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1.
In a randomized trial, the effect of preabortion counseling was evaluated and contraceptive use postabortion described. The 420 women, who were assigned into either an intervention group (n = 210) or a control group (n = 210), were followed-up 4–6 months later, a total of 148 and 128 women in each respective group. No significant difference was found between the two groups regarding contraceptive use after abortion (86%, 85%), which indicates no immediate intervention effect. The women, in both groups, who had previously undergone abortion were less likely to use contraception. The main contraceptive methods used by intervention and control groups were oral contraceptives (61% and 58%, respectively) and injectables (12% and 11%). Choice of method was mainly based on women's prior perception of effectiveness and convenience of use. A majority of the women in both groups could not specify their contraceptive plans. A postrandomization inequality regarding age, education and parity in the two groups had, however, to be taken into account. Intensive contraceptive counseling before abortion may not be effective, but those who are at higher risk of unplanned pregnancy need special attention. 相似文献
2.
Julia R. Steinberg Jeanne M. Tschann Jillian T. Henderson Eleanor A. Drey Jody E. Steinauer Cynthia C. Harper 《Contraception》2013
Objective
We investigated whether more psychological distress before an abortion is associated with the effectiveness of contraception selected (low, moderate, or high effectiveness) at an abortion clinic visit.Method
Using data from 253 women attending an urban abortion clinic that primarily serves low-income women, we tested the association between pre-abortion psychological distress and the effectiveness level of post-abortion contraceptive choice. Based on typical use failure rates, we classified effectiveness of contraceptive choice into three levels—low, moderate, and high effectiveness. We measured psychological distress with four validated measures of depressive, anxious, and stress symptoms, and negative affect, as well as with a global measure comprising these four measures. We used multivariable ordinal logistic regression to measure the association of each psychological distress measure with post-abortion contraceptive method effectiveness level, adjusting for sociodemographic factors, pregnancy history, trimester of abortion, and importance of avoiding pregnancy in the next year.Results
We found that compared to women experiencing less stress symptoms, negative affect and global psychological distress, women experiencing more stress symptoms [AOR=1.028, 95% CI: 1.001–1.050], negative affect [AOR=1.05, 95% CI: 1.01–1.09] and global psychological distress [AOR=1.46, 95% CI: 1.09–1.95] were more likely to choose more effective versus less effective methods, p<.05, in adjusted models. Using dichotomous psychological measures we found similar results.Conclusions
Women experiencing more psychological distress before an abortion selected more effective contraceptive methods after their abortion. Future research should examine whether this distress is associated with subsequent contraceptive use or continuation.Implications
The current study suggests that contraceptive providers should not assume that women experiencing more psychological distress prefer to use less effective contraceptive methods. 相似文献3.
孕期避孕指导对产后避孕行为的影响 总被引:5,自引:0,他引:5
目的 了解孕期给予避孕指导对产后避孕方法选择、使用率及其产后 1年内再次妊娠率的影响。 方法 募集 5 2 7名孕妇 ,随机分为干预组和对照组 ,干预组在孕期接受专家的避孕指导 ,对照组接受常规的孕期教育。干预组 2 5 4例和对照组 2 6 3例在产后 16周及 2 4 6例和 2 4 9例在 5 2周接受随访。 结果 产后 16周 2组各种避孕方法使用率差异无显著性 (P>0 .0 5 ) ,已恢复性生活者中干预组的避孕率 97.8(178/ 182 )高于对照组 92 .8% (192 / 2 0 7)差异有显著性 (χ2 =4 .5 7,P>0 .0 5 ) ;2组有 4 3.7% (2 2 6 / 5 17)的对象夫妇采用避孕套 ;平均性生活恢复和产后避孕开始使用之间的时距 ,干预组为 (0 .2± 0 .9)周 ,对照组为 (0 .3± 1.2 )周 ,差异无显著性 ;产后 16周表示产后未来 8个月内可能更换现用避孕方法的有 5 2 .2 % (2 70 / 5 17) ,其中约 30 %的准备放置宫内节育器。在产后5 2周时 ,干预组 5 1.6 % (12 7/ 2 4 6 )和对照组 4 0 .2 % (10 0 / 2 4 9)的使用避孕套 ,差异有显著性 (χ2 =6 .2 7,P>0 .0 5 ) ,但其他避孕方法差异无显著性 (P>0 .0 5 ) ;干预组 2 .8% (7/ 2 4 6 )和对照组 2 .0 %(5 / 2 4 9)曾经使用过紧急避孕方法 ,2组共 79.6 % (394 / 4 95 )从未听说过紧急避孕方法或仅一知半解 相似文献
4.
