Ho pepesehela mecha ea phatlalatso e bonts'ang likamano tsa botona le botšehali lilemong tsa bocha ho amana le boitšoaro bo kotsi ba thobalano ho batho ba baholo ba lilemong tsa bocha (2020)

inahaneloang

Background

Ho pepesetsoa litaba tse pepenene ka tsa thobalano nakong ea bohlankana ho fumanoe hore li amahanngoa le boitšoaro bo kotsi ba thobalano. Leha ho le joalo, phuputso e fetileng e bile le bothata ba mekhoa ea ts'ebetso, joalo ka khetho ea leeme. Ntle le moo, ha ho tsejoe letho ka phello ea ho pepesehela litaba tse bobebe tse atisang ho ba le thobalano e kotsi mabapi le boitšoaro bo kotsi ba thobalano, le hore kamano ena e ka sebelisoa joang ho batho bao e seng bophirima.

maikemisetso

Boithuto bona bo ikemiselitse ho ntlafatsa lithutong tse fetileng ka ho sebelisa likhakanyo tsa lisebelisoa tse fapaneng. Ntle le moo, thuto ena e boetse e kenyelletsa mekhoa e mengata ea litaba tse amanang le thobalano le litekanyetso tse tharo tse kotsi tsa boitšoaro ba thobalano ho tsoa mehlala ea bacha ba Taiwan.

mekhoa

Barupeluoa ba ile ba hapuoa ho tsoa thutong e neng e ka lebelloa ea thuto e telele. Tsohle li ne li le ho tse 7th kereiti (e bolela lilemo = 13.3) ha thuto e ne e qaloa ka 2000. Phatlalatso ea litaba tsa thobalano e kenyelletsang, ho kenyelletsa ho pepesetsoa kamehla le palo ea mekhoa e pepesitsoeng, e lekantsoe ka wave 2 (8)th sehlopha). Boitšoaro bo kotsi ba thobalano bo ne bo lekantsoe ka maqhubu a 8 (ho bolela lilemo = 20.3) le 10 (ho bolela lilemo = 24.3). Ho sebelisitsoe sekirini sa mekhahlelo e meholo e mekato e mmedi, ka nako ea lipapatso e le phetoho ea matla.

Results

Hoo e ka bang 50% ea bankakarolo ba ne ba pepesitsoe ke litaba tsa thobalano ke 8th grade, ho tloha karolelano ea mokhoa o le mong. Ho pepesetsoa litaba tsa thobalano ho pepesang thobalano, thobalano e sa bolokehang, le balekane ba bangata ba thobalano (kaofela: p <.05). Ntle le moo, ho pepesetsoa mekhoa e meng ea phatlalatso ho ekelitse menyetla ea boits'oaro bo kotsi ba thobalano. Leha ho le joalo, ke phello feela qalong ea thobalano e neng e sa fetohe.

Nahanisisa

Ho pepesehela mecha ea phatlalatso e bontšang thobalano lilemong tsa bocha ho ne ho e-na le kamano e matla le boitšoaro bo kotsi ba thobalano ho batho ba baholo ba ntseng ba hlaha. Tsebo ea mokhoa ona o ts'oanang le ona e fana ka motheo oa ho theha mananeo a betliloeng a ho thibela pelehi lilemong tsa bocha. Mokhoa o mong o tummeng ke thuto ea pele mabapi le tsebo ea litaba mecheng ea litaba, mme lingaka ka botsona li ka hloka ho tloaelana le litaba tse joalo ho e qala.

Tlhaloso: Lin WH, Liu CH, Yi CC (2020) Ho pepesetsoa litaba tsa thobalano bocheng ba bongoaneng ho amana le boitšoaro bo kotsi ba thobalano ho batho ba baholo ba ntseng ba hlaha. PLoS ONE 15 (4): e0230242. https://doi.org/10.1371/journal.pone.0230242

mohlophisi: Luis M. Miller, Lekhotla la Naha la Lipatlisiso la Spain, SPAIN

Re amohetse: June 24, 2019; E amohetse: February 26, 2020; E phatlalalitsoe: April 10, 2020

Copyright: © 2020 Lin et al. Ena ke sengolo se bulehileng sa phihlello se tsamaisitsoeng tlasa maemo a License ea Boikarabelo ba Creative Commons, e lumellang hore ho sebelisoe, ho abeloa, le ho beleha ho sa sebelisetsoe, ho fana ka moqapi le mohloli oa pele.

Ho fumaneha ha Data: Lintlha tse hlahisitsoeng le ho hlahlobisisoa nakong ea lipatlisiso tsa morao-rao li fumaneha ho Sesebelisoa sa Tlhahlobo ea Patlisiso ea Patlisiso (https://srda.sinica.edu.tw/). Lintlha tsa TYP li fumaneha bakeng sa ts'ebeliso ea sechaba mme li ka sebelisoa bakeng sa lipatlisiso ka tumello ea Academia Sinica e Taiwan (http://www.typ.sinica.edu.tw).

Lithuso: Patlisiso ena e ne e tšehelitsoe ke chelete e tsoang ho Lekala la Saense le Theknoloji, Taiwan (MOST 107-2410-H-010-001 ho Wen-Hsu Lin). Bafani ba lichelete ba ne ba sena karolo morerong oa ho ithuta, pokello ea data le tlhahlobo, qeto ea ho phatlalatsa, kapa ho hlophisa sengoloa.

Lithahasello tse tsitsitseng: Bangoli ba bolela hore ha ba na likhohlano tsa thahasello.

Likhaloso: ATE, Phello ea Karolelano ea Phekolo; HIV / AIDS, vaerase ea human immunodeficiency virus / tlhahlobo ea bohloeki ba mmele; IV, Mohalafala o Fetohileng; OLS, Likoloa Tse Tloaelehileng Tse sa Tloaelehang; PDS, Sekala sa Nts'etsopele ea Pubertal; RCT, Teko ea Taolo ea Tlhahlobo; SLS, Likoloe tse peli tsa Lethathamo la Bobeli; Mafu a likobo, tšoaetso ea thobalano; TYP, Morero oa Bacha oa Taiwan

SelelekelaMekhoa ea boitšoaro ea thobalano e kenyelletsang ho qalella ha thobalano e sa sireletsehang, thobalano e sa sireletsehang (mohlala, tšebeliso ea khohlopo e sa lumellaneng), le balekane ba bangata ba thobalano (ke hore, maemo a phahameng a phetoho ea balekane).1], ba amohetse tlhokomelo lefatšeng ka bophara bakeng sa litlamorao tse mpe tsa bona tsa nako e telele [2], haholo-holo e amanang le bophelo bo botle, joalo ka ho fumana tšoaetso ea thobalano (STI) [3], mafu a mang [4], boimana bo sa lebelloang / ba lilemong tsa bocha [3-5], le tšebeliso ea lithethefatsi [6]. Bacha ba fumane tlhokomelo e khethehileng hobane e har'a ba kotsing ea mafu a likobo a mang (mohlala, gonorrhea) linaheng tse ngata, joalo ka US [7] le Taiwan [8] le bakeng sa likarolo tse ngata tsa lefats'e (mohlala, Asia le Afrika) hajoale ba na le seoa sa HIV / AIDS [9]. Kahoo, ho na le tlhoko ea ho utloisisa litlalo tsa pele tsa boitšoaro bo bobe ba thobalano bakeng sa thibelo ea pele, e le e 'ngoe ea maano a matle a ho loants'a litlamorao tse mpe hamorao.

Boitšoaro bo kotsi ba thobalano bocheng bo susumetsoa ke likarolo tse 'maloa tsa bohlokoa tsa bophelo, tse kang lelapa / batsoali, lithaka le lintlha ka bomong. Mohlala, lintlha tse 'maloa tse amanang le lelapa, tse kang ho ba motsoali ea thata [10-11], taolo e tlase ea batsoali [12], le kopanelo ea lelapa [13] li fumanoe e le mabaka a kotsi bakeng sa boitšoaro ba ho nka likotsi tsa thobalano mme mekhoa e tlatselletsang e boetse e hlahisoa (mohlala, taolo e tlase ea batsoali → taolo e tlase e sa tsitsitseng → boitšoaro bo kotsi kapa tšoaro e mpe ea pele → maikutlo a seng kotsi → boitšoaro bo kotsi. Ka mokhoa o ts'oanang, lithuto tse ling li hanyetsane ho tsoa mehopolong e fapaneng ea thuto mme tsa fumana tse ka pele tsa boitšoaro bo kotsi ba thobalano. Mohlala, tharollo ea mathata a boitšoaro [14] pheha khang boits'oaro ba boitšoaro bo tloaetse ho qhoqha; ka hona, tšebeliso ea lithethefatsi tsa pele e amana haholo le boits'oaro bo kotsi ba hamorao, ho kenyeletsoa boits'oaro bo kotsi ba thobalano [15-16]. Ka mokhoa o ts'oanang, khopolo ea taolo ea sechaba [17] o phehisa khang ea ho hloka bonngoe sechabeng (mohlala, boitlamo ba sekolo se tlase) "lokolla" motho bakeng sa ho kheloha, ho kenyelletsa le boits'oaro bo kotsi ba thobalano [18]. Lintlha tse ling li fana feela ka menyetla ea ho etsa thobalano mme li amana le boitšoaro bo kotsi ba thobalano, joalo ka ba kamanong ea lerato [15, 19]. Le ha lintlha tsena tse ling li amana le boits'oaro bo kotsi ba thobalano, liphuputso li bonts'a le taolo bakeng sa baitlami ba bohlokoa bona, ntlha e le 'ngoe e ntse e na le kamano e matla le boits'oaro bo bobe ba thobalano - litaba tsa thobalano mecheng ea litaba kapa mecha ea litaba e buang ka thobalano (SEM) [20-22]. Strasburger et al. [23] e finyeletseng litaba tsa thobalano mecheng ea litaba ke ntlha ea bohlokoa e susumetsang bana le bacha mekhoeng e amanang le thobalano, maikutlo le tumelo. Wright [24] ho pepesetsoa SEM ho etsa hore batho ba fetohe le ho theha boits'oaro bo bobe ba thobalano, bo amanang haholo le boits'oaro bo kotsi ba ho ba le thobalano hamorao bophelong. Boithuto bo bong bo bontšitseng ho pepesehela SEM bo amana le boitšoaro bo kotsi ba thobalano hobane bo fetola maikutlo a bashebelli ka tsa thobalano le basali [25-26]. Kahoo, phuputso e 'ngoe e ngangisitse, le ha litlamorao tsa litaba tsa thobalano e ka ba tse poteletseng, ho bohlokoa haholo ho laola le ho lekanya [27]. Ka lebaka leo, SEM e ka ba ea bohlokoa ha ho utloisisoa boitšoaro bo kotsi ba thobalano.

