河北省农村已婚育龄妇女生殖健康状况及影响因素分析
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摘要
目的了解河北省农村已婚育龄妇女的生殖健康现状,探讨其影响因素,为政府部门制定有关促进生殖健康的策略和措施提供科学依据。
方法在河北省范围内,采用多阶段整群抽样方法抽取了966名符合条件的20～49周岁农村已婚育龄女性为调查对象,用自拟的调查表统一进行调查。调查内容包括人口学特征有年龄、民族、学历、职业、婚姻、和家庭年收入,生殖健康概括为生育调节、妇女保健、生殖道感染、生殖健康服务。由经过培训的调查员对其进行入户面访,问卷由调查员亲自填写,所有资料应用EXCEL软件录入数据和校验,数据采用SPSS13.0统计软件包进行分析处理,影响因素分析分别采用χ2检验、logistic分析方法,检验水准为0.05。
结果
1人口学特征:调查对象涉及到年龄、学历、职业、和家庭年收入等。其中,年龄以30～39岁组人数最多,平均年龄(33.85+6.85)岁。职业农民占大多数,文化程度初中和高中以上为主,以高中为多;婚姻初婚的占90%,家庭年收入普遍较低。
2生育调节情况:河北省育龄妇女的避孕节育知识知晓率不高,其中知道4种以上、3种、2种和1种避孕方法的妇女比例依次为:32%、53.2%、79.5%、和100.0%。已婚育龄妇女大多采取了避孕措施,以“女性绝育(含宫内节育器)”和“避孕套”为主,在避孕方法选择上仅有20.97%能够自己决定,其余的79.03%的妇女是由计划生育人员建议或政策规定,对于所用避孕方法满意为34.5%。人工流产方面:36.3%的育龄妇女曾经做过人工流产(包括药物流产)或引产,其中,做过2次及2次以上人流的女性占14.9%;人工流产的主要原因“违反生育计划政策”和“避孕失败造成意外怀孕”,为主,占到了总数的76%。
3妇幼保健情况:本次调查已婚育龄妇女中,怀孕活产率为78.3%,她们中只有620人接受过产前检查。而她们初次分娩的地点主要集中在乡卫生院、其它综合医院和计生服务站,占到了总数的77%。
4生殖道感染:有47.3%的人在近一年参加过定期妇科检查,其中有439人查出患有各种妇科疾病,所患妇科疾病主要为:月经不调、阴道炎、慢性盆腔炎、妇科肿瘤等为主,有60%的人选择去医院治疗。在性病、艾滋病知晓情况方面;90%左右调查对象都听说过,但对性病、艾滋病症状、传播途径及预防方法等方面的知识水平掌握都很低。
5生殖健康服务状况:占调查总数37.7%已婚育龄妇女最希望所了解生殖健康知识是“性心理、性生理”,48.5%人最希望获得生殖健康知识的渠道为“广播、电视”。在遇到生殖健康问题首先会选择“专业水准高”的“专科医院”。
6生殖健康影响因素分析:以农村已婚育龄妇女是否患有妇科病为因变量,应用logistic回归分析影响因素。结果:初婚年龄、避孕措施和人工流产为已婚育龄妇女患妇科病的主要影响因素。
结论
1河北省农村育龄妇女整体生殖健康状况不容乐观,生殖健康相关知识的掌握水平较低,患病就诊意识差,生殖健康服务利用行为有待进一步改善。
2初婚年龄、避孕措施、流产史是影响农村已婚育龄妇女妇科病的主要因素。
3针对农村育龄妇女的薄弱环节开展生殖健康教育,提高避孕有效率,减少人工流产率,提倡晚婚晚育,改善育龄妇女生殖健康水平。
Objective
To know the reproductive health status among rural married reproductive women in Hebei province and explore its influencing factors , and to provide the scientific basis for government departments to establish the strategies and measures of reproductive health.
Methods
In Hebei province range, 966 rural married reproductive women, aged from 20 to 49 years old ,were selected with the multi-stage cluster sampling method and investigated by face-to-face with the questionnaire designed by ourselves, which included the demographic characteristics( age, nationality, education, occupation, marriage and family year income), reproductive health summarized as fertility regulation, women care, genital infection, reproductive health services. All the survey data were checked and analyzed with SPSS13.0 statistical packages,χ2 test and multivariate Logistic regression were used to analyze the affecting factors.
Results
1 Demographic characteristics: There are some survey relate to age, education, occupation, and family income, etc. Among them, the age of 30 to 39 is in highest number, and the average age is 33.85 + 68.5 years. Professional: fainters constitute the majority; Education degree: the most is middle and high school, and the high school is higher; Marriage: first-marriage families is 90%, with incomes is generally low.
