【摘要】：研究目的通過調(diào)查北京和西安城區(qū)婚檢人群對婚前保健相關(guān)知識(shí)的掌握及對生育健康知識(shí)的需求情況,分析婚前健康教育工作中存在的問題,提出適宜的生殖健康教育模式的建議,期望能夠降低不孕不育的發(fā)生,促進(jìn)圍婚人群的生殖健康水平。研究方法本研究采用定量研究和定性研究相結(jié)合的研究方法。定量研究在2016年10月至2016年12月期間,對北京朝陽區(qū)婦幼保健院和陜西省西安市蓮湖區(qū)婦幼保健計(jì)劃生育服務(wù)中心的婚檢人群,根據(jù)現(xiàn)況調(diào)查公式計(jì)算樣本量為780人,由經(jīng)過培訓(xùn)的醫(yī)務(wù)人員進(jìn)行一對一的問卷調(diào)查,調(diào)查婚檢人群婚前保健相關(guān)知識(shí)的掌握情況。定性研究對2016年12月期間,在兩所保健院各隨機(jī)抽取10名(共20人)婚檢人員,根據(jù)訪談提綱,了解研究對象對生育健康知識(shí)的需求情況。利用EpiData軟件進(jìn)行數(shù)據(jù)的回收錄入,利用SPSS 17.0統(tǒng)計(jì)軟件完成數(shù)據(jù)的整理與分析。統(tǒng)計(jì)分析方法:定量調(diào)查采用描述性研究,分析數(shù)據(jù)的頻數(shù)分布、所占百分比的情況,做卡方檢驗(yàn)、t檢驗(yàn)、方差分析。定性調(diào)查采用Colaizzi提出的現(xiàn)象學(xué)資料分析法進(jìn)行資料的處理與分析。研究結(jié)果本次調(diào)查共發(fā)放問卷780份,收回774份,回收率99.2%。經(jīng)核查有效問卷約763份,有效率97.8%。年齡方面:20～25歲占12.5%;26～30歲占49.1%;31～35歲占24.4%;大于36歲占14.0%。符合晚婚年齡(男25周歲,女23周歲)的男性占87.1%、女性占93.9%。處在最佳生育年齡(男性25-35歲,女性24-29歲),男性占78.4%、女性占48.9%。文化程度方面:小學(xué)/初中組最少,占3.8%;高中/�？平M占24.5%;本科組最多,占50.7%;碩士以上組占20.3%。北京、西安兩地各文化程度組的人數(shù)接近,比較無統(tǒng)計(jì)學(xué)差異(P0.05)。男、女不同年齡組對婚前保健知識(shí)認(rèn)知的平均得分比較無統(tǒng)計(jì)學(xué)差異(P0.05),不同文化程度組平均得分比較有顯著差異(P0.05)。再進(jìn)一步做組間兩兩比較的t檢驗(yàn),小學(xué)/初中組與高中和本科組的平均得分存在顯著差異(P0.05),本科組與碩士以上組的平均得分不存在顯著差異(P0.05)�；榍氨＝≈R(shí)判斷正確率較高的題目(正確率60%以上):對過度吸煙、酗酒會(huì)影響精子質(zhì)量、胎兒發(fā)育的認(rèn)識(shí),正確率96.6%;造成不孕的原因可能來自男女雙方的認(rèn)識(shí),正確率94.1%選擇;暫時(shí)不宜婚育的疾病,正確率83.4%;對淋病、梅毒等性傳播疾病需經(jīng)正規(guī)治療臨床治愈后方可結(jié)婚,正確率68.6%;優(yōu)生優(yōu)育應(yīng)避免的不利因素,正確率69.6%�；榍氨＝≈R(shí)判斷正確率較低的題目(正確率60%以下):獲取生殖健康知識(shí)的態(tài)度,男性不主動(dòng)獲取或無所謂態(tài)度者(69.7%)高于女性(30.3%),男、女性別組的差異存在統(tǒng)計(jì)學(xué)意義(P0.05);選擇不適合短期避孕的方法,正確率57.9%;選擇男性和女性的最佳生育年齡,正確率51.2%;是否會(huì)計(jì)算排卵期,會(huì)計(jì)算者占49.0%;選擇婚后需要限制性生活的時(shí)期,正確率26.7%;對不孕癥的認(rèn)識(shí),正確率23.2%,不清楚45.1%。選擇經(jīng)性行為傳播的疾病,正確率14.2%;對遺傳性疾病的知曉情況,正確率為8.0%;選擇失敗率相對較高的避孕方式,正確率7.1%。對生育知識(shí)需求前三位的是如何注意生殖衛(wèi)生、避免不利優(yōu)生因素、如何計(jì)劃受孕,最后兩位的是性病主要傳播途徑、最佳生育年齡。其中北京地區(qū)對生育知識(shí)需求前三位的是如何注意生殖衛(wèi)生、限制性生活的時(shí)期、常用的短期避孕方法。西安地區(qū)是如何注意生殖衛(wèi)生、如何計(jì)劃受孕、避孕失敗后的補(bǔ)救措施。訪談中調(diào)查人群對生殖健康、優(yōu)生優(yōu)育知識(shí)的需求突出。生育知識(shí)的主要獲取途徑,通過網(wǎng)絡(luò)獲取者最多,占69.3%,其次是書刊占40.9%,宣傳冊占27.4%,知識(shí)講座占11.2%,更希望通過醫(yī)生當(dāng)面咨詢指導(dǎo)者占30.2%。選擇避孕措施情況中,使用避孕套者最多,占78.2%,其次是服用避孕藥,占20.1%,計(jì)算安全期避孕3.4%,使用宮內(nèi)節(jié)育器2.7%。研究結(jié)論處于最佳生育年齡的女性比例偏低;調(diào)查人群對婚前保健知識(shí)的掌握程度處于中等水平;男性對獲取生育健康知識(shí)的態(tài)度較為懈怠;對宣傳和普及力度小的生殖健康知識(shí)認(rèn)知較差;調(diào)查人群對生殖健康、優(yōu)生優(yōu)育知識(shí)的需求突出;對不合理避孕、意外妊娠、不安全流產(chǎn)及補(bǔ)救措施存在錯(cuò)誤認(rèn)識(shí)和知識(shí)盲區(qū);普遍的途徑獲取的知識(shí)缺乏準(zhǔn)確性,對理想的獲取方法又缺乏可及性。建議:應(yīng)加強(qiáng)圍婚人群的生育健康知識(shí)的宣傳和指導(dǎo);探索提高人群對生育知識(shí)認(rèn)知的方式方法;充分發(fā)揮婚檢門診健康教育的突出作用;關(guān)注生殖健康服務(wù)的性別公平視角;普及生育健康知識(shí)關(guān)口前移,改善人群獲取知識(shí)渠道的可及性。
[Abstract]:The purpose of this study is to analyze the problems existing in the work of pre-marital health education and to put forward the appropriate model of reproductive health education by investigating the knowledge of pre-marital health care and the demand of reproductive health knowledge by the people in Beijing and Xi 'an. It is desirable to be able to reduce the occurrence of infertility and to promote the level of reproductive health of the bigamy population. The research method is a research method combining quantitative and qualitative research. The quantitative study, during the period from October 2016 to December 2016, calculated the sample size of 780 people according to the current