Carneiro Gomes Ferreira AL Impieri Souza A Evangelista Pessoa R Braga C 《Contraception》2011,84(4):377-383
Background
Brazilian women who have undergone abortion use contraceptive methods; however, their use of contraceptive methods is inconsistent and/or inappropriate.Study Design
This randomized trial evaluated the effectiveness of a personalized counseling on contraceptive acceptability and its use for postabortion women in the northeast of Brazil. It was conducted in July 2008 to September 2009, enrolling 246 women randomly distributed in intervention (n=123) and control (n=123) groups. An intention-to-treat analysis was performed.Results
In the follow-up, 98.4% women in the intervention group were using contraceptive methods compared with 70.6% women in the control group (p<.001). The probability of adherence and of the use of any kind of contraceptive method 6 months after the abortion was 41% greater in the intervention group.Conclusions
The strategy on individualized contraceptive counseling increased the acceptance and the use of contraceptive methods and increased the adequate use of the methods. 相似文献5.
目的:了解闵行区新婚女性对避孕方法的知晓及使用情况,为进一步实施干预和提高育龄妇女的生殖健康水平提供依据。方法:采用面对面的方式对450名登记结婚的新婚女性进行避孕知识问卷调查。结果:调查对象对避孕套、口服避孕药的知晓率较高,达到95%以上,避孕率为83.33%;使用率最高的避孕方法是避孕套,满意率最高的是口服避孕药;避孕知识主要来源于报刊、杂志、书籍。结论:生殖健康服务要真正实现避孕知情选择,必须开展各种形式的健康教育,让人们全面、正确地掌握避孕知识和信息,提高其避孕知识水平和避孕意识。 相似文献
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育龄妇女避孕知识知晓率调查及影响因素分析 总被引:5,自引:1,他引:5
目的:了解山东省育龄妇女避孕知识知晓率及其影响因素。方法:采用问卷调查,对4 828名20-49岁育龄妇女的避孕知识得分及其影响因素进行分析。结果:①大部分育龄群众的避孕知识得分在10-30分(满分50分),占65%,及格率只有13.1%。调查对象大多知道IUD、避孕套、输卵管结扎术、输精管结扎术及避孕药。②影响避孕节育知识得分的因素有年龄、文化程度、村分类、是否参加计生宣传培训、读报刊、看电视听广播、上网、个别查询、是否了解现采用避孕措施、技术服务人员是否提供宣传资料、是否知道知情选择的含义、能否自主选择避孕方法等。结论:采取有针对性的干预措施和开展健康教育,促进生殖健康,推动育龄妇女避孕方法知情选择,可提高育龄妇女避孕知识知晓率。 相似文献
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山东省已婚育龄妇女避孕方法知情选择现状及影响因素 总被引:1,自引:0,他引:1
目的:了解山东省已婚育龄妇女避孕方法知情选择现状及其影响因素。方法:对4828名20~49岁的已婚育龄妇女进行问卷调查,采用卡方检验进行单因素分析,采用非条件Logistic回归进行多因素分析。结果:①调查对象中,能够对避孕方法进行知情选择的人占72.9%,不能者占27.1%;②影响避孕方法知情选择的因素为村别、收入、文化程度、避孕知识得分、是否集中面授过、是否听说过避孕方法知情选择、是否知道"选择"的含义、服务机构技术人员向调查对象介绍避孕方法的种数等。结论:应加强宣传教育,提高技术服务人员的业务水平。 相似文献
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目的探讨辽宁省医护人员抑郁症状及影响因素,改善医护人员身心健康及生命质量。方法随机抽取辽宁省20所综合医院工作6个月以上的4 602名医护人员进行自填式问卷调查。应用流行病学调查用抑郁自评量表(CES-D)评价抑郁症状,logistic回归分析探讨医护人员抑郁症状的影响因素。率的比较采用χ^2检验,P〈0.05为差异有统计学意义。结果辽宁省医生的抑郁症状率为65.3%,高于护士55.7%(P〈0.01)。按OR值的顺序,医生抑郁症状的影响因素为高任务不适、医患关系严重紧张、有慢性病、高任务冲突、低理性处事、高任务过重及低社会支持;护士抑郁症状的影响因素为高任务过重、护患关系严重紧张、高任务冲突、有慢性病、低社会支持、高任务不适及低理性处事。结论辽宁省医生的抑郁症状率高于护士,人口学特征、工作状况、职业任务及个体应对资源与抑郁症状密切相关。 相似文献