Le ha ho pepesetsoa SEM ho ka etsa hore motho ka mong a be kotsing ea boitšoaro bo kotsing ba ho ba le thobalano, ho joalo le ho bacha ka mabaka a mararo. Taba ea pele, SEM ha e felle feela, empa e na le tšusumetso nakong ea bocha.28-30]. Mohlala, Owens et al. [29] ba pheha khang ea hore litšoantšo tse manyala tse hlephisang boitšoaro li eketsehile "li amme semelo sa bacha le nts'etsopele ea bacha ka litsela tse sa tloaelehang le tse fapaneng." Taba ea bobeli, bacha ke ba bang ba bareki ba SEM khafetsa.31-32] le ho bona litšoantšo tse nkuoang e le tsa nnete32]. Ntle le moo, bacha ba angoa ke tsela eo ba sebelisanang ka eona (mohlala, sebelisa le ho utloisisa) mecha ea litaba mme hangata ba lumella mecha ea litaba ho susumetsa le ho hlalosa thobalano ea bona, lerato le likamano tsa bona [33]. Qetellong, linaheng tse ngata tse tsoetseng pele, ho fihlella ho SEM ho laoletsoe ka molao le ka molao, e leng se etsang hore e khahloe ke bacha ka lebaka la "litholoana tse thibetsoeng"34].

Mabaka a kaholimo a fana ka maikutlo a hore bacha le batho ba baholo ba baholo ke bareki ba SEM mme ba kotsing ea SEM. Leha ho le joalo, haeba litaba tsa SEM li se "kotsi", ho pepesehela SEM ho kanna ha lebisa ho litlamorao tse mpe. Mohlala, ba bang ba pheha khang ea hore SEM e fana ka thuto ea thobalano [35-36hape e eketsa maikutlo a tekano ea bong:37]. Ka bomalimabe, lipatlisiso li bonts'itse hore litaba tsa SEM li bonts'a khotsofalo ea boitšoaro ba thobalano mme ha li tsotelle kapa li sa tsotelle letho ka litlamorao tse mpe [38], e nyenyefatsa basali ebile e "skew tsoa hole le kamano le bonolo" (leq. 984) [39], hape e fana ka sengoloa se lumellehang sa thobalano se lumellehang [24]. Ka lebaka leo, lithuto tse ngata tse fetileng li bontšitse hore ho pepesetsoa SEM nakong ea bocha ho amana le qalo ea thobalano [40-41], tšebeliso ea likhohlopo tse sa lumellaneng / thobalano e sa sireletsehang [20, 25], le balekane ba bangata ba thobalano [42-43]. Leha ho le joalo, tšusumetso e mpe ea "ho nahanoa" ea ho pepesetsoa SEM le boitšoaro bo kotsi ba thobalano ha e a ka ea fumanoa ka ho sa feleng lithutong tse ling [44-48]. Mohlala, phuputso ea morao-rao e fumane hore ho pepesetsoa SEM ho ne ho sa amane le qalo ea thobalano [48] kapa balekane ba bangata ba thobalano (ke hore, ba fetang balekane ba babeli ba thobalano) [44].

Ntle le phapang ea sampole le phapang ea litekanyo, liphetho tse tsoakiloeng le tsona li ka hlaha ka lebaka la khethollo e fapaneng le / kapa khetho ea boits'oaro (ke hore, bacha ba kopaneng le thobalano ba nang le monyetla oa ho bona litaba tsa thobalano mecha ea phatlalatso) tse re thibelang ho tseba kamano e matla pakeng tsa Ho pepesetsoa SEM le boitšoaro bo kotsing ba ho ba le thobalano [49-51]. Joalokaha Tolman le McClelland ba ngangisana [51], "Litlamorao tsa ho bona mecha ea litaba tsa thobalano li apareloa ke phephetso ea 'khoho kapa lehe'; ka mantsoe a mang, haeba bacha ba etsang thobalano ba bulehile haholo ba ka sebelisa SEM kapa bacha ba kenella thobalanong ka lebaka la ho pepesoa ke SEM. Ts'ebeliso ea liteko tse laoloang ka mokhoa o ikhethileng (RCTs), "standard standard", e kanna ea se sebetse ka lebaka la molao (mohlala, ho hlahisa litaba tsa thobalano ho bana) le melao ea boitšoaro (mohlala, ho abela batho maemo a ka behang litaba tsa bophelo bo botle). Mokhoa o mong o tloaelehileng oa ho ikarabella ka khetho ea motho ka mong ke ka mokhoa o tšoanang. Lithuto tse tharo tse fetileng li sebelisitse lintlha tsa ho lekanya lintlha 'me kaofela li senotse hore ho pepesetsoa SEM ho ne ho sa amane le ho qala thobalano.46-47, 49]. Leha ho le joalo, lintlha tsa boholo ba eona li ka khona ho "tlosa" phapang e bonoang (ke hore, e bapisoa le litšobotsi tse bonoang) empa e lekantsoe ho li-account tsa li-heterogeneity tse ke keng tsa bonoa (ke hore, liphapang tse sa bonahaleng). Mokhoa o mong oa ho lokisa meeli ena ke ho sebelisa lintlha tsa phanele ho hakanya likamano, ha ho ntse ho kenyelletsoa le phapang (IV), e le mokhoa oa ho ntlafatsa RCT. Ka lebaka leo, ha e sebelisoa hantle52], Mokhoa oa IV o fana ka mokhoa oa ho khetholla phello ea kalafo ho tsoa tlhaisong ea leihlo (ke hore, kamano e fetelletseng).

Ntle le meeli ea mokhoa, ho sa tsotelleng mekhoa e fapaneng ea SEM ho tla lebisa ho monyetla o moholo oa boits'oaro bo bobe ba ho kopanela liphate ha o e-so fumane tlhokomelo e ngata. Boithuto bo bongata ba pejana bo shebile mefuta e meng feela ea lisebelisoa tsa thobalano (mohlala, libaesekopo tse X tse lekantsoeng kapa marang-rang a SEM) [44-48] le litlamorao tse itseng (mohlala, pele ho thobalano kapa balekane ba bangata ba thobalano). Ho tsebo ea rona, ke phuputso e le 'ngoe feela e fetileng e ileng ea hlahloba phello ea ho pepesetsoa mefuta e' maloa ea thobalano le ho fumana hore ho pepesehela mekhoa e fapaneng ea SEM ho ne ho amana hantle le menyetla ea ho itlosa bolutu ka ho kopanela liphate le ho qala thobalano pele.31]. Ha ho fanoa ka litholoana tse kopaneng tsa kamano lipakeng tsa ho pepesetsoa SEM le boits'oaro bo kotsing ba ho ba le thobalano le thuto e le 'ngoe feela e faneng ka tlhahlobo e hlakileng ea litlamorao tsa ho pepesoa ha SEM ka mefuta e mengata ka boitšoaro bo kotsi ba ho etsa thobalano, ithute hape ka lebaka la meeli ea mokhoa le ka nako e ts'oanang Nako e nka ho senoloa ha SEM ka mefuta e mengata le mekhoa e fapaneng ea boits'oaro bo botle e lokela ho ba teng.

Kamora nako, lithuto tse ngata tse fetileng li ile tsa ts'epa lisampole tsa Bophirimela (mohlala, United States, United Kingdom, le linaha tsa Europe). Ho pepesetsoa ha SEM le kamano ea eona le boits'oaro bo kotsi ba ho kopanela likobo mekhatlong e meng e bolokiloeng (mohlala, linaha tsa Asia) ha e sa tsotelloa. Ho tsoa lingoliloeng tse fumanehang hona joale, ho ka bonahala eka ho pepesetsoa SEM ka bobeli le boitšoaro bo kotsi ba thobalano li fapane haholo litsong tsa Asia ho feta linaheng tsa Bophirimela. Mohlala, lithuto tse tsoang linaheng tse 'maloa tsa Asia Bochabela li bontšitse hore sekhahla sa ho pepeseha SEM ho bacha le batho ba baholo se ne se le haufi le 50%: 4.5-57% Chaena [53], 40-43% naheng ea Taiwan [54] le Korea [55], le 9-53% Hong Kong [56]; ka lehlakoreng le leng, lithuto tse tsoang mekhatlong ea Bophirimela, ho kenyeletsoa United States [57], Engelane [58], Sweden [59], Jeremane [60], le Australia [61] hangata e tlaleha litheko tsa tlhahiso ea 80% kapa ho feta. Ka mokhoa o ts'oanang, ho sebelisa tšimolohong ea boitšoaro ba thobalano e le mohlala, tekanyo ea bacha ba nang le likamano tsa botona le botšehali ba sa le banyenyane (ke hore, ≦ 16 kapa ≦ 14) hangata e phahame sechabeng sa Bophirima ho feta Asia [62-64]. Ha ho fanoa ka liphapang tsena tse kholo, ho pheta liphetho ho tloha Bophirima ho ea tikolohong e bolokehileng ea Bochabela ho bohlokoa. Velezmoro le basebetsi-'moho [65] ba pheha khang ea hore ho ithuta puo ea botona le botšehali maemong a fapaneng a setso ho fana ka leseli le leholo mabapi le ho tšoana le ho fapana ha ketsahalo e tšoanang litsong tsohle. Ntle le moo, linaha tse ling tsa Asia li hlokofatsoa ke ho ata ha mafu a likobo, joalo ka sekhahla sa tšoaetso ea HIV har'a bacha ba China [53, 66] le Korea Boroa [67] ka bobeli HIV le mafu a mang a likobo (mohlala, gonorrhea) li maemong a holimo hofeta hara bacha le bacha ba baholo (11-29) naheng ea Taiwan [8]. Le ha ho entsoe liphuputso tse 'maloa' me li hlahisitse litholoana tse tšoanang, lithuto tsena le tsona li utloisitsoe bohloko ke meeli e boletsoeng pejana [68, 53-54].

Boithuto ba hona joale

Phuputso ena e sebelisitse tekanyetso ea IV le moralo oa sehlopha sa mosotho ho hlahloba kamano pakeng tsa ho pepeseha SEM bongoaneng le boits'oaro bo kotsi ba ho kopanela liphate ho ba motho e moholo. Re boetse ra hlahloba litlamorao tsa mekhoa e mengata ea SEM (mohlala, inthanete le filimi) mabapi le boitšoaro bo kotsi ba thobalano. Litlhatlhobo tsohle li entsoe ka ho sebelisa sampole e tsoang Taiwan, e leng sechaba se nang le boitšoaro bo matla; ke ka hona ho ka bonoang liphapang tse tšoanang le setso le liphapang [65]. Re ile ra kholoa hore ho pepesetsoa SEM ho amana le boitšoaro bo kotsing ba ho ba le thobalano le hore kamano e ka matlafala ha bacha ba sebelisa mekhoa e mengata ea SEM. Kamora nako, ka lebaka la hore bashanyana le banana ba ba le kholo e fapaneng holima mmele [69'me ba botsoalle ka mokhoa o fapaneng mabapi le boitšoaro ba thobalano [70], ntle le ts'ebetso e kholo, re boetse re arotsoe ke bong ho hlahloba phapang lipakeng tsa kamano ea SEM le boitšoaro ba thobalano ho banna le basali.

