对哺乳期妇女及早提供计划生育服务的探讨

目的　探讨对产后哺乳期妇女及早提供计划生育服务对提高避孕率 ,减少意外妊娠的效果。方法　利用产后 4 2天生殖健康检查服务时 ,对足月活产妇女 988例 (干预组 )自 4 2天开始及早提供避孕方法知情选择 ,避孕节育全程服务和提高对生殖健康认识的计划生育优质服务 ,观察避孕措施预防产后哺乳期意外妊娠的效果 ,并与对照组 2 60例比较。结果　干预组、对照组避孕率分别为 96.8%、56.7% ,妊娠率为 1.3%、2 0 .0 % ,经X2 检验 ,两组间差异有非常显著意义 (P <0 .0 0 1)。结论　产后 4 2天康检是提供避孕宣传咨询健康教育的良好时机 ,及早对产后哺乳期妇女实行以知情为目标和避孕节育全程的优质服务 ,将会使妇女自觉地、知情地实行计划生育 ,提高避孕方法的可接受性和避孕效果。     

对产后42天妇女提供计划生育服务和加强母乳喂养的干预性研究

应用流行病学方法,在3个贫困县各选出3对有可比性的乡,分为干预组和对照组。对第一次足月活产后满42天的妇女2 518例(干预组1237例,对照组1281例)各监测18个月。对干预组妇女,观察从产后42天起加强母乳喂养指导和提供计划生育优质服务对预防产后意外妊娠的效果,并和对照组比较。结果表明:在监测18个月中,干预组妇女纯母乳喂养满6个月的比例为60.39％,避孕率为97.74％,妊娠率为1.46％;对照组纯母乳喂养满6个月的比例占51.76％,避孕率为64.09％,妊娠率为23.19％,经统计学检验,两组间差异均有非常显著意义。提示:产后42天是提供避孕宣传教育咨询的适宜时机,以知情选择为目标的优质服务可提高避孕的可接受性和避孕效果,从而减少产后意外妊娠,有利于延长生育间隔,提高母婴健康水平。     

对产后42天妇女提供计划生育服务和加强母乳喂养的干预…

应用流行病学方法，在３个贫困县各选出３对有可比性的乡，分为干预组和对照组。对第一次足月活产后满４２天的妇女２５１８例各监测１８个月。对干预组妇女，观察从产后４２天起加强母乳喂养指导和提供计划生育优质服务对预防产行娠的效果，并和对照组比较。     

产后妇女对产后避孕的认知与态度调查

目的:了解产后服务对象有关产后避孕的知识、态度、行为,为医院开展产后避孕服务提供科学依据。方法:随机抽取2013年10~12月在天津医科大学总医院及天津市永久医院住院分娩且自愿接受调查的939名产后服务对象进行问卷调查,获取服务对象产后避孕的知识、态度、行为情况。结果:产后服务对象产后避孕知识问卷回答总正确率28.9%,总分100分,得分28.45±14.8分;70%的调查对象认为产后避孕有必要或非常有必要;70%的服务对象在产前、分娩后、出院前或产后返诊时未接受指导或落实避孕措施。结论:产后妇女对产后避孕的态度积极,然而提供的宣教不足,产后避孕知识严重匮乏。医疗机构应积极开展产后避孕服务,借助网络、公共传媒、社区卫生服务等辅助设施,在产前、分娩后、出院前及产后返诊时全面展开产后避孕宣教并积极落实避孕措施。     

计划生育工作人员对向未婚年轻成人提供避孕服务的态度分析

本文利用8个省市对1927名避孕药具提供者和避孕药具发放者调查的问卷资料就我国计划生育工作人员对向需要避孕药具的18～24岁未婚年轻成人提供避孕服务的态度进行了分析。结果提示赞同者占69.64％,说不清者占3.22％,不同意者占27.14％。影响他们对向需要避孕药具的未婚年轻成人提供避孕服务态度的可能影响因素包括工作年限、户口性质、对婚前性行为情况的了解及看法等。     

上海市中心城区产后妇女避孕需求及产后避孕服务利用调查

目的:调查上海市中心城区产后妇女避孕节育现况及避孕相关生殖健康服务利用情况。方法:2019年8月至12月期间,采用横断面调查的方法对在上海市4个区（长宁区、静安区、普陀区、杨浦区）产后42 d健康检查门诊就诊和前往儿童保健门诊的妇女进行问卷调查。数据分析采用频率和logistic回归分析等方法。结果:调查的1170名产...     