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目的:探讨两种干预方案对流产妇女避孕知识、态度的影响及其影响因素。方法:采取以医院为基础的干预性实验研究方法。结果:接受全面干预的人群避孕知识得分(9分)高于接受基本干预(7分)的人群(Z=16.6,P<0.01)和干预前(8分)的人群(Z=12.7,P<0.01);接受基本干预的人群避孕知识得分不比干预前高(Z=1.5,P=0.14)。全面干预组流产后愿意使用和准备使用避孕套避孕的比例最高,三组比较差异有统计学意义。Logistic回归分析结果表明,去除了其它变量对避孕知识得分的影响后,年龄越大、出生在城市、女方及其男伴教育水平越高和接受全面干预的人群避孕知识得分也越高。结论:提供流产后计划生育服务的全面干预能提高流产妇女的避孕知识水平和避孕药具使用率;年龄、本人及男伴文化程度和出生地是避孕知识的影响因素。 相似文献
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目的 探讨中学生出现抑郁症状的影响因素,建立风险预测的列线图模型,为防控中学生抑郁提供理论依据。方法 采用分层整群抽样的方法,抽取大连市城市和农村中学生共3 470名,使用学生健康行为调查表及抑郁量表进行问卷调查;采用多因素logistic回归分析抑郁症状的影响因素,并建立列线图,预测中学生出现抑郁症状的风险。 结果 中学生的抑郁症状检出率为24.12%,肯定有抑郁症状的检出率为16.22%。遭受校园欺凌(OR = 2.748,95%CI:2.257~3.346)、被家长打骂(OR = 2.025,95%CI:1.679~2.433)、学段(职高:OR = 1.883,95%CI:1.286~2.758;高中:OR = 1.242,95%CI:1.001~1.541)、上网时间越长(≥3 h:OR = 1.773,95%CI:1.366~2.302;2~<3 h:OR = 1.525,95%CI:1.190~1.954)、女生(OR = 1.352,95%CI:1.141~1.603)、农村地区(OR = 1.351,95%CI:1.126~1.622)均是中学生抑郁症状检出的危险因素;体育课时数多(2 节:OR = 0.685,95%CI:0.504~0.931;≥3 节:OR = 0.583,95%CI:0.425~0.799)、睡眠时间充足(OR = 0.676,95%CI:0.562~0.812)都是中学生抑郁症状检出的保护因素;基于以上影响因素建立的列线图模型具有较好的区分度(一致性指数C - index = 0.700,95%CI:0.680~0.721)和准确度(Hosmer - Lemeshow检验χ2 = 2.885,P = 0.941)。 结论 遭受校园欺凌、被家长打骂、职高或高中、上网时间越长、女生、来自农村地区、体育课时数少、睡眠时间不足的中学生更容易出现抑郁症状,可以利用列线图直观、有效地预测中学生出现抑郁症状的风险,从而有针对性地对高危群体及时采取干预措施。 相似文献
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已婚育龄妇女避孕节育方法知情选择调查 总被引:4,自引:1,他引:4
目的:调查农村已婚育龄妇女接受避孕方法咨询服务及避孕节育知情选择知晓率,分析开展避孕节育知情选择咨询服务的前景及必要性。方法:对湖北省潜江市1479例已婚育龄妇女进行问卷调查。结果:农村已婚育龄妇女接受过避孕方法咨询服务和避孕方法知情选择咨询服务的比例很低,并与年龄呈负相关,与文化程度呈正相关;多数调查对象对避孕节育知情选择咨询服务持肯定态度,认为非常有必要开展避孕节育优质服务;育龄妇女对避孕节育知情选择的知晓程度与妇女接受避孕咨询的状况、对避孕节育知情选择所持的态度及自主选择避孕方法的能力直接相关。结论:避孕节育咨询服务在农村有很大的空间,对提高农村育龄妇女自愿、自主选择合理有效的避孕方法及积极配合我国计划生育政策的实施具有十分重要的意义。 相似文献
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目的 了解我国老年居民抑郁症状的流行现状及其影响因素。方法 采用中国家庭追踪调查(CFPS)2018年最新调查数据,共纳入60岁及以上老年居民7 138人,对不同特征的老年居民抑郁症状进行单因素分析,拟合两水平logistic回归模型探讨影响因素。结果 中国老年居民抑郁症状检出率为30.7%。多水平模型拟合结果表明数据在高水平单位存在聚集性,其层次结构不能忽略。农村户口(OR=1.32,95%CI:1.02~1.70)、女性(OR=1.48,95%CI:1.29~1.69)、未婚(OR=2.69,95%CI:1.44~5.04)、离婚及丧偶(OR=1.99,95%CI:1.70~2.33)、文化程度越低、人均年收入越低的老年居民发生抑郁症状的风险更高(P<0.05);自评健康状况良好的老年居民发生抑郁症状的风险更低(OR=0.25,95%CI:0.22~0.29);幸福感得分越高的老年居民发生抑郁症状的风险较低(OR=0.76,95%CI=0.74~0.78)。结论 中国老年居民抑郁情况目前仍十分严峻,抑郁的疾病负担在不断增加,应该采取强有力的干预措施,改善抑郁症状在老年居民中的流行和预防抑郁症的发生。 相似文献
