakeng tsa maemo a phahameng a matšoao a khatello ea maikutlo le ketsahalo e phahameng ea ketsahalo ea IGD nakong ea tšalo-morao ea likhoeli tse 12 har'a bana ba nang le kotsi e tlase ea IGD (<10 IGURSS scores) qalong. Sekhahla sa ketsahalo ea boemo bo phahameng ba matšoao a sithabetsang khoeling e latelang ea 12 se baliloe har'a bana ba se nang matšoao a sithabetsang qalong. Re balile liRR tse sa hlaka le ho li fetola ha re ntse re laola lintho tse ka ferekanyang.
Ho ngolisa thutong ea iCURE, tumello e ngotsoeng e fumanoeng e fumanoe ho tsoa ho bohle ba nkang karolo le ho batsoali ba bona kapa bahlokomeli ba molao ka mor'a litlhaloso tsa mofuta oa melaoana ea lipatlisiso, ho kenyelletsa lekunutu le bolokolohi ba ho ikhethela ho nka karolo ho latela Phatlalatso ea Helsinki ea 1975 (Mokhatlo oa Lefatše oa Bongaka, 2013). Boithuto bona bo ile ba hlahlojoa ka botlalo mme ba amoheloa ke Institutional Review Board of The Catholic University of Korea (MC19ENSI0071). Boto ea taolo ea iCURE ea data e lokolotse lintlha tse khethiloeng bakeng sa tlhahlobo ea data.
Results
Boemo ba palo ea batho le likarolo tsa kliniki tsa barupeluoa ba 366 li hlalositsoe ka bokhutšoanyane ho Tafole 1. Nako ea bohareng ba barupeluoa e ne e le lilemo tse 10 (mefuta: lilemo tse 9 - 12). Ho barupeluoa ba 366, 188 (51.4%) e ne e le bashanyana. Boholo ba karolo (n = 337; 92.1%) ba ne ba tsoa malapeng a sa sisinyeheng, 68% ea bankakarolo ba ne ba sebetsa hantle lithutong, mme 71% ba tlalehile hore SES ea bona e ne e le tlase ho ea maemong a holimo.
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Tafole 1. Mefuta e akaretsang le ea bongaka ea baithuti ba sekolo sa mathomo ba 366 lithutong tsa ICURE
| Mefuta-futa | N (%) | Medi (mefuta) | Cronbach's α |
|---|---|---|---|
| Sex | |||
| Boys | 188 (51.4) | ||
| Girls | 178 (48.6) | ||
| Age | 10 (9 - 12) | ||
| Sebopeho sa lelapa | |||
| Lelapa le kopaneng | 337 (92.1) | ||
| Lelapa le sa sebetseng | 29 (7.9) | ||
| Boemo ba maemo a bophelo | |||
| Tlaase le bohareng | 263 (71.9) | ||
| High | 103 (28.1) | ||
| Ho atleha sekolong | |||
| Good | 249 (68.0) | ||
| Bad | 117 (32.0) | ||
| Liteko tsa motheo | |||
| Bothata ba ho bapala Inthanete | 2 (0 - 22) | .78 | |
| ho tepella maikutlo | 6 (0 - 46) | .88 | |
| ho Tšoenyeha | 26 (20 - 58) | .89 | |
| Liteko tse latelang tsa khoeli le khoeli | |||
| Bothata ba ho bapala Inthanete | 2 (0 - 23) | .86 | |
| ho tepella maikutlo | 5 (0 - 45) | .89 | |
| ho Tšoenyeha | 24 (20 - 58) | .94 |
Litumellano lipakeng tsa mefuta-futa ea lithahasello li tlalehiloe ka har'a Tafole 2. Ka nako e 'ngoe, boemo ba khatello ea maikutlo ba mantlha bo ne bo amana hantle le ho teba ha IGD ho tsa pele le ho lateloa ha likhoeli tse 12. Nako e telele, boemo ba khatello ea maikutlo (basement) bo ne bo amana hantle le ho teba ha IGD (ho latela khoeli ea 12), le ho teba ha IGD (basement) ho ne ho amana hantle le boemo ba khatello ea maikutlo (ho latela likhoeli tse 12).
