A method for assessing early pen-holding and pre-writing abilities in preschool children

Abstract

The present invention discloses a method for evaluating the early pen-holding and pre-writing abilities of preschool children. An intelligent writing evaluation tool and a pinch dynamometer tool are used to conduct standardized evaluations of children in the middle and senior classes, and the relevant data are statistically analyzed to obtain the results of the early pen-holding and pre-writing abilities of preschool children. The results show that more than half of the preschool children begin to form functional pen-holding in the middle class, and all pre-writing abilities are significantly improved after entering the senior class. Finger strength directly promotes the formation of children's functional pen-holding and the development of pre-writing abilities. The formation of pre-writing abilities can also help children adapt to Chinese character writing tasks faster. This study innovatively conducted exploratory research on the quantitative evaluation of preschool children's pre-writing abilities, established a standardized evaluation process and a reference range in the Shanghai area, and proposed a feasible writing ability promotion plan for the pre-writing stage.

Description

Technical Field

[0001] The invention relates to a quantitative evaluation method for preschool children's pre-writing ability, and in particular to an evaluation method for preschool children's early pen-holding and pre-writing ability. Background Art

[0002] Writing is an integrated process that requires the mobilization of visual perception, motor skills (gross motor, fine motor), visual motor integration and other abilities. In recent years, the writing problem of school-age children has received increasing attention. In order to better evaluate children's writing ability, writing assessment for school-age children has also been continuously developed, and the computer-based objective Chinese writing assessment system has also been continuously improved, such as the Chinese Handwriting Analysis System (CHAS) established by Wong et al. and the Smart Handwriting Analysis and Recognition Platform (SHARP) established by Li et al. Writing speed and writing accuracy are both the most important evaluation indicators.

[0003] Although formal writing training often begins at school age, the formation and initial training of writing-related skills begin in the preschool period, also known as the "pre-writing stage." Some studies have explored the correlation between the development of pre-writing skills in preschool children and their writing performance at school age, and there is a lack of tools that can be used for standardized assessment.

[0004] Visual-motor integration (VMI) is considered a prerequisite for learning to write, especially for preschool children's early writing skills. A meta-analysis showed that VMI has a high correlation with early writing skills in children under 6 years old. Therefore, it is scientific and reliable to use computer technology with VMI-related paradigms to carry out standardized writing evaluation of children in the pre-writing stage. Summary of the invention

[0005] Purpose of the invention: The purpose of the present invention is to provide a method for evaluating the early pen-holding and pre-writing abilities of preschool children.

[0006] Technical solution: The method for evaluating the early pen-holding and pre-writing abilities of preschool children of the present invention uses intelligent writing evaluation tools and pinch dynamometer tools to conduct standardized evaluations of children in middle and senior classes, and statistically analyzes the relevant data to obtain the results of the early pen-holding and pre-writing abilities of preschool children.

[0007] Furthermore, the intelligent writing assessment tool is composed of an intelligent writing board and external computer software. An A4-sized imitation drawing test paper is placed on the writing board, and the vertical and horizontal edges of the paper are parallel to the two sides of the writing board. The device is equipped with a standard-sized intelligent writing pen, which is a wireless electronic ink pen with a force-sensitive pen tip; the pinch force meter tool is composed of a pinch force meter and computer software.

[0008] Furthermore, the evaluation indicators are divided into three parts:

[0009] The first part is the objective indicators obtained by using the writing board, including the total task time, writing time, pause time, track length, and writing pressure of the imitation task and the copying task;

[0010] The second part is the pinch force measurement results, including lateral pinch force, three-finger pinch force and fingertip pinch force, the unit is Newton;

[0011] The third part is the pen holding posture;

[0012] In the fourth part, professional assessors give a 4-point score to the line results completed by the children in the imitation drawing task, and obtain three sub-scores of stability, coordination and force regulation as well as a total score.

[0013] Furthermore, the imitation drawing task: the test includes 9 lines in total. The subjects are required to imitate the red line example on the left side of the green double solid line and draw in the answer area on the right. The test is divided into three groups, each group includes three line shapes: curve, wall line and broken line. The three groups test the stability, coordination and weight control ability of the pen respectively. The first group requires the subjects to complete the imitation drawing without touching the black solid lines on both sides; the second group requires to draw lines evenly around the black dots; the third group requires to draw hard on the thickened line position on the basis of continuous drawing.

