本文選題：未婚 + 男性青年��； 參考：《北京協(xié)和醫(yī)學院》2012年碩士論文

【摘要】：[研究目的] (1)了解未婚男性青年生殖健康知識的現(xiàn)況； (2)比較其不同背景之間生殖健康知識的差異及影響因素； (3)了解其生殖健康方面行為的狀況； (4)比較其不同背景之間生殖健康行為的差異及影響因素； (5)探索其生殖健康行為的成因； (6)探討現(xiàn)有為其提供的生殖健康服務的可及性與需求之間的差距。 [研究方法] 本研究采用定量研究和定性研究相結合的方法進行資料收集。定量研究采用觀察流行病學中的描述性流行病學方法進行調查。定性研究采用個人深入訪談(IDI)和焦點組討論(FGD)方法,通過收集研究對象的認識、看法、行為和態(tài)度等資料,從訪談對象的角度去了解并盡量理解發(fā)生的現(xiàn)象,進一步地探索感興趣的信息。 本次研究選擇了婚前保健定點醫(yī)療機構作為研究現(xiàn)場。研究對象,為在2011年8月至2011年12月之間,所有到選定婚前保健定點衛(wèi)生機構的符合納入標準的未婚／初婚的男性青年1680人。應用EpiData2.1軟件錄入數(shù)據(jù)和校驗,數(shù)據(jù)采用SAS9.2統(tǒng)計軟件包進行分析處理。 [研究結果] 一、定量研究 本次研究共回收合格問卷1589份,合格應答率為94.58%。其平均年齡為26.33±3.18歲。63.9%平均月收入在2000-4999元之間。49.13%受教育程度為大專及以下。從事職業(yè)的前三位依次為從事體力勞動的工人48.75%,從事腦力勞動的職員28.67%,經(jīng)商/個體群體10.01%。本地戶口占88.67%,外地戶口占11.33%。研究對象的居住狀況前三位依次為與現(xiàn)女友同住51.49%,與父母同住25.53%,獨居14.45%。90.22%的父母為在婚,3.42%為再婚,3.62%為喪偶,2.75%為離異。 1.了解未婚男性青年生殖健康知識的現(xiàn)況 44.7%的研究對象生殖健康知識得分低于60分,生殖健康知識水平整體上尚存在不足。其中關于性健康相關問題的得分率最低,回答正確率最低的題僅有17.75%的研究對象得分。正確率最低的三個問題,有兩個來自于性健康相關方面,一個來自于生殖道感染/性傳播疾病相關方面。 2.比較不同背景的未婚男性青年之間生殖健康知識的差異及影響因素 對不同背景的研究對象知識得分水平進行比較分析,不同地區(qū)、不同年齡組、不同文化程度、居住狀況的調查對象間知識得分水平不同,且差異均具有統(tǒng)計學意義(P0.05)。進一步分析發(fā)現(xiàn),接受過高等教育的研究對象知識得分更高的可能性比未接受過高等教育的高1.363倍；合租的研究對象生殖健康知識較低(OR=0.428)；在即墨居住的研究對象生殖健康知識得分更高的可能性是黃島區(qū)的2.283倍；25-27周歲組的研究對象生殖健康知識得分更高的可能性是22-24周歲組的1.366倍。 3.了解未婚男性青年生殖健康方面行為的狀況 9.03%的研究對象首次性行為對象為非固定伴侶。85.07%的研究對象存在以下威脅生殖健康的行為。23.25%的研究對象表示在過去的1年中,曾經(jīng)與一個以上性伴侶有過性生活。12.93%的研究對象曾經(jīng)發(fā)生過商業(yè)性行為。8.90%的研究對象曾經(jīng)有過肛交行為。采用的避孕措施中,選擇避孕套的占73.42%。研究對象最近一次性行為中未避孕的占30.27%,在采取了避孕措施的人群中,未正確使用避孕措施的達到了23.11%。目前不打算懷孕但有性行為的研究對象中,過去半年內55.04%的人不能夠做到一直堅持使用避孕措施。12.52%的研究對象遭受過非意愿性行為,46.34%的研究對象實施過非意愿性行為。34.21%的研究對象明確表示曾經(jīng)使女伴意外懷孕。 4.比較不同背景的未婚男性青年之間生殖健康行為的差異及影響因素 logistic回歸分析顯示,研究對象首次性行為對象的選擇,與居住地點、平均月收入、居住狀況以及父母婚姻狀況有關。即墨的研究對象首次性行為對象為非固定的可能性更低(OR=0.197)；平均月收入越高的研究對象,首次性行為對象為非固定的可能性越大,平均月收入10000元以上的研究對象,首次性行為對象為非固定的可能性是2000元以下的4.022倍；合租的研究對象首次性行為對象為非固定的可能性較高(OR=2.242)；父母婚姻狀況的為離異的研究對象,首次性行為對象為非固定的可能性是在婚狀況父母的3.358倍。 而研究對象的生殖健康知識、教育水平、居住狀況以及職業(yè)與其是否有威脅生殖健康的行為有統(tǒng)計學關聯(lián)。生殖健康知識高的研究對象,發(fā)生威脅生殖健康的行為的可能性較低(OR=0.413)；接受過高等教育的研究對象,發(fā)生威脅生殖健康的行為的可能性較低(OR=0.471)；合租的研究對象,發(fā)生威脅生殖健康的行為的可能性是獨居研究對象的3.421倍；從事經(jīng)商活動的研究對象發(fā)生威脅生殖健康的行為的可能性是體力勞動的工人的1.888倍。 