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目的 探讨体力活动(physical activity,PA)与医学专科生抑郁症状的关联及其性别差异。方法 采取整群抽样的方法,于2019年11-12月选取安徽省2所医学专科院校8 198名在校生为研究对象,使用国际体力活动问卷短卷(IPAQ-SF)、抑郁自评量表(SDS)评估PA和抑郁症状。应用限制性立方样条分析PA与抑郁症状的剂量-反应关系,据此将PA分成4组;应用非条件logistic回归模型分析PA与抑郁症状的关系。结果 PA与抑郁症状呈非线性的剂量-反应关系(P<0.001),按PA分为4组:<570 MET-min/week组(1636例)、570~1331.5 MET-min/week组(2131例)、>1331.5~1848 MET-min/week组(1075例)、>1848 MET-min/week组(2692例)。7 534名医学专科生抑郁症状检出率为16.1%,其中男生抑郁症状检出率为19.6%,女生抑郁症状检出率为14.9%,差异有统计学意义(〖XC五号.EPS;P〗=24.20,P<0.001)。以>1848 MET-min/week为参照组,与参照组相比,在总人群以及男、女生中,PA<570 MET-min/week均与抑郁症状风险增加有关(OR=1.50,95%CI: 1.28~1.77;OR=1.90,95%CI: 1.41~2.55;OR=1.36,95%CI: 1.11~1.65)。结论 PA与抑郁症状呈非线性关系,增加适当的体力活动有利于大学生抑郁症状的防控。 相似文献
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目的 探索抑郁症对社区老年人群健康结局的影响。方法 对上海市静安区同一批非痴呆55岁以上人群应用中文版流行病学调查用抑郁自评量表(CES-D)等调查工具,进行5年随访。按当年抑郁症状的严重程度,对5年后多项心理和躯体健康结局指标进行多因素分析。结果 (1)2次面访者2927名。按照首次CES-D得分将有无抑郁症状分为4个等级,基线分布除年龄外、性别、教育程度、中文版简易智能状态检查(MMSE)、日常生活活动能力量表(ADL)差异均存在显著性。(2)以首次CES-D分数、年龄、性别、教育程度、MMSE、ADL为自变量,进行多元回归分析发现,CES-D得分与5年后MMSE、ADL、生活满意度指数A(LSIA)得分无显著性相关。(3)在控制基线变量后,首次CES-D得分与5年自我健康评价、记忆力自我评价呈显著性正相关。(4)分别以5年后躯体疾病指数、是否死亡为因变量,以首次CES-D得分等级、年龄、性别、教育程度、MMSE、ADL为自变量,进行多元logistic回归分析。在躯体疾病影响指数和死亡的风险预测中,5年前抑郁症状影响最大,其OR值分别为1.52(95%CI:1.19-1.95)和2.68(95%CI:1.41-5.06)。结论 抑郁症状是影响社区老年人心身健康结局的主要因素之一。 相似文献
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Latent profile analysis was used to summarize profiles of depressive symptoms among a nationally representative sample of US-born and Caribbean-born Blacks. Analyses are based on the responses of 4915 African Americans and Caribbean Blacks from the National Survey of American Life. A high symptoms and a low symptoms class were identified. Age, gender, negative interaction within the individual's social network (e.g., conflict, demands, criticism) and racial discrimination were associated with depressive symptoms in the low symptoms class, whereas socioeconomic status, gender, emotional support and negative interaction were associated with depressive symptoms in the high symptoms class. The findings demonstrate the heterogeneity within the Black population in the USA and the distinct sociodemographic, family network and stress correlates of depressive symptoms for each latent class. 相似文献
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Gallo WT Bradley EH Teng HM Kasl SV 《International archives of occupational and environmental health》2006,80(2):109-116
Objectives: The objective of this study was to assess whether recurrent involuntary job loss among US workers nearing retirement resulted in increasingly less severe changes in depressive symptoms with successive job losses. Methods: With data drawn from the US Health and Retirement Survey (HRS), we used repeated measures longitudinal analysis to investigate the effect of recurrent job loss on follow-up depressive symptoms, measured up to 2 years following job loss. Study participants include 617 individuals, aged 