产后避孕服务的研究进展

产后近期意外妊娠对育龄妇女的生殖健康影响较大，产后1年内人工流产率高于育龄妇女的平均水平，低文化程度、低经济收入和社会贫困层次的妇女以及未婚青少年是产后近期意外妊娠的高危人群。尽管目前产后避孕技术成熟，但推广不足，尚未形成针对高危人群和高危行为有效的产后避孕服务规范。随着生育高峰的到来，在加强产前、产时安全的同时，预防产后意外妊娠、减少高危人工流产的发生是生殖健康领域的重要内容。     

产后避孕服务的研究进展

产后近期意外妊娠对育龄妇女的生殖健康影响较大,产后1年内人工流产率高于育龄妇女的平均水平,低文化程度、低经济收入和社会贫困层次的妇女以及未婚青少年是产后近期意外妊娠的高危人群。尽管目前产后避孕技术成熟,但推广不足,尚未形成针对高危人群和高危行为有效的产后避孕服务规范。随着生育高峰的到来,在加强产前、产时安全的同时,预防产后意外妊娠、减少高危人工流产的发生是生殖健康领域的重要内容。     

向产后妇女事先提供紧急避孕药对意外妊娠率影响的研究

目的:了解对产后妇女事先提供紧急避孕药能否降低产后意外妊娠率,从而明确事先提供紧急避孕药在临床上有无重要意义。方法:随机接纳2000例产后妇女,教育组(1002例)接受常规产后避孕教育,教育+药物组(998 例)除接受常规教育外事先提供3次剂量的10mg米非司酮。两组妇女均在产后16周、32周和52周接受电话随访。结果:产后1年内教育+药物组妇女服用紧急避孕药物的人数较教育组多,但两组产后1年内的意外妊娠率无显著差别;两组妇女的避孕模式基本相同。结论:对产后妇女事先提供紧急避孕药不能显著减低意外妊娠率,在临床上更应加强对产后妇女的避孕指导工作。     

女性流动人口计生基本公共服务均等化调查

目的 了解厦门市湖里区女性流动人口计生基本公共服务均等化现状。方法 于2014年6-7月,对厦门市湖里区590名在当地居住满3个月的18~49岁育龄妇女进行计生技术与生殖健康、计生政策普及、优生优育、生育关怀等内容调查。结果 38.2%(153/401)的女性流动人口和79.4%(150/189)的女性户籍人口接受过"两癌"筛查;66.7%(126/189)的女性户籍人口采用避孕套避孕,女性流动人口为41.6%(167/401);优生优育免费服务和节育政策在女性流动人口中的普及率低于女性户籍人口;已在厦门本地生育过子女的女性流动人口从未接受过免费产检的占87.5%(342/391),女性户籍人口占82.9%(145/175);接受过5次以上产检的女性流动人口占59.8%(234/391),女性户籍人口占84.6%(148/175);83.4%(146/175)的女性户籍人口和75.2%(294/391)的女性流动人口的子女接种了所有适龄免费疫苗。结论 女性流动人口享受的计生基本公共服务的总体水平低于女性户籍人口,计生基本公共服务均等化有待进一步推进。     

Health service utilization for perceived postpartum morbidity among poor women living in Karachi

To explore traditional beliefs and practices, to assess puerperal morbidity, and to understand care-seeking behaviors, a qualitative and quantitative study was conducted in low socio-economic settlements of Karachi, Pakistan. Five focus group discussions and 15 in-depth interviews were conducted in July and August 2000. 525 Muslim women, who were 6-8 weeks post-partum, were then interviewed at home. Maternal care was relatively good-more than three-quarters of recent mothers sought antenatal care and more than half (267/525) delivered in a hospital or maternity home. Counseling to attend post-partum clinics among facility deliveries was 16% (43/267), of which only 26% (11/43) attended. Practices during the delivery and puerperium, such as massaging the vaginal walls with mustard oil during labor to facilitate delivery and inserting vaginal or rectal herbal pessaries to facilitate 'shrinkage of the uterus' and/or 'strengthening of the backbone', were pervasive. The core symptoms that are clinically significant during the puerperium are heavy vaginal bleeding and high fever, since they are potentially fatal symptoms if appropriate and timely care is not sought. About half of the study women (53.3%) reported at least one illness symptom, high fever (21.1%), heavy vaginal bleeding (13.9%), and foul smelling vaginal discharge (9.6%). Women did not know the underlying biologic cause of their perceived post-partum morbidity; weakness was frequently mentioned. Women sought care initially from close relatives or traditional healers and if they continued to suffer from their morbidity they finally approached a trained health care (allopathic) provider. The high prevalence of perceived post-partum morbidity illustrates the demand for post-partum community-based health care programs. We suggest promoting maternal health education that encourages women to seek appropriate and timely care by accessing public or private health services.     

