社区综合护理模式对农村孕妇知-信-行的改善效果分析

目的：探讨社区综合护理模式对中山市农村孕妇知-信-行的改善效果。方法：选择2011年6月-2013年6月来本院产前检查的中山市农村户籍孕妇作为研究对象,将自愿参加综合护理干预的600名孕妇作为试验组,开展社区综合护理管理;另选取同时在本院产前检查不愿意参加试验的600名孕妇作为对照组,开展常规管理。对两组孕妇跟踪随访到产前1周,比较两组孕妇对孕产保健的相关知识、态度和行为的变化情况。结果：在管理前,两组孕产保健相关知识知晓情况均较低,其中产褥期保健知识、孕妇饮食和早产流产预防的知晓率最低,分别占18.0%、22.0%和23.4%。经社区综合护理管理后,试验组各项知晓率均高于85.0%,孕产保健相关态度和行为得到明显的改善,与管理前比较差异均有统计学意义（P〈0.05）;对照组对部分孕产保健知识、态度和行为也有一定的改善,但试验组的干预效果明显优于对照组（P〈0.05）。结论：社区综合护理模式应用于农村孕妇管理效果满意,值得推广。     

上海市嘉定区产妇孕产期保健知信行分析

目的分析上海市嘉定区产妇在孕产期各时期保健知识、认知态度和行为现状,为探索孕产期保健干预策略研究提供依据。方法借鉴健康教育的"知信行"理论,自行设计调查问卷,对上海市嘉定区4个社区的产妇进行了孕产期保健现状调查,分析比较产妇在孕产期各时期保健的知信行情况。结果产妇对各时期保健的知识知晓率均>93.0%;产妇对各时期保健的正确态度形成率均>98.0%;产妇对各时期保健的正确行为持有率均>76.0%,其中孕前保健(76.5%)、参加孕妇学校(89.1%)和产时自然分娩(78.6%)是持有率较低的行为;产后42 d去医院健康检查(86.5%)则是产妇态度重视但又未能很好付诸实施的行为。产妇的孕产期保健知识、态度和行为具有正相关关系(P<0.01)。结论上海市嘉定区产妇的孕产期保健知信行结果总体良好,但仍需逐步提高孕产妇的自我管理能力,强化全流程的孕产期保健健康教育。     

河南省卫生Ⅷ项目对妇女产前保健的影响

目的:评价卫生Ⅷ项目对河南贫困地区妇女产前保健的影响。方法:采用分层随机抽样的方法确定要调查的村,入户问卷调查综合项目县、基本项目县和对照县共1238名5岁以下儿童母亲。结果:项目县的产前检查率、检查次数和在乡镇卫生院检查人次都比较高;3县的平均产前检查次数都小于5次,孕早期检查率也都比较低(综合项目县25.80%、基本项目县26.26%、对照县9.40%)。结论:项目在很大程度上改善了产前保健情况,但河南省贫困地区妇女产前保健服务水平相对还比较低,有待项目进一步支持。     

秦巴卫生项目干预效果评价:对产前保健利用的影响

目的:分析秦巴卫生项目(卫生Ⅷ项目B部分)对项目地区产前保健服务利用的影响,为促进中国农村贫困地区孕产期保健提供具有实效的思路和建议。方法:利用卫生Ⅷ项目终末家庭调查数据库,选取2002-2006年期间有过活产的妇女的相关信息,从产前检查时间和产前检查次数两方面分析干预措施对项目覆盖的四川、陕西和宁夏3省产前保健的作用效果。结果:产前检查不少于5次的比例受项目干预措施、民族、受教育程度、收入、生育史、年份、到达医疗机构所需时间的影响,干预乡孕妇相对于对照乡妇女接受不少于5次产前检查的OR值为1.85(P0.0001);孕早期检查率主要受产妇民族、受教育程度、收入和年份影响,是否项目乡并非孕早期检查率的显著影响因素。结论:秦巴卫生项目的实施促进了产前保健服务利用,但主要表现为产前检查次数的增加,干预措施对提高孕早期检查率,即提前产前检查时间无明显作用。秦巴地区妇女产前保健服务利用水平仍比较低,有待项目和配套政策的进一步支持。     