Lisebelisoa le mekhoa

Barupeluoa le moralo oa ho ithuta

Lintlha li nkuoe ho tsoa ho Project ea Bacha ea Taiwan (TYP), e leng patlisiso e neng e tla ba teng ea baithuti ba sekolo se phahameng ba tsoang litoropong tse peli (New Taipei City le Taipei) le setereke se seng (Yi-Lan County) e ka Leboea ho Taiwan se neng se thehiloe ka 2000. Sekolong se seng le se seng se khethiloeng, ho ile ha khethoa lihlopha tse peli ka tšohanyetso bakeng sa sehlopha se seng le se seng (7th sehlopha (J1) le 9th sehlopha sa (J3)), mme baithuti bohle sehlopheng se seng le se seng se khethiloeng ba ile ba ngolisoa. Ba neng ba nkile karolo mohloling oa motheo ba ne ba lateloa selemo le selemo ho fihlela ka 2009 (wave 9), leha maqhubu a mang a ne a sa lekane selemo se le seng. Ka selemo sa 2011, sehlopha sa lipatlisiso se bile le karolo ea 10, 'me se se se qetile lilemo tse tharo kamora ho latela (wave 11 ka 2014 le wave 12 ka 2017). Phuputso ena e hlahlobile sehlopha sa J1 (7th grade) data ho tloha ho wave 1 (basement; bolele age = 13.3 (SD = .49)) ho phahamisa lilemo tse 10 (ho bolela lilemo = 24.3 (SD = .47)).

Phuputso ena e hlahlobile J1 cohort (7th grade) data ho tloha ho wave 1 (basement; bolele age = 13.3 (SD = .49)) ho wave 10 (bolelang lilemo = 24.3 (SD = .47)). Hoo e ka bang halofo ea sampole e ne e le banna (51%). Boholo ba sampole ea ho hlahloba litekanyetso tsa thobalano tsa pele le thobalano e sa bolokehang e ne e le 2,054, athe balekane ba bangata ba thobalano e ne e le 1,477. Phapang ea boholo ba sampole e bakoa ke litefiso tse fapaneng tse sa arabeloang. Ho theoha ha mohlala ona ho etsahetse hobane nako e ne e le telele haholo (ke hore, lilemo tse peli le halofo lipakeng tsa wave 9 le 10) ha li bapisoa le maqhubu a pejana. Lintlha tsa motheo (wave 1) le data ea wave 2 (ke hore, ho pepesetsoa SEM) li ne li ipapisitse le tlaleho ea bacha ea boits'oaro; ka lehlakoreng le leng, tlhahlobo e tšoanang ea batsoali e sebelisitsoe thutong ea botsoali le chelete ea lelapa, e ileng ea etsoa ka lipotso tsa ka malapeng. Bakeng sa maqhubu a lithuto tsa rona tsa morao-rao (wave 8, 9, le 10), lipuisano ka lapeng li ile tsa etsoa ho bokella lintlha tsohle. Ho motheo (wave 1), bacha bohle ba ileng ba lumela ho nka karolo ba ile ba fana ka tumello ea molomo. Bakeng sa bacha bana ba nkileng karolo, e mong oa batsoali ba bona ba tlhaho kapa bahlokomeli ba molao ba fane ka tumello e ngotsoeng. Ntle le moo, ba ile ba memeloa ho nka karolo lipatlisisong tsena, 'me ba ka bang 97% ba ile ba nka karolo. Boithuto ba hajoale bo amohetsoe ke boto ea tlhahlobo ea kahare Univesithing ea Yang Ming (YM108005E) moo mongoli oa pele a sebelitseng e le setho sa lefapha la thuto ea bolumeli.

Mehato

Phatlalatso e pepesang ea thobalano (wave 2)

Phapang ena e lekantsoe ho wave 2 (e bolela lilemo = 14.3) o sebelisa potso e le 'ngoe: "Na o kile oa bona seea-le-moea se latelang sa batho ba baholo feela kapa se thibetsoeng (se lekantsoeng)?" Ba fuoe lethathamo la mekhoa e tšeletseng ea litaba: marang-rang, limakasine, libuka tsa metlae, lipale tsa lipale, lifilimi le tse ling. Ha a ntse a "batho ba baholo-feela" le "mecha ea phatlalatso ea R-rated" ke se hakaalo hore e ba ho kopanela liphate ha lintho tsa tlhaho ho Lichabeng tse ngata, mantsoe a sebelisitsoeng ho potso e ka Semandarin (Xian Zni Ji) e ne e tla utloisisoa sechabeng sa Taiwan ha e bua ka litaba tsa thobalano (mohlala, likamano tsa botona le botšehali le thobalano). Kahoo, ntho ena e hapile litaba tsa SEM tse reriloeng. Lintho tse amanang le ho pepesetsoa SEM le boitšoaro ba thobalano li ne li tebile; ka hona, barupeluoa ba kanna ba hana ho fana ka tlaleho. Ho qoba sena, tlhahlobo eohle ea TYP e ne e itlaleha mme e phethiloe ka phapusing ea baithuti moo ho neng ho le teng baithuti ba nkang karolo le bathusi ba sehlopha sa lipatlisiso. Barekisi ba lipatlisiso ba hlaloselitse baithuti hore ha ho motho e mong ntle le bafuputsi ba tla bona litaba tsa phuputso ea bona le hore lipatlisiso tsohle li sa tsejoe. Ho ile ha thehoa mefuta e 'meli e le ho ts'oara ponts'o ea SEM: ho bonts'a mekhoa e mengata le ho senoloa kamehla. Bakeng sa tsa pele, re balile palo ea mekhoa eo liithuti li ileng tsa pepesetsoa ho eona, kahoo lintlha li ne li tloha ho 0 (ho sa pepesehe) ho isa ho 6 (li sebelisitse mekhoa eohle e tšeletseng). Bakeng sa bobeli, barupeluoa ba ile ba aroloa ho ba SEM exposal (1) le ho se senoloe (0).

Boitšoaro bo bobe ba ho kopanela liphate (wave 8-wave 10)

Sena se ne se kenyelletsa mekhoa e meraro: pele ho thobalano, thobalano e sa sireletsehang, 'me balekane ba bangata ba thobalano. Qalo ea pele ea thobalano e ne e lekantsoe ho wave 8 (bolela lilemo = 20.3). E mong le e mong ea nkang karolo o ile a botsoa ho tlaleha lilemo tsa hae tsa thobalano ea pele. Ho lumellana ka hore na ke lilemo life tse nkoang li emela ho qaptjoa ha ho e-so fihle ho lingoliloeng, ka lithuto tse fapaneng tse sebelisang lilemo tse fapaneng joalo ka ba khaotsoeng, joalo ka motho ea lilemo li 14 kapa ho feta [71], Ea lilemo li 16 kapa ho feta [72-73], kapa le lilemo tse 17/18 kapa ho feta [74]. Ho latela lilemo tse sebelisitsoeng, liperesente tsa ba qalang ba qala ho tloha ho 17% [72] ho 44% [73]. Phuputsong e teng hona joale, lilemo tse 17 kapa ho isa tlase li sebelisitsoe joalo ka litheko, tse hlahisang liperesente tse ka bang 11.9% (n = 245) sampole e khethiloe e le ba qalang. Ho khaola hona ho na le moelelo tikolohong ea Taiwan ka mabaka a mabeli. Taba ea pele, lilemo tse 18 li nkuoa ka molao e le motho ea moholo. Ho feta moo, lehlabula la lilemo tse 18 ke nako e phahameng eo bacha ba ileng ba lahleheloa ke boroetsana ba bona hobane ba qeta sekolong se phahameng mme ba le haufi le ho kena koleche, e leng hona teng Korea Boroa moo thuto le setso li tšoanang [75]. Taba ea bobeli, liperesente tsa ho khaola hona ho haufi le sampole ea baemeli ho tsoa ho baithuti ba sekolo se phahameng (10th-12th grade), e bonts'ang hore ke hoo e ka bang 13% ea baithuti ba sekolo se phahameng ba kileng ba ba le likamano tsa thobalano [76].

Thobalano e sa sireletsehileng e ile ea hlahlojoa ho wave 8 ka potso ea tšebeliso ea likhohlopo nakong ea thobalano (ke hore, "Na u sebelisa likhohlopo ha u etsa thobalano?"). Likarolo tsa likarabo li kenyelletsa "ho hloka boiphihlelo," "ho sebelisa likhohlopo kamehla," "ka linako tse ling sebelisa khohlopo," le "ho se sebelise likhohlopo hangata." Barupeluoa ba ileng ba khetha likarabo tse peli tsa ho qetela ba nkuoa ba etsa thobalano e sa sireletsehang. Leha tekanyo ena e kanna ea fapana le mekhoa e sebelisoang hangata (mohlala, tšebeliso ea likhohlopo bakeng sa likamano tsa thobalano tsa morao-rao), e hapile tloaelo e tloaelehileng ea ba arabelitsoeng. Kahoo, e fane ka datha mabapi le ts'ebeliso e tloaelehileng ea khohlopo ho fapana le ts'ebeliso kapa ts'ebeliso ea morao-rao maemong a itseng. Kahoo, e nkile moelelo oa "'nete" oa boitšoaro bo sa bolokeheng ba thobalano. Ho ipapisitsoe le tekanyetso ena, liperesente tse tsa thobalano e sa bolokehang ea thobalano ke 18%.