二、定性研究 5.探索未婚男性青年生殖健康行為的成因 在不愿采用避孕套的人群中,主要理由是“就是不愛用(安全)套子,影響感覺”,“拿(安全)套之類的多麻煩啊,還不舒服”,“不是有這個(安全)期嘛,從沒出過事,比那個(安全套)痛快多了”。研究對象對避孕藥的副作用認識上存在很大的誤區(qū)“聽說過的(避孕藥),那個要影響生孩子吧……”,“是藥三分毒”。很多研究對象尚不能很好的了解多性伴對于生殖健康的可能造成的影響,“更容易(造成)懷孕了”,“做好保護措施是最主要的,其他也沒什么……”。另一方面,研究對象實施危險性性行為,易受不良影視劇的影響,“就是看見網(wǎng)上有嘛……所以嘗試一下,應該挺安全的”,“不是(色情)電影里有嘛……”。對于非意愿性行為的討論存在一定的忌諱,“反正她也沒有很厲害地拒絕,估計她也想,也不能算完全拒絕吧”,“她沒有反對就是了,半推半就吧”,“都夫妻了,其實沒什么”。研究對象依然無法清楚的認識到意外懷孕對女伴的影響,“有兩個(人流手術),那個無痛的(流產(chǎn)手術)比較好,不怎么傷身體”；“影響肯定是有的,應該不大吧. 6.探討現(xiàn)有為未婚男性青年提供的生殖健康服務的可及性與需求之間的差距 研究對象表現(xiàn)出了愿意去公立醫(yī)院就診的態(tài)度,“肯定去正規(guī)的大醫(yī)院”,“看病會去中醫(yī)院的,是我們這里最大的醫(yī)院了”,“真要有(性病),肯定去縣中醫(yī)院,是醫(yī)保(在那里)……”。同時也有很多人承認私立醫(yī)院的存在有一定的合理原因,尤其是良好的私密性,對于隱私的保護是研究對象傾向于選擇私立醫(yī)院的首要原因,“聽說過有人去私人門診的,最主要不容易有人知道啊……”,“對,得了這種病,不好開口(告訴周圍的人),就會去私人(門診)的”。其次是醫(yī)院就診流程引起的看病難、醫(yī)務人員態(tài)度差以及價格因素,“(正規(guī)醫(yī)院)看個病不容易,(醫(yī)生)態(tài)度又不好,感覺欠他的似的”,“對,那天我就看見(醫(yī)生和患者)差點打起來”“(私人醫(yī)院)那里態(tài)度可好了,而且超市都有打折卡(發(fā)放)”,“(私人醫(yī)院)小護士都滿臉微笑的,還經(jīng)常有人發(fā)免費的體檢卡”。對于避孕藥具獲得的可及性方面,絕大多數(shù)的研究對象表明了明確的會選擇正規(guī)商店超市購買避孕藥具的意愿,“商店也有賣的”,“超市啊,還能是哪里……”,“我們那里有賣這些(賣避孕藥具)的藥店”。之所以會選擇非正規(guī)的成人用品店購買避孕藥具與所處地理環(huán)境有相當大的關系,同時也與營業(yè)時間的安排有一定的關系,“我們那兒地方小,(超市)都不進這個的,都得去市里才有”,“想要(購買避孕藥具)的時候方便”,“感覺最難的是找不到買(避孕藥具)的地方……正規(guī)的關門早”。 [研究結論] 未婚男性青年對生殖健康知識的掌握總體較差。未接受過高等教育、年齡小、與非親屬合租的研究對象,生殖健康相關知識的水平較低。同時即墨市的研究對象生殖健康知識水平要相對較高。未婚男性青年避孕節(jié)育選擇避孕套的占據(jù)絕對多數(shù)。在不愿采用避孕套的人群中,主要理由是不喜歡使用避孕套后對同房感受的影響。首次性行為是與非固定性伴發(fā)生、曾經(jīng)發(fā)生過商業(yè)性行為的比例較高。研究對象對于非意愿性行為原因的訪談多采取回避的態(tài)度,同時非意愿性行為發(fā)生率很高。其致使女伴意外懷孕的比例高,且無法清楚的認識到意外懷孕對女伴的影響。
[Abstract]:[Objective]
(1) understand the status of unmarried young male reproductive health knowledge;
(2) to compare the difference of reproductive health knowledge and influence of different background factors;
(3) to understand the reproductive health behavior;
(4) the difference between the different background factors of reproductive health behavior and influence;
(5) to explore the causes of reproductive health behavior;
(6) to investigate the existing provides reproductive health services accessibility and demand gap.
