未婚女性人流与流产后服务现状及重复流产影响因素研究
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摘要
目的
随着性观念的开放，青少年婚前性行为增多，导致未婚女性人工流产率及重复流产率居高不下，严重危害着未婚青少年的身心健康。本研究旨在了解未婚女性人工流产与流产后服务现状，探索未婚女性重复流产影响因素，为保护其生殖健康，完善我国流产后服务体系提供依据。
方法
采用现况研究方法，对2010年7月-2011年1月，到山西省6所医院进行人工流产的18-24岁的492例未婚女性进行问卷调查，收集其人工流产知识、态度、行为的资料，应用EpiData软件录入、SPSS13.0软件分析资料，了解未婚女性人流和流产后服务现状，并将其分成重复流产组(163例)和首次流产组(329例)，使用多因素Logistic回归模型和决策树模型探讨未婚女性重复流产影响因素。
结果
(1)研究对象平均年龄为21.62±1.82岁，52.6%为非本市户口，47.9%为大专及以上学历，职业为公司职员、学生、服务员的分别占20.5%、20.9%、23.0%，73.6%不与父母同住，与父亲和母亲交流性话题的分别占5.3%和48.8%。
(2)研究对象中，58.9%同意双方愿意就可婚前性行为，44.1%同意婚前性行为可判断双方是否合适，17.3%认为一夜情可以接受，86.0%同意今后避孕，79.5%需要生殖健康知识。
(3)研究对象性病与妊娠知识得分的均分为5.74±1.69(满分9分)，避孕知识得分的均分为4.50±1.87(满分8分)，85.6%通过电视/电台/网络获得以上知识。
(4)研究对象中，57.5%首次性行为年龄为19-21岁，36.8%有两个性伴以上，13.2%每次都避孕，84.9%选择避孕套，未坚持避孕者45.7%认为偶尔的性行为不会怀孕；33.1%为重复流产、最多流产5次，62.0%距上次流产时间在6个月内；此次怀孕，62.6%的研究对象因为未避孕。
(5)医生服务态度较好，对流产知识有一定宣教，但50.8%的研究对象未被介绍避孕方法的种类，69.9%未被介绍避孕药具的使用方法，98.4%和88.6%未被提供避孕药具、介绍到其他地方进行计划生育宣教。
(6)研究提示：学历、职业、性伴个数、避孕频率、距首次性行为时间、性伴了解避孕知识情况、性伴关心避孕问题情况、是否同居、了解生殖健康知识情况为未婚女性重复流产的影响因素。
结论
(1)未婚人流女性多为外来人口，职业多为服务员、学生，与父母同住者较少，且很少与父母交流性话题。
(2)未婚人流女性对婚前性行为的态度开放，对今后避孕和需要生殖健康知识持肯定态度。
(3)未婚人流女性生殖健康知识多来自于网络、书籍，对这方面知识的掌握程度不够深入，且有一些错误的概念和认知。
(4)只有少数未婚人流女性坚持每次避孕，避孕措施多使用安全套，此次流产距上次流产时间较短。
(5)医生服务态度好，对流产知识有一定的宣教，但计划生育服务欠缺。
(6)多因素Logistic回归与决策树模型综合应用效果良好，提示未婚女性学历低，无职业，性伴个数多，避孕频率低，距首次性行为时间长，有同居生活，了解生殖健康知识少，性伴对避孕知识了解少、对避孕问题关心少，发生重复流产的可能性大。
Objective
With the opening of the sexual concept, teenagers’sexual behaviour before marriage is increased,it lead to the abortion rate and repeated abortion rate remains high in unmarried women, it isvery harmful to their health of body and mind.The study is to learn the status of induced abortionand post-abortion care, and to explore the factors of repeated abortion in unmarried women forproviding basis for protect their reproductive health and perfect the system of post-abortion care.
Methods
492 cases of unmarried women aged 18-24 years, classified into repeated abortion group with163 cases and abortion for the first time group with 329cases, from six hospitals of ShanxiProvince were surveyed from July 2010 to January 2011 through questionnaires,collect the dataof abortion knowledge,attitude and behavior,EpiData software was applied to input the data andSPSS13.0 software was used for analysis of data, and multi-factor logistic regression model anddecision tree model were used to explore the factors concerning repeated abortion.
Results
(1) The mean age of the objects was 21.62±1.82 years; 52.6% of all objects were registeredresidents of other cities; 47.9% had received education of a junior college or higher; and 20.5%of company staff, 20.9% of students, 23.0% of attendants; and 73.6% of all objects didn’t livewith their parents; 5.3% and 48.8% communicate the topic of sex with their father and mother.
(2) 58.9% of all objects agreed to have premarital sex with the consent from both sides; 44.1%agreed that whether lovers were right to be together or not could be judged through premaritalsex; 17.3% thought that one-night stand was acceptable; 86.0% and 79.5% agreed that theywould have contraception in the future and believed that they were needy in reproductive healthknowledge.