Kamora nako, ho wave 10 (ho bolela lilemo = 24.3), barupeluoa ba ile ba botsoa palo ea bophelo ba bona ba baratuoa. Sena se ne se sebelisetsoa ho lekanya balekane ba bangata ba thobalano. Linomoro li tsoa ho 0 (ha ho na boiphihlelo ba thobalano) ho isa ho 25 (bolela = 1.76; SD = 2.46). Leha tekanyo ea boitšoaro bo kotsi ba thobalano e ka kenyeletsa boits'oaro bo fapaneng ba thobalano, boits'oaro bohle bo hlahlojoang hangata bo eketsa kotsi ea ho tšoaroa ke mafu a likobo. Kahoo, thuto ena e sebelisitse qalo ea thobalano ea pele, thobalano e sa sireletsehang, le balekane ba bangata ba thobalano e le mefuta e meraro ea boitšoaro bo kotsi ba thobalano. Phuputso e 'ngoe e fetileng e sebelisitse mekhoa ena e meraro [1] mme ba bang ba sebelisitse tse peli ho tsena tse tharo e le moleko oa boitšoaro bo kotsi ba thobalano [48]. Ntle le moo, likamano tsa thobalano tsa pele-pele le balekane ba bangata ba thobalano li amana le menyetla e phahameng ea thobalano e sa sireletsehang le tšoaetso ea mafu a likobo [77-78]. Le ha tekanyo ea rona e kanna ea se felle ka matla, e kenyelletsa boits'oaro ba bohlokoa ba boitšoaro ba thobalano bo kileng ba hlahlojoa lithutong tse fetileng.

Nako ea phatlalatso (wave 1)

Nako ea phatlalatso e ile ea hlahlojoa ho wave 1 (bolele lilemo = 13.3) ka ho itlaleha. Bakeng sa banana, lintho tse 'ne tse itlalehang tse tsoang ho Pubertal Development Scale (PDS) li ne li hiriloe [79]: Nts'etsopele ea moriri oa "pubic", ho fetoha ha letlalo, lilemo tsa ho ilela khoeli, le leqhubu la ho hola. Mekha ea likarabo e tsoa ho 40 (ha e so qale) ho isa ho 1 (e ntlafalitsoe ka botlalo). Banana ba ne ba arotsoe ka lihlopha tse tharo tsa nako ea likhatiso tse thehiloeng molemong oa ho kheloha tloaelo e le 'ngoe (SD) ho tsoa lenaneong la PDS le bolelang: (1) pele ho nako (1 SD kaholimo ho se boleloang), (2) morao haholo (1 SD ka tlase ho moelelo), le (3) ka nako. Bakeng sa bashanyana, re boetse re sebelisitse lintho tse tsoang ho PDS: phetoho ea lentsoe, nts'etsopele ea moriri oa "pubic", nts'etsopele ea litelu. Likarabo le morero oa sehlopha se ne se tšoana le sa banana. Mokhoa ona oa sehlopha o sebelisitsoe lithutong tse fetileng [80-81] le ho ts'epahala le ho nepahala ha PDS li tiisitsoe [82]. PDS e bonts'itsoe e fana ka tekanyo e loketseng ea ho kena bohlankaneng le ho ts'oara likarolo tsa boiketlo le boiketlo ba ntšetso-pele [83]. Leha ho le joalo, leha tekanyo ena e netefalitsoe lithutong tse fetileng, e kanna ea se khone ho hapa mohopolo o tšoanang ha e sebelisoa ka mokhoa oa setso. Lipatlisiso tse peli tse sa tobang li ka rarolla bothata bona. Taba ea pele, lingoliloeng li bonts'itse hore nako ea phatlalatso ea pejana e amana le bosholu le khatello ea maikutlo [84-85], le lithuto tse peli tse sebelisitseng lethathamo le tšoanang le la thuto ena li bonts'itse kamano ena [80, 86]. Taba ea bobeli, kabo ea lilemo tsa ho qala ho ea matsatsing a baemeli ba bacha ba Taiwan e ne e tšoana hantle le sampole ea moemeli oa naha: 82.8% pele kapa ka 7th sehlopha; thuto ea hajoale: 88% pejana kapa ho 7th sehlopha) [87]. Ka kakaretso, PDS e fana ka tekanyo e nepahetseng ea nts'etsopele ea lipapatso Taiwan. Bohlahlobisisong bo ileng ba latela, ho fapana lipakeng tsa PDS ho sebelisitsoe ho theha IV.

Lintho tse laoloang (wave 1 le wave 2)

Phuputso e teng hona joale e laoloe bakeng sa ba bang ba bangata ba ferekanyang: bong [88], boemo ba thuto ea bo-ntate, boemo ba thuto ea bo-mme [89], chelete ea lelapa ea khoeli le khoeli [90], ho ba le mathata a lelapa [91]92], taolo ea batsoali [93], kopanelo ea lelapa [94], ts'ebetso ea thuto [95], bophelo bo botle bo ikatisang [96], matšoao a sithabetsang [97], likamano tsa lerato [98], le sephetho se tsitsitseng sa sekolo [99]. Phapang e 'ngoe le e' ngoe e fumanoe e amana le thobalano ea lilemong tsa bocha kapa SEM le boitšoaro bo kotsi ba thobalano. Mohlala, lintho tse amanang le lelapa (mohlala, taolo ea batsoali le tšebelisano) li nkile monyetla oa hore lelapa le batsoali ba phethe karolo ea bohlokoa ho susumetseng boitšoaro bo bobe ba bacha (ke hore, ho pepesetsoa SEM le boitšoaro bo kotsi ba thobalano). Ka mokhoa o ts'oanang, joalo ka ha ho boletsoe kaholimo, taolo ea mathata a sechaba e ka fokotsa boitšoaro bo sa tloaelehang ba bacha, joalo ka ts'ebeliso ea SEM le boits'oaro bo kotsi ba thobalano. Ntle le moo, maikutlo a ho ithuta sechabeng a ka pheha khang ea hore bana ba motho le litlamorao tsa lithaka ba bapala karolo ea bohlokoa ea kheloho nakong ea bocha le ho ba motho e moholo ea tlang [100]; ka hona, re laola le palo ea bana ba motho. Lintho tse ling (mohlala, sekolo) li ka etsa tikoloho eo ho eona bacha ba fumanang litlatsetso tse fapaneng tse ka amang boits'oaro ba bona (mohlala, thuto ea thobalano). Mefuta eohle e fapaneng e ile ea hlahlojoa ho wave 1 kapa 2. Adolescent tekano e ne e ngotsoe joalo ka e motona (1) kapa e tšehali (0). Ka bobeli ntate 'me thuto ea bo-mme maemo a ne a tsoa lipatlisisong tsa botsoali ho wave 1 mme a fuoe lintlha ka mekhahlelo e meraro: tlase ho sekolo se phahameng, sekolong se phahameng, le kolecheng ea junior kapa ka holimo. Bohlahlobisisong bo latelang, ho sebelisitsoe mefuta e 'meli ea dummy e nang le "tlase ho feta sekolo se phahameng" e le sehlopha sa litšupiso. Chelete ea khoeli le khoeli ea lelapa, e lekantsoe ke wave 1 ho tsoa tlhahlobisong ea botsoali, e arotsoe ka lihlopha tse hlano (ho ipapisitsoe le lidolara tse ncha tsa Taiwan): tlase ho 30,000, 30,000-50,000, 50,001-100,000, 100,001-150,000, le tse fetang 150,000. Ka mokhoa o ts'oanang, mefuta e mene ea li-dummy e sebelisitsoe ka "tlase ho 30,000" e le mokoloto oa litšupiso. Ho tiea ha lelapa e ne e le phapang ea dichotomized ka ho se tsitse ha sehlopha sa liphatlalatso, se neng se thehiloe holim'a wave 2 ea ho itlaleha. Mehato eohle ea ngoan'eno e ne e ipapisitse le tlaleho ea bacha ea ho ithaopa ho ba 1 mme e kenyelelitse palo ea bana ba motho e mong le e mong ea nkang karolo le taelo ea ngoana ka mong ea tsoalo. Ho tsoa tlhahisoleseling ena, re bōpile palo ea banab'eno 'me boteng ba bana beso ba holileng. Tse latelang li ne li kenyelletsa lihlopha tse tharo: ngoana a le mong, e, 'me che (sehlopha sa litšupiso). Tataiso ea batsoali e ne e ipapisitse le lintho tse 5-dichotomised tse ileng tsa botsa bacha hore na batsoali ba bona ba laola liketso tse hlano tsa letsatsi le letsatsi (mohlala, nako ea tšebeliso ea mohala le nako ea TV). Likolo tse phahameng li bontšitse taolo e phahameng ea batsoali. Momahano ea lelapa e ne e ipapisitse le likotoana tsa lintho tse ts'eletseng tse ananelang thuso ea lelapa le maikutlo a lerato (mohlala, "ha ke le fatše, nka khothatsoa ke ba lelapa leso"). Ntho e 'ngoe le e ngoe e ne e thehiloe sekaleng sa likert tsa 4, (ke hore, "hana haholo" ho "lumellana ka matla"). Likolo tse phahameng li bontšitse tšebelisano-lelapa e phahameng. Mosebetsi oa thuto e ile ea hlahlojoa ka potso e reng, "Sehlopha sa hau sa semaraka se joang?" Likarolo tsa karabo e ne e le 1 (holimo 5), 2 (6-10), 3 (11-20), le 4 (tse fetang 21). Boemo ba bophelo e ne e ipapisitse le bophelo bo botle bo ikhahlang ka mefuta e mehlano ea karabelo. Re ile ra arola batho ka mekha e meraro: e mpe / e mpe haholo (sehlopha sa litšupiso), e hlokang leeme, ebile e ntle / e ntle haholo. Matšoao a sithabetsang e ne e le litekanyetso ho lintlha tsohle tse 7 tse nyahamisang (mohlala, "Ke ikutloa ke sithabetse maikutlo"), e ileng ea amoheloa ho tsoa ho Sy Symbom Checklist-90-Revised (SCL-90-R) [101]. Ntho e 'ngoe le e' ngoe e ne e thehiloe sekaleng sa lintlha tse 5 (ke hore, che (0) ho e, 'me e tebile haholo (4). Kakaretso maemong ohle a supileng e ile ea sebelisoa ho bala kakaretso. Phihlelo ea ho laetsana e ne e thehiloe nthong e le 'ngoe, e ileng ea botsa bacha hore na ba na le moshanyana / kharebe. Kamora nako, lintho tse sa hlokeng sekolo li ile tsa laoloa ke ho kenyelletsa sephetho sa sekolo se tsitsitseng tlhahlobisong e latelang (lipalo-palo tse hlalosang bakeng sa lintho tsohle tse fapaneng li ka fumanoa ho Lethathamo 1).

ponahalo e nyane

Lethathamo 1. Lipalo-palo tse hlalosang bakeng sa lintho tsohle tse fapaneng.

https://doi.org/10.1371/journal.pone.0230242.t001

Tlhahlobo ea statistical

Mokhoa o ka sebelisoang oa ho leka ho sebelisa (LPM) o thehiloeng ho sekhechana se tloaelehileng (OLS) o ile oa sebelisoa ho hakanya litlamorao tsa ho senoloa ha SEM (ho pepeseha le ho pepesetsoa hoa maemo a mangata) nakong ea bocha ba lilemong tsa bocha tsa boitšoaro bo bobe ba thobalano. Ha kopano bakeng sa liphetho tsa rona e kanna ea sebelisa mokhoa oa logit / probit bakeng sa dichotomised (ke hore, thobalano ea pele ea thobalano le thobalano e sa bolokehang) le Poisson bakeng sa palo e fapaneng (ke hore, balekane ba bangata ba thobalano), re sebelisitse OLS ka mabaka a 'maloa. Khetlo la pele, Hellevik [102] e bonts'itse hore LPM e haufi le mohlala oa logit ka lits'ebetsong tse ngata empa e na le monyetla oa hore ho be bonolo ho e hlalosa. Taba ea bobeli, mohlala o ka sehloohong o matla pampiring ke likhetla tse peli tse bonyane mekhahlelo e 'meli (2SLS) e leng mehlala e fapaneng. Ka hona, tlhahlobo ea boiphetetso e sebelisa mehlala ea "regression regression" kapa mehlala e bonolo bakeng sa papiso ho etsa hore ho be bonolo ho bapisa. Ha li-covariate tse ngata li ne li laoloa bakeng sa, phello e hakantsoeng e kanna ea ba le leeme ka lebaka la lintho tse fapaneng tse sa hlakang. Kahoo, ho fumana tekanyo e sa fetoheng, e sa ts'oaroang ea litlamorao tsa ho pepesetsoa ha SEM ka boitšoaro bo kotsi ba thobalano har'a bacha, mokhoa oa 2SLS ka nako ea nako ea phatlalatso ha IV e sebelisoa.