[Methods]
This research adopts the method of quantitative and qualitative research data were collected. The quantitative study used observation method of descriptive epidemiology in the epidemiology investigation. By qualitative in-depth interviews and focus group discussions (IDI) (FGD) method, through the understanding, collected opinions, behavior and attitude of the data from the interview the way to learn and try to understand the occurrence of the phenomenon, to further explore the information of interest.
This study chose the premarital care fixed-point medical institutions as the research field. As the research object, between August 2011 and December 2011, all to the selected point of premarital care health institutions in accordance with the inclusion criteria of unmarried young men first / 1680. Application of EpiData2.1 software for data entry and verification, data packets for analysis by SAS9.2 statistical software.
[results]
A quantitative study.
This study collected 1589 valid questionnaires, the response rate is qualified with the average age of 94.58%. was 26.33 + 3.18 years.63.9% the average monthly income of 2000-4999 yuan between the.49.13% level of education for college and the following occupation. The first three were manual workers in 48.75%, mental labor staff of 28.67%, business individual / group 10.01%. local Hukou accounted for 88.67%, the field accounts for 11.33%. study of the living conditions are the top three with current girlfriend live 51.49%, live with their parents living alone 25.53%, 14.45%.90.22%'s parents got married in 3.42%, remarried, 3.62% widowed, 2.75% were divorced.
1. understand the unmarried young men in reproductive health knowledge
The study of 44.7% reproductive health knowledge score is below 60, the overall level of reproductive health knowledge is still insufficient. The related problems about sexual health score was the lowest, the lowest rate of correct answer on question only 17.75% of the three lowest score. The correct rate of two, from sexual health. One from RTIs / STDs related aspects.
Comparison between 2. different backgrounds between unmarried young men of reproductive health knowledge and its influencing factors
Through the comparison and analysis of different regions of the research object level knowledge scores of different backgrounds, different age groups, different cultural degree, survey of living conditions between different levels of knowledge scores, and the differences were statistically significant (P0.05). Further analysis showed that the possibility of the research object received higher education knowledge score higher than before have received higher education 1.363 times higher; the research object flat-share reproductive health knowledge was low (OR=0.428); the possibility of health knowledge score research object of Jimo live germ is 2.283 times higher in Huangdao district; the possibility of health knowledge score research object under the age of 25-27 group was 1.366 times higher reproductive age group 22-24.
3. understand the unmarried young men reproductive health behavior
Study 9.03% of the first sex object as the research object of non regular partner.85.07% has the following threats to reproductive health behavior of.23.25% said in the past 1 years, and had more than one sexual partner to have research objects of life.12.93% once had sex business had.8.90% anal sex. The choice of contraception, condoms without contraception accounted for 73.42%. study the latest sexual behaviors accounted for 30.27%, to take contraceptive measures among contraceptive measures were not using the right to 23.11%. does not currently intend to pregnancy but the research object of sexual intercourse in the past six months, 55.04% people can not insist on the research object of the contraceptive use.12.52% suffered from unwanted sexual behavior, 46.34% conducted the unwanted behavior of.34.21% As expressly made the companion with an unwanted pregnancy.