2 Fertility regulation situation: In HeBei province reproductive Women who knowledge about masses contraceptive are not high, which know the contraceptive methods as four, three, two and one is as follows: the proportion is 32% 53.2%, 79.5%,and 100.0%. Married Reproductive Women mostly are contraceptive, most of whom are female sterilization (contain intrauterine device)" and "condom". About contraceptive methods, 20.97% of them can only make decision by themselves, and the others made decision by the staff’s suggestion or policy. 34.5% of them suggestion is satisfaction. Abortion aspects: 36.3% of reproductive Women once made abortion (including drug abortion) or induced labor, 14.9% of whom have done more than 2 times and 2 times. The main reason for the artificial abortion are "violation planning policy" and "contraceptive failure causes accidental pregnancy", accounted for 76 % of the total.
3 Maternity and child care situation: In this survey, 78.3% of Women are pregnant. 620 people of them only received antenatal examination. And they first delivery locations are mainly concentrated in township hospital, other general hospital and family planning service station, accounted for 77% of the total.
4 Genital infection: A commendable 47.3% of people attended a regularly gynaecological check-up in recent one year, and found 439 people with various gynecological diseases, mainly for: menstruation, vaginitis, the chronic pelvic inflammation, gynecological tumors etc give priority to, and 60% of them chose to go to a hospital for treatment. About 90% investigation objects were heard about venereal disease and AIDS awareness, but the mastering of knowledge about transmitted and prevention method of aspects were very low.
5 Reproductive health service status: 37.7% of total number of married reproductive women hoped to know the knowledge about reproductive health is "sexual psychology, physiological"most, and 48.5% of them hoped to gain most channels of reproductive health knowledge for "radio, TV".And they could choose "professional high" "specialized subject hospital" firstly when they met the reproductive health problems.
6 Analysis of reproductive health:Take rural women of reproductive age who are suffering from gynecological diseases as the dependent variable, apply logistic regression to analysis factors. Results: The main factors for married women of reproductive age suffering from gynecological diseasesge are: first marriage age, contraception and abortion.
Conclusion
1 The child-bearing age overall reproductive health of rural women in Hebei province was not optimistic, and reproductive health related knowledge grasping level was low, and sick medical consciousness was difference, and reproductive health services utilization behavior need further improvement.
2 First marriage age, contraceptive measures, and the history of abortion is married reproductive women on the disease of department of gynaecology main factors.
3 It is necessary to educate reproductive women for the weak link in rural reproductive health to improve the contraceptive efficiency, and reduce the abortion rates, and delay the marriage and childbearing, and improve the reproductive health of reproductive women.
方法在河北省范围内,采用多阶段整群抽样方法抽取了966名符合条件的20～49周岁农村已婚育龄女性为调查对象,用自拟的调查表统一进行调查。调查内容包括人口学特征有年龄、民族、学历、职业、婚姻、和家庭年收入,生殖健康概括为生育调节、妇女保健、生殖道感染、生殖健康服务。由经过培训的调查员对其进行入户面访,问卷由调查员亲自填写,所有资料应用EXCEL软件录入数据和校验,数据采用SPSS13.0统计软件包进行分析处理,影响因素分析分别采用χ2检验、logistic分析方法,检验水准为0.05。
结果
1人口学特征:调查对象涉及到年龄、学历、职业、和家庭年收入等。其中,年龄以30～39岁组人数最多,平均年龄(33.85+6.85)岁。职业农民占大多数,文化程度初中和高中以上为主,以高中为多;婚姻初婚的占90%,家庭年收入普遍较低。
2生育调节情况:河北省育龄妇女的避孕节育知识知晓率不高,其中知道4种以上、3种、2种和1种避孕方法的妇女比例依次为:32%、53.2%、79.5%、和100.0%。已婚育龄妇女大多采取了避孕措施,以“女性绝育(含宫内节育器)”和“避孕套”为主,在避孕方法选择上仅有20.97%能够自己决定,其余的79.03%的妇女是由计划生育人员建议或政策规定,对于所用避孕方法满意为34.5%。人工流产方面:36.3%的育龄妇女曾经做过人工流产(包括药物流产)或引产,其中,做过2次及2次以上人流的女性占14.9%;人工流产的主要原因“违反生育计划政策”和“避孕失败造成意外怀孕”,为主,占到了总数的76%。
3妇幼保健情况:本次调查已婚育龄妇女中,怀孕活产率为78.3%,她们中只有620人接受过产前检查。而她们初次分娩的地点主要集中在乡卫生院、其它综合医院和计生服务站,占到了总数的77%。