Phapang lipakeng tsa nako ea selemo bakeng sa cohort e le 'ngoe (boemo1i le pubertal2i) e sebelisetsoa ho sebelisoa ha SEM exposal (ysem,i) mohatong oa pele, o laoloa ke litšobotsi tsa motho ka mong (Xi) le likotsi tse tsitsitseng tsa sekolo se phahameng sa boemo bo phahameng (ai0): (1) moo ysem,i e itshetlehile ka ho pepeswa ha maemo a mangata a SEM le ho pepeswa ha SEM, ka ho latellana; kotara vi ke polelo ea phoso. Kamano lipakeng tsa nako ea pubertal le tlhahiso ea SEM e lokela ho ba tse ntle. A F tlhatlhobo e kopaneng e sebelisoa bakeng sa ho leka tšibollo ea maiketsetso ea hore li-coefficients tse ho liletsa (ke hore, nako ea phatlalatso) kaofela ke zero. Ha e tsamaellana F-statistic e feta 10, ebe lisebelisoa li matahantsoe haholo le tlhahiso ea SEM.

Karolo ea bobeli ea tekanyo e hakanya phello ea ho pepesetsoa ha SEM bongoaneng ba bonyatsi mabapi le boitšoaro bo kotsi ba thobalano (ykotsi ya ho etsa thobalano) ka ho ba motho e moholo ea holileng: (2) moo ykotsi ya ho etsa thobalano ke boitšoaro bo kotsing ba ho etsa thobalano ho batho ba pele ba thobalano, thobalano e sa sireletsehang, le palo ea balekane ba thobalano ka ho latellana; semelo sa motho ka mongXi) le likotsi tse tsitsitseng tsa sekolo se phahameng sa boemo bo phahameng (ai0) li tšoana le tse kenang Eq (1) le phapano ea tlhaho ea (2) ke tlhahiso ea SEM (ysem,i). Re tla hakanyetsa litla-morao tsa SEM-pono le mefuta e mengata ea SEM mabapi le boitšoaro bo kotsi ba thobalano (lihlahlobo tsohle tsa pele li ka fumanoa ho S1 Sehlomathiso).

Nako ea phatlalatso e thehiloe e le IV, kaha e phethahatsa litlhoko tse peli tsa mantlha tsa li-IV tse sebetsang: bohlokoa le exogeneity [103]. Ea pele e hloka hore IV e amanang haholo le kalafo (ke hore, SEM exposal). Ho kena bohlankaneng ho bontšoa ke ho phahama ha li-hormone, 'me liphuputso li bontšitse hore ho pepesetsoa SEM ho atile nakong ea bohlankana. Ka hona, batho ba nang le bocha ba banyane ba na le monyetla oa ho pepesetsoa SEM ho feta balekane ba bona, mme sena se tšehelitsoe ke lithuto tse ngata [104-105]. Tlhokahalo ena e kanna ea netefatsoa ka lipalo ka F-F > 10) sethaleng sa pele sa 2SLS [106]. Exogeneity, ka lehlakoreng le leng, e hloka hore IV e senoloe le polelo ea phoso ho equation equation. Taba ea pele, nts'etsopele ea "pubertal" ke ts'ebetso ea likokoana-hloko e batlang e le batho bohle. Ntlafatso ena e susumetsoa ke liphatsa tsa lefutso le tikoloho eo batho ba se nang taolo ho eona [107]. Mohlala, liphuputso tse entsoeng ka mafahla li bontšitse hore liphesente tse 50-80 tsa phapang ea nako ea ho ilela khoeli li hlaha ka lebaka la liphatsa tsa lefutso mme tse setseng li ka hlahisoa ka tikoloho e sa arolelanoang kapa phoso ea tekanyo [108-109]. Bakeng sa tsa morao-rao, joalo ka ha ho bonts'itsoe kholomong ea ho qetela le tlase ea Lethathamo 1, pampiri e hlahloba khokahano e ka bang teng lipakeng tsa nako ea liphatlalatso le lisebelisoa tsa boiketlo ba sechaba mme ha e fumane kamano e kholo pakeng tsa nako ea phatlalatso le lisebelisoa tse ling tse bonoang tsa maemo a bophelo (mohlala, boemo ba motsoali ba thuto le chelete ea lelapa ea khoeli le khoeli). Ntle le moo, mabaka a mangata a tikoloho (mohlala, sekolo le ba lelapa) a ne a laoloa bakeng sa litlhahlobo, tse ka fokotsang letsoalo la khethollo e fapaneng. Ka hona, li-IV li lokela ho ba le monyetla oa ho se kopane le mabaka afe kapa afe a sa bonts'itsoeng a ileng a beha boitšoaro bo kotsi ba thobalano. Ntle le moo, mohlala o hakantsoeng o kenyelletsa li-IV tse peli (mefuta e 'meli ea dummy). Teko e bontšang ka ho fetesisa (liteko tsa J-test) kapa tlhahlobo ea Sargan-Hansen [110] e ka fana ka tlhahlobo ea lipalo ea hore na litla-morao tsa kalafo tse lekantsoeng li lumellana hakae tekanyetsong ea 2SLS.

Le ha moralo o sebetsang oa IV o ka fana ka likhakanyo tsa ho ts'oaroa, ho hohela kapa ho lahleheloa ke datha ho ntse ho ka lekanya likhakanyo tsena. Phuputso ena e sebelisitse mekhoa e mengata ho hlahloba khethollo e ka bang teng. Taba ea pele, mohlala oa rona oa ho hlahlobisisa o ne o ipapisitse le ba nang le tlhaiso-leseling ka tšebeliso ea SEM ho wave 2; sekhahla sa tlhaiso-leseling sa tlhaiso-leseling bakeng sa mefuta eohle e meng e hlalosang le kenyelletso ea lisebelisoa (nako ea phatlalatso) e ne e le tlase haholo (Bona. Lethathamo 1). Ka lebaka leo, tlhaiso-leseling e haellang lehlakoreng le letona la letsoho le letšehali lithutong tse latelang tsa tlhahlobo e kanna ea se be bothata bo tebileng. Taba ea bobeli, karolo ea tlhaiso-leseling e lahlehileng litabeng tsa boitšoaro bo bobe ba thobalano e ne e se tlase joalo: 20% (514 / 2,568) bakeng sa bohlatso ba thobalano le ba sa sireletsehileng ba thobalano le 42% (1,091 / 2,568) ho balekane ba bangata ba thobalano. Boholo ba ya data e sieo ke ka lebaka la ho hohela. Bakeng sa ba sa kang ba araba lipotso tse peli tsa pele tse neng li le kotsing ea ho etsa thobalano (ho bolelang, litšebelisano tsa pele tsa thobalano le tšebeliso e sa ts'oaneng ea likhohlopo), re ile ra kenya letsoho ntho e ngoe le e ngoe ka ho sheba tlaleho ea bona nthong e le 'ngoe ho wave 9 kapa wave 10. Leha ho le joalo, bakeng sa balekane ba bangata ba thobalano. , re akhetse ba sa kang ba fana ka karabo. La boraro, re bapisitse kabo ea sampole e boletsoeng le sampole ea mantlha mabapi le nako ea nako ea phatlalatso, tlhahiso ea SEM, le mefuta eohle ea taolo (bona Lethathamo 1). Joalokaha re ka bona, phapang ea moelelo le SD lipakeng tsa disampole tse fapaneng tse boletsoeng le sampole ea mantlha mabapi le mefuta eohle e sebelisitsoeng e ne e le nyane feela. Kamora nako, mokhoa oa ho khetha oa Heckman o ile oa sebelisoa ho bona hore na ho hohela ho amana le boitšoaro bo kotsi ba thobalano. Mohlaleng ona, re sebelisitse lintho tse 'ne e le lithibelo tse kathoko: mofuta oa bolulo (mohlala, ho lula ntlong e le' ngoe kapa foleteng), re rata sebaka seo re lulang ho sona hona joale, polokeho ea baahisani (mohlala, "Na u nahana hore sebaka sa heno se bolokehile?" ), le palo ea lilemo tse lulang atereseng ea hajoale. Liphetho li ka fumanoa ho Lethathamo 2. Ho tloha karolong e ka tlase ea Lethathamo 2, motho a ka fumana hore liteko tsa Wald li bonts'itse hore kamano pakeng tsa ho khahla sampole le boitšoaro bo kotsi ba thobalano ha e bohlokoa mehlaleng eohle (ke hore, litekanyetso tse peli li ikemetse ka bomong). Ka mantsoe a mang, khaello ha e amane le liqeto tsa ho etsa boitšoaro bo bobe ba thobalano. Liteko tsena tse eketsehileng li fane ka kholiseho ea hore tlhaelo-leseling e haellang mabapi le mefuta ea sephetho e ka ba e sa reroang. Ka lebaka leo, likhakanyo tse hlahisitsoeng ha lia ka tsa ts'oaroa empa ka litšenyehelo tsa tahlehelo ea tlhaiso le matla hobane liphoso tse tloaelehileng li ne li lula li le kholo ho feta likhakanyo tse thehiloeng ho datha e felletseng. Liteko tsohle tsa lipalo-palo li ne li thehiloe litekong tse peli tsa mahlakore a mahlano ka liphoso tsa maemo a holimo tsa heteroskedasticity-robust tse fetotsoeng bakeng sa ho kopanya sehlopheng sa sekolo se phahameng sa junior mme li entsoe ka software ea Stata (Stata 2; Stata Corp, Setsi sa Kholo, TX).

