Sir kien - Nhan dinh xahgihgc,s64(i36),2ou CAC YEU TO XA HOI CO LIEN QUAN DEN H A N H VI ROI RO CUA HOC SINK TRUNG HQC PHO THONG (NghiSn ciiu tgi thdnh phd HdNgi) DUONG THI THU HUONG" NQUYEN QUY THANH" Tdm tat: Nghien cieu tgi qudn ndi thdnh Hd Ngi ndm 2016 nhdm tim hiiu cdc yeu tdxd hdi cd mdi lien hf vdi hdnh vi rdi ro: hut thudc Id, udng bia/rugu, sie dymg ma luy, bgo luc d hgc sinh THPT Kit qud cho thiy cd hdnh vi rdi ro cua hgc sinh diu chfu dnh hudng bdi ddc diim cd nhdn vd mdi trudng sdng, dgc biet Id gia dinh vd bgn thdn S^gdn kit chgt che vdi gia dinh Id yiu Id ldm gidm viec sii dung mang xd hgi true tuyin qud nhieu ldm tdng nguy ca cd hdnh vi hut thudc Id vd sit dung ma Viec ngudi thdn, bgn be cd hdnh vi rui rg hay tieng cd ngudi ySu Id cdc yiu td ldm tdng nguy ca hgc sinh cd cdc hdnh vi rui ro Phiit hien tie nghien cieu gdp phdn dud nhiing ggi y ve gidi phdp todn di$n hon viec gido due vi thdnh niSn trudng hgc TU khod: hoc sinh trung hoc phi thdng, vi thdnh nidn, hanh vi rui ro Gioi thi^u O moi giai doan khde cila vdng ddi, eon ngudi ed thi phdi dii mdt nguy co tilm dn cua rdt nhiiu nhflng hdnh vi rui ro khac nhau, Hdnh vi rui ro Id nhttng hanh vi c6 thi gay nguy co hay dnh hudng ttudc mdt hoac Idu dai din sue khoe thi chdt, tinh thin hay cdc dnh hudng xd hdi khac cho cd nhan hay c$ng ding, Ddy Id vin dl rat ddng quan tdm d Ida tudi vi nien vi cae bdng chiing tu: nhiiu nghidn oiiu tren thi gidi dlu cho thay vi nien Id giai doan Hdn qutm din nhiiu rdi ro vl siie khoe va su phdt triin (DiClemente va edng su, 1996), Thyc tl d nhiiu quic giatednthi gidi, nguy co xdy hdnh vi mi roteongvi nien Id khd cao, gdp phan tao ede thdch thiic, gdnh ndng va nhflng bdt dn v6 kinh tl, xa hdi (Dilemente vd cdng su, 1996; Ruangkanehanasett,'2005; Sychareun, 2011), Tai Viet Nam, vi nien ehilm khodng 30% ddn si (WHO, 2014), Trong bdi cdnh eua su hoi nhdp, phat triin vd sji biin dii nhanh chdng eua mii gia dinh hien nay, co khd nhieu hdnh vi rui ro nhu sit dimg bia, ruou, hut thulc la, ma tuy, hdnh vi bao l u c , teong vi thdnh ni6n noi chung va hoc sinh teung hpe phi thdng (THPT) n6i neng (xem U Cvt Linh, 2010; Le Thi Kim Thoa, 2013; Trdn Thi Hdng, 2013; Nguyin Hgc vi4n Bdo chi va Tuyen truyin " Bgi hpc Qudc gia Hd Ngi Duang Thj Thu Huang Nguyin Qt^ Thanh 49 Thanh Liem, 2010) Tuy nhiSn s6 li$u \h cac ydu t6 xS hpi co liSn quan dSn h^nh vi rui ro cua nhom d6i tugng ndy c6n hatn chS \k it dugc phan tich h? thfing NhSm co them nhiing hi^u biet ve muc dfi ph6 bi6n va cac y^u t6 xa h$i dnh hucmg