4生殖道感染:有47.3%的人在近一年参加过定期妇科检查,其中有439人查出患有各种妇科疾病,所患妇科疾病主要为:月经不调、阴道炎、慢性盆腔炎、妇科肿瘤等为主,有60%的人选择去医院治疗。在性病、艾滋病知晓情况方面;90%左右调查对象都听说过,但对性病、艾滋病症状、传播途径及预防方法等方面的知识水平掌握都很低。
5生殖健康服务状况:占调查总数37.7%已婚育龄妇女最希望所了解生殖健康知识是“性心理、性生理”,48.5%人最希望获得生殖健康知识的渠道为“广播、电视”。在遇到生殖健康问题首先会选择“专业水准高”的“专科医院”。
6生殖健康影响因素分析:以农村已婚育龄妇女是否患有妇科病为因变量,应用logistic回归分析影响因素。结果:初婚年龄、避孕措施和人工流产为已婚育龄妇女患妇科病的主要影响因素。
结论
1河北省农村育龄妇女整体生殖健康状况不容乐观,生殖健康相关知识的掌握水平较低,患病就诊意识差,生殖健康服务利用行为有待进一步改善。
2初婚年龄、避孕措施、流产史是影响农村已婚育龄妇女妇科病的主要因素。
3针对农村育龄妇女的薄弱环节开展生殖健康教育,提高避孕有效率,减少人工流产率,提倡晚婚晚育,改善育龄妇女生殖健康水平。
Objective
To know the reproductive health status among rural married reproductive women in Hebei province and explore its influencing factors , and to provide the scientific basis for government departments to establish the strategies and measures of reproductive health.
Methods
In Hebei province range, 966 rural married reproductive women, aged from 20 to 49 years old ,were selected with the multi-stage cluster sampling method and investigated by face-to-face with the questionnaire designed by ourselves, which included the demographic characteristics( age, nationality, education, occupation, marriage and family year income), reproductive health summarized as fertility regulation, women care, genital infection, reproductive health services. All the survey data were checked and analyzed with SPSS13.0 statistical packages,χ2 test and multivariate Logistic regression were used to analyze the affecting factors.
Results
1 Demographic characteristics: There are some survey relate to age, education, occupation, and family income, etc. Among them, the age of 30 to 39 is in highest number, and the average age is 33.85 + 68.5 years. Professional: fainters constitute the majority; Education degree: the most is middle and high school, and the high school is higher; Marriage: first-marriage families is 90%, with incomes is generally low.
2 Fertility regulation situation: In HeBei province reproductive Women who knowledge about masses contraceptive are not high, which know the contraceptive methods as four, three, two and one is as follows: the proportion is 32% 53.2%, 79.5%,and 100.0%. Married Reproductive Women mostly are contraceptive, most of whom are female sterilization (contain intrauterine device)" and "condom". About contraceptive methods, 20.97% of them can only make decision by themselves, and the others made decision by the staff’s suggestion or policy. 34.5% of them suggestion is satisfaction. Abortion aspects: 36.3% of reproductive Women once made abortion (including drug abortion) or induced labor, 14.9% of whom have done more than 2 times and 2 times. The main reason for the artificial abortion are "violation planning policy" and "contraceptive failure causes accidental pregnancy", accounted for 76 % of the total.
3 Maternity and child care situation: In this survey, 78.3% of Women are pregnant. 620 people of them only received antenatal examination. And they first delivery locations are mainly concentrated in township hospital, other general hospital and family planning service station, accounted for 77% of the total.
4 Genital infection: A commendable 47.3% of people attended a regularly gynaecological check-up in recent one year, and found 439 people with various gynecological diseases, mainly for: menstruation, vaginitis, the chronic pelvic inflammation, gynecological tumors etc give priority to, and 60% of them chose to go to a hospital for treatment. About 90% investigation objects were heard about venereal disease and AIDS awareness, but the mastering of knowledge about transmitted and prevention method of aspects were very low.
5 Reproductive health service status: 37.7% of total number of married reproductive women hoped to know the knowledge about reproductive health is "sexual psychology, physiological"most, and 48.5% of them hoped to gain most channels of reproductive health knowledge for "radio, TV".And they could choose "professional high" "specialized subject hospital" firstly when they met the reproductive health problems.