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Tafole ea 2. Mefuta ea likhetho bakeng sa kamano lipakeng tsa sephetho sa thobalano se sa lahleheng le se kotsi1.

https://doi.org/10.1371/journal.pone.0230242.t002

Results

Lipalo-palo tse hlalosang

Joalokaha ho bontšitsoe Lethathamo 1, hoo e ka bang halofo ea ba lilemong tsa bocha (50%) ba ile ba pepesoa ke SEM bongoaneng, ka tekanyo ea boits'oaro bo le bong (M = 1.02; SD = 1.37). Mokhoa o tloaelehileng ka ho fetesisa e ne e le libuka tsa metlae (32.7%) mme tse nyane tse tloaelehileng e ne e le limakasine (9.4%). Kakaretso, leha ho le joalo, ho ata ha boits'oaro bo kotsi ba thobalano e ne e le tlase: qalo ea thobalano ea pele, 11.9%; thobalano e sa sireletsehang, 18.1%; karolelano ea nako balekane ba thobalano e ne e ka ba 2. Ho se tšoane ka bong ho fumanoe ka mekhoa e 'meli ho e meraro e kotsi ea ho etsa thobalano. Ntle le moo, ea bohlokoa tLiphethot = -3.87; p <.01) e bonts'itse hore banna ka karolelano ba na le balekane ba bangata ba thobalano (M = 1.99) ho feta basali (M = 1.51). Joalokaha ho ka bonoa, mokhoa o tloaelehileng oa SEM e ne e le libuka tsa metlae (32.7%), tse lateloang ke lifilimi (22.7%). Ho makatsang ke hore ke 18.5% feela ea bacha ba sebelisang Marang-rang ho sheba SEM. Liphuputso tse ling li bonts'itse hore bashanyana ba bangata ba sebelisitse mofuta o mong le o mong oa SEM ho feta banana, ntle le mokhelo o le mong: banana (22.5%) ba pepeselitsoe libuka tsa lipale ho feta bashanyana (13.7%). Ho feta moo, tLiphethot = -7.2; p <.01) e bonts'itse hore ka karolelano bacha ba batona ba ne ba sebelisa mefuta e mengata ea SEM ho feta bacha ba basali.

Ho pepesetsoa litaba tsa thobalano le boitšoaro bo kotsi ba thobalano

Ho fumana ho sa fetoheng (bona Setšoantšo sa 1A le 1B) e ne e le hore ho pepeseha ha SEM bongoaneng ho ne ho amana haholo le boits'oaro bo kotsi ba ho ba le thobalano lilemong tsa bocha. S2 Sehlomathiso). Ka ho khetheha, ka Setšoantšo sa 1A le 1B, sephetho sa litekanyetso tsa 2SLS li senotse hore ho amanang le balekane ba bona, bacha ba pepesetsoeng SEM bongoaneng ba ne ba le 31.7% le 27.4% ba le monyetla oa ho etsa boitšoaro ba thobalano pele ba lilemo tse 17 le ho etsa thobalano e sa sireletsehang. Ntle le moo, bacha bana ba ne ba e-na le balekane ba bararo kapa ho feta ba thobalano ka lilemo tse 24. Liphetho tse hakantsoeng tsa mehlala ea 2SLS li ne li le makhetlo a 2.8 ho isa ho a 5.7 ho feta tsa litekanyetso tsa OLS.

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Feiga 1. Litlamorao tsa mantlha tse tsoang ho litholoana tsa OLS le 2SLS.

(a) Monyetla o eketsehang oa thobalano ea pele ho tsa thobalano le thobalano e sa sireletsehang, le palo e eketsehang ea balekane ba thobalano ho tsoa ho pepesheneng ha SEM bakeng sa sephetho sa bobeli sa OLS le 2SLS (b) Ho eketseha ha monyetla oa thobalano ea pele le thobalano e sa sireletsehang, le palo e eketsehang ea thobalano. Molekane bakeng sa ho pepesetsoa SEM bakeng sa sephetho sa bobeli sa OLS le 2SLS.

https://doi.org/10.1371/journal.pone.0230242.g001

Joalokaha ho bontšitsoe ho Lethathamo 3, litlamorao tsa ho pepesoa ha SEM ka mekhoa e mengata ea boitšoaro bo botle ba ho kopanela liphate le tsona li ne li le matla. Bacha ba ne ba le 12.3% le 10.8% ho feta tekano ea ho etsa thobalano ea pele ho tsa thobalano mme ba kenya letsoho thobalanong e sa sireletsehang, ka nako eo, ha ba ne ba shebella mekhoa e le 'ngoe kapa tse ngata tsa SEM nakong ea bocha ba bongoaneng ha ba bapisoa le ba sa boneng SEM efe kapa efe. Ho tšoenyang haholo ke hore boits'oaro bo bong le bo bong nakong ea bohlankana bo ile ba lebisa ho, ka karolelano, molekane e mong hape oa thobalano nakong ea bohlankana. Kameho ea mekhoa e mengata ea SEM e ka utloisisoa le ho feta ke Setšoantšo sa 2 moo re bonts'a menyetla e fapaneng ea ho ba le thobalano ea pele le thobalano e sa sireletsehang le balekane ba bangata ba thobalano (ho palo e haufi) ho 1 (bolela), 2 (1 SD), 4 (2 SD), le 6 (tse phahameng ka ho fetisisa) mekhoa e metle. From hlakileng e, mokhoa ho bontša ka ho hlaka hore ho pepesehela haholoanyane ile amanang le kgonego e phahameng ea boitšoaro le kotsi ea ho kopanela liphate 'me palo e khōlō ea bao ho sebedisanwang thobalano. phapang ne le bitsoa pakeng tsa li bolela'ng (1 bokgoni fela) le feteletseng (6 bokgoning). The 2SLS diphopholetso ne 2.3 ho 3.4 ka makhetlo a kholoanyane ho feta ba OLS ba ne ba. Sephetho ho tswa hodimo ne e lumellana le bao e leng ba lithuto tsa mehleng eo fumanoa SEM kgahlamelo ya maqhubu a e amanang le maitshwaro a sa tšoaneng kotsi thobalano [20, 41-43, 56-57].

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Setempe sa 2. Litlamorao tsa ho pepesetsoa mekhoa e mengata ka tsela e fapaneng holima monyetla oa boitšoaro bo kotsi ba thobalano le balekane ba thobalano.

https://doi.org/10.1371/journal.pone.0230242.g002

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Lethathamo la 3. Liphello tsa ho pepesetsoa ha mekhoa e mengata ea SEM litlamorao tsa likotsi tsa thobalano.

https://doi.org/10.1371/journal.pone.0230242.t003

Leha SEM kgahlamelo ya maqhubu a ile substantively amanang le maitshwaro hamorao kotsi ho kopanela liphate, le litla hakanngoa ka feela ho ea moo e le hantle, ka karolelano kalafo (morao) ho ena le ka karolelano e le hantle kalafo (e ja) [111], ka lebaka la hore litlamorao tsa kalafo tse lekantsoeng li tla sebetsa ho barekisi feela (ke hore, ba holileng tsebong ba neng ba boetse ba ja SEM), eseng ho bohle ba nkang karolo, ba sebelisa mokhoa oa hona joale oa lipalo. Ho rarolla taba ena, dikai ba ne ba e lekantsoeng ke qobella foromo tshebetso e le hore ho phekoloa hantle, phello ka 'na ka etsa kōpo ea ho barupeluoa ba tsohle (mohlala, e bivariate Probit ea mohlala bakeng sa leha e le neng-pepesehela polygonal le jwa dipoelothuto dichotomized). Joalokaha ho bontšitsoe Lethathamo 4, liphetho li bonts'a hore litlamorao tsohle tsa ho pepesoa ha SEM ka boits'oaro bo kotsi ba thobalano li lula li le bohlokoa, leha boholo bo fokotsoe hanyane.

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Lethathamo la 4 Litekanyetso tsa sebopeho se senang marang-rang bakeng sa litlamorao tsa SEM liphellong tse kotsi tsa thobalano1.

https://doi.org/10.1371/journal.pone.0230242.t004

Kamora ho netefatsa phello e kholo, thuto ena e ile ea sekaseka litlamorao ka ho kheloha ke bong. Ha liphetho li lula li ts'oana ka lehlakoreng le leng, boholo bo ne bo le tlase bakeng sa lihlopha tsohle tsa bong. Bakeng sa bashanyana, liphetho li ile tsa lula li tšoana; ke hore, ho pepesehela pele ho nako e SEM le bokgoning ho feta eo bashanyana ba lilemong tsa bocha ba senoloa, le ho feta ka etsahala hore ebe ba ne ba ho ba le likamano tse pele ba ho kopanela liphate, mathoasong a 'me ke balekane ho feta ho kopanela liphate. Ka lehlakoreng le leng, liphello tsa tse tšehali kaofela fokotseha ho maemo nonsignificant ntle mathoasong a qalo ho kopanela liphate. Ka mantsoe a mang, ho pepesetsoa SEM le ho pepesetsoa mekhoa e mengata ea SEM ho matlafalitse monyetla oa likamano tsa botona le botšehali bakeng sa bacha ba basali ba leboea ho Taiwan. Leha ho le joalo, motho o tlameha ho lula a hopola hore litlamorao tsohle li ne li ntse li le tseleng e nepahetseng (ke hore, litlamorao tse ntle). Fuoa fokotswa sampole boholo, le fokotseha ka boholo ho ne ho lebeletsoe (See S3 Sehlomathiso).