[0014] Furthermore, the copying task: the older children completed this test, which required the subjects to copy the words on the left to the grid on the right. There were a total of 5 simple words, all of which were common words required by the first-grade syllabus, and contained single-character, left-right structure, up-down structure, Pin structure, and semi-enclosed structure.

[0015] Furthermore, pinch strength measurement includes three test items, namely, side pinch strength, with the sides of the thumb and index finger as the contact surface; three-finger pinch strength, with the middle of the thumb, index finger and middle finger as the contact surface; fingertip pinch strength, with the thumb and index finger as the contact surface.

[0016] Furthermore, pen-holding posture: the pen-holding posture in the preschool period is divided into four stages: palm supination grasp at 1 to 1.5 years old, finger pronation grasp at 2 to 3 years old, static quadruped or tripod grasp at 3.5 to 4 years old, and dynamic tripod grasp at 4.5 to 5 years old; for children in the middle class and above, both static tripod and posterior tripod grasp are considered functional grasp.

[0017] Furthermore, based on the dynamic tripod, a variation of the rear tripod can be formed by using the back of the thumb to hold the pen.

[0018] Furthermore, the statistical analysis method adopted was: using EpiData 3.1 Chinese version and smart writing board to collect valid evaluation results, using Microsoft Office Excel for preliminary data cleaning and collation, using SPSS20 to establish a database, and performing statistical processing.

[0019] Furthermore, the statistical processing methods were as follows: the mean description and parameter test were used for the measurement data that conformed to the normal or approximately normal distribution; the median and Mann-Whitney U test were used for the measurement data that did not conform to the normal distribution; the number of cases was used to describe the count data, the Pearson correlation coefficient was used to explore the correlation between quantitative data, and the SPSSAMOS26 was used to construct the structural equation model. P < 0.05 was considered statistically significant.

[0020] Compared with the prior art, the present invention has the following beneficial effects:

[0021] The present invention conducted a cross-sectional sampling survey on the pre-writing ability of preschool children in Shanghai, established a standardized assessment process and objective assessment tools, and obtained the pre-writing ability development characteristics and reference range of the population at this stage. In addition, the present invention reported the pen-holding posture of preschool children for the first time, explored the correlation between finger strength, pen-holding posture and writing performance of preschool children, and explored the promoting relationship between pre-writing ability and the later development of copying ability. BRIEF DESCRIPTION OF THE DRAWINGS

[0022] Figure 1 It is an intelligent writing assessment tool and a pinch gauge;

[0023] Figure 2 Testing materials for imitation painting tasks;

[0024] Figure 3 Structural equation modeling of preschool children's prewriting performance. DETAILED DESCRIPTION

[0025] In order to make the purpose, technical solution and advantages of the present invention clearer, the technical solution of the present invention will be further described below.

[0026] In order to understand the development of early pen-holding and pre-writing abilities of preschool children and establish standardized assessment tools and methods, this study used a self-developed intelligent writing assessment tool to sample and conduct an assessment of early pen-holding and pre-writing abilities of preschool children in Shanghai from April to May 2024, and discussed the development of abilities and characteristics, as a basis for later standardized assessment and early intervention.

[0027] 1 Clinical Data

[0028] 1.1 Inclusion and exclusion criteria:

[0029] Inclusion criteria: ① Normally developed students in the middle and senior classes of kindergarten, aged 4 to 5 years old; ② Mandarin Chinese is the main language used at home; ③ Able to understand instructions and cooperate to complete simple tasks.

[0030] Exclusion criteria: ① No uncorrectable visual impairment, hearing impairment, limb movement disorder or other physiological functional impairment; ② No neurological or mental developmental disorder, such as cerebral palsy, autism, developmental delay, language or speech disorder, etc.

[0031] 1.2 Study subjects

[0032] According to the 2020 Shanghai census data, stratified sampling was conducted by city, town, and village, and 8 kindergartens were selected from 16 districts for sampling. A total of 284 subjects were recruited, including 141 middle-class children (67 boys and 74 girls) and 143 senior-class children (65 boys and 78 girls). Parents of the children participating in the study signed informed consent forms, and this study was reviewed by the Ethics Committee of Shanghai Children's Hospital (2022R126-F01).