中西部贫困地区母亲妇幼保健知识、态度及行为研究

目的:了解西部农村地区3岁以下儿童母亲孕产期保健和儿童保健的知识、态度和行为现状,为今后制定健康教育方案、有效开展健康活动提供依据。方法:在母子系统保健项目9个项目县中随机抽取118名3岁以下儿童母亲进行专题小组访谈。结果:受访者对产前检查的知晓率较高,但能够正确接受产前检查的比例较低;母亲对儿童保健相关知识了解不足,不能对儿童进行正确的喂养、发育监测等相关保健。结论:建议加强对孕产妇和儿童家长的健康教育,特别是参与式健康教育,使其了解更多的孕产期保健和儿童保健相关知识,能够主动接受相关服务和采纳健康行为。     

小学生口腔卫生知识、态度和行为社区干预效果评价

目的探讨社区健康教育干预对小学生口腔卫生知识、态度、行为(KAP)的影响,提高社区口腔卫生保健工作。方法采用分层整群随机抽样方法,将对抽中的学生分为干预组和对照组,对干预组开展社区健康教育干预,并观察干预组、对照组间口腔卫生知识、态度及行为情况。结果干预后干预组小学生的口腔卫生KAP 3方面正确回答率分别为87.35%、92.77%、86.75%,明显高于对照组(46.61%、61.95%、38.94%)和干预前干预组(45.37%、60.60%、37.91%)的正确回答率,差异均有统计学意义(P0.01);干预后所有18项调查内容均有显著提高,差异均有统计学意义(P0.01);对照组的干预前后差异无统计学意义(P0.05)。结论社区健康教育干预对高桥社区小学生口腔卫生KAP水平有显著的提高作用。口腔卫生保健人员应继续加强对小学生的健康教育和行为干预,不断提高社区口腔卫生保健工作。     

健康教育是农村边远贫困地区孕产妇获得产时保健的有效措施——附659例育龄妇女调查分析

为了解“降低农村边远贫困地区产后出血死亡社区干预措施”在项目县中的研究结果 ,对开展研究项目的 5个县妇幼卫生健康教育和健康促进进行调查 ,重点进行了育龄妇女的孕产期保健知识、态度、行为 (KAP)调查分析 ,评估社区干预措施的效果 ,在 5个课题县对 6 79名妇女进行了 KAP问卷调查 ,并与项目健康教育基线调查结果进行比较。结果 :育龄妇女保健知识水平较项目实施前有较大幅度的提高 ,主要是改善了对产前检查、孕期营养、新法接生、住院分娩和母乳喂养等方面的认识。从调查对象主动接受产前检查和寻求住院分娩的行为改变可观察到项目健康促进的干预效果 ,课题结束时 5县住院分娩率从 1992年的 19.6 5 %提高到 2 0 0 0年的 6 1.91%。因产后出血引起的孕产妇死亡降低一半 ,说明了广泛开展社区健康教育是农村边远贫困地区孕产妇提高利用保健服务的能力 ,获得产前保健 ,降低孕产妇死亡率的有效措施。     

医学院女生月经疾病相关因素及健康干预效果分析

探究有利于医学院女生月经健康的易行有效的健康干预方法,为高校开展女大学生健康保健工作提供科学依据.方法 通过问卷方式对随机选取的600名女医学生进行月经疾病及相关因素的调查,并根据调查结果及大学生的特点制定干预方案,采用综合干预措施对其中298名学生(以宿舍为单位随机抽取)进行健康干预,其余的302人为对照组,不做任何干预.比较干预前后2组人员健康状况、健康行为形成及保健意识等方面的差别,探讨干预方法的效果及可行性.结果 医学院女生痛经(67.16%)及月经失调(47.83%)发病率较高,健康行为形成率(49.33%)较低,月经疾病就医率(27.22%)及保健知识知晓率(51.66%)较低;通过健康干预上述健康状况、健康行为及保健意识具有明显改善(P<0.05);同学们对干预方式的认可度较高(99.3%).结论 干预方法可明显提高女大学生月经健康方面的保健意识,促进健康行为的形成,从而改善月经健康,可行性好,值得推广.     