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Tafole 2. Correlation matrix, ho bolela, le ho kheloha tloaelo (SD) bakeng sa mefuta-futa ea sehlooho
| Mefuta-futa | 1 | 2 | 3 | 4 | E bolelang | SD |
|---|---|---|---|---|---|---|
| 1. Boemo ba khatello ea maikutlo (basement) | 1 | 7.4 | 6.5 | |||
| 2. Bosholu ba IGD (basement) | .443 * | 1 | 2.6 | 3.2 | ||
| 3. Boemo ba khatello ea maikutlo (ho latela likhoeli tse 12) | .596 * | .339 * | 1 | 6.7 | 6.6 | |
| 4. Bosholu ba IGD (ho latela likhoeli tse 12) | .359 * | .453 * | .447 * | 1 | 2.9 | 3.6 |
Hlokomela. IGD: Bothata ba lipapali tsa inthanete.
*p <.001.
Figure 1 e bonts'a mofuta oa theorized (A) le mofuta o hlahlobiloeng (B) o nang le lits'oants'o tsa 'mila tse lekantsoeng (beta e emeng, β). Mabapi le litsela tse tsamaeang ka motlakase, boemo ba khatello ea maikutlo maemong a mantlha a boletsoeng esale pele ka matla a likarolo tsa IGD khoebong ea likhoeli tse 12 (β = 0.55, p <.001). Ntle le moo, ho tiea ha likarolo tsa IGD maemong a mantlha a boletsoeng esale pele a khatello ea maikutlo nakong ea tatellano ea likhoeli tse 12 (β = 0.37, p <.001). Liphetho li bonts'itse hore maemo a mabeli a khatello ea maikutlo le ho tiea ha likarolo tsa IGD a ne a hokahane haholo lipakeng tsa mantlha le tatellano ea likhoeli tse 12. Ka mokhoa o ts'oanang, ho tiea ha likarolo tsa IGD ho ne ho tsamaisana le lintlha tse peli tsa nako.
Mabapi le tsela ea khokahano ea karolo e arohaneng, boemo ba matšoao a nyahamisang le ho teba ha litšobotsi tsa IGD li ne li hokahane hantle ka nako e ngoe le e ngoe ea nako (β = 0.46, p <0.001 ho ea mantlha le β = 0.27, p <.001 ho latela likhoeli tse 12). Liphetho li bonts'itse kamano e ntle lipakeng tsa matšoao a khatello ea maikutlo le ho tiea ha likarolo tsa IGD nako le nako.
Litlhatlhobo tse nang le sefapano se senotseng boemo boo ba khatello ea maikutlo nakong e fetileng bo boletseng esale pele ka botebo ba litšobotsi tsa IGD ho latela-pele ea likhoeli tse 12 (β = 0.15, p = .003). Bokhabane ba likarolo tsa IGD maemong a mantlha le tsona li boletsoe esale pele hore na boemo ba khatello ea maikutlo ke bofe ha ho latela khoeli ea 12 (β = 0.11, p = .018), kamora ho laola lintho tse ka ferekanyang. Tlhatlhobo ea tsela e sarolohileng e bonts'a kamano e iphetang pakeng tsa ho tiea ha likarolo tsa IGD le boemo ba matšoao a tepelletsang.
Mohlala oa rona o akaretsang o bonts'itse hantle loketseng ho latela li-indices tse nepahetseng. Karolelano ea χ2 ho isa tekanyong ea tokoloho e ne e le 1.336, e bonts'a mohlala o motle o loketseng. RMSEA e ne e le 0.03, GFI e ne e le 0.997, TLI e ne e le 0.976, CFI e ne e le 0.997, mme AGFI e ne e le 0.964, le yone e supa go lekana. Ha li kopantsoe hammoho, lipalo-palo tse lumellanang li bonts'a hore sena se ne se lekane ho hlahisa mofuta o nepahetseng o thehiloeng ho moralo o matla oa theoretical theoretical le li-trust tse amohelehang.
