本文關鍵詞： 育齡婦女 反復人流 知識 態(tài)度 兩性關系權力　出處：《第二軍醫(yī)大學》2017年碩士論文　論文類型：學位論文

【摘要】：研究目的反復人流是一種不良健康行為,發(fā)生率高,威脅育齡婦女健康。文獻回顧中所提出的婦女反復人流行為的影響因素,因所用研究工具可靠性不佳,測量條目不一等問題,使得研究結果缺乏可比性甚至存在矛盾。已發(fā)表文獻所提出的影響因素對婦女反復人流行為的綜合解釋度較低,提示尚有重要影響因素未被認識,有研究提示兩性關系因素可能在婦女反復人流的行為中發(fā)揮作用。因此,本研究旨在以知信行理論為框架,性別權力理論為補充,結合文獻回顧形成育齡婦女反復人流行為影響因素概念框架,研制相關調查問卷,在育齡婦女中進行反復人流行為及其影響因素的現(xiàn)狀調查,探索主要影響因素,以期為減少育齡婦女反復人流行為、提高生殖健康水平提供參考。研究方法基于文獻回顧及理論研究形成育齡婦女反復人流行為的影響因素概念框架,以下各部分研究均基于該框架展開:第一部分:育齡婦女反復人流行為影響因素調查問卷的研制。問卷分兩部分,首先基于循證指南和文獻回顧形成《育齡婦女人工流產(chǎn)知識和態(tài)度調查問卷》初稿,經(jīng)兩輪專家咨詢修訂問卷條目的適切性并評估問卷的內(nèi)容效度,在同質的樣本中進行預調查調試語義,形成調查版問卷。其次是《兩性關系權力量表》的漢化,遵從量表漢化指南,結合本研究實際條件通過翻譯回譯等過程形成漢化后量表初稿,專家咨詢及小樣本適用調試,達到習語和經(jīng)驗等同性,形成中文調查版量表。第二部分:育齡婦女反復人流行為及其影響因素的橫斷面調查。以所研制的《育齡婦女人工流產(chǎn)知識和態(tài)度調查問卷》及中文版《兩性關系權力量表》為調查工具,方便抽取上海市某三級甲等醫(yī)院婦科診療室因非意愿妊娠行人工流產(chǎn)的育齡婦女進行調查,共調查329例婦女。采用項目分析、Cronbach’sα系數(shù)、探索及驗證性因子分析及條目水平的內(nèi)容效度指數(shù)檢驗所研制工具的信效度;采用描述性統(tǒng)計分析、單因素分析及二分類非條件logistic回歸分析探索育齡婦女反復人流行為的影響因素。研究結果問卷信效度檢驗結果:《育齡婦女人工流產(chǎn)知識和態(tài)度調查問卷》包含11個條目,其中知識分問卷包含2個維度共7個條目,態(tài)度分問卷為單維度共4個條目。漢化版《兩性關系權力量表》包含兩個維度共23個條目。項目分析結果提示知識、態(tài)度各分問卷及《兩性關系權力量表》各條目均具有較好的鑒別力。探索性因子分析顯示累計方差貢獻率分別為59.540%、50.739%和42.137%。驗證性因子分析結果顯示模型整體擬合。所研制問卷各條目水平的內(nèi)容效度指數(shù)在0.88~1.00之間。內(nèi)部一致性信度結果為知識分問卷的內(nèi)部一致性信度系數(shù)0.764,風險知識維度0.820,生育知識維度0.604,態(tài)度分問卷的內(nèi)部一致性信度系數(shù)為0.622。中文版《兩性關系權力量表》的內(nèi)部一致性信度系數(shù)為0.858,兩維度分別為0.873和0.724�，F(xiàn)狀調查結果顯示:329例人流婦女中反復人流者182例,占55.3%,在反復人流者中人流兩次者107例(58.8%),三次者53例(29.1%),四次或以上者22例(12.1%)。調查對象對了解人流相關知識掌握程度較好,對人流持認可態(tài)度。二分類非條件logistic回歸結果顯示,性生活暴露時間長是育齡婦女反復人流行為的危險因素,兩性關系權力大是反復人流行為的保護因素。研究結論本研究研制的《育齡婦女人工流產(chǎn)知識和態(tài)度調查問卷》和中文版《兩性關系權力量表》信效度較理想,可分別作為評估育齡婦女人工流產(chǎn)知識水平、對人工流產(chǎn)所持態(tài)度以及在兩性關系中權力大小的測量工具。醫(yī)務人員應對性生活暴露時間長和在兩性關系中處于權力弱勢的育齡婦女加強關注,嘗試采取措施幫助該類婦女提高在兩性關系中的權力,或指導她們采取可獨立掌控的避孕方法。知識掌握水平高并不能減少反復人流行為,提示單靠健康教育手段促進育齡婦女生殖健康效果不可靠,對育齡婦女反復人流行為的影響因素研究還需進一步探索。
[Abstract]:The purpose of the study is to repeatedly people is a kind of unhealthy behavior, high incidence, threatening the health of women of childbearing age. The influence factors of the proposed review of women repeatedly people's behavior, because the instruments used in the research of poor reliability, not a measurement item and other issues, makes the research results lack of comparability and even contradictions. Factors have been published the influence of the proposed comprehensive interpretation of women repeatedly people behavior is low, there are important factors that influence is not understanding, studies suggest that sex factors may play a role in the women repeatedly people behavior. Therefore, this study aimed at the KAP theory, gender power theory as a supplement, review form repeatedly people behavior of women of childbearing age factors related to the development of a conceptual framework combined with literature, questionnaire, repeated abortion behavior in women of childbearing age and its influencing factors of adjustment The investigation, to explore the main influencing factors, in order to reduce the repeated abortion behavior of women of childbearing age, provides reference for improving the level of reproductive health. Influence of research methods and theoretical research on literature review based on the formation behavior of women of childbearing age and people factors conceptual framework, the following studies were based on the framework: the first part: the research questionnaire repeated abortion the behavior of women of childbearing age. The questionnaire is divided into two parts. Firstly, based on evidence-based guidelines and literature review the formation of artificial abortion in women of childbearing age "survey of knowledge and attitude questionnaire > draft by two rounds of expert consultation questionnaire revised to appropriate and assess the content validity of the questionnaire survey, pre commissioning semantics in the homogeneous sample, the formation of the investigation version the questionnaire. Second is the relationship of power scale < > finished, comply with the scale of