杭州市某医院产妇产后生殖保健健康教育干预效果分析

目的调查产妇产后生殖保健知识、认知态度和行为现状,并根据调查现状制定干预措施,提高产妇产后生殖保健工作效率。方法以"知信行"理论为指导,采用方便抽样方法抽取2014年11月—2015年7月分娩的产妇532名作为调查对象,了解产妇产后生殖保健知信行现状,随后采用平行对照设计分析比较接受常规健康教育的50名产妇(对照组)与接受"知信行"模式健康教育的50名产妇(研究组)干预前、后的知信行变化情况。结果 532名产妇知识、态度、行为、总量表评分分别为(19.32±5.03)分、(33.24±7.48)分、(39.12±7.56)分和(92.32±24.12)分;知识维度中,对乳房护理方法及产后恢复性生活时间的认知率最低,分别为65.79%、64.29%;态度维度中,对分娩后无禁忌及早下床活动的认可率最低,仅为42.67%;行为维度中,对定期开窗通风,月子期间坚持刷牙、洗脸,月子期间注意饮食的执行率最低,分别为29.14%、26.88%和21.99%。健康教育后,研究组知识(22.75±5.71)分、态度(36.88±6.82)分和行为(43.58±7.50)分均高于干预前及对照组,差异均有统计学意义(P0.05)。结论产妇产后生殖保健知信行现状良好,但对部分健康知识的认知、健康信念的坚持及健康行为的形成等仍存在一定误区与不足,临床应据此加强健康教育。     

经济欠发达地区农村产前保健项目中间结果评价

目的:对经济欠发达地区农村开展的产前保健项目的中间结果进行评价.方法:由县卫生局组织有关产前保健专家对乡镇卫生院产科医务人员进行业务培训;由县卫生局和乡镇领导协调卫生与计划生育部门开展农村社区产前保健的健康教育;由乡镇卫生院产科助产士负责开展产前检查.应用整群随机分组的设计及做干预前后测量的方法进行评价.评价的指标包括初次产前检查孕周、产前检查次数和产前检查率.结果:干预使孕妇初次产前检查的时间提前.干预提高了产前检查率.干预提高了高危妊娠妇女的产前检查次数.结论:卫生与计划生育部门合作开展产前保健是促进经济欠发过地区农村母婴保健工作可行与有效的途径.     

新疆生产建设兵团已婚育龄妇女孕产期保健状况调查

目的：了解新疆生产建设兵团1971-2006年间孕产期保健状况。方法：采取分层整群、四阶段、概率比例随机抽样方法,调查员入户面对面问卷调查。结果：共调查有活产已婚育龄妇女6624人,2001年以来,产前检查率、孕早期（妊娠≤12周）检查率、师直≥8次产前检查率、团场≥5次产前检查率、住院分娩率分别达到了86.60％、66.64％、58.70％、65.19％、82.01％,在家分娩率降到14.10％,而产后访视率仅为32.01％。育龄妇女的分娩时期、民族、受教育程度、生育史、家庭年收入、职业与是否参加产前检查有关。结论：近几年孕产期保健状况有明显改善,但产前检查率、孕早期检查率和产后访视率偏低,应特别加强对文化程度低、从事农业、少数民族孕妇的健康教育,普及孕产期卫生保健知识,规范产后访视,提高孕产期保健服务质量和服务利用率。     

Knowledge,attitudes, and practices regarding seasonal influenza vaccination during pregnancy in Costa Rica: A mixed-methods study