The difference between 4. different background factors of unmarried young male reproductive health behavior and influence
Logistic regression analysis showed that the research object for the first time sex selection of objects, and place of residence, the average monthly income, the living status and marital status of parents. The research object of Jimo first sex object is non fixed less likely (OR=0.197); the average monthly income of the object more high, for the first time for non sexual behavior fixed the more likely, the average monthly income of 10000 yuan more than the research object, the first sex object is non fixed 4.022 times more likely to be less than 2000 yuan; the research object flat-share first sex object for non high probability fixed (OR=2.242); marital status of parents divorced as the research object, for the first time. The behavior object is non fixed possibility is 3.358 times in the marriage status of parents.
The study of reproductive health knowledge, education level, occupation and living conditions, if there is a threat of reproductive health behavior was significantly associated with high reproductive health knowledge. The object of study, the possibility of threats to reproductive health behavior of the lower (OR=0.413); received the research object of higher education, the possibility of threatening the reproductive health behavior the lower (OR=0.471); the research object flat-share, possibility of threat to reproductive health behavior is 3.421 times of solitary object; possibility research object of business activities threatening the reproductive health behavior is 1.888 times the physical labor of workers.
Two, qualitative research
To explore the causes of 5. unmarried young men of reproductive health behavior
In the crowd to use condoms, the main reason is that "love is not used (safety) covers, effect of feeling", "take (safety) sets such as much trouble ah, still not comfortable", "not this (safety) well, never been out of things, than the more happy (An Quantao)". Side effects study on Contraceptive Awareness of the existence of big misunderstanding "heard that (CA), will affect the child.", "three drug". A lot of research object is not a very good understanding of sexual partners for reproductive health may cause, "more easily (cause) pregnant", "is the most important protection measures to do a good job, the other did not. What". On the other hand, the object of study the implementation of sexual risk behaviors, are easily affected by the bad TV drama, "is to see the Internet. So try, should be very safe," not "(porn movie) There. ". to discuss the unwanted behavior there is a taboo," she is not very powerful to estimate, she wants to, can not be completely rejected. "" she did not oppose it, half hearted "," husband and wife, is not what the research object ". Still unable to clearly recognize the unexpected effect of pregnancy on women," two (abortion), the painless (abortion) is good, do not hurt the body ";" is definitely some impact, it should not.
6. of existing for unmarried young men's reproductive health services accessibility and demand gap
Study shows a willingness to go to public hospital's attitude, "must go to the regular big hospital", "the doctor will go to the hospital, the largest hospital is here", "there will be (STD), certainly to the county hospital of traditional Chinese medicine, health insurance (there). At the same time. There are a lot of people admitted to private hospitals have some reasonable reasons, especially good for privacy, privacy protection is the primary cause of the research object tend to choose private hospitals," heard of people go to private clinics, the most important is not easy to have people know. "" yes, got the disease not open (tell people), will go to the private (outpatient) ". The hospital process caused by the difficulty and attitude of medical personnel and price factors," (the regular hospital) to see a sick easily, (Doctor) attitude is not good, you owe him. "", I saw that day (doctors and patients) and almost hit "(private hospitals) where the attitude of these days, and supermarkets have discount card (issued)", "(private hospital) small nurses are smiling, but people often send free medical card". For the availability of contraceptives the vast majority of subjects showed a clear will choose a regular store supermarket to buy Contraceptives will, "stores have sold", "where is the supermarket ah, but also." "we have to sell these (sell contraceptives) pharmacy." why choose to buy non regular contraceptives the Adult supplies store and geographical environment have significant relationship, but also have a certain relationship with Business Hours arrangements, "we are there in small places (supermarkets) are not into this, have to go to the city", "want to (buy Contraceptives) when Convenient "," feel the most difficult is to find a place to buy (contraceptive). Regular closed early.
[Conclusion]
Unmarried young men of reproductive health knowledge is poor. Not received higher education, age, research object and non relatives flat-share, level of reproductive health related knowledge is low. At the same time, the level of health knowledge in Jimo as research object to the reproduction is relatively high. The young unmarried male contraceptive choice condom has an absolute majority. In the crowd to use condoms, the main reason is not love to use condoms after intercourse feeling. First sex with non regular sexual partners, had a higher proportion of commercial sex. The research object interview for reasons of unwanted sexual behavior to take a more evasive attitude, and non volitional behavior the incidence rate is very high. It resulted in a high proportion of pregnant women, and can not be aware of the impact of her pregnancy.

【學位授予單位】：北京協(xié)和醫(yī)學院
【學位級別】：碩士
【學位授予年份】：2012
【分類號】：R169.1

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