[0033] 2 Methods

[0034] 2.1 Research Methods

[0035] A cross-sectional study was conducted, and the early pen holding and pre-writing ability of children in the middle and senior classes of eight kindergartens in Shanghai were assessed in May 2024 using an intelligent writing assessment tool.

[0036] 2.2 Evaluation Method

[0037] 2.2.1 Evaluation Equipment

[0038] 2.2.1.1 Intelligent writing assessment tool This study used an intelligent writing assessment tool to assess pre-writing ability. The tool consists of an intelligent writing board (ZY-A41, 210mm x 297mm, EMR resolution 5080LPI, reading speed 200 dots / second, Shanghai Zhongyi) and external computer software. An A4-sized imitation drawing test paper is placed on the writing board. The vertical and horizontal edges of the paper are parallel to the two sides of the writing board ( Figure 1 Left). The device is used with a standard-sized smart writing pen, a wireless electronic ink pen with a force-sensitive tip, to simultaneously collect motion and pressure data during writing. The smart writing board and pen are placed on the desktop in advance, and the children are instructed to sit in front of a desk and chair of appropriate height, and keep the writing environment quiet and well-lit. After the experiment begins, the writing data is synchronously transferred to the software via USB and statistically analyzed.

[0039] 2.2.1.2 Pinch dynamometer The pinch dynamometer is used to test the pinch strength of children's fingers. The device consists of a pinch dynamometer (ZY332, 0-50 Newton, accuracy 0.1%, Shanghai Zhongyi, Figure 1 During the data collection process, the subjects were seated, with their feet naturally placed on the ground, knees and hips flexed to 90°, shoulders adducted to neutral position, elbows flexed to 90°, forearms in neutral position, wrists extended to 0-30°, and ulnar deviation of 0-15°.

[0040] 2.2.2 Evaluation Method

[0041] There are a total of 6 full-time investigators in this study, all of whom are qualified in child development assessment and have been engaged in this field for more than 3 years. The project research objectives, recruitment requirements, and standardized assessment procedures were uniformly trained before the test, and a centralized assessment was conducted on the project investigation process and testing specifications to ensure that they met the standardization requirements of the project investigation.

[0042] The evaluation process uses unified instructions to ensure that the subjects understand the evaluation requirements before starting the task. The evaluation results are collected on the spot. All the above materials are uniformly reviewed and numbered by the research team, and the data entry is completed by two people in duplicate. Finally, the data is proofread to ensure the accuracy of data entry and reduce data input errors.

[0043] 2.2.3 Imitation drawing task

[0044] like Figure 2The test includes 9 lines in total. The subjects are asked to imitate the red line example on the left side of the green double solid line and draw it in the answer area on the right. The test is divided into three groups, each of which contains three types of lines: curves, wall lines, and broken lines. The three groups test the stability, coordination, and weight control of the pen respectively. The first group requires the subjects to complete the imitation drawing without touching the black solid lines on both sides; the second group requires the subjects to draw the lines evenly around the black dots; the third group requires the subjects to draw hard on the thickened lines on the basis of continuous drawing.

[0045] 2.2.4 Finger pinch strength

[0046] There are three test items in total, namely, side pinch force (the side of the thumb and index finger is used as the contact surface), three-finger pinch force (the middle of the thumb, index finger and middle finger is used as the contact surface), and fingertip pinch force (the thumb and index finger are used as the contact surface). Repeat twice and take the average as the final score. The interval between the two measurements is 15 seconds. The unit is Newton.

[0047] 2.2.5 Copying Tasks

[0048] The test was completed by the older children. The test required the subjects to copy the words on the left into the grid on the right. There were 5 simple words in total, namely "door, autumn, flowers, forest, schoolbag", all of which were common words required by the first grade syllabus, and included single-character, left-right structure, up-down structure, Pin structure, and semi-enclosed structure.

