Objectives: To understand the status of screen exposure in children with epilepsy and analyze the influencing factors for screen exposure time, providing a scientific basis for managing screen exposure in these children.
Methods: A convenience sampling method was used to select 275 children with epilepsy from outpatient clinics or those undergoing 24-hour electroencephalogram monitoring at two tertiary hospitals in Jinan from March to June 2023. Their parents (fathers or mothers) completed a questionnaire to collect data on screen exposure, parental screen regulation behaviors, and related information about the children and their families. The Wilcoxon rank-sum test or the Kruskal-Wallis H test was used to conduct a univariate analysis of the average screen exposure time of children on school days and weekends, as well as the daily average screen exposure time. A multivariate logistic regression analysis was used to identify the risk factors for children whose screen exposure time exceeded the recommended guidelines (average screen exposure time on school days >1 hour or average on weekends >2 hours).
Results: The median screen exposure duration on school days was 40 minutes, while on weekends it was 120 minutes. Among the children studied, 23.1% (63/273) had average screen exposure time exceeding 1 hour on school days, and 42.5% (117/275) had average screen exposure time exceeding 2 hours on weekends. Four children experienced seizures while using screen devices. Multivariate logistic regression analysis indicated that using screen devices shortly before sleep, lower educational levels of parents, caregivers discussing screen content with children, and longer seizure durations in children were risk factors for exceeding recommended guidelines (P<0.05).
Conclusions: Some children with epilepsy have a screen exposure time exceeding the recommended guidelines. A longer seizure duration, lower parental education levels, and permissive digital parenting are closely associated with children's screen exposure time exceeding the recommended guidelines. Families and children exhibiting these characteristics should be prioritized for attention and health education.
目的: 了解癫痫儿童屏幕暴露现状，并分析屏幕暴露的影响因素，为癫痫患儿屏幕暴露管理提供科学依据。方法: 采用方便抽样法于2023年3—6月选取济南市两所三甲医院门诊或进行24 h脑电监测复诊的癫痫患儿275例，由其父亲或母亲进行问卷填写，收集癫痫儿童屏幕暴露、父母屏幕调节行为，以及患儿和家庭的相关资料。使用Wilcoxon秩和检验或Kruskal-Wallis H检验对患儿上学日和周末日均屏幕暴露时间及每日平均屏幕暴露时间进行单因素分析。使用多因素logistic回归分析探讨患儿屏幕暴露时间高于指南推荐标准（上学日日均屏幕暴露时间>1 h或周末日均>2 h）的危险因素。结果: 上学日日均屏幕暴露时长中位数为40 min，周末日均为120 min；23.1%（63/273）的患儿上学日日均屏幕暴露时间>1 h，42.5%（117/275）周末日均屏幕暴露时间>2 h。4例患儿在使用屏幕设备时癫痫发作。多因素logistic回归分析显示，患儿临睡前使用屏幕设备、父母受教育程度较低、照顾者与患儿一起讨论屏幕内容，以及患儿癫痫发作持续时间较长是屏幕暴露时间高于指南推荐标准的危险因素（P<0.05）。结论: 部分癫痫儿童屏幕暴露时间高于指南推荐标准；癫痫发作持续时间较长、父母受教育程度较低和放纵型数码教养与患儿屏幕暴露时间高于指南推荐标准密切相关，需对具备这些特征的家庭和患儿予以重视并给予健康教育。.
Keywords: Child; Epilepsy; Family; Screen exposure; Screen time.