dSn cac hanh vi nii ro cua vi niSn tu goc dg tiip cdn xa hgi hgc, nghiSn ciiu ndy tim hieu lidnh vi rui ro dang chu y nhit cioa hgc sinh thdng trung hgc, bao gom: hut thufic la, u6ng bia/rugu, va su dung ma tiiy, qua khao sat t^ Ha N6i vdo thang 1/2016 Phuong phap nghiSn cihi 2.1 Mau nghiin citu Nghien cuu sii dyng phuong phap phong vdn thu thdp Ihong tin dinh lugng v6i thu tuc chon mau bao gfim buac nhu sau Tai budc thii nhit, 12 qu|n ngi Ha Ngi dugc chia thdnh nhom dai diSn cho ba giai doan phat triSn va m6 r^ng Ha Ngi (tru6c nam 1994 voi qudn ngi thanh, tCc 1994 - 2008 voi qudn dugc bfi sung thSm vatu 2009 den v6i quan nfii dugc b6 sung them) vd tir mfii nhom chgn nglu nhien qudn Tgi buac thti hai, trucmg THPT dugc chgn nglu nhien h6 thfing danh sach cac truang THPT (bao gom ca cong l|p vd ngoai cong lap) tii ba qudn kS tren Cu6i ciing, t^ mSi trucmg, tii moi khoi l\ra chgn ngSu nhien lop va todn bg hgc sinh 16p dugc mai tir nguyen tham gia phong van Tong hgp lai, cugc khdo sat dd phong vdn dugc 1.333 hgc sinh tii 36 lop hgc (tii khfii 10 dSn khfii 12) thufic trucmg THPT tai qudn Hodn Kiem, Cdu Gidy va Bac Tir Liem a Hd Ngi 2.2 Cdc biin so phan ttch Biin sdphyi thugc: Trong nghifin curu ndy, bon hanh vi nii ro a hgc sinh THPT dugc xdc djnh qua bien so: dd tiing hiit thufic la; da tiing uong hit c6c bia/ch6n rugu; da timg sii dung ma tuy; da timg c6 hdnh vi bao lire thS chdt' Bien sd gidi thich (biin sd dgc Igp) dugc chia ldm nhdm: Voi gid thiet hanh vi riii ro ciia hgc sinh dugc quyit dinh boi ba nh6m yeu tfi sau: Thii nhit la dac diem cd nhan, bao gom: gioi tinh, kh6i hgc, hgc lyc (hgc ky gdn nhit), loai truong (cfing lap/ ngodi cfing lap); Thii hai Id nhom cdc dac diim gia cBnh, bao g6m: ddc diim hfin nhdn b6 me, sy gdn ket voi cac viSn gia dinh, c6 nguoi than c6 hanh vi nii ro (ufing bia/rugu, hiit thuoc la, su dung ma tu;^, c6 hanh vi bao luc); Thii ba Id sy gdn ke v6i ban be, bao gfim: 6si tung/ dang co nguoi y^u, co ban co cdc hanh vi riii ro, gdn kit vdi b?n be tren mgng xd hgi true,tuyin (co tir 1.000 ban hh tren mang xa hfii tra ISn, CO thai gian trung binh sii dvmg mang xd hgi tir tilng/ngay trd len) Ddc bi^t, yiu tl "gdn kit vdi c ^ thdnh vifin gja dinh" Id chi s6 tfing hgp bdng each cgng chi so phdn, mfii chi so thdnh phdn dugc danh gia bdng thang dikra tii din Cdc chi sfi phdn bao gfim: (1) co quan h§ gin gui, thdn thiit vdi cac vien gia dinh; (2) co mfii quan he tfit vdi b6; (3) co mfii quan he tfit vdi me; (4) khfing CO cam giac co dan gia dinh minh; (5) gia