Ho barupeluoa ba 366, ba 351 ha baa ka ba tlaleha hore ba kotsing ea boemo bo phahameng ba IGD. Ho bankakarolo bana ba 351, 15 (4.3%) ba thathamisitsoe e le ba kotsing e kholo ea IGD tlhahlobisong ea likhoeli tse 12. Kamora ho etsa liphetoho bakeng sa mabaka a ka bakang pherekano, barupeluoa ba nang le matšoao a sithabetsang motheong oa motheo ba ne ba na le RR e kholo ea 3.7D ea IGD ka likhoeli tse 12 ho feta barupeluoa ntle le matšoao a sithabetsang ho motheo (RR = 3.7, 95% CI = 1.1–13.2).
Ho barupeluoa ba 366, ba 353 ha baa ka ba tlaleha boemo bo phahameng ba matšoao a sithabetsang qalong. Ho bankakarolo bana ba 353, 8 (2.3%) ba ne ba thathamisitsoe e le ba nang le matšoao a sithabetsang ho latela tlhahlobo ea likhoeli tse 12. Kamora ho etsa liphetoho bakeng sa mabaka a ka bakang pherekano, barupeluoa ba neng ba le kotsing e phahameng ea IGD motheong oa mantlha ba bile le menyetla e mengata ea 3.6 ea khatello ea maikutlo nakong e latelang ea likhoeli tse 12 ha ba bapisoa le bankakarolo ba neng ba se kotsing e kholo ea IGD qalong e ne e se bohlokoa lipalo-palo (RR = 3.6, 95% CI = 0.5-29.0; Tafole 3).
|
Tafole 3. Ts'ebetso ea IGD ka bobeli le khatello ea maikutlo har'a bana ho latela-likhoeli tse 12
| E | Che | IR | RR | RRRa | ||
|---|---|---|---|---|---|---|
| Likhoeli tse 12 tsa IGDb | ||||||
| Ho sithabela maikutlo | E | 2 | 8 | 20 | 5.2 (1.4 - 20.2) | 3.7 (1.1 - 13.2) |
| Che | 13 | 328 | 3.8 | |||
| Khatello ea maikutlo ea likhoeli tse 12c | ||||||
| Motheo oa IGD | E | 1 | 11 | 8.3 | 4.1 (0.5 - 30.4) | 3.6 (0.5 - 29.0) |
| Che | 7 | 334 | 2.1 | |||
Hlokomela. IR: sekhahla sa liketsahalo; RR: kotsi ea kamano; ARR: kotsi e lekantsoeng; IGD: Bothata ba lipapali tsa inthanete.
aE fetotsoe ke thobalano, mofuta oa lelapa, katleho ea thuto, le boemo ba boiketlo ba sechaba.
bSekhahla sa ts'oaetso ea IGD ha ho latela likhoeli tse 12 har'a bana ba se nang IGD motheong oa motheo (n = 351).
cSekhahla sa khatello ea maikutlo selemong se latelang sa likhoeli tse 12 har'a bana ntle le khatello ea maikutlo sethaleng (n = 353).
Puisano
Re fumane khokahano e ntle pakeng tsa matšoao a nyahamisang le ho teba ha likarolo tsa IGD lithutong tsa mantlha le ho latela bana ka likhoeli tse 12. Liphetho tsena li bonts'a hore matšoao a sithabetsang a baka kotsi e kholo ea bophahamo bo phahameng ba IGD, 'me ho teba ha likarolo tsa IGD ho ka baka sesosa sa kotsi ea matšoao a sithabetsang selemo se tlang.
Tlhahlobo ea marang-rang e nang le litšepe e lumella likamano tse ngata ho hlahlobisisoa ka nako e le ngoe, li hlahise mefuta e rarahaneng ea lipalo ho feta e ka fumanoang ka ho tsamaisa mehala e mengata e arohaneng. Matla a lekanang a likamano tsa nako e telele a ka khethoa ka papiso ea li-coefficients tse emeng hantle. Ho teba ha litšobotsi tsa IGD le boemo ba matšoao a sithabetsang li bonts'itse likarolo tse kholo tsa sefapano, khokahano ea koloi le likoloi tse ikopantseng.