[0049] 2.2.6 Pen holding posture

[0050] According to previous studies, the pen-holding posture in preschool can be roughly divided into four stages: palmar supinate grasp at 1 to 1.5 years old, digital pronate grasp at 2 to 3 years old, static quadruped or tripod grasp at 3.5 to 4 years old, and dynamic tripod grasp at 4.5 to 5 years old. Among them, on the basis of dynamic tripod, using the back of the thumb to hold the pen can form a variation of posterior tripod grasp. For children in middle class and above, both static tripod and rear tripod are considered functional grasps, but in addition there are some incorrect pen-holding postures, namely inefficient grasps, including inter-digital brace (i.e. placing the pen between the fingers to hold the pen), thumb tuck grasp (i.e. placing the thumb under or wrapped around the other fingers to hold the pen), key or lateral pinch grasp (i.e. using the thumb to press the side of the index finger to hold the pen), hyperextended index finger (i.e. tripod grip with hyperextended index finger, which can cause excessive pressure on the index finger), etc. [7，8] Based on the above classification, this study evaluated children's pen-holding posture.

[0051] Evaluation Metrics

[0052] The evaluation dimensions are divided into three parts.

[0053] The first part is the objective indicators obtained using the writing board, including the total task time (seconds), writing time (seconds), pause time (seconds), trajectory length (meters), and writing pressure (reference coefficient) of the imitation task and the copying task.

[0054] The second part is the pinch force measurement results, including lateral pinch force, three-finger pinch force and fingertip pinch force, and the unit is Newton.

[0055] The third part is the pen holding posture;

[0056] In the fourth part, professional assessors give a 4-point score to the line results completed by the children in the imitation drawing task, and obtain three sub-scores of stability, coordination and force regulation as well as a total score.

[0057] 2.3 Statistical methods

[0058] EpiData 3.1 (Chinese version) and smart writing board were used to collect 284 valid evaluation results. Microsoft Office Excel was used for preliminary data cleaning and collation, and SPSS20 was used to establish a database and perform statistical processing. Mean [95% confidence interval (CI)] was used to describe and parameter test the measurement data that conformed to normal or approximately normal distribution; median [interquartile range] (M[IQR]) and Mann-Whitney U test were used for measurement data that did not conform to normal distribution. The number of cases (%) was used to describe the count data. Pearson correlation coefficient was used to explore the correlation between quantitative data. SPSS AMOS26 was used to construct a structural equation model. P < 0.05 was considered statistically significant.

[0059] 3 Results

[0060] 3.1 Previous writing ability assessment results

[0061] 3.1.1 Results of Pen-holding Posture Evaluation

[0062] The survey results show that early grasping (static four-legged grasping) rarely appears in both the middle and senior classes, indicating that most children in the middle class have begun to gradually form a tripod pen grip. As the grade increases, the number of people who master functional pen grip increases (77 in the middle class and 102 in the senior class), while the number of people with inefficient grasping also decreases (53 in the middle class and 36 in the senior class). Although overall, there is a statistically significant difference in the distribution of pen grip between the two grades (χ 2 =16.0, P = 0.014), but there was no statistically significant difference in the distribution of functional pen grip and inefficient grasp between the two groups (Table 1).

[0063] Table 1 Evaluation of pen-holding posture

[0064]

[0065]

[0066] 3.1.2 Comparison of the results of imitation drawing task and pinch strength assessment among different grades

[0067] The study compared the middle class and the senior class in the imitation drawing task and pinch force assessment. In the imitation drawing task, the senior class had shorter total time and pause time than the middle class, and the writing pressure was relatively greater (P < 0.05). In terms of pinch force, the senior class had stronger side pinch force, three-finger pinch force and fingertip pinch force than the middle class (P < 0.01). In terms of imitation writing performance, the senior class also had better stability, coordination and force control (P < 0.01).

[0068] Table 2 Comparison of imitation drawing tasks and pinch strength assessment results among different grades

[0069]

[0070] 3.2 Correlation between pinch strength and pen-holding posture and pre-writing performance in preschool children

[0071] The different pen-holding postures were assigned values ​​according to functional pen-holding (dynamic tripod, rear tripod-4; static tripod-3), inefficient grasp (lateral pinch grasp, clasping grasp, index finger hyperextension grasp-2) and early grasp (static quadruped grasp-1). At the same time, pinch force, imitation writing performance and pen-holding posture scores were included to explore their correlation. According to the results in Table 3, the three pinch forces and the three imitation writing performances showed significant consistency (all P < 0.01). In addition, there was a significant correlation between the force regulation score and the lateral pinch force (r = 0.15, P < 0.05), and there was a significant correlation between the pen-holding posture score and the three-finger pinch force and fingertip pinch force (r = 0.15, P < 0.05; r = 0.20, P < 0.01).