51–61 years at the 1992 study baseline, who had at least one job loss between 1990 and 2000. Our primary outcome variable was a continuous measure of depressive symptoms, constructed from the 8-item Center for Epidemiologic Studies-Depression (CES-D) battery administered at every HRS wave. A second, dichotomous outcome, derived from the continuous measure, measured clinically relevant depressive symptoms. The exposure (recurrent job loss) was defined by binary dummy variables representing two and three/four job losses. All job losses were the result of either plant closing or layoff. Results: Our main finding indicates that, after relevant covariates are controlled, compared to one job loss, two job losses result in a modest increase in the level depressive symptoms (not significant) at two-year follow-up. Three or more job losses result, on average, in a decline in depressive symptoms to a level near pre-displacement assessment (not significant). Somewhat in contrast, two job losses were found to be associated with increased risk of clinically relevant depressive symptoms. Conclusions: The principal finding confirms our hypothesis that, among US workers nearing retirement, repeated exposure to job separation results in diminished effects on mental health. Adaptation to the job loss stressor may underlie the observed response, although other explanations, including macroeconomic developments, are possible. 相似文献
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ABSTRACTUnderstanding health disparities in the early stage of life is complicated by the complex interplay of psychosocial and environment factors. Despite these complexities, few studies have investigated multidimensional aspects of determining health trajectories of Korean children and adolescents. Thus, this study aims to investigate the impact of intrapersonal, interpersonal, and environmental factors on trajectories in self-rated health and depressive symptoms. Totally, 2378 Korean student samples were selected from the Korean Children and Young Panel Survey for data analysis. The findings indicated that higher levels of self-esteem, attachment to parents, and relationship with friends predicted better self-rated health and less depressive symptoms at baseline. Perception on community only predicted better self-rated health but not depressive symptoms at baseline. Among multidimensional factors, only self-esteem predicted the rate of changes in self-rated health and depressive symptoms. This study suggested that enhancing self-esteem and supportive environment should be provided throughout childhood and adolescence. 相似文献