本文選題：紡織女工　切入點：生殖健康　出處：《北京協(xié)和醫(yī)學(xué)院》2013年碩士論文　論文類型：學(xué)位論文

【摘要】：研究目的 一、總目的 了解西安市紡織城女工生殖健康“知信行"的現(xiàn)狀,以及探討工效學(xué)因素對紡織女工生殖健康的影響。 二、具體目標 1、了解紡織女工生殖健康相關(guān)知識水平及其影響因素。 2、了解紡織女工生殖健康相關(guān)行為,如避孕節(jié)育、人工流產(chǎn)、孕產(chǎn)婦保健、生殖道感染自覺癥狀及其求醫(yī)行為的情況。 3、探討職業(yè)噪聲暴露對紡織女工生殖健康的影響,包括月經(jīng)、自然流產(chǎn)、早產(chǎn)和子代出生低體重。 研究方法 本研究為橫斷面調(diào)查。我們采用分層整群的抽樣方法,在西安四棉和五環(huán)集團兩家紡織工廠對1700名符合入選標準(年齡20-49歲,在所選紡織廠上班,當?shù)爻Ｗ∪丝?并自愿參加本次研究)的紡織女工進行自填式面對面問卷調(diào)查。運用均數(shù)和標準差對定量資料進行描述,運用頻數(shù)和百分比對定性資料進行描述,影響因素分析采用卡方檢驗和多因素Logistic回歸模型。 研究結(jié)果 本研究期間(2012年5月-7月)共發(fā)放問卷1700份,實際回收合格問卷1659份,最終合格率為97.59%。 一、基本人口學(xué)特征 紡織女工平均年齡為38.03±7.21歲。52.4%和41.8%的女工文化程度分別為初中和高中/中專。93.0%的女工為在婚,3.5%為未婚,2.5%為離異,1.0%為喪偶。41.5%的女工家庭成員平均月收入為1000-1499元。本地戶口占92.7%,外地戶口占7.3%。96.3%的女工參加了醫(yī)療保險。82.1%的女工是運轉(zhuǎn)班,17.9%是常日班。女工的工作年限平均為17.43±8.28年。 二、生殖健康相關(guān)知識 1、生殖健康相關(guān)知識基本情況 紡織女工生殖健康知識平均得分為14.57±5.43分(滿分30分)。滿分的60%為及格,即≥18分為及格,及格率僅為31.0%。其中,避孕節(jié)育知識平均得分為2.76±1.50分,人工流產(chǎn)知識平均得分為3.29±1.68分,生殖道感染/性傳播疾病知識平均得分為2.38±1.27分,性健康知識平均得分為2.76±1.44分,孕產(chǎn)婦保健知識平均得分為3.37±1.52分(上述5個方面滿分均為6分)�；卮鹫_率最低的三個問題分別是：“手淫有損身體健康”(13.3%),“葉酸可以預(yù)防胎兒神經(jīng)管畸形,還可以治療月經(jīng)不調(diào)”(17.8%),“性交后沖洗陰道,可以避免罹患生殖道疾病”(18.8%)。 2、生殖健康相關(guān)知識影響因素分析 我們采用多因素Logistic回歸分析可知,紡織女工生殖健康相關(guān)知識水平受到年齡(P=0.024)、文化程度(P0.001)、婚姻狀況(P=0.001)、工作單位(P=0.001)的影響。30-39歲女工知識得分及格的可能性是20-29歲的1.516倍；40-49歲女工知識得分及格的可能性是20-29歲的1.085倍,但無統(tǒng)計學(xué)意義。文化程度為高中及以上的女工知識得分及格的可能性是初中及以下的1.855倍。在婚的女工知識得分及格的可能性是其它婚姻狀況的2.436倍。四廠的女工知識得分及格的可能性是五廠的1.589倍。 三、生殖健康相關(guān)行為 1、避孕節(jié)育的情況 調(diào)查時過去6個月內(nèi),紡織女工的避孕率為93.8%。其主要的避孕方法為：宮內(nèi)節(jié)育器(44.0%)和安全套(35.2%)。另外,還有女工采取安全期避孕(4.1%)和體外排精(3.8%)。50.5%和4.0%的女工對采用的避孕方法的滿意度分別為“一般”和“不滿意”。未避孕的女工其主要原因為：“怕麻煩”(37.0%)和“僥幸心理”(25.0%)。 2、人工流產(chǎn)的情況 51.4%的紡織女工有過人工流產(chǎn)史,其中,有過2次及以上人工流產(chǎn)史的占15.9%。最后一次人工流產(chǎn)的主要原因為：“避孕失敗”(41.2%)和“未避孕”(28.2%)。最后一次人工流產(chǎn)的地點主要是“醫(yī)院"(81.5%)和“婦幼保健院”(9.5%)。 