status survey formula for the children and child health care institute of Chaoyang District of Beijing and the marriage inspection population of the Family Planning Service Center of the Family Planning Service Center of the Lianhu District, Xi 'an City, Shaanxi Province. A one-to-one questionnaire was conducted by trained medical personnel to investigate the knowledge of pre-marital health care of the people. During the period of December,2016, the qualitative research conducted 10 (20) people in each of the two health care centers, according to the interview outline, to understand the needs of the study object on the reproductive health knowledge. The data is collected and entered by using the EpiData software, and the data is finished and analyzed by using the SPSS 17.0 statistical software. Statistical analysis method: a descriptive study was used for quantitative investigation, the frequency distribution of data was analyzed, the percentage of the data was analyzed, and the chi-square test, t-test and variance analysis were made. The qualitative investigation adopts the phenomenological data analysis method proposed by Colaizzi to process and analyze the data. The results showed that 780 parts of the questionnaire were distributed,774 parts were recovered and the recovery rate was 99.2%. The effective rate was 97.8%. Age: 12.5% in 20-25 years, 49.1% in 26-30 years, 24.4% in 31-35 years, and 14.0% over the age of 36. According to the age of late marriage (male 25, female 23), 87.1% and 93.9% of women. At the best reproductive age (25-35 years for men,24-29 for women), 78.4 per cent for men and 48.9 per cent for women. The level of culture: the minimum of the primary/ middle school group, accounting for 3.8%; the high school/ special group account for 24.5%; the undergraduate group is the most, accounting for 50.7%; the above group of the master's degree account for 20.3%. There was no statistical difference between Beijing and Xi 'an (P0.05). There was no significant difference in the average scores of pre-marital health-care knowledge in male and female group (P0.05), and the average scores of different cultures were significantly different (P0.05). There was no significant difference between the average scores of the primary/ junior high school group and the high school and the undergraduate group (P0.05), and there was no significant difference in the average scores between the two groups (P0.05). The accuracy rate of pre-marital health-care knowledge is higher (the correct rate is more than 60%): for excessive smoking, the drinking can affect the quality of the sperm and the development of the fetus, and the correct rate is 96.6%; the cause of infertility can be from the understanding of both men and women, and the correct rate is 94.1%; The correct rate is 83.4% for the diseases which are not suitable for marriage, and the rate is 68.6% after the normal treatment of the sexually transmitted diseases such as gonorrhea, syphilis and the like, and the correct rate is 69.6%. The accuracy of pre-marital health-care knowledge was lower (the correct rate was less than 60%): the attitude of obtaining the knowledge of reproductive health, the non-active or indifferent attitude of the male (69.7%) was higher than that of the female (30.3%), and the difference between the male and female groups was statistically significant (P0.05); The method is