(3) Mean credit for knowledge concerning sexually transmitted diseases and pregnancy was 5.74±1.69 (out of 9 points), and for knowledge related to contraception 4.50±1.87 (out of 8 points);85.6% obtain above knowledge through TV, radio and internet channels.
(4) The age of first sexual intercourse for 57.5% of all objects was 19-21;36.8% had more thanone sexual partners; 13.2% had contraception once they had sex and 84.9% through condoms;and 45.7% believed that occasional sexual intercourse would not lead to pregnancy;33.1% of allobjects underwent repeated abortion,and some even had abortion of five times;62.0% whounderwent repeated abortion had the last abortion less than 6 months ago; and this time ,62.6%didn’t use any contraceptive method.
(5) Attitude of doctors’was good to their patients, knowledge of abortion also have introduced,50.8% and 69.9% were not be introduced the types of contraceptive methods and how to use thecontraceptive medicines and devices,98.4% and 88.6% are not provided contraceptive medicinesand devices , to other place accept family planning education.
(6) Results showed that education, occupation, the number of sexual partners, contraceptiveusage, length from the first sexual intercourse to now, the status of sexual partners realize andconcern the contraception,cohabitation,awareness of reproductive health knowledge of theunmarried women were factors for repeated abortion.
Conclusion
(1) Most of unmarried women are people from other regions, they are most attendants andstudents, and mostly not living regularly with their parents, and rarely have sexual topics withtheir parents.
(2) The attitude to premarital sex is open of unmarried women，and they are positive about thatthey will use contraceptive in the future and need reproductive health knowledge.
(3) Reproductive health knowledge for unmarried women are from the Internet, books, but theydon’t know much about such knowledge, even they have wrong concepts and cognition onreproductive health knowledge.
(4) Only a small portion of unmarried women adopt contraception for each sexual intercourseand commonly choose condoms, the length from last abortion to now is short.
(5) Doctors Attitude was good to their patients, and they provide some education of inducedabortion, but lack of family planning services.
(6) The effect is good of comprehensive application of Logistic regression and decision treemodel.Point out unmarried women with lower level of education, no job, more sexual partners,the fewer frequency of contraception, the longer the length from the first sexual intercourse tonow, the fewer awareness of contraceptive knowledge of sexual partners, sexual partners wereconcerned about contraception lesser, cohabitation, and the less awareness of reproductive healthknowledge are more likely to undergo repeated abortion.
随着性观念的开放，青少年婚前性行为增多，导致未婚女性人工流产率及重复流产率居高不下，严重危害着未婚青少年的身心健康。本研究旨在了解未婚女性人工流产与流产后服务现状，探索未婚女性重复流产影响因素，为保护其生殖健康，完善我国流产后服务体系提供依据。
方法
采用现况研究方法，对2010年7月-2011年1月，到山西省6所医院进行人工流产的18-24岁的492例未婚女性进行问卷调查，收集其人工流产知识、态度、行为的资料，应用EpiData软件录入、SPSS13.0软件分析资料，了解未婚女性人流和流产后服务现状，并将其分成重复流产组(163例)和首次流产组(329例)，使用多因素Logistic回归模型和决策树模型探讨未婚女性重复流产影响因素。
结果
(1)研究对象平均年龄为21.62±1.82岁，52.6%为非本市户口，47.9%为大专及以上学历，职业为公司职员、学生、服务员的分别占20.5%、20.9%、23.0%，73.6%不与父母同住，与父亲和母亲交流性话题的分别占5.3%和48.8%。
(2)研究对象中，58.9%同意双方愿意就可婚前性行为，44.1%同意婚前性行为可判断双方是否合适，17.3%认为一夜情可以接受，86.0%同意今后避孕，79.5%需要生殖健康知识。
(3)研究对象性病与妊娠知识得分的均分为5.74±1.69(满分9分)，避孕知识得分的均分为4.50±1.87(满分8分)，85.6%通过电视/电台/网络获得以上知识。
(4)研究对象中，57.5%首次性行为年龄为19-21岁，36.8%有两个性伴以上，13.2%每次都避孕，84.9%选择避孕套，未坚持避孕者45.7%认为偶尔的性行为不会怀孕；33.1%为重复流产、最多流产5次，62.0%距上次流产时间在6个月内；此次怀孕，62.6%的研究对象因为未避孕。
(5)医生服务态度较好，对流产知识有一定宣教，但50.8%的研究对象未被介绍避孕方法的种类，69.9%未被介绍避孕药具的使用方法，98.4%和88.6%未被提供避孕药具、介绍到其他地方进行计划生育宣教。
(6)研究提示：学历、职业、性伴个数、避孕频率、距首次性行为时间、性伴了解避孕知识情况、性伴关心避孕问题情况、是否同居、了解生殖健康知识情况为未婚女性重复流产的影响因素。
结论
(1)未婚人流女性多为外来人口，职业多为服务员、学生，与父母同住者较少，且很少与父母交流性话题。
(2)未婚人流女性对婚前性行为的态度开放，对今后避孕和需要生殖健康知识持肯定态度。
(3)未婚人流女性生殖健康知识多来自于网络、书籍，对这方面知识的掌握程度不够深入，且有一些错误的概念和认知。
(4)只有少数未婚人流女性坚持每次避孕，避孕措施多使用安全套，此次流产距上次流产时间较短。
(5)医生服务态度好，对流产知识有一定的宣教，但计划生育服务欠缺。
(6)多因素Logistic回归与决策树模型综合应用效果良好，提示未婚女性学历低，无职业，性伴个数多，避孕频率低，距首次性行为时间长，有同居生活，了解生殖健康知识少，性伴对避孕知识了解少、对避孕问题关心少，发生重复流产的可能性大。
Objective
With the opening of the sexual concept, teenagers’sexual behaviour before marriage is increased,it lead to the abortion rate and repeated abortion rate remains high in unmarried women, it isvery harmful to their health of body and mind.The study is to learn the status of induced abortionand post-abortion care, and to explore the factors of repeated abortion in unmarried women forproviding basis for protect their reproductive health and perfect the system of post-abortion care.