BackgroundInfluenza increases stillbirth risk, morbidity and mortality in pregnant women. Vaccination protects pregnant women against severe disease and indirectly protects their infants, but coverage among pregnant women remains low worldwide. We aimed to describe knowledge, attitudes, and practices (KAP) regarding seasonal influenza vaccination among postpartum women and prenatal care physicians in Costa Rica.MethodsWe conducted cross-sectional KAP surveys to women one to three days after childbirth at Costa Rican Social Security Fund maternity hospitals, and obstetricians and general practitioners who provided prenatal care in 2017. Principal components analysis, multiple imputation, and logistic regression were used to examine associations between influenza vaccination and demographics, prenatal care, and sources of information—separately for postpartum women and physicians. We also held two focus groups of six healthcare workers each to further describe vaccination KAP.ResultsWe surveyed 642 postpartum women and 146 physicians in maternity hospitals in five Costa Rican provinces of whom 85.5 % (95 % CI: 82.6 %-88.0 %) and 57.9 % (95 % CI: 49.6 %-65.7 %) were vaccinated for influenza, respectively. Factors associated with influenza vaccination for postpartum women included tetanus vaccination (aOR: 3.62, 95 % CI: 1.89–6.92); received vaccination recommendations from clinicians during prenatal check-ups (aOR: 3.39, 95 % CI: 2.06–5.59); had other children in household vaccinated for influenza (aOR: 2.25, 95 % CI: 1.08–4.68); and secondary/university education (aOR: 0.15–0.31) with no formal education as reference. For postpartum women, reasons for vaccination were perceived benefits for mother and infant, whereas not being offered vaccines was most cited for non-vaccination. Most prenatal care physicians recommended influenza vaccines during prenatal check-ups but believed vaccination causes flu-like symptoms.ConclusionVaccination campaigns and provisions of free vaccines effectively increased knowledge and coverage among women in Costa Rica. To improve access, women should be offered vaccines during prenatal care appointments. Educating healthcare workers about vaccine benefits for themselves and patients is needed to mitigate safety concerns.     

农村地区产后出血防治措施的探讨

为探讨农村地区产后出血的防治措施，降低产后出血对农村孕产妇的危害，作者对82例产后出血病例进行了分析。发现乡镇卫生院及在家分娩的产后出血孕产妇失血量大于市医院分娩组，差异值有显著性。作者认为：建立完善的转诊制度是防治产后出血导致严重危害的重要措施；提高基层卫生人员的技术水平是农村地区产后出血防治的关键；在产后出血的防治中加强农村孕产妇保健管理也很必要。     

An Assessment of the Use and Impact of Ancillary Prenatal Care Services to Medicaid Women in Managed Care

Objectives: Managed care plans under Medicaid are becoming a usual source of care for low-income pregnant women. This study describes an ancillary prenatal care service intervention developed by one managed care organization (MCO) for Medicaid-enrolled women, assesses the extent to which the intervention services were used, and appraises the influence of the intervention on prenatal care participation. Method: There were 226 intervention and 258 control women with a single live birth delivered between 28 and 44 weeks gestation who (1) were enrolled in the MCO's Medicaid program, (2) were high-risk based on a prenatal risk assessment, and (3) started prenatal care prior to 26 weeks gestation. Less than adequate and intensive prenatal care utilization were chosen as intervention outcomes measures. Results: Family planning, a 2-month postpartum baby visit, a maternal postpartum visit, and a WIC (Special Supplemental Nutrition Program for Women, Infants, and Children) referral were among the most self-selected intervention services for this population; home health aide and breast-feeding support were the least requested services. Over 90% of those needing family planning or breast-feeding services received the services, while over 20% of the intervention group refused child care, food assistance and family violence referrals, and home health aide and smoking cessation services. The intervention group had a significantly lower risk of less than adequate utilization of prenatal care (OR = .32; 95% CI: 0.17–0.60) and was more likely to have an intensive number of prenatal care visits (OR = 1.61; 95% CI: 1.05–2.48). Conclusions: The ability of managed care organizations to provide ongoing prenatal care to Medicaid populations in a cost-effective manner depends partly on their development of packages of prenatal services that foster positive preventive health care utilization behaviors and good pregnancy outcomes. The results of this project suggest that the intervention was beneficial in the area of improving utilization of prenatal care.     