not suitable for short-term contraception, the correct rate is 57.9%, the optimal reproductive age of the male and the female is selected, the correct rate is 51.2%, the ovulation period is calculated, the calculated rate is 49.0%, the period of the restriction life is selected after the marriage is required, the correct rate is 26.7%, and the understanding of the infertility is realized, The correct rate was 23.2%, and it was not clear 45.1%. It was found that the correct rate of the disease was 14.2%, and the correct rate was 8.0% for the knowledge of the genetic diseases, and the correct rate was 7.1%. How to pay attention to reproductive health in the first three aspects of the needs of reproductive knowledge is to avoid the negative factors, how to plan the conception, and the last two are the main transmission route of the venereal disease and the optimal reproductive age. Among them, the first three of the demand for reproductive knowledge in Beijing is how to pay attention to the reproductive health, the period of restricted life, and the common short-term contraceptive method. The Xi 'an area is how to pay attention to the reproductive health, how to plan the conception, and the remedial measures after the failure of the contraception. In the interview, the population has a prominent demand for reproductive health and eugenic knowledge. The main way to get the knowledge of the birth of the child is that the number of people in the network is up to 69.3%, followed by 40.9% of the book, 27.4% of the brochure, 11.2% for the knowledge lecture and 30.2% for the doctor's face-to-face advice. In the case of contraceptive use, the most common use of the condom was 78.2%, followed by the use of the contraceptive, which accounted for 20.1%, the safety period was 3.4%, and the use of the intrauterine device was 2.7%. The research conclusion is that the proportion of women in the optimal reproductive age is low; the level of knowledge of the pre-marital health-care knowledge in the survey population is at a middle level; the attitude of the male to the knowledge of obtaining the reproductive health knowledge is relatively weak; and the knowledge of the reproductive health knowledge which is small in the promotion and the popularization is poor; The population has a high demand for reproductive health and eugenic knowledge; there are misconceptions and knowledge blind areas for irrational contraception, accidental pregnancy, unsafe abortion and remedial measures; the lack of accuracy in the knowledge acquired by the general approach, and the lack of accessibility to the ideal method of acquisition. It is suggested that the promotion and guidance of the reproductive health knowledge of the people in the bigamy should be strengthened; the way to improve the cognition of the population to the knowledge of the reproductive knowledge should be explored; the prominent role of the health education in the clinic for marriage inspection should be given full play; the gender equity perspective of the reproductive health service should be paid attention to; and the popularization of the knowledge of reproductive health knowledge should be popularized. Improve the accessibility of the knowledge channel for the population.
【學(xué)位授予單位】：中國疾病預(yù)防控制中心
【學(xué)位級(jí)別】：碩士
【學(xué)位授予年份】：2017
【分類號(hào)】：R169.1

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