本文選題：孕產(chǎn)婦 + 健康教育　； 參考：《中南大學(xué)》2013年碩士論文

【摘要】：目的：在了解懷化地區(qū)孕產(chǎn)婦保健服務(wù)利用和不良妊娠結(jié)局的現(xiàn)狀的基礎(chǔ)上,探討應(yīng)用手機(jī)短信對孕產(chǎn)婦進(jìn)行健康教育干預(yù)的效果,以提高孕產(chǎn)婦保健服務(wù)質(zhì)量和降低不良妊娠結(jié)局的發(fā)生,為選擇適合我國孕產(chǎn)婦的健康教育方式提供科學(xué)依據(jù)。 方法：①采用分層整群隨機(jī)抽樣的方法,從懷化地區(qū)的13個縣市中隨機(jī)抽取10個縣市作為研究對象,各層抽出的縣再按等額隨機(jī)分配到干預(yù)組和對照組(每組五個縣)。研究對象為2012年1月至2012年10月期間,在這10個縣市的婦幼保健院(站)進(jìn)行產(chǎn)前登記的孕產(chǎn)婦且其本人或家人具有手機(jī)者。②“知信行”問卷調(diào)查：每個縣隨機(jī)抽取50人進(jìn)行孕產(chǎn)期保健知識的“知信行”問卷調(diào)查,分別于產(chǎn)前第一次登記時和產(chǎn)后42天進(jìn)行“知信行”問卷調(diào)查。采用χ2檢驗(yàn)、t檢驗(yàn)或方差分析進(jìn)行統(tǒng)計分析。 結(jié)果：①基本情況：2012年1月～2012年10月在干預(yù)組和對照組進(jìn)行產(chǎn)前登記的符合納入條件的孕產(chǎn)婦人數(shù)分別為11477和12699,截至2013年2月共收集到孕產(chǎn)婦結(jié)局資料分別為6603和6213,隨訪完成率分別為57.5%和48.9%。兩組孕產(chǎn)婦在年齡、孕次間的差異無統(tǒng)計學(xué)意義(P0.05)；在產(chǎn)次和戶籍方面差異具有統(tǒng)計學(xué)意義(P0.001),干預(yù)組中孕產(chǎn)婦為農(nóng)業(yè)戶籍的人數(shù)高于對照組,初產(chǎn)婦人數(shù)低于對照組。②基線調(diào)查結(jié)果：對研究地區(qū)孕產(chǎn)婦保健服務(wù)利用和妊娠結(jié)局進(jìn)行基線調(diào)查,收集2011年6月～2011年12月期間(干預(yù)前)分娩的孕產(chǎn)婦保健服務(wù)利用和妊娠結(jié)局資料。共收集到9113名孕產(chǎn)婦資料,其中干預(yù)組4971人,對照組4142人。結(jié)果顯示：對照組的孕產(chǎn)婦早孕檢查率、產(chǎn)前篩查率、艾滋病抗體檢測率均高于干預(yù)組(P0.05),梅毒抗體檢測率、乙肝表面抗原檢測率、產(chǎn)前檢查、產(chǎn)前檢查≥5次率和葉酸補(bǔ)服率兩組差異無統(tǒng)計學(xué)意義(P0.05)。③“知信行”問卷調(diào)查：每縣隨機(jī)抽取50人進(jìn)行問卷調(diào)查(干預(yù)組和對照組各250人),共收集到205份干預(yù)組和227份對照組孕產(chǎn)婦完整的問卷資料,有效應(yīng)答率分別為82.0%和90.8%。“知信行”問卷調(diào)查結(jié)果顯示：干預(yù)組干預(yù)后知識、態(tài)度和行為得分升高幅度均高于對照組(P0.05)。④孕產(chǎn)婦保健服務(wù)利用比較：利用手機(jī)短信對孕產(chǎn)婦進(jìn)行健康教育后干預(yù)組的產(chǎn)前篩查率、艾滋病抗體檢測率、產(chǎn)前檢查率、產(chǎn)前檢查≥5次率、葉酸補(bǔ)服率均高于干預(yù)前水平(P0.05)。⑤孕產(chǎn)婦妊娠結(jié)局比較：健康教育干預(yù)前孕產(chǎn)婦剖宮產(chǎn)率干預(yù)組(40.2%)和對照組(39.6%)差異無統(tǒng)計學(xué)意義；健康教育干預(yù)后干預(yù)組的剖宮產(chǎn)率(35.6%)明顯低于對照組(40.1%)。 結(jié)論：①我國懷化地區(qū)孕產(chǎn)婦保健服務(wù)利用率較低；剖宮產(chǎn)率為40.0%,孕產(chǎn)婦死亡率為38.75/10萬,圍生兒死亡率為9%0。②利用手機(jī)短信對孕產(chǎn)婦進(jìn)行健康教育能夠促進(jìn)孕產(chǎn)婦知識、態(tài)度、行為的改變；提高產(chǎn)前篩查率、艾滋病抗體檢測率、產(chǎn)前檢查率和葉酸補(bǔ)服率；降低剖宮產(chǎn)率,促進(jìn)孕產(chǎn)婦及嬰幼兒的健康。③應(yīng)用手機(jī)短信對孕產(chǎn)婦進(jìn)行健康教育具有較好的可行性。
[Abstract]:Objective: to understand the maternal health services utilization in Huaihua area and adverse pregnancy outcome status on the application of mobile phone messages for the effects of the health education intervention on maternal health care of pregnant women, in order to improve service quality and reduce the occurrence of adverse pregnancy outcomes, and provide scientific basis for health education mode selection for Chinese pregnant women.
Methods: using stratified random sampling method, 10 counties were randomly selected from 13 counties in Huaihua area as the research object, each layer out of the county and then by matching the randomly assigned to the intervention group and the control group (five in each county) as the research object. During the period from January 2012 to October 2012, in the 10 the county MCH (station) of antenatal registration and the person or family with mobile phone. A survey of the KAP: each county randomly selected 50 people survey of maternal health care knowledge KAP, respectively in the first antenatal and postpartum 42 days of registration "the questionnaire of KAP. Using 2 test, t test or analysis of variance was used for statistical analysis.