Liphetoho tsa karolo e bohareng li senotse kamano e ntle pakeng tsa matšoao a nyahamisang le ho teba ha likarolo tsa IGD ka nako e ngoe le e ngoe. Ka mokhoa o tšoanang, ho ikamahanya le boiketsetso ho senotse hore matšoao ana a mabeli a nyenyefatsang le ho teba ha likarolo tsa IGD li ne li hokahane haholo le botsitso maemong ohle a nako. Tlhahlobo ea tsela ea mahlakore a sefapano e bonts'itse ho pheta-pheta pakeng tsa kotsi ea IGD le boemo ba matšoao a nyahamisang. Mekhatlo ena e nang le likaroloana tse telele le tse telele e ile ea phehella kamora ho ba le matla a ho ferekanya. Matla a kamano a ne a le matla le ho feta lipakeng tsa motheo oa khatello ea maikutlo le boima ba likhoeli tse 12 tsa likarolo tsa IGD (β = 0.15, p = .003) ho feta pakeng tsa matla a mantlha a likarolo tsa IGD le boemo ba khatello ea maikutlo ea likhoeli tse 12 (β = 0.11, p = .018), tse khothalelitsoeng ho ba boholo ba sephetho se mahareng. Sephetho sena se fana ka maikutlo a hore khatello ea maikutlo ke seabo se matla ho feta tsa likarolo tsa IGD ho fapana le hoo, le hore ho na le kamano e ts'oanang nakong e tlang.
Litloaelano lipakeng tsa IGD le khatello ea maikutlo ka linako tse ling li 'nile tsa hlalosoa ka tšusumetso ea maikutlo, e fanang ka maikutlo a hore batho ba nang le maikutlo a fosahetseng ba ka batla mesebetsi ea boithabiso ho baleha linaheng tsa dysphoric. Lithuto tse fetileng li ne li tsamaisana le phetisetso ea mohopolo bakeng sa hore kamano e kholo, e ntle lipakeng tsa khatello ea maikutlo le IGD e hlokometsoe (Ostovar et al., 2019; Seyrek, Cop, Sinir, Ugurlu, & Senel, 2017; Yen, Chou, Liu, Yang, & Hu, 2014; Younes et al., 2016). Boiteko ba ho baleha khatello ea maikutlo le matšoenyeho a 'nete a lefatše ka ho sebelisana le marang-rang bo ka baka potoloho e mpe e eketsang khatello ea maikutlo.
Ho ea ka tšebeliso ea maikutlo a boiketlo ba ho khesoa sechabeng, ha motho a qeta nako e ngata a etsa ntho e le 'ngoe, nako e fokolang eo a ka e qetang a etsa e ngoe. Bana ba sebelisang nako e ngata lipapaling tsa inthanete hangata ba qeta nako e fokolang ba buisana le batho ba bang (Caplan, 2003). Mohopolo oa phello ea boiketlo ba sechaba ke hore nako e sebelisoang ho papali e tla beha mesebetsi e meng joalo ka ts'ebelisano 'moho le bohlokoa ba ho holisa kelello le bana.Zamani, Kheradmand, Cheshmi, Abedi, & Hedayati, 2010). Ho haelloa ke tšebelisano-'moho ho ka baka maikutlo a mabe. Molichaba et al. (2011) e tlaleha matšoao a phahameng a sithabetsang kamora hore mathata a papali ea video a qale, mme matšoao ana a phehella (Molichaba et al., 2011). Haeba tšebeliso ea maikutlo a boiketlo ba batho ka ho hlaka e lokile, joale IGD e ka lebisa khatello ea maikutlo (Amorosi, Ruggieri, Franchi, & Masci, 2012; Dalbudak et al., 2013).