项目地区获取孕产期保健知识对孕产妇死亡率影响的研究

目的:分析孕产妇及其家属获取孕产期保健知识对孕产妇死亡率的影响,探讨提高该地区的孕产期保健知识的有效措施。方法:采用1∶1配对病例对照研究方法,选择孕产妇死亡率较高、人均收入较低、多民族聚居的贵州省内22个项目县中所有在2004年死亡的农村孕产妇与非死亡的孕产妇,应用多因素Logistic回归分析了解获取孕产期保健知识的内容和途径对孕产妇死亡率的影响。结果:被调查地区孕产妇了解孕产期保健知识的比例低于45%。其中,对照组获取孕产期保健知识多于病例组,两组获取知识的内容和途径存在明显差异,病例组获取知识的主要途径是自己的经验和亲朋传说。结论:该地区孕产妇对孕产期保健知识的获取不足,存在信息来源、获取信息的能力、理解信息的程度、宣传方式方法的差异,这些差异影响了孕产妇死亡率。     

Factors associated with postpartum care among Massachusetts users of the Maternal and Infant Care Program

Records of the 21 Maternal and Infant Care (MIC) offices run by the Massachusetts Department of Public Health located in community-based facilities in high-risk areas provided data for the period 1985-87. MIC services include a postpartum visit within 2-6 weeks after birth. 24% of the deliveries in the MIC program were to teenagers. Unmarried women, high school dropouts, and minority group members were greatly overrepresented in the MIC program. 78% (10,854) of the women who received MIC care returned for a postpartum visit. Maternal age, educational status, parity, ethnicity, primary language, adequacy of prenatal care, length of maternal hospitalization, transfer of the infant to a neonatal intensive care unit, length of pregnancy, birth outcome, type of delivery, and birth weight were factors studied. The largest effect appeared to be correlated with adequacy of prenatal care utilization (the Kessner Index is used). Only 63% of women with inadequate utilization returned, compared with 76% of those with intermediate care and 86%, adequate care. The higher the women's level of education, the more likely she was to have a postpartum visit. The more children she had, the less likely she was to return. 82% of those with 1st births returned and 70% of those with 4 or more children. Women who did not speak English were more likely to return, (82%) than those who did (78%). NonEnglish speaking Asian women had the highest return rate (92%). Women under age 26 were likely to return than older ones. Factors associated with postpartum care were analyzed by year of delivery, so time trends could be seen. In 1985 and 1986, 78.9% returned for postpartum care; in 1987, the figure decreased to 76.4%. The % with adequate prenatal care who returned for postpartum care declined each year, from 87.4% in 1985 to 85.9% in 1986, and 83.8% in 1987. This was statistically significant. The % of Blacks who received postpartum care also declined, significantly. There was no change in the proportion getting adequate postpartum care among nonBlack groups. Factors associated with the lack of postpartum care in the multivariate analysis included Hispanic ethnicity, or later birth, and having a repeat cesarean section. The findings were shown to be stable across the years. In 1986 and 1987, women on the Healthy Start (a state-funded reimbursement program that pays for obstetric care of women with incomes between 100 and 185% of the poverty level) were less likely to miss their postpartum visit than those with commercial insurance.     

湖北省阳新县农村群众防治血吸虫病知信行情况分析

目的调查湖北省阳新县不同人群的血防知信行情况，为血防大众传播策略的制定提供依据。方法在湖北农村于2006年5月进行了问卷调查，共调查本地成人294人，流动人口126人，学生344人，对不同人群和不同地区的血防知信行情况进行了比较研究。结果流动人口的血防知信行普遍低于本地成人；成人的大部分血防知识、态度和行为在不同性别间无差异；学生年级越高，知识的知晓率越高，学生受教育程度与态度、行为无相关性；疫情越轻的地区，人们知识的知晓率和态度、行为的正确率越低。结论学生和流动人口是血防健康教育的重点人群；宣传内容要有人群针对性和地区针对性。     

孕产妇对孕期保健知识的需求现状调查

目的:了解孕妇对于孕期保健知识的需求现状和特点,为孕妇学校的课程设置提供依据。方法:选择2008年5～6月来我院门诊产检的484名孕妇进行问卷调查。结果:①93%的孕妇希望了解孕期保健知识;②对于孕妇学校课程需求最高的知识模块是新生儿喂养与护理模块,其次为产后心理问题及调试模块、胎儿发育过程及自我监测模块;③孕妇对于孕妇学校授课方式的需求较高的依次为讲座、观看录像、模仿操作、角色扮演。结论:孕产妇对于孕期保健知识的需求比较迫切,孕妇对于授课方式、授课内容的多样性有了更高层次的要求。