3、孕產(chǎn)婦保健的情況 紡織女工初次懷孕的活產(chǎn)率為86.8%,她們中有96.2%的人接受過產(chǎn)前檢查。在做過產(chǎn)檢的女工中,83.7%的人初次產(chǎn)檢在12周以前,67.6%的人產(chǎn)檢總次數(shù)大于7次,39.8%的人接受過產(chǎn)后訪視。產(chǎn)前檢查的地點主要是在“醫(yī)院"(85.3%)和“婦幼保健院”(11.8%)。 4、生殖道感染自覺癥狀及求醫(yī)行為 調(diào)查時過去6個月內(nèi),生殖道感染自覺癥狀的自我報告率為51.7%,其中,“陰道分泌物增多、異味”(28.3%)和“外陰瘙癢”(26.5%)最常見。出現(xiàn)癥狀后,僅有58.7%的女工選擇去醫(yī)療機構(gòu)看病,其中,立即去看病的人較少(39.4%)。而女工未就診的原因主要是：“每個婦女都會有,沒什么關(guān)系”(40.1%)和“治療費用太貴”(17.5%)。 四、噪聲對紡織女工生殖健康的影響 1、噪聲對紡織女工月經(jīng)的影響 紡織女工月經(jīng)周期平均為29.09±5.67天(16-41天),月經(jīng)周期異常者占21.1%；行經(jīng)天數(shù)平均為5.42±2.03天(1-13天),行經(jīng)天數(shù)異常者占9.4%；出現(xiàn)痛經(jīng)情況的占18.0%。上述三種異常情況出現(xiàn)一種即為月經(jīng)異常,占30.7%。通過多因素Logistic回歸調(diào)整潛在的混雜因素可知,中噪聲暴露的女工月經(jīng)異常的風險是低噪聲暴露的2.419倍；高噪聲暴露的女工月經(jīng)異常的風險是低噪聲暴露的4.033倍。 2、噪聲對紡織女工自然流產(chǎn)的影響 紡織女工自然流產(chǎn)發(fā)生率為8.0%。通過多因素Logistic回歸調(diào)整潛在的混雜因素可知,與高噪聲暴露的女工相比,中噪聲暴露的女工發(fā)生自然流產(chǎn)的風險降低58.8%,低噪聲暴露的女工發(fā)生自然流產(chǎn)的風險降低77.3%。 3、噪聲對紡織女工早產(chǎn)的影響 4.3%的紡織女工初次生產(chǎn)為早產(chǎn)。通過多因素Logistic回歸調(diào)整潛在的混雜因素可知,中噪聲暴露的女工發(fā)生早產(chǎn)的風險是低噪聲暴露的1.756倍,高噪聲暴露的女工發(fā)生早產(chǎn)的風險是低噪聲暴露的2.162倍,但均無統(tǒng)計學(xué)意義。 4、噪聲對紡織女工子代出生低體重的影響 10.1%的紡織女工初次生產(chǎn)子代為出生低體重。通過多因素Logistic回歸調(diào)整潛在的混雜因素可知,中噪聲暴露的女工分娩低體重兒的風險是低噪聲暴露的3.768倍,高噪聲暴露的女工分娩低體重兒的風險是低噪聲暴露的5.016倍。 結(jié)論 一、生殖健康相關(guān)知識 1、紡織女工的生殖健康相關(guān)知識水平較差。生殖道感染／性傳播疾病、避孕節(jié)育和性健康知識是薄弱環(huán)節(jié)。 2、年齡小,初中及以下學(xué)歷,婚姻狀況為未婚、離異、喪偶和五廠的紡織女工生殖健康相關(guān)知識水平更差。 二、生殖健康相關(guān)行為 1、紡織女工避孕率較高,但是部分女工未采用有效的避孕措施。紡織女工對避孕藥具的滿意度也一般。 2、紡織女工人工流產(chǎn)發(fā)生水平較高,避孕失敗和未避孕是其主要原因。 3、紡織女工孕產(chǎn)婦保健水平一般,特別是產(chǎn)檢次數(shù)符合率和產(chǎn)后訪視率較差。 4、紡織女工生殖道感染自覺癥狀報告率較高,但是就診意識淡薄,且就診不及時。 三、噪聲對紡織女工生殖健康的影響 1、職業(yè)噪聲暴露對紡織女工的月經(jīng)、自然流產(chǎn)和子代出生低體重有影響,且風險隨著噪聲分貝的增加而增加。 2、本研究尚未發(fā)現(xiàn)職業(yè)噪聲暴露對紡織女工早產(chǎn)有影響。 政策建議 一、有針對性的開展形式多樣、可接受的生殖健康知識宣傳活動,宣傳內(nèi)容側(cè)重生殖道感染/性傳播疾病、避孕節(jié)育和性健康,宣傳的重點人群為年齡小、學(xué)歷低、未婚、離異、喪偶以及五廠的女工。 二、加強當?shù)赜媱澤芾砗头⻊?wù)工作。加大管理力度,對女工孕產(chǎn)婦保健服務(wù)工作進一步細化、深入,提高計生服務(wù)提供者的業(yè)務(wù)能力,如科普宣傳和避孕藥具的知情選擇推薦能力。 三、定期開展健康體檢,進行婦科病和生殖道感染疾病的篩查,同時對她們進行健康教育,改善其就診意識和自我保健意識。 四、加強紡織女工工作時的自我保護意識,及時穿戴必要的個體防護措施,合理安排工作和休息。 五、工廠領(lǐng)導(dǎo)要重視和做好女工的勞動保護,改善作業(yè)環(huán)境和強度,妊娠女工應(yīng)及時調(diào)離噪聲工作崗位,做好女工經(jīng)期勞動保護和定期健康監(jiān)護工作。
[Abstract]:research objective
First, the general purpose
To understand the present status of the reproductive health of women workers in Xi'an Textile City, and to explore the effects of ergonomics on the reproductive health of textile women workers.
Two, specific objectives
1, to understand the knowledge level of the reproductive health of textile women workers and their influencing factors.
2, to understand the reproductive health related behaviors of textile women workers, such as contraception, abortion, maternal health care, conscious symptoms of reproductive tract infection and the behavior of seeking medical treatment.
3, the effects of occupational noise exposure on the reproductive health of textile women workers were investigated, including menstruation, spontaneous abortion, premature birth and low birth weight of the offspring.
research method
This study is a cross-sectional survey. We use stratified cluster sampling method, in Xi'an four cotton textile factory in two group five and 1700 met the inclusion criteria (age 20-49 years old, work in the selected textile factory in the local resident population, and volunteered to participate in this study) of textile workers self-administered face-to-face questionnaire survey. The mean and standard deviation to describe quantitative data, using qualitative data to describe the frequency and percentage, the influential factors were analyzed by chi square test and multiple Logistic regression model.
Research results
During the period of this study (-7 month of May 2012), a total of 1700 questionnaires were issued, and 1659 qualified questionnaires were actually recovered. The final pass rate was 97.59%.
