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目的探讨广州地区未婚女青少年实现安全流产需求的障碍。方法选取2012年9月-2013年8月在广东省人民医院、广州市妇女儿童医疗中心珠江新城院区、广州市妇女儿童医疗中心妇婴院区、天河区计划生育服务中心就诊的广州地区未婚女青少年332人,采取统一自制的自填式问卷进行调查。在上述每所医院的计划生育部门、计划生育手术室及病房分别抽取医生及护士各1名,根据自行设计的“流产服务提供者调查表”进行个体访谈和集体访谈,采用单因素分析及多因素Logistic回归分析。结果居住在乡、镇以及流动未婚女青少年更倾向于不接受婚前性行为,独生子女更倾向于不接受婚前性行为。(2)城市未婚女青少年发生性行为的概率更高。有性行为的未婚女青少年生殖健康知识得分较高。有宗教信仰的未婚女青少年有多个性伴的概率高于无宗教信仰的未婚女青少年。有多个性伴的未婚女青少年生殖健康知识得分较低。未婚女青少年生殖健康知识的得分越低,有多个性伴的概率越高。在所知道的性与生殖健康服务的咨询方式中,医疗机构的面访应答人数百分比最高;需要生殖健康治疗的问题中月经问题最高;在选择服务提供者时所考虑的主要因素是医疗技术水平;人工流产最关注的问题最多为安全;知道人工流产术后近期或远期并发症最多的是不孕;流产术后想得到最多的避孕知识是流产后注意事项及避孕方法的种类。愿意选择的生殖健康服务形式最多为咨询交谈。流产服务提供者认为部分未婚青少年缺乏避孕知识;家庭对青少年性教育方面缺乏指导及沟通。公立医院就医流程繁琐;对公立医院“看病难看病贵”的印象妨碍其选择公立医院作为提供流产服务的机构。私立医疗机构过度宣传其好处;如果没有专门机构监管,其流产手术风险较高。结论广州地区未婚女青少年整体缺乏全面正确的生殖健康知识,多种因素影响着广州地区未婚女青少年实现安全流产的需求。
Objective To explore the barriers to achieving safe abortion in unmarried girls and adolescents in Guangzhou. Methods From September 2012 to August 2013 in Guangzhou Pearl River New City Hospital of Guangdong Provincial People’s Hospital, Guangzhou Women and Children Medical Center, Maternal and Child Hospital of Guangzhou Women and Children Medical Center and Guangzhou Family Planning Service Center of Tianhe District, Guangzhou 332 young women and adolescents, using a self-contained questionnaire to conduct a survey. One doctor and one nurse were taken from the family planning department, family planning operating room and ward of each hospital. Individual interview and collective interview were conducted according to self-designed “Questionnaire on Abortion Service Provider”. Univariate analysis And multivariate logistic regression analysis. Results Residents living in townships, towns and migrant unmarried teenagers tended to not accept premarital sex, while single children tended not to accept premarital sex. (2) The probability of unmarried girls and adolescents in urban areas is higher. Reproductive health knowledge score among unmarried women who have sex is higher. The probability of unmarried female adolescents with multiple religions is greater than that of unmarried female adolescents without religion. Female adolescent girls with multiple partners have lower reproductive health knowledge scores. The lower the score of reproductive health knowledge for unmarried women and adolescents, the higher the probability of having multiple partners. The percentage of face-to-face respondents to medical institutions was the highest among consultations on sexual and reproductive health services that were known; menstrual problems were highest in those requiring reproductive health treatment; and the main factor considered in the selection of service providers was medical skill level ; Abortion is the most concerned about the most security issues; know that abortion is the most recent short-term or long-term complications of infertility; the most sought after abortion knowledge of contraception is the precautions after abortion and types of methods of contraception. Willing to choose the most form of reproductive health services for counseling and conversation. Abortion providers think that some unmarried adolescents lack the knowledge of contraception; the family lacks guidance and communication on adolescent sexual education. The public hospital medical treatment process cumbersome; public hospital “see a doctor difficult to expensive” impression hindered its choice of public hospitals as an institution to provide abortion services. Private health care facilities over-publicize their benefits; the risk of miscarriage is high without the supervision of specialized agencies. Conclusions The unmarried female adolescents in Guangzhou lacks a comprehensive and correct knowledge of reproductive health. Various factors affect the demand for safe abortion among unmarried female adolescents in Guangzhou.