[0072] Table 3 Correlation between pinch strength, pen-holding posture and pre-writing performance of preschool children

[0073]

[0074] (aP<0.05, b P<0.01).

[0075] 3.3 Correlation between pre-writing ability and copying ability of older children

[0076] To further explore the correlation between preschool children's pre-writing ability and Chinese character writing ability. This study conducted a separate word copying task for the older class (Table 4), and conducted a correlation study on the results of the imitation drawing task and the copying task. According to Table 5, the total time, writing time, and pause time of the imitation drawing task and the copying task were significantly correlated (all P < 0.01). The writing pressure of the imitation drawing task was also significantly correlated with the total time, writing time, pause time, and writing pressure of the copying task (all P < 0.05).

[0077] Table 4 Results of the copying task for large classes

[0078]

[0079] Table 5 Correlation between pre-writing ability and copying ability of older children

[0080]

[0081] ( a P<0.05, b P<0.01)

[0082] 3.4 Construction of the structural equation model of preschool children’s pre-writing ability performance

[0083] According to the evaluation index of pre-writing ability of preschool children, a structural equation was constructed (e.g. Figure 3 ). The model showed a good fit, χ 2 The P value was 48.4, the P value was 0.05, the degrees of freedom were 34, the standardized root mean square residual was 0.04, the root mean square error of approximation was 0.04, the comparative fit index was 0.99, and the Tucker-Lewis index was 0.98.

[0084] According to the structural equation, the pen-holding posture in the preschool period is directly affected by pinch force, that is, the development of fine motor skills, and as a mediating variable, it mediates the effects of writing pressure and pinch force on writing performance; and the control of pinch force is also positively correlated with the writing pressure shown by children. In addition, task time, writing pressure, and proficiency in the task also affect the overall writing performance. Among them, good control of writing pressure in the preschool period may be related to the improvement of the speed of completing writing tasks for young children.

[0085] 4 Discussion

[0086] This study conducted a cross-sectional sampling survey on the pre-writing ability of preschool children in Shanghai, established a standardized assessment process and objective assessment tools, and obtained the development characteristics and reference range of pre-writing ability of the population at this stage. In addition, this study reported the pen-holding posture of preschool children for the first time, explored the correlation between finger strength, pen-holding posture and writing performance of preschool children, and explored the promoting relationship between pre-writing ability and the later development of copying ability.

[0087] Cross-sectional surveys show that more than half of preschool children begin to develop functional pen grip in the middle class stage, but if the fingertip strength is insufficient at this stage, inefficient grasping is likely to occur, affecting overall writing performance. This study found that children's pre-writing ability is directly related to the development of fine motor skills, especially the development of fingertip pinch strength and three-finger pinch strength, and finger strength directly affects whether children can form a functional pen grip posture. The structural equation model also suggests that the greater the child's pinch strength and the greater the writing pressure, the shorter the time for the imitation drawing task and the shorter the pause time, suggesting that focusing on training children's finger strength in the pre-writing stage can promote the development of writing ability.

[0088] In addition, the ability to write lines in the pre-writing stage is correlated with the children's ability to write Chinese characters in the later stage. In addition to the positive correlation between the time taken to complete the two tasks, it is worth noting that the writing pressure in the pre-writing stage is negatively correlated with the time taken to copy the Chinese characters, suggesting that the power control ability formed when practicing basic lines can promote the efficiency of completing the task when writing Chinese characters. Therefore, in the pre-writing stage, children's power control ability to hold and move the pen can be trained by drawing lines and graphics, and similar exercises can promote the development of visual-motor integration ability, thereby adapting to writing tasks more quickly after entering school age.

[0089] 5 Conclusion

[0090] This study innovatively conducted an exploratory study on the quantitative assessment of pre-writing ability in preschool children, established a standardized assessment process and reference range in Shanghai, and proposed a feasible writing ability promotion plan for the pre-writing stage based on the research results. In the future, more subjects from different regions can be included to expand the sample characteristics of different regions across the country and obtain more universal conclusions.

[0091] The above is only a preferred embodiment of the present invention and does not limit the present invention in any way. Any technician in the relevant technical field, without departing from the scope of the technical solution of the present invention, makes any form of equivalent replacement or modification to the technical solution and technical content disclosed in the present invention, which does not depart from the content of the technical solution of the present invention and still falls within the protection scope of the present invention.