First, basic demographic characteristics
Textile workers with an average age of 38.03 + 7.21 years.52.4% and 41.8% women culture respectively the junior and senior high school / secondary school.93.0% women got married in 3.5%, unmarried, 2.5% divorced, 1% were widowed women.41.5% family average monthly income of 1000-1499 yuan. Local accounts accounted for 92.7% of the field accounts for 7.3%.96.3% of women in the medical insurance.82.1% women running class, 17.9% is often the day. Women work for an average of 17.43 + 8.28 years.
Two, reproductive health related knowledge
1, basic knowledge of reproductive health related knowledge
Textile workers reproductive health knowledge average score was 14.57 + 5.43 points (out of 30). Out of the 60% pass, which is more than 18 for a pass, the pass rate was 31.0%. the average contraceptive knowledge score was 2.76 + 1.50, artificial abortion average knowledge score was 3.29 + 1.68, reproductive tract infection knowledge of sexually transmitted diseases, the average score was 2.38 + 1.27, health knowledge average score was 2.76 + 1.44, maternal health knowledge average score was 3.37 + 1.52 (the above 5 aspects are out of 6 points). The rate of correct answers three questions: "the lowest are detrimental to the health of her hand" (13.3%), "folic acid can prevent fetal neural tube defects, but also can treat menstruation" (17.8%), "wash the vagina after sexual intercourse, can avoid suffering from genital tract disease" (18.8%).
2, analysis of influencing factors of reproductive health related knowledge
We used multivariate Logistic regression analysis, reproductive health related knowledge level of textile workers by age (P=0.024), education (P0.001), marital status (P=0.001), the work unit (P=0.001) the possibility of.30-39 years old women influence the knowledge score is 1.516 times the 20-29 year old 40-49 year old female workers; possibility of knowledge score of 1.085 times at the age of 20-29, but had no statistical significance. The possibility of education for senior high school and above the workers knowledge score is 1.855 times. In the junior middle school and married women the knowledge score can be 2.436 times the other marital status. The possibility of four factory worker knowledge score is 1.589 times five factory.
Three, reproductive health related behavior
1, the situation of contraception
In the past 6 months, textile workers the contraceptive rate of 93.8%. the main methods of contraception: IUD (44%) and condom (35.2%). In addition, there are women take the rhythm (4.1%) and in vitro ejaculation (3.8%).50.5% and 4% women pregnant with the method of obstacle of satisfaction the "general" and "not satisfied". Do not use contraceptive women the main reason is: "trouble" (37%) and "luck" (25%).
2, the situation of abortion
51.4% textile workers had a history of artificial abortion, which is the main reason for more than 2 times and the history of artificial abortion accounted for 15.9%. of the last abortion: "contraceptive failure" (41.2%) and "without contraception" (28.2%). The last abortion place is mainly "hospital" (81.5%) and "maternal and child health hospital" (9.5%).
3, the situation of maternal health care
Textile workers first pregnancy live birth rate was 86.8%, 96.2% of them received antenatal examination. After prenatal women, 83.7% of the initial production inspection in 12 weeks ago, 67.6% people total number is more than 7 times, 39.8% people had received prenatal postpartum visits. The place is mainly in the "hospital" (85.3%) and "maternal and child health hospital" (11.8%).
4, the conscious symptoms of genital tract infection and the behavior of seeking medicine
In the past 6 months, self-reported symptoms of reproductive tract infection rate was 51.7%, among them, "vaginal secretions, smell" (28.3%) and "vulva itch" (26.5%). The most common symptoms, only 58.7% of women choose to go to the doctor, medical institutions, go to the doctor immediately there are fewer people (39.4%). And the reason of unpregnancy treatment mainly is: "each woman will have, not what relationship" (40.1%) and the cost of treatment is too expensive "(17.5%).