Matšoao a sithabetsang ho bacha a atisa ho hlaha pele a kena bohlankaneng. Mabapi le ho ba kotsing ea liphatsa tsa lefutso bakeng sa bothata bo boholo ba khatello ea maikutlo, boiphihlelo ba liketsahalo tse sithabetsang tsa bophelo kapa ho ba teng ha mafu a kelello nakong ea bongoana bo hokahane le ho qaleha ha khatello ea maikutlo (Piko et al., 2011; Shapero et al., 2014). Ho tloha moo khatello ea maikutlo esale pele e hokahane le nts'etsopele ea khatello ea kelello le ho lemalla (Ryan, 2003), ho ka etsahala hore boiteko ba thibelo ea ts'ebeliso ea lithethefatsi tsa inthanete bo lokela ho kenngoa ts'ebetsong ba sa le banyenyane ho fokotsa litlamorao tse totisang khatello ea maikutlo. Ka hona, tlhokomelo e eketsehileng e lokela ho fanoa ho khatello ea maikutlo le litšusumetso tsa eona tse ka bang teng kholisong ea IGD ho bana.
Bana ba nang le matšoao a sithabetsang motheong oa mantlha ba bonts'itse kotsi e eketsehang ea makhetlo a 3.7 ea ho ba le matšoao a IGD kamora ho latela likhoeli tse 12 ha ba bapisoa le bana ba se nang matšoao a sithabetsang motheong, kamora ho fetoha bakeng sa mabaka a ka bakang pherekano. Kaha CI ea 95% e pharalletse joalo ka 1.1–13.2, ho kanna ha ba le meeli ea ho netefatsa ho nepahala ha litekanyetso, ka hona liphetho tsena li lokela ho fetoleloa ka hloko. Ntle le moo, bana ba nang le matšoao a IGD qalong ba ka ba kotsing e kholo ea ho ba le matšoao a sithabetsang litulong tse latelang tsa likhoeli tse 12 ha li bapisoa le bana ba se nang matšoao a IGD ho basiling; leha ho le joalo, liphetho e ne e se tsa bohlokoa ka lipalo.
Banana ba fihle lilemong tsa bocha lilemong tse ka bang 12 pejana ho bashanyana. Karolelano ea lilemo tsa banana ba qalang ho kena bohlankaneng kapa boroetsaneng ke lilemo tse 12.7 ho li-sampuli tsa naha ka bophara (Lee, Kim, Oh, Lee, & Park, 2016). Ho tloha ka maikutlo ana, boholo ba barupeluoa thutong ena ba ne ba ka se be le lilemo tsa ho kena bohlankaneng. Kakaretso ea bana ba 8 (2.2%) ba fumanoe ba fihlile boroetsaneng (3 basiling; ba 5 ba latelang ka likhoeli tse 12). Ka lebaka la palo e nyane ea bana ba kenang lilemong tsa bocha, litholoana tsa thuto ena li kanna tsa se susumetsoe ke liphetoho tse amanang le ho kena bohlankaneng.
Sekhahla sa ho hohela khoao kamora ho latela likhoeli tse 12 e ne e le 9.1% (bana ba 33). Ho hohela hohle ho etsahetse hobane baithuti ba falletse sekolong se seng. Ho ne ho se na phapang ea bohlokoa mehlaleng ea motheo, ho kenyeletsoa thobalano, lilemo, mofuta oa lelapa, ts'ebetso ea thuto, SES, ts'ebetso ea inthanete, kapa ho teba ha likarolo tsa IGD, lipakeng tsa barupeluoa ba entseng mme ba sa phethela thuto.
Lintho tse amanang le khatello ea maikutlo li ka fapana har'a linaha. Ho sithabela maikutlo ke boemo bo kopaneng, bo bonts'ang phapang e kholo lipakeng tsa batho ba fapaneng mme bo amana le lintlha tse ngata tsa liphatsa tsa lefutso le maemo a bophelo bo fapaneng, le li-subtypes tse 'maloa tse nang le li-etiology tse fapaneng. Korea e ne e le naha ea pele ho fana ka tekanyetso ea naha ea ho sebetsana le mathata a marang-rang le ho lemalla papali ea chelete.Ka, 2015). Phapang ea kelello, tikoloho le setso li ka ama likamano lipakeng tsa matšoao a nyahamisang le ho teba ha litšobotsi tsa IGD, leha ho ka lebelloa hore kopano ea mantlha pakeng tsa khatello ea maikutlo le IGD e shejoe hohle ho matla le litso. Kahoo, liphetho tsa boithuto bona li ka sebetsa ho bana ba linaheng tse ling, leha tlhokomeliso e eletsoa ha ho akaretsa liphetho. Hobane ba arabileng ba ne ba beiloe mohlala har'a bacha ba neng ba kena likolo mme ba sa kenye bana ba sa kenang sekolo. Likolo tse nkang karolo hammoho le bana le batsoali li ne li nkile karolo ka boithaopo; ka hona, likolo tsena li ne li na le tjantjello ea ho thibela IGD bapisoa le likolo tse sa nke karolo. Monyetla oa khetho ea khethollo le ho nyenyefatsa ho ata ha IGD o ke ke oa hlakoloa.