Puisano

lithuto tse ngata li tlaleha hore ho pepesehela pele ho nako e SEM ka 'na ba le tshusumetso e mpe a sa tšoaneng ka tsoelo-pele ea boitšoaro bo kotsi ba ho kopanela liphate. Boitšoaro bo kotsi ba thobalano bo hokahane le mathata a 'mele (mohlala, boimana bo sa batleheng le mafu a likobo) le mathata a kelello (mohlala, khatello ea maikutlo). Ho feta moo, litaba tse amanang le tsa thobalano ho kenyelletsa boitšoaro ba thobalano le ho pepesetsoa SEM li ka fapana litsong tsohle; ka hona, ho utloisisa likamano tse joalo litsong tse nang le boitšireletso ho ka fana ka temohisiso e eketsehileng kamanong ena. Ntle le moo, ho fanoa ka keketseho ea mafu a likobo le ho ima ha bacha lilemong tsa Asia tse ngata [53, 66-67] le mohala oa WHO mabapi le bophelo ba bacha ba lefatše la ho ba le bana [112], ho utloisisa kamano ho ka hlakisa mekhoa ea thibelo. Litlhahlobo tsena tsa bohlokoa hammoho le meeli e meng ea lithuto tsa nakong e fetileng (mohlala, litekanyo tse lekanyelitsoeng tsa SEM le boits'oaro bo kotsi ba thobalano le mekhoa ea mekhoa), li bonts'itse hore lipatlisiso tse eketsehileng tsa ho pepesoa ha SEM le boitšoaro bo kotsi ba thobalano li loketse. Morero oa thuto ena e ne e le ho aha nyeoe e matla bakeng sa kamano pakeng tsa ho pepesetsoa SEM le boitšoaro bo kotsi ba thobalano, 'me ka nako e ts'oanang ho hlahloba litlamorao tsa ho pepesoa ha SEM ka mekhoa e meraro e mebe ea thobalano. Ntle le moo, thuto ena e boetse e hlahloba kamano ena sechabeng seo e seng sa bophirimela.

Liphello tsa ho ithuta sena li ne li thehiloe ho e IV fopholetsa ea mohlala eo tsejoa e le e bakang joaloka phello ea SEM kgahlamelo ya maqhubu a ka boitšoaro bo kotsi ba ho kopanela liphate (bonyane bakeng sa compliers). Ka mantsoe a mang, batho ba holileng tsebong ba neng ba pepesehetse SEM le bona ba ne ba na le menyetla ea ho etsa thobalano e kotsi. ditshekatsheko rona ka linako tsohle o ile a bontša hore mathoasong a SEM pepesehela (8th sehlopheng) e amanang le maitshwaro le kotsi ea ho kopanela liphate ka ho hlahella ba motho e moholo ho akarelletsa le qalo, mathoasong a ho kopanela liphate, thobalano e sa sireletsehang, 'me bophelong ho sebedisanwang multiple thobalano. Leha ea mohlala unadjusted (mohlala, kamehla bofokoli ea mohlala) le 2SLS bofokoli bobeli o ile a bontša liphello tsa bohlokoa tsa mathoasong a SEM kgahlamelo ya maqhubu a ka boitšoaro boo hamorao kotsi ho kopanela liphate, ho magnitudes ya tsohle coefficients hakanngoa ne ba le matla ka dikai le 2SLS. Kahoo, seo a se fumaneng tsa ho ithuta ona ha feela pheta tsa ba lithuto tsa fetileng empa a boela a senola hore kamano ena e ke substantive. liphetho tsena ba ne ba ka utloisisa ho tloha ditebo pedi mogopolofela. Pele, khopolo ho ithuta ea sechaba [113] e pheha khang ea hore boitšoaro bo ithutoa ka boiphihlelo bo ikhethileng, boiphihlelo bo tsoang ho ho shebella ba bang (ke hore, mohlala) le ts'ebetso e rarahaneng ea tlhokomeliso (ke hore, ho boloka le ho sebetsana le leseli). Bacha ba “bona” boitšoaro ka SEM 'me ba ithuta ho e etsa. Li ka boela tsa boloka le thulaganyo lesedi ithutileng sona SEM (mohlala, litlhaloso kapa liphello tsa boitšoaro ba a), ka tsela eo e ntseng e eketseha kapa aa fokotseha monyetla oa bona oa ho ithuta le ho sebelisa boitšoaro bo amanang. Ka ho tšoanang, Wright o fumana, Tshebediso ya, le kopo (AAA) ea mohlala [114] e hlalosa hore bacha ba ithuta lingoloa tsa thobalano ka ts'ebetso ena e meraro: e leng, ba sheba le ho fumana lingoloa ho tsoa mecheng ea litaba, 'me ho tloha ka nako eo ho pepesehela litekanyetso tse tšoanang tsa tikoloho ho tla nyolla mangolo a ithutileng ("ts'ebetso"). Ha liphello tsa boitšoaro bo sa scripted ba Keepsake ke mecha ea litaba e le ntle haholoanyane ho feta mpe, batho ba ka 'na ho feta ho sebelisa ngotsoeng.

Ntle le phumaneho e akaretsang (mohlala, sebali se sa bonahatse) eseng, re boetse ra nka mekhoa e mengata ea ts'ebeliso ea SEM hobane Morgan [31] ba pheha khang ea hore tekanyo e joalo ea ts'ebeliso ea SEM e bohlokoa. Liphetho tsa rona li bonts'itse hore mekhoa e mengata ea ts'ebeliso ea SEM nakong ea bohlankana e boetse e amana haholo le boits'oaro bo kotsi ba thobalano. Ka mantsoe a mang, ho bokgoning ho feta tsa SEM ho eo e 'ngoe e pepesa, kgonego e phahameng ea ho kopanela boitšoaro bo kotsi ba ho kopanela liphate ka ho hlahella batho ba baholo. Liphetho li tsamaellana le mohopolo oa bobeli oa ho ithuta [113] le AAA [114] Model hobane kgahlamelo ya maqhubu a ho feta tla pepesang mengolo ithutile le hlalosoang e tšoanelang ea boitšoaro ka tsela e tšoanang ka SEM. Ha litekanyetso tse ngata tsa ts'oaetso li sebelisoa ts'ebetsong ea khafetsa kapa matla a pepesetsong boitšoaro, lingoliloeng tse ling tsa pejana li holisa kamano ena ho bokella boiphihlelo bo bobe ba mefuta e fapaneng [115-116]. Ka ho khetheha, Felitti [115] et al a pheha khang ea hore liphetho tsa bona e ne e le litla-morao hobane batho ba nang le mefuta e fapaneng ea likhathatso tsa bongoana ba na le bophelo bo tlase (mohlala, bophelo bo tlase ba kelello).

Qetellong, ha feela hore mefuta tshebetso nahana ka e hlahloba ka ho eketsehileng e ne e nepahetse, liphetho tsa rōna li ne li le haufi haholo ho ja, eo ha joale ke phapang e bolela'ng ha ea boitšoaro kotsi thobalano lipakeng tsa tšoaroa (SEM kgahlamelo ya maqhubu a) le untreated (bao e seng ho pepesehela ) batho ka kakaretso ho palo eohle ea batho, eseng feela phello e tloaelehileng ea kalafo bakeng sa tlatsetso (ke hore, barekisi). Sena se re fa tšepo ea hore ho pepesehela SEM kapele ho ka ba kotsi bophelong ba motho ba ho ba le bana mme litlamorao tse joalo li qetella li fetoha batho ba baholo.

Leha phello ea rona ea mantlha e ne e le bohlokoa ebile e le matla, litlamorao ha lia ka tsa omnibus ha li ne li aroloa ke bong. Ha a ntse a liphello ho fetisisa e ne e le ka tsela e tšoanang ka ho ya ka tataiso le boholo, feela qalo mathoasong a thobalano 'me ke balekane multiple thobalano ne bohlokoa bakeng sa bashanyana le qalo, mathoasong a ho kopanela liphate ho banana. Liphetho tsena tse sa reng letho li ka bakoa ke ho hloka matla. Phapang e khōlō bakeng sa banana ba ka 'na boela ho amanang le lintlha tse ling tsa bohlokoa. Mohlala, sechabeng sa bapatriareka (mohlala, Chaena, Taiwan le US), maemo a bosoasoi ba bong bo tebile haholo. Ka hona, ha ho pepesetsoa SEM ho ka baka likamano tsa thobalano pele ho lilemo tse tharo ho isa ho tse nne hamorao, sekhobo sa boitšoaro bo bobe ba thobalano (ke hore, balekane ba bangata ba thobalano) le ho haella ha matla a puisano ea ts'ebeliso ea ts'ireletso li ka fokotsa litlamorao tsa SEM.

Ka kakaretso, matla a 'maloa a totobatsa seo re se fumaneng. Taba ea mantlha, mehato ea rona ea ho pepesetsoa SEM le boitšoaro bo kotsi ba thobalano e pharalletse ho feta tse sebelisitsoeng lithutong tse ngata tse fetileng, tse ileng tsa thusa thuto ena ho lekola likamano lipakeng tsa mekhoa e mengata ea ho pepesetsoa SEM le boits'oaro bo fapaneng ba boitšoaro bo bobe ba thobalano. matla a ena o ile a senola e thahasellisang lethal dose-na karabelo e-joaloka kamano. Ea bobeli, sete ea datha ke longitudinal moso cohort sete ea datha. Sena se re thusitse ho sebelisa likhakanyo tsa lisebelisoa tse fapaneng bakeng sa tšusumetso ea lintlha tse sa lefelloeng le ho fana ka tatellano e nepahetseng ea nako. Le sena, Thutong ena o ile a senola ho ba le kamano substantive pakeng SEM kgahlamelo ya maqhubu a le kotsi boitšoaro ba ho kopanela liphate. Ho phaella moo, re hlahloba liphello e ka ho sebelisa dikai le likhopolong ho feta ka thata-thata distributional (mohlala, e bivariate probit ea mohlala) 'me a tla ho etsa qeto e tšoanang. Ka lebaka leo, re na le ba bang ba kholisehile hore ho hakanngoa morao ke haufi haholo le o ile a ja. Ho feta moo, ditshekatsheko laoloang bakeng sa mefuta e fapaneng ya confounders tse kang boemo ba bophelo bo botle, le matšoao a tepelletsang le phihlelo intša hammoho le litla sekolong e tsitsitseng ho fokotsa tšusumetso ea khoneha lea ka la boleloa polygonal leeme. Sena se re fa menyetla ea ho hlahloba sephetho se ts'oanang le bophelo bo botle ba bongoana litsong tse fapaneng.