Four, the effect of noise on the reproductive health of textile women workers
1, the effect of noise on the menstruation of textile female workers
Menstrual cycle for an average of 29.09 + 5.67 days (16-41 days), menstrual cycle abnormalities accounted for 21.1%; the average number of days was 5.42 + 2.03 days (1-13 days), the number of abnormalities accounted for 9.4%; appear dysmenorrhea accounted for 18.0%. of the above three kinds of abnormal situation is an abnormal menstruation, accounted for the 30.7%. Logistic regression adjusted for potential confounding factors by multiple factors, the risk of abnormal noise exposure workers menstruation is 2.419 times of low noise exposure; risk of abnormal noise exposure workers menstruation is 4.033 times of low noise exposure.
2, the effect of noise on spontaneous abortion of textile female workers
Textile workers and the rate of spontaneous abortion was 8.0%. by multivariate Logistic regression showed that adjusting for potential confounding factors, compared with the high noise exposure workers in noise exposure workers, the risk of spontaneous abortion decreased 58.8%, low noise exposed workers of spontaneous abortion in lower risk 77.3%.
3, the effect of noise on the preterm labor of textile women workers
4.3% of the initial production for textile workers. Premature by multiple factor Logistic regression showed that adjusting for potential confounding factors, the risk of noise exposure workers preterm delivery is 1.756 times the risk of low noise exposure, high noise exposure workers preterm delivery is 2.162 times of low noise exposure, but no statistical significance.
4, the effect of noise on the low birth weight of the female textile worker
The first 10.1% production of textile workers on behalf of low birth weight. By multivariate Logistic regression showed that the adjustment for potential confounders, the risk in noise exposure workers low birth weight children is 3.768 times of low noise exposure, high noise exposure workers low birth weight children is 5.016 times the risk of low noise exposure.
conclusion
First, reproductive health related knowledge
1, the level of knowledge related to reproductive health of textile women workers is poor. Reproductive tract infection / sexually transmitted diseases, contraception and sexual health knowledge are weak links.
2, young age, junior high school and below, the marital status of unmarried, divorced, widowed and five factories of textile women's reproductive health related knowledge level is worse.
Two, reproductive health related behavior
1, textile workers contraception rate is higher, but some women not using effective contraception. Textile workers satisfaction of contraceptives in general.
2, the high level of artificial abortion of textile women workers, the failure of contraception and the failure of contraception are the main reasons.
3, the health level of pregnant and lying in women of textile women workers is general, especially the rate of compliance and the rate of postpartum visits.
4, the report rate of female textile women's reproductive tract infection is higher, but the awareness of medical treatment is weak and the medical treatment is not timely.
Three, the effect of noise on the reproductive health of textile women workers
1, occupational noise exposure affects the menstruation of textile women, spontaneous abortion and offspring birth weight, and the risk increases with the increase of noise decibels.
2, the study has not found that occupational noise exposure has an impact on the preterm labor of textile women workers.
policy suggestion
First, there are targeted ways to carry out various forms of reproductive health knowledge publicity activities, focusing on reproductive tract infections / sexually transmitted diseases, contraception and sexual health. The focus of publicity is age, education, marriage, widowhood, and five factory women workers.
Two, strengthen the local family planning management and service work. Strengthen the management of maternal health care service workers to further refinement, further improve family planning service provider business ability, such as propaganda and contraceptive informed choice is recommended.
Three, regular physical examination should be carried out for gynecological diseases and reproductive tract infections. Meanwhile, health education should be carried out to improve their awareness and self-care consciousness.
Four, to strengthen the self-protection awareness of the work of the textile women workers, to wear the necessary individual protection measures in time, and to arrange the work and rest reasonably.
Five, factory leaders should pay attention to and improve the labor protection of female workers, improve the working environment and intensity. Pregnant women workers should be removed from the noise jobs in time, and the labor protection and regular health care for women workers can be done during the menstrual period.

【學(xué)位授予單位】：北京協(xié)和醫(yī)學(xué)院
【學(xué)位級別】：碩士
【學(xué)位授予年份】：2013
【分類號】：R173

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本文編號：1561332