Nako ea bongoana ke nako e kotsing ea ho holisa khatello ea maikutlo le IGD. Mathata ana a mabeli a kopane khafetsa bongoaneng ebile a amana le ho senyeha hoa bohlokoa bophelong. Ha ho fanoa ka nts'etsopele e tsoelang pele ea litšobotsi tsa kelello ho tloha boseeng le bophelong ba batho ba baholo ba lilemong tsa bocha, kutloisiso e nepahetseng ea tataiso ea ho qala le thuto ea mathata ana nakong ea bongoana e tla ba le thuso ho nts'etsapele maano a atlehang a thibelo le kalafo.
Tlhahlobo-leseling ea tsela e tšoaetsanoang e bonts'itse likamano tsa tekano lipakeng tsa botebo ba likarolo tsa IGD le boemo ba khatello ea maikutlo. Boemo bo phahameng ba matšoao a sithabetsang motheong oa motheo bo ile ba bolela ho teba ho tebileng ha likarolo tsa IGD kamora likhoeli tse 12. Ho feta moo, botebo ba motheo ba likarolo tsa IGD li ne li amana haholo le boemo bo phahameng ba matšoao a sithabetsang kamora likhoeli tse 12 ho bana. Ho utloisisa likamano tsa ho hlabolloha lipakeng tsa matšoao a sithabetsang le ho teba ha likarolo tsa IGD ho ka thusa lipuisanong ho thibela maemo ana ka bobeli. Liphumano tsena li fana ka tšehetso ea theoretical bakeng sa merero ea thibelo le khalemelo bakeng sa IGD le matšoao a nyahamisang ho bana.
HJ o ile a etsa tlhahlobo mme a etella pele mongolo o ngotsoeng. HWY o ne a tataisa le ho hlokomela mongolo o ngotsoeng. HJ le HWY ba nts'etsapele le ho hlahisa tlhahiso ea mohopolo oa mantlha oa thuto. S-YL, HL le MNP ba ile ba hlahloba litaba tsa mahlale mme ba hlophisa buka e ngotsoeng ka letsoho. HWY, HJ, S-YJ, le HS ba ile ba khanna thuto. Bangoli bohle ba ile ba fana ka maikutlo a bongoli mabapi le buka e ngotsoeng ka letsoho.
Bangoli ha ba phatlalatse hore ha ho na khohlano ea lithahasello mabapi le se ngotsoeng. Dr. MNP e tlaleha liphatlalatso tse latelang. O kopanetse le ho eletsa Game Day Data, Sethala sa Pholisi ea Tlatsetso, HealthMend Health, Lakelight Therapeutics / Opiant le Jazz Pharmaceuticals; e amohetse tšehetso ea lipatlisiso ho tsoa ho Mohegan Sun Casino le Setsi sa Naha sa Papali e Ikarabellang; o nkile karolo lipatlisisong, liposong tsa mangolo, kapa lipuisanong tsa mehala tse amanang le bokhoba ba lithethefatsi, mathata a taolo ea tšusumetso, kapa lihlooho tse ling tsa bophelo bo botle; hape e rerisane le liofisi tsa molao le mekhatlo ea papali ea chelete mabapi le litaba tse amanang le taolo ea tšusumetso kapa bohlasoa.
Lisebelisoa tsa data tse hlahisitsoeng nakong le / kapa tse hlahlobiloeng nakong ea thuto ena li fumaneha ho tsoa ho sengoli se lumellanang.
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