Ha diphetho joale etsa fana ka ea bohlokoa haholo temohisiso joang ho kopanela liphate mecha ea phatlalatso ea ho pepesehela ama boitšoaro ba hamorao kotsi ho kopanela liphate, ba bang ba caveats lokela ho tobisoa. Taba ea pele, litekanyo tsa ho pepesetsoa litaba tsa thobalano ka thobalano ha li kenyeletse ho pepesetsoa khafetsa. Ho feta moo, tekanyo e ne e le e tsitsitseng; ka hona, liphetoho tse matla pakeng tsa ho pepeseha litaba tsa thobalano le boitšoaro bo kotsi ba thobalano li ne li ke ke tsa bonoa [117]. Taba ea bobeli, tekanyo ea rona ea SEM e kenyelletsa boholo ba litaba tse amanang le Inthanete. Sena se ka tsosa ho tšoenyeha ho itseng ha o sebelisa sephetho ho mehla ea hona joale. Ho isa bohōleng bo itseng, sena e kanna ea ba tšitiso ho thuto ena; Leha ho le joalo, fuoa ithuta ena e ile khanna qalong ea ikutloe ka tšebeliso Internet, ka tekanyo e itseng e lekanyelitsoeng ea SEM kgahlamelo ya maqhubu a ho utloisisa. Leha marang-rang e fetoha mecha ea litaba ea boithabiso le mohloli o ka sehloohong oa litaba tsa SEM, tšusumetso ea SEM ho tsoa ho mecha ea litaba ea setso mabapi le boitšoaro bo kotsi ba thobalano e lula e fumanoa [20]. Kahoo, moedi ena ka 'na se ke ua le kotsi ka ho teba ka ho ithuta hona joale. Leha ho le joalo, puisano ea maemo a mararo a ke ea bohlokoa. Ntlha ea pele, ba fuoa setšoantšo se hlakileng sa SEM ka-line 'me e ba ho feta "interactional," hakanngoa litla rona ya SEM tloha mecha ea phatlalatso ea lineano tse maitshwaro kotsi thobalano ka ba le ho underestimation tsa litla mecha ea phatlalatso. Taba ea bobeli, tšebeliso ea mecha ea litaba ea inthanete e ka lebisa ho fokotseng likamano tsa sechaba, tse ka fokotsang boitšoaro ba thobalano. Mohlala, boima Internet / mathata inthanete tšebeliso e ka amanang le lethargic mpe maikutlo (ke hore, ho jeoa ke bolutu le ho tepella maikutlo) [118], E leng ho ka etsa hore maemo a mesebetsi thobalano theola. Tabeng ena, ho pepesehela SEM Inthaneteng e ka fokotsa boitšoaro bo kopanela liphate, ka kakaretso, 'me le kotsi boitšoaro ba ho kopanela liphate, ka ho khetheha; kahoo, fopholetsa rona ka overestimated. Taba ea boraro, tlhahlobo e le 'ngoe e bonts'itse hore lits'ebetso tsa ho ratana (App) ha e le hantle ha lia ka tsa eketsa monyetla oa ho haha ​​likamano tsa lerato tsa nako e telele, tse ka fanang ka menyetla ea thobalano. Leha ho le joalo, Lisebelisoa tsena li ile tsa eketsa mofuta o le mong oa boits'oaro bo kotsi ba ho etsa thobalano le batho ba sa kopaneleng thobalanong (ke hore, ho-hula)119]. Ka boemo bona ea ho qetela, liphello tsa Internet ka boitšoaro boo kotsi thobalano e-positive empa ka 'na ba mpe bakeng sa boitšoaro bo akaretsang ho kopanela liphate. Le ha tsena e le litlhaloso le likhakanyo feela, lithuto tsa nako e tlang li lokela ho nahana ka litaba tsena.

Taba ea bobeli, tlhokahalo ea hore IV e se ke ea lumellana le polelo ea bobeli ea phoso e ke keng ea netefatsoa ka botlalo lithutong tse matla. Tlhahlobo ea lipalo-palo e bontšitse hore IV e ne e utloahala, empa sena se lula se nyatsuoa. Ka mohlala, le hoja ba bang ba lithuto tsa li bontšitse hore nako pubertal e sa amanang le maitshwaro hamorao kotsi thobalano [120-121], ba bang ba bontšitse kamano e sa lekanyetsoang [122-123]. Kahoo, motho a ka pheha khang ea hore ho ka ba le khokahano e tobileng lipakeng tsa nako ea kemiso le boitšoaro bo kotsing ba ho kopanela likobo. Leha ho le joalo, lithuto tse ngata tse fetileng ha lia ka tsa nahana ka mokhoa o ka sebelisang nako ea ho hola nakong ea boits'oaro le boitšoaro bo kotsing ba ho ba le thobalano (mohlala, ho pepesetsoa SEM) mme ba bonts'a hore litlamorao tsa ho kena bohlankaneng kapa boroetsaneng nakong ea boits'oaro hamorao li kanna tsa phela hakhutšoanyane hobane batho bohle qetellong ba bona phetoho ena. ka ba motho e moholo mocha [122,124]. Ha re nahana hore re hakanya litlamorao tsa nako e telele tsa ho pepesoa ha SEM ka boitšoaro bo kotsi ba thobalano, re na le tshepo ho li-IV tsa rona. Ho feta moo, sephetho teng hape o ile a bontša hore ho khoneha ka nako e telele phello ea nako pubertal ka boitšoaro bo kotsi ba ho kopanela liphate ka eona ke ka SEM pepesehela (See Lethathamo 2 bakeng sa phello e fokolang ea nako ea nako ea pubertal mabapi le boitšoaro bo kotsi ba thobalano ha o laola ho pepesetsoa ha SEM). Sephetho sena se ile sa imolla letsoalo la hore nako ea lipapatso e na le phello e tobileng le e telele ea boitšoaro bo bobe ba thobalano. Taba ea boraro, sephetho sa rona sa sephetho se ne se lekanyelitsoe ho ba bararo ba tloaetseng ho ba kotsing ea boitšoaro ba thobalano; kahoo, liphetho tsa rona ka 'na se ke ua ho tshwanetseng ho maitshwaro kotsi thobalano tse ling ho feta bana ba bararo ba boitšoaro bo kotsi ba ho kopanela liphate. Leha ho le joalo, lithuto tsa pejana li bontšitse hore ho pepesetsoa ha SEM ho ne ho amana haholo le boits'oaro bo bong bo kotsi ba thobalano kapa sephetho se amanang, joalo ka thobalano e tloaelehileng [31] 'Me a lefile ho kopanela liphate kapa sehlopha ho kopanela liphate [125]. La bone, liphetho tsohle li ne li thehiloe tlalehong ea boits'oaro; ka lebaka leo, ho tlaleha khethollo ka 'na eaba susumetsoa sephetho jwale.

Bafuputsi ba tsa bongaka le tsa bophelo bo botle ba lula ba pheha khang ea hore thibelo ea pele ke mokhoa o sebetsang le o betere oa ho loants'a mafu a morao. Ha ho fanoa ka kamano e matla lipakeng tsa ho pepesehela SEM le boits'oaro bo kotsi bo fumanoeng thutong ena ea morao-rao, maano a thibelo mabapi le ho pepesetsoa SEM a tlameha ho kenngwa ts'ebetsong bongoaneng, mohlomong pele kapa ha a qala ho kena bohlankaneng. tlhahiso ena e corroborated ke American Academy ea Pediatrics hore o ile a bontša hore lilemong tsa bocha, mathoasong a ke nako ea ho qala dipuisano ho kopanela liphate [126]. Leano le leng la ho thibela pelehi ke ho holisa tsebo ea bacha ea litaba tsa bongoana, joalo ka tsebo ea litaba (ke ho ba le tsebo ka mehopolo le litaba tse hlahisitsoeng mecheng ea litaba) le tsebo ea puo ea puo (ke hore, tsebo ea mahlale a sebelisitsoeng ho hlahisa litaba tse hlahang mecheng ea litaba. ka mahlakoreng le zooms) [127]. Ho kenya dikahare bala le ho ngola, ba boholong (mohlala, lingaka tsa bana le matichere sekolong) le batsoali ba ka e nkang ho etsa boikhathatso ba ho fana ka bacha ba nang le lesedi loketseng ho tse thathamisitsoeng ho kopanela liphate (mohlala, litsela tsa ho fokotsa kotsi ea ho kopanela liphate). Ho ntlafatsa tsebo ea puo ea puo, batsoali le liofisiri tsa sekolo ba ka thusa bana ho bala lingoliloeng ho SEM le "ho tsebisa" mangolo a nepahetseng (mohlala, litlamorao tse mpe tsa thobalano e sa bolokehang kapa ya thobalano). Tlhahlobo e 'ngoe ea morao-rao e bonts'itse hore ts'ebetso ea ho bala le ho ngola ea litaba e sebetsa hantle ho thibela tšusumetso e mpe ea mecha ea litaba mabapi le boitšoaro bo bobe ba bongoaneng [127]. Ntle le moo, thuto ea thobalano e kenya tlhaiso-leseling e nepahetseng joalo ka thibelo (mohlala, thibelo ea likotsi) le boits'ireletso (mohlala, ts'ireletso ea mafu a likobo) e kanna ea ba le tšusumetso e kholo bophelong ba thobalano ba bacha. Ha e le hantle, phuputso e 'ngoe e bontšitse hore ho fumana tlhaiso-leseling e nepahetseng ho ntlafalitse liketso tsa ts'ireletso khahlanong le boits'oaro bo kotsi ba nakong e tlang [128]. Leha ho le joalo, fuoa mofuta nahanela ya dihlooho tsena, ka pel'a ba boholong sekolong 'me batsoali ba leka ho hlaolela bacha' mecha ea phatlalatso bala le ho ngola kapa ho fana ka tlhahisoleseding e mabapi le ho kopanela liphate-e amana, lekunutu pakeng tsa lihlopha tseo tse peli e lokela ho thehwa [129]. Qetellong, ntle ho mphumanang rona ka sehloohong, ba rōna ba pele-ba sethaleng sa diphetho 2SLS ile a bontša hore tshebedisano hara lelapa e amana le ho kgonego ka tlaase ea SEM pepesoe; ka hona, ho khothatsa batsoali ho theha moea o futhumetseng le o tšehetsanang oa lelapa ho ka thusa ho fokotsa ho pepesehela SEM, e tla thusa ho fokotsa ho ipeha kotsing ea ho etsa thobalano nakong e tlang.

fihlela qeto e

Liphetho tse peli tsa bohlokoa li hlahile thutong ena. Ntlha ea pele, ho kopanela liphate mecha ea phatlalatso ea ho pepesehela ho kena bohlankaneng kapa boroetsaneng, mathoasong a ile ka matla e amanang le kotsi tse tharo thobalano maitshwaro-mathoasong a qalo thobalano, thobalano e sa sireletsehang, 'me ke balekane-in thobalano lilemong tsa bocha ka mor'a nako, le kamano ena e ne e le haufi haholo le e bakang. Ea bobeli, mokhatlo ne lethal dose-arabela, joalo hore ho sebelisa bokgoning feta mecha ea phatlalatso ea ho kopanela liphate se ile sa etsa ya kgonego e phahameng ea ho ameha boitšoarong kotsi thobalano hamorao bophelong. Ha ho nahanoa hore litlamorao tse mpe tsa boits'oaro bo kotsi ba thobalano (mohlala, mafu a likobo le boimana bo sa reroang) li na le litšenyehelo tse ngata sechabeng le libakeng tsa Bophirima le Asia, ho bohlokoa ho kenya tšebetsong maano a thibelo pele ho nako.

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