Results: the basic situation: from January 2012 to October 2012 in the intervention group and control group were registered with the number of pregnant women in prenatal conditions were 11477 and 12699, as of February 2013 were collected from the maternal outcome data were 6603 and 6213, the follow-up completion rates were 57.5% and 48.9%. of two groups of maternal age, there was no statistically significant difference. Between the (P0.05); in the production and household differences have statistical significance (P0.001), the number of pregnant women in the intervention group for agricultural household registration was higher than the control group, the number of primipara is lower than the control group. The baseline survey results of maternal health services research area by using the baseline survey and the pregnancy outcomes were collected from June 2011 to December 2011. During the period (before intervention) of maternal health care services utilization childbirth and pregnancy outcomes of 9113 pregnant women. The data were collected in the intervention group 497 1 people, 4142 people in the control group. The results showed that the control group the rate of maternal pregnancy examination, prenatal screening rate of HIV antibody detection rate were higher in the intervention group (P0.05), syphilis antibody detection rate of hepatitis B surface antigen detection rate, prenatal examination, prenatal examination of more than 5 times the rate of wear rate was two and Ye Suanbu was not statistically meaning (P0.05). A survey of the "KAP: each county randomly selected 50 questionnaires (intervention group and control group of 250 people), collected a total of 205 copies and 227 copies of the intervention group control group maternal questionnaire complete, with rates were 82% and 90.8%." KAP "answer: the survey results show that the effect of intervention group knowledge, attitude and behavior scores increased were higher than that of the control group (P0.05). By comparing the maternal health care services: prenatal screening for the use of mobile phone text messages to carry out health education for pregnant women after the intervention group, AI HIV antibody detection rate, the rate of prenatal examination, prenatal examination of more than 5 times the rate of folic acid supplementation, rates were higher than before the intervention level (P0.05). Compared the pregnancy outcome of pregnant women: health education intervention before cesarean section rate of intervention group (40.2%) and control group (39.6%) there was no significant difference in the rate of cesarean section; intervention the health education intervention group (35.6%) was significantly lower than the control group (40.1%).
Conclusion: the maternal health care services in Huaihua area of our country low utilization rate; the rate of cesarean section was 40%, the maternal mortality rate was 38.75/10 million, the perinatal mortality rate was 9%0. 2 of the maternal health education can promote maternal knowledge, the use of mobile phone message attitude, behavior change; improve the prenatal screening rate of HIV antibody detection rate. The rate of prenatal examination and folic acid supplementation rate; reduce the rate of cesarean section, promote maternal and infant health. The application of mobile phone SMS health education is feasible to the pregnant women.

【學(xué)位授予單位】：中南大學(xué)
【學(xué)位級別】：碩士
【學(xué)位授予年份】：2013
【分類號】：R173

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