dinh khong thudng xuySn xay bat dfing, xung dot Nhu vgy, chi sfi tfing hgp miic d0 gdn kit gia dinh Id biin sfi lidn tyc, ^ Gia fliilt c ^ hpc sinh Ihyc h i ^ hSnh vi rili ro nSy ldi6ng qui ISu trade ftdi diim k h ^ s& (thing 1-2 nam 201Q so Cdc yiu ti xd hgi cd lien quan din hdnh vi rui ro cita hgc sinh win thidnteongkhodng tir din 25 diim vd diim cdng cao thi hidn mirc dd gan kit gia dmh edng bdn chdt, Ket qua chinh 3,1 Thtfc trang cdc hanh vi rdi ro cia hgc sinh THPT Kit qua khdo sdt hpc smh THPT t?i hdi thdnh Hd Ngi eho thdy,teong4 hdnh vi nii ro thi hdnh vi dattmguIng hit elc bia/chen ruou la hanh vi phi biin nhdt (63,5%), tiip din Id hdnh vi bao luc (24%), hut thule Id (21%) vd culi edng Id sd dimg ma tty (6,9%), Thuc tl cd hon 80% hgc smh eho biit ddtung udng bia/rugu, hiy nhidn nghidn cuu lya chpn mile dp "da timg uIng hit mOt cic bia hoac mgt chdn ruou" lam ngudng dd ddnh gid d muc cd nguy CO cao, Lugng cin ttong mdt elc bia hoae mgt chdn ruou Id ddng ke va dd cd kha ndng uIng mdt lugng bia/rugu nhu vdy, hgc sinh dl tiip tuc ed hdnh vi lap lai, ddng thdi gdp phin ldm tdng nguy co cac hanh vi riii ro khde nhu bao lire hay tham gia giao thdng khdng an todn, Ddc bidt Id hgc smh ntt ciing cd t) le ddttmguIng hit elc bia/chdn rugu khd cao (55,9%) va khdng thdp hon nhiiu so vdi hgc sinh nam (70,7%), Bdng T^ 1$ h9C sinh d3 timg cd iidnh vi gSy b^o I ^ thi chat theo gii3-i tinh vd tinh tr^ng uSng bia/rirgli, bdt thudc Id, vd sil* dyng ma tu^ Banvi:% ^ Hoc sinh nfl Hgc sinh nam Chung 21,3 11,3 37,3 14,9 30,5 12,8 50,0 ]\$ 58,9 19,6 56,2 15,5 60,0 15,6 17,0 82,4 25,0 30^7 77 20,3 24^0 644 689 1.333 a) U6ng h^t c6c bia/ ch6n nrpu; Nh6m da ttmg u n | Nh6m chua timg uong b) Hiit thu6c 14: Nh6m da timg hdt Nh6m chua timg hut c) Sii dyng ma tdy: Nhdm da timg sd dyng Nhom chua timg siJr dyng fl Chung Ngu6n: Ichdo sdl tai truang THPT a Hd Ndi ndm 2016 Lidn quan din hdnh vi gdy b?io Ive thi chit, ed gdn 1/4 hgc smhteongmau nghien cilu cho biet dd ttmg tham gia gdy gl, ddnh (ehu muu hay W ldi keo) vdi ban be teong ho^c ngoai teuong Dilu khdng ngac nhidn la tj' Ip nam da timg cd hanh vi gay b?o Ive the chat eao hon so vdi nii (30,7% d hpc sinh nam vd gdn 17% d hge smh nii) So vdi uIng bia/rugu, hdnh vi hit thulc it phd biin hon teong hpc smh THPT bdi chi CO 21% hpe sinhteongmlu nghien eiiu cho bill ddttmghdt thulc Dp tuditeungbinh bat dau hit thudc la 13,6 tudi, Nhung hut thule Id khdng cdn Id hdnh vi qua hiim gdp d nil ty Ip hpe smh nil da ttmg hut thule Id 13,4% vd ty 1? hoe smh nQ ed hit