6 Analysis of reproductive health:Take rural women of reproductive age who are suffering from gynecological diseases as the dependent variable, apply logistic regression to analysis factors. Results: The main factors for married women of reproductive age suffering from gynecological diseasesge are: first marriage age, contraception and abortion.
Conclusion
1 The child-bearing age overall reproductive health of rural women in Hebei province was not optimistic, and reproductive health related knowledge grasping level was low, and sick medical consciousness was difference, and reproductive health services utilization behavior need further improvement.
2 First marriage age, contraceptive measures, and the history of abortion is married reproductive women on the disease of department of gynaecology main factors.
3 It is necessary to educate reproductive women for the weak link in rural reproductive health to improve the contraceptive efficiency, and reduce the abortion rates, and delay the marriage and childbearing, and improve the reproductive health of reproductive women.
引文
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16唐永军,田爱平,赵小菲.全球生殖道感染和性传播疾病流行概况.中国计划生育学杂志,2003,11(5):313-315.
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3王哲蔚,王丽珍上海地区妇女围婚期生殖健康现状调查中国妇女保健, 2001, 6 ( 1) : 53
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6林彩菊,钟国红,张淑莹,等.育龄妇女使用五种宫内节育器临床效果分析.实用临床医学,2008年第9卷第6期
7王存同,郑晓瑛,陈功.我国已婚育龄人群避孕水平及避孕方法使用趋势[J].人口学刊, 2007, (4):57-62.
8 Bruce J.Fundamental Elements of the Quality of Care:A SimPle Framework [J]Studies in Family planning Mareh/April,1990,21(2):61一91.21
9RuthSimmonsPeterHall.TheStrategicAPProachtoContraeePtiveIntroduetion[J]Studies in Family Planning,1997,28(2):79一94.
10安小霞,丁晓英,孙洁,等.行人工流产的未婚女青年避孕行为、知识及需求现状调查[J].护理研究2011年2月第25卷第2期(总第350期)
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15Goto A,Nguyen QV,Pham NM,et al.Prevalence of and factors associated withreproductive tract infections among pregnant women in tencommunesinNgheanprovince,Vietnam.JEpidemiol,2005,15(5):163-172.
16唐永军,田爱平,赵小菲.全球生殖道感染和性传播疾病流行概况.中国计划生育学杂志,2003,11(5):313-315.
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19薛志雯.育龄期妇女生殖健康调查与分析.中国城乡企业卫生.2009年6月第3期(总第131期)
20杨华,任娟,蒋幼芳,等.浙江省育龄妇女生殖道感染及性传播疾病知识调查[J] .浙江预防医学, 2007,19 (5):8 -9, 12.
21张亦心,路庆章,吕丽华,等.河北省农村已婚育龄妇女生殖道感染现状调查[ J ] .中国计划生育学杂志, 2009, 17 ( 6 ) : 347 - 348.
22王德文,龚正兰,李芝兰.甘肃省永靖县农村已婚育龄妇女生殖健康现况调查.兰州医学院学报,2003;29(l):26一28
23张文辉,彭玲,刘春兰.贫困地区农村已婚育龄妇女生殖道感染危险因素分中国妇幼保健,2003;18(10):589一591
24赵更力,王临虹,陈丽君,鲍月琴.已婚育龄妇女生殖健康状况的流行病学调查.中国公共卫生.2000;16(12):1125一1128
25张红杰,高淑云,岑阳.农村已婚育龄妇女生殖道感染及其影响因素调查.中国公共卫生,2002;18(7):838
26郭素芳,Oratia Rauyajin,Vanawip ha Pasandhanatom等.中国农村生殖道感染妇女卫生服务需求情况调查.中国公共卫生,2001,17(5):441
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29任学锋,余冬宝主编.艾滋病防治媒体报道参考手册.北京:军事医学科学出版社,2005:28
30林丹华,方晓义等.中国流动人口艾滋病问题及预防干预.中国艾滋病性病,2005,11(2):158
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33王昌亚,曲蓓蕾,井明霞.我国生殖道感染妇女就医行为研究进展.现代生物医学进展. 2010年11月第10卷第16期
34于淑丽,张开宁,方著,龚幼龙.贫困农村妇女生殖道感染服务提供与利用研究.中国卫生资源,2003:6(3):120一122
35李晓梅,张开宁,时黎.云南农村妇女对生殖道感染诊疗质量的评价.中国妇幼保健,2002;26:100一202
36王德文龚正兰李芝兰等.甘肃省永靖县农村已婚育龄妇女生殖健康现况调查兰州医学院学报2003年3月第29卷第1期J Lanzhou Med Coll ,Mar. 2003 ,Vol 29 , No1