Chinese guide, combined with the actual conditions of this study through the translation back translation process As a Chinese draft scale, expert consultation and a small sample for debugging, to idioms and experience the same form Chinese survey version scale. The second part: a cross-sectional survey of repeated people behavior and its influencing factors in women of childbearing age. The development of the "women of childbearing age abortion knowledge and attitude questionnaire" and "gender Chinese version the relationship between power scale" as the survey tool, gynecological clinic a grade three hospital of Shanghai City, convenient extraction of unwanted pregnancy induced abortion for women of childbearing age were investigated, investigated a total of 329 cases of women. By project analysis, Cronbach s coefficient of reliability and validity, content validity index test exploring and confirmatory factor analysis and item the level of the developed tool; descriptive statistical analysis, single factor analysis and two classification of non conditional logistic regression analysis to explore the influencing factors of women of childbearing age. People repeated behavior research Results the questionnaire test results: "women of childbearing age abortion knowledge and attitude questionnaire" contains 11 entries, of which knowledge questionnaire contains 2 dimensions and 7 items, divided into single dimension attitude questionnaire consists of 4 items. The finished version of < sex power scale > contains two dimensions and 23 items project analysis showed that knowledge, attitude of the questionnaire and power relationships scale < > items are with good discrimination. Exploratory factor analysis showed that the cumulative variance contribution rates were 59.540%, 50.739% and 42.137%. confirmatory factor analysis showed that the model fit. The content validity index of questionnaire for each item level in the range of 0.88~1.00. The internal consistency reliability the internal consistency reliability coefficient of knowledge questionnaire 0.764, 0.820 dimensions of risk knowledge, knowledge of family 0.604 dimensions, the internal consistency of letter attitude questionnaire Coefficient of internal consistency coefficient 0.622. Chinese version < relationship power scale > 0.858, two dimensions respectively 0.873 and 0.724. survey results showed: 329 cases of women's status in people in 182 cases, accounting for 55.3%, 107 cases of abortion in repeated people in two times (58.8%, 53) three times (29.1%), 22 cases of four or more (12.1%). The object of investigation to understand better grasp the flow of knowledge, hold a recognized attitude towards people. Two classification logistic regression results showed that life long exposure time are risk factors for the prevalence of women of childbearing age who repeatedly, the protective factors of gender the relationship between big powers is repeatedly people's behavior. The research conclusions of this study developed "induced abortion knowledge and attitude questionnaire > and < Chinese version relationship power scale > ideal reliability and validity, can be used as evaluation of induced abortion The level of knowledge, attitude and the relationship in the power size measurement tool on artificial abortion. The medical staff to deal with life and exposed for a long time in a relationship in the power of vulnerable women of childbearing age should pay attention, try to take measures to help the women increase in two in a relationship of power, or help them take contraceptive methods independent control. Knowledge level is high and should not reduce the repeated people behavior, suggesting that only by means of health education to promote women's reproductive health effect is not reliable, the impact of repeated abortion behavior of women of childbearing age factors still need further exploration.

【學位授予單位】：第二軍醫(yī)大學
【學位級別】：碩士
【學位授予年份】：2017
【分類號】：R473.71

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