thulc teong 12 thang qua Id 37% Rat ed theteonghrong lai, vdi quan'dilm sdng tv vd cdi mo hem, ty le phv nu uong bia/rupu vd hit thule Id se cd xu hudng tang din nhu d mdt si nuoe dang phatteienteongkhu virc Chdu A, hay khong cd qud nhiiu khoang cdch so vdi nam gioi nhu o eae nuoc phat teidn, Vipe su dvng chit gdy nghidn nhu cdn sa, ma heroin, thudc lie la hdnh vi dupe xem la co muc dg rut ro eao nhdt, khdng ehi ddi vdi sue khoe thi ehdt, tinh thdn eua hpc .Duang Thi Thu Huang, Ngityen Quy Thanh 51 sinh md anh hudng tieu cue din hgc tdp va ca tuomg lai phia truoc niu nhu roi vao tinh trang nghien ngdp Kit qua nghiSn ciiu cho thdy co m$t thyc trang dang quan tdm la gdn 7% hgc sinh mdu nghiSn cihi cho biit da timg sir dung hodc th& m§t cdc loai cl^t gdy nghien kl tren, ty 1$ hgc sinh nam dd timg sii dung ma tu^ cao gap han Idn so vdi nii (10,2% so vdi 3,3%) Ngoai phat hi?n hgc sinh nam co lien quan din cd hanh vi nii ro cao han so vdi hgc sii?h nft, cac phdn tich tuong quan hai cbilu cho thdy viec hgc sinh c6 hdnh vi bao luc CO mfii quan hfi ch^t che vdi tinh trang sii dung bia/rugu, hiit thufic la va sue dung ma tiiy Cy thi, nhom hoc sinh da timg uIng hit cfic bia/chen rugu c61^ le da timg gdy gfi, danh la 30,5%, cao gap 2,5 Idn so vdi nhom hgc sinh chua tiing uong hit mgt cfic bia, chen rugu, va xu hudng ndy c6 d cd hgc sinh nam vd hgc sinh nii Trong nhom hgc sinh timg hut thufic la, ty ig dd tiing cd hdnh vi bao luc thi chdt vdi bgn be vd ngoai trudng rdt cao (56,2%), vd cao han gdp nhiiu lan so vdi nhdm hgc sinh chua tiing hut thuoc la (15,5%) NIU tdch rieng theo gidi thi ty le Id 50% d hgc sinh nil vd 58,9% d hgc sinh nam, t^ \% hgc sinh dd tiing c6 hanh vi bao lyc the chdt d nhoih hgc sinh nii va nam chua tiing hiit thulc la Idn lucrt chi la 11,9% vd 19,6% ^ ^ Tuang ty, nhdm hgc sinh da timg su dung ma tuy, ty le da tiing cd hanh vi bao luc the chdt vdi ban be la 77,3%, gap khoang gdn Idn ty 1$ nhdm chua tiing sur dung ma Nhu vay, ket qua phan tich cho thdy khd ro mfii quan he giua hanh vi bao lyc the ehdt vdi cac hdnh vi hut thuoc la, su dyng bia/rugu, vd sii dung ma dhgc sinh THPT Phan tich tuang quan giiia cdc cap hdnh vi khac ciing cho hit qud tuong ty Khi hgc sinh cd mgt hanh vi nii ro thi kha nang xdy cdc hdnh vi nii ro khac Id khd cao Do vay, viec giam sat hanh vi nii ro cua hgc sinh tir sdm dl co bi^n phdp ngdn chan va cung c ^ cho hgc sinh du thong tin, ky ndng song trdnh hdnh vi rui ro la vific r4t can thiit, gop phin giam nguy ca rui ro "kep" d hgc sinh 3.2 Cdc yiu