Claims

1. A method for evaluating the early pen-holding and pre-writing abilities of preschool children, characterized in that: Intelligent writing assessment tools and pinch dynamometers were used to conduct standardized assessments on children in middle and senior classes, and the relevant data were statistically analyzed to obtain the results of preschool children's early pen holding and pre-writing abilities.

2. The method for assessing the early pen-holding and pre-writing abilities of preschool children according to claim 1, characterized in that: The intelligent writing assessment tool consists of an intelligent writing board and external computer software. An A4-sized imitation drawing test paper is placed on the writing board, and the vertical and horizontal edges of the paper are parallel to the two sides of the writing board. The device is equipped with a standard-sized intelligent writing pen, which is a wireless electronic ink pen with a force-sensitive pen tip; the pinch force meter tool consists of a pinch force meter and computer software.

3. The method for assessing the early pen-holding and pre-writing abilities of preschool children according to claim 1, characterized in that: The evaluation indicators are divided into four parts: The first part is the objective indicators obtained by using the writing board, including the total task time, writing time, pause time, track length, and writing pressure of the imitation task and the copying task; The second part is the pinch force measurement results, including lateral pinch force, three-finger pinch force and fingertip pinch force, the unit is Newton; The third part is the pen holding posture; In the fourth part, professional assessors give a 4-point score to the line results completed by the children in the imitation drawing task, and obtain three sub-scores of stability, coordination and force regulation as well as a total score.

4. The method for assessing the early pen-holding and pre-writing abilities of preschool children according to claim 3, characterized in that: Imitation drawing task: The test includes 9 lines in total. The subjects are required to imitate the red line example on the left side of the green double solid line and draw in the answer area on the right. The test is divided into three groups, each of which includes three types of lines: curve, wall line, and broken line. The three groups test the stability, coordination, and weight control ability of the pen respectively. The first group requires the subjects to complete the imitation drawing without touching the black solid lines on both sides; the second group requires them to draw lines evenly around the black dots; The third group requires drawing with force on the thickened lines based on continuous drawing.

5. The method for assessing the early pen-holding and pre-writing abilities of preschool children according to claim 3, characterized in that: Copying task: Children in the senior class completed this test. The test required the subjects to copy the words on the left to the grid on the right. There were 5 simple words in total, all of which were common words required by the first-grade syllabus, and contained single-character words, left-right structures, up-down structures, Pin structures, and semi-enclosed structures.

6. The method for assessing the early pen-holding and pre-writing abilities of preschool children according to claim 3, characterized in that: Pinch force measurement: It includes three test items, namely, side pinch force, with the sides of the thumb and index finger as the contact surface; three-finger pinch force, with the middle of the thumb, index finger and middle finger as the contact surface; fingertip pinch force, with the thumb and index finger as the contact surface.

7. The method for assessing the early pen-holding and pre-writing abilities of preschool children according to claim 3, characterized in that: Pen-holding posture: The pen-holding posture in the preschool period is divided into four stages: palm supination grasp at 1 to 1.5 years old, finger pronation grasp at 2 to 3 years old, static quadruped or tripod grasp at 3.5 to 4 years old, and dynamic tripod grasp at 4.5 to 5 years old. For children in the middle class and above, both static tripod and posterior tripod grasp are considered functional grasps.

8. The method for assessing the early pen-holding and pre-writing abilities of preschool children according to claim 7, characterized in that: Based on the dynamic tripod, a variation of the rear tripod can be formed by using the back of the thumb to hold the pen.

9. The method for assessing the early pen-holding and pre-writing abilities of preschool children according to claim 1, characterized in that: The statistical analysis method used was as follows: EpiData 3.1 Chinese version and smart writing board were used to collect valid evaluation results, Microsoft Office Excel was used for preliminary data cleaning and collation, SPSS20 was used to establish a database, and statistical processing was performed.

10. The method for assessing the early pen-holding and pre-writing abilities of preschool children according to claim 9, characterized in that: Statistical processing methods: For measurement data that conformed to normal or approximately normal distribution, mean description and parameter test were used; for measurement data that did not conform to normal distribution, median and Mann-Whitney U test were used, and the number of cases was used to describe the count data. The Pearson correlation coefficient was used to explore the correlation between quantitative data, and the structural equation model was constructed using SPSS AMOS26. P < 0.05 was considered statistically significant.

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