我国熟肉制品生产企业应尽快建立HACCP体系

作者介绍了我国熟肉制品生产及管理现状 ,阐述了HACCP在保证熟肉制品质量方面的重要性 ,具体描述了在熟肉制品企业建立HACCP体系的要求和步骤     

Support for the clinician in providing a regional telehealth service

However attractive the idea of telehealth may appear to them, clinicians in regional hospitals will be preoccupied with clinical matters and are unlikely to have either the time or the expertise necessary to address the infrastructure and organizational aspects of establishing a telehealth service. Our experience of telepaediatrics in Queensland has shown that the support of the central service and coordinator has been essential in overcoming initial difficulties and has freed us as clinicians to concentrate on appropriate clinical referrals and consultation via telehealth. The central service is also able to assist in data collection, and in the analysis and interpretation of telehealth activity, for example in measuring cost-effectiveness. We have found that consolidating most consultations into planned clinics creates efficiency. The central coordinator can teach and support those new to telehealth in the regional and primary care setting, thus relieving the local clinician of this responsibility. As telehealth services expand in a regional centre, having a dedicated local telehealth coordinator may become appropriate. A central telehealth support service, which is clinically focused and responsive to clinicians' needs, is an essential foundation for successful telehealth.     

医疗行业应尽快全面建设和发展临床信息系统

本文从我国医疗发展需要出发,介绍临床信息系统在国内外的发展情况,以及发展的主要方向与在发展各个子系统的过程中所应注意的问题。     

妇女对产后访视服务的体验与需求

为了深入了解产后妇女对社区提供的产后访视服务的看法及对此项服务的需求 ,并由此提出改进现有产后访视服务的可能做法 ,在上海某中心城区的 2个街道深入访谈了 5 3名在 1998年 12月～ 1999年 7月期间接受过产后访视服务的妇女 ,并进行了 2组产后妇女的专题小组讨论。结果 :产后访视覆盖率达 10 0 % ,其中 9%的对象接受过 1次、32 %的对象接受过 2次、5 9%的对象接受过 3次产后访视。大多数产妇接受了产后访视常规中问诊、检查和宣教。在产妇所遇的问题中有关小儿护理的问题占第 1位 ,其次是产后妇女本人的情绪问题。产后妇女对与婴儿健康成长有关的服务内容需求最大 ,希望能从专业医护人员处获取可靠信息 ,有多种媒体的健康教育教材可供家庭选用 ,同时还呼吁在社区内有形式多样的面对面教育活动 ,如咨询、父母学校和母亲俱乐部等。研究结果提示产后访视服务现已有较满意的覆盖率 ,但其内容、形式和服务质量尚有待以服务对象需求为导向 ,在条件具备的情况下不断改善。     

以妇女为中心的保健服务研究——产科服务现状与需求

以妇女为中心的保健服务研究是从服务对象的角度 ,对上海及邻近地区所选医院进行的住院分娩服务现状及需求调查。结果显示 :本组产妇中阴道分娩者占 5 0 .5 % ,高龄、初产和城市医院的剖宫产显著增多 ;自然分娩中常使用的干预措施有剃毛 (72 .3% )、肛查 (70 .3% )、会阴切开术 (81.8% )和仰卧体位分娩 (99.0 % )。医护人员对分娩时有效干预的最新认识水平不高 ,孕妇对医护人员的态度和人际关系比较满意 ,但认为医护人员向产妇解释诊治过程不够。提出了“以产妇为中心的爱母分娩服务”等一组建议。     

Weight-management interventions for pregnant or postpartum women

BACKGROUND: A review of randomized controlled trials of weight-management interventions for pregnant or postpartum women was conducted to assess whether effective weight-management interventions exist for this population. METHODS: The MEDLINE, EMBASE, PsycINFO, Sociological Abstracts, and CINAHL databases were searched, as well as the reference lists of relevant publications. English-language articles published between January 1985 and August 2007 that used a randomized controlled trial study design and incorporated a weight-related outcome measure were reviewed. All potentially relevant articles were reviewed separately, and final selections were based on consensus reached through discussion. RESULTS: Three studies met the inclusion criteria, one conducted among pregnant women and two among postpartum women. The interventions addressed modifications in diet and exercise and included individual or group-counseling sessions combined with written and telephone correspondence or food and exercise diaries. In two studies, the weight-related outcome was significantly better in the intervention group than in the control group. The third study found a significant interaction between weight category and intervention group. In all studies, the refusal or attrition rates were high. CONCLUSIONS: While these studies indicate that interventions can help pregnant and postpartum women manage their weight, many questions remain unanswered. Several research gaps for weight-management interventions in this important population have been identified.