ti anh hi^ng den hanh vi rui ro cua hoe sinh THPT Bang tihih bdy bfin mfi lunh hfii quy da bien logistic lan lugt ve cdc hanh vi riii ro; dd tung udng hit mgt cdc bia/chen rugu, dd tung hut thuoc Id; dd timg sd dung tna tdy, dd timg cd hdnh vi bgo lifc (gdy gd, ddnh nhau) vdi cac bien so dgc lap nhu da trinh bdy muc 2.2 Ket qua lan niia cho thdy gidi tinh nam ldm tang nguy co d cd hanh vi nii ro Mgt diem chung niia Id viec hgc sinh co ngudi than gia dinh hay c6 ban than, ban nhdm choi chung thyc hien hanh vi riii ro (tuong iing vdi tiing hdnh vi nii ro ciia hgc sinh d timg mfi hmh) Id yfiu tfi nguy ca co moi lifin quan chdt che dfii vdi cd hdnh vi nii ro dugc dl cdp, Nhu vdy, vi$c gdn kit vd quan he tfit vdi bl, me vd cdc thdnh vien, gia dinh cimg nhu vi6c khfing choi vdi ban co hanh vi rui ro Id hai yeu tfi quan trgng bao ve hgc sinh trudc nguy ca uong rugu bia, hiit thufic la, su dung ma hiy, hay co hdnh vi b£K) lyc Tuy nhiSn, viec dang hay dd timg co ngudi yeu ciing lam gia tang nguy ca thuc hifn hanh vi rui ro dugc xet ciia hgc sinh THPT Nhu vay, kit qua ndy khdiig djnh them sy phu thufic cCia hanh vi riii ro ndi rieng cung nhu hdnh vi cd nhan ndi chung vao mfii trudng xa hfii, d$c bigt la moi trudng gan gfli nhdt vdi hgc sinh THPT nhu gia dinh va ban be thdn thiet 52 Cdc yiu td xa hgi cd liin guan din hdnh vi rui ro cua hpc sinh Bang Cic m6 hinh hhi quy logistic phSn tfch cfic y^u tl Snh hirflTig d^n vi?c aa tihig u6ng het I c6c bia/ch£n rirgru, hut thu6c Ifi, sii- dyng ma tu^ vk hanh vi bgo lyc CSc yiu t6 dv doSn (biSn d^c l§p) Md hinh M6 hinh uIng bia, Hiit niyu fliuoc li - Bi^c diim bpc sinh -0,655 Gidi tfaih n& (nam=ref.) 0,309 HQcldi6ill,12(kh6ilO=ref.) 0,236 H(?c Ivrc tnmg binh, k6m (gidi, khd= ref.) -0,157 Tnr6ng ngoii cong lap (cfing l§p=Tef.) ' GSn kit gia dinh 0,108 B6 m? Iy thfin/ly h6n/khdc (song chung==ref.) -0,028 MAc d$ g9n ket vdi ckc vign gia dinh -0,912 Ngudi than khdng c6 hkah vi nii ro (c6=ref.) -Ginkitb^nbi -0,946 B^nbfe khdng cd hinh vi rui ro, tirong tag -0,712 Chua tiing c6 ngu&i ybi (c6=ref.) - GSn kit mgng xS hpi true tuyin Dudi giij (tir gidr trd ien=ref.) -0,176 Dudi 1000 b^n trSn m^g xa hdi (tfi 1000=ref.) -0,159 Mo hinh Sii dvmg ma tdy Md hinh HAnh vi bjiolyc -1,080 • " 0,416 • 0,448 * 0,566 • -1,290 •• 0,578 0,734 * 0,089 -0,648 0,357 0,397 0,462 •• 0,132 -0,054 • -1,500 ••• -0,415 -0,127 • -1,874 • " 0,170 •0,043 -0,918 •• ••• •• -1,340 • " -1,100 " • -1,210 " -1,010 • -0,915 ••• -0,679 •• -0,174 -0,350 • -0,178 -0,404 -0,484 < -0,108 " •• "