Methods
492 cases of unmarried women aged 18-24 years, classified into repeated abortion group with163 cases and abortion for the first time group with 329cases, from six hospitals of ShanxiProvince were surveyed from July 2010 to January 2011 through questionnaires,collect the dataof abortion knowledge,attitude and behavior,EpiData software was applied to input the data andSPSS13.0 software was used for analysis of data, and multi-factor logistic regression model anddecision tree model were used to explore the factors concerning repeated abortion.
Results
(1) The mean age of the objects was 21.62±1.82 years; 52.6% of all objects were registeredresidents of other cities; 47.9% had received education of a junior college or higher; and 20.5%of company staff, 20.9% of students, 23.0% of attendants; and 73.6% of all objects didn’t livewith their parents; 5.3% and 48.8% communicate the topic of sex with their father and mother.
(2) 58.9% of all objects agreed to have premarital sex with the consent from both sides; 44.1%agreed that whether lovers were right to be together or not could be judged through premaritalsex; 17.3% thought that one-night stand was acceptable; 86.0% and 79.5% agreed that theywould have contraception in the future and believed that they were needy in reproductive healthknowledge.
(3) Mean credit for knowledge concerning sexually transmitted diseases and pregnancy was 5.74±1.69 (out of 9 points), and for knowledge related to contraception 4.50±1.87 (out of 8 points);85.6% obtain above knowledge through TV, radio and internet channels.
(4) The age of first sexual intercourse for 57.5% of all objects was 19-21;36.8% had more thanone sexual partners; 13.2% had contraception once they had sex and 84.9% through condoms;and 45.7% believed that occasional sexual intercourse would not lead to pregnancy;33.1% of allobjects underwent repeated abortion,and some even had abortion of five times;62.0% whounderwent repeated abortion had the last abortion less than 6 months ago; and this time ,62.6%didn’t use any contraceptive method.
(5) Attitude of doctors’was good to their patients, knowledge of abortion also have introduced,50.8% and 69.9% were not be introduced the types of contraceptive methods and how to use thecontraceptive medicines and devices,98.4% and 88.6% are not provided contraceptive medicinesand devices , to other place accept family planning education.
(6) Results showed that education, occupation, the number of sexual partners, contraceptiveusage, length from the first sexual intercourse to now, the status of sexual partners realize andconcern the contraception,cohabitation,awareness of reproductive health knowledge of theunmarried women were factors for repeated abortion.
Conclusion
(1) Most of unmarried women are people from other regions, they are most attendants andstudents, and mostly not living regularly with their parents, and rarely have sexual topics withtheir parents.
(2) The attitude to premarital sex is open of unmarried women，and they are positive about thatthey will use contraceptive in the future and need reproductive health knowledge.
(3) Reproductive health knowledge for unmarried women are from the Internet, books, but theydon’t know much about such knowledge, even they have wrong concepts and cognition onreproductive health knowledge.
(4) Only a small portion of unmarried women adopt contraception for each sexual intercourseand commonly choose condoms, the length from last abortion to now is short.
(5) Doctors Attitude was good to their patients, and they provide some education of inducedabortion, but lack of family planning services.
(6) The effect is good of comprehensive application of Logistic regression and decision treemodel.Point out unmarried women with lower level of education, no job, more sexual partners,the fewer frequency of contraception, the longer the length from the first sexual intercourse tonow, the fewer awareness of contraceptive knowledge of sexual partners, sexual partners wereconcerned about contraception lesser, cohabitation, and the less awareness of reproductive healthknowledge are more likely to undergo repeated abortion.
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