妇女生殖健康影响因素调查及计划生育对策

目的 探讨计划生育与生殖健康的关系,为开展计划生育与生殖健康优质服务提供依据.方法 收集门诊2007-2008年计划生育手术病例共900例,对患者的年龄、职业、地区、子女、避孕措施、选择终止妊娠方式等进行统计分析,以了解其生殖健康影响因素.结果 对900例门诊计划生育手术病例的分析结果显示,不同年龄、职业、地区的患者在选择终止妊娠方式及避孕方面存在差异.结论 应关注外地人口,普及避孕知识,加大避孕方法的实施力度,降低人工流产率,以利于女性生殖健康.     

惠州地区未婚流动人口性与生殖健康的行为调查

目的调查惠州地区未婚流动人口的性和生殖健康的行为状况,分析其主要生殖健康问题和影响因素。方法通过问卷调查方式收集资料,并进行统计分析。结果本次问卷调查共回收1333份有效问卷。在未婚流动人口中,未婚男性30.27%有性行为,高于女性的23.84%,两组比较差异统计学意义（χ^26.97,P=0.008）。有性生活人群里有32.49%的人回答女方曾有怀孕,在未采用避孕原因构成中普遍存在有侥幸心理和不知道如何避孕;但在不同性别间存在差异。在获取性与生殖健康知识的来源方面,从未与父母交流生殖健康问题、从未在单位接受生殖健康教育、从未与同事间交流生殖健康相关知识与话题比例分别为80.80%、69.09%、38.11%。结论未婚流动人口的性行为与生殖健康知识的教育缺乏,不同性别间性行为态度存在差异;建议通过多种渠道加强未婚流动人口生殖健康知识教育,并且应考虑到性别之间的差异。     

集中群组孕期健康教育对女性孕晚期心理体验的影响研究

目的:探讨集中群组孕期健康教育对女性孕晚期心理的影响.方法:采用深入访谈法,对25例参加过集中群组孕期健康教育的孕妇在课程结束后进行深度访谈,访谈内容根据Colaizzi的现象学分析法进行整理.结果:通过对访谈资料进行分析,共提炼出5个主题:提升了孕期的自我护理效能;降低了因担忧母婴安全而产生的压力;缓解了面对分娩的焦虑和恐惧;打消了对产后母乳喂养的顾虑;增加了对母亲角色适应的自信.结论:集中群组孕期健康教育对孕晚期女性的心理起到积极的作用,可有效提升女性围生期心理体验及孕育幸福感.     

未婚人流女性生殖感染状况及干预对策探讨

目的：了解未婚人流女性的生殖健康状况和健康知识需求。方法：对2006年1月-2008年12月来我院就诊的496例未婚人流女性进行问卷调查，包括外籍流动人口。结果：77．21％的未婚人流女性合并生殖系统感染；18．95％的患者有过2次以上的人工流产史；影响生殖健康的危险因素依次为：急、慢性宫颈炎，急、慢性盆腔炎／附件炎，多次人流、剖宫产史。知晓生殖系统感染、人工流产及生殖系统感染的预防等方面知识的分别为41．94％、16．73％、28．43％，而不定期检查生殖健康状况的为33．06％，从不检查治疗者高达58．06％。未婚人流女性的生殖健康知识需求主要为生殖系统感染的危害、人流危害和避孕知识。期望获取生殖健康知识的途径主要为医院咨询门诊和报纸杂志。结论：未婚人流女性存在生殖健康问题，应加强对其生殖健康知识的教育并提供生殖健康服务。     

妇女生殖健康影响因素调查及计划生育对策

目的探讨计划生育与生殖健康的关系,为开展计划生育与生殖健康优质服务提供依据。方法收集门诊2007—2008年计划生育手术病例共900例,对患者的年龄、职业、地区、子女、避孕措施、选择终止妊娠方式等进行统计分析,以了解其生殖健康影响因素。结果对900例门诊计划生育手术病例的分析结果显示,不同年龄、职业、地区的患者在选择终止妊娠方式及避孕方面存在差异。结论应关注外地人口,普及避孕知识,加大避孕方法的实施力度,降低人丁流产率,以利于女性生殖健康。     

虎门镇异位妊娠患者生殖健康状况及其相关知识调查

目的了解异位妊娠患者的生殖健康状况和健康知识需求。方法对虎门镇2家“二甲”医院就诊的496例异位妊娠患者进行生殖健康状况检查和生殖健康知识及需求的问卷调查。结果77.3%的患者合并生殖系统感染,19.0%的患者有过2次以上的人工流产史;影响生殖健康的危险因素依次为:急、慢性宫颈炎,急、慢性盆腔炎/附件炎,多次人流,剖宫产史。生殖系统感染、人工流产与异位妊娠关系及生殖系统感染的预防等方面知识的知晓率低,从不检查治疗者高达58.13%。生殖健康知识需求主要为生殖系统感染的危害、人流危害和避孕知识。期望获取的途径主要为医院咨询门诊和报纸杂志。结论异位妊娠患者存在生殖健康问题,需要进行生殖健康知识教育和提供生殖健康服务。     

室友间同伴教育对女大学生避孕及生殖健康认知状况影响的研究

[目的]探讨寝室室友间同伴教育对女大学生避孕及生殖健康认知状况的影响。[方法]抽取武汉市城区两所重点综合性大学非医学专业的女大学生,随机分为干预组和对照组,对照组不进行干预,干预组采用室友间同伴教育的方式进行避孕及生殖健康知识教育,干预前后采用自编的避孕及生殖健康相关知识问卷进行调查并进行面对面访谈。[结果]干预前干预组和对照组女大学生避孕及生殖健康知识问卷得分分别为10.5分±1.7分和11.3分±2.4分,两组比较差异无统计学意义（P〉0.05）;干预后两组得分分别为20.7分±1.1分和12.5分±2.0分,两组比较差异有统计学意义（P〈0.01）;干预组对避孕及生殖健康知识的掌握情况干预后均较干预前明显提高,尤其是“安全期和最容易怀孕的时间”“避孕套能否保证性病和艾滋病不传播”“偶尔手淫是否对身体有害”“体外射精是否是安全有效的避孕措施”“人工流产对女性身心影响是否很大”等问题,干预前回答正确率较低,干预后正确率明显提高,干预前后比较差异有统计学意义（P均〈0.01）;干预后干预组仅有1.1%不懂紧急避孕的方法,而对照组为60.4%,干预组对流产并发症、后遗症的认知明显高于对照组;干预组100.0%和对照组97.1%均认为应从新生入学开始进行避孕及生殖健康知识教育;干预组93.0%认可寝室室友间同伴教育这种方式。[结论]在女大学生中采取寝室室友间同伴教育是较好的避孕及生殖健康知识教育方式,可提高女大学生对避孕及生殖健康的认知评分及正确率。     

室友间同伴教育对女大学生避孕及生殖健康认知状况影响的研究

[目的]探讨寝室室友间同伴教育对女大学生避孕及生殖健康认知状况的影响。[方法]抽取武汉市城区两所重点综合性大学非医学专业的女大学生,随机分为干预组和对照组,对照组不进行干预,干预组采用室友间同伴教育的方式进行避孕及生殖健康知识教育,干预前后采用自编的避孕及生殖健康相关知识问卷进行调查并进行面对面访谈。[结果]干预前干预组和对照组女大学生避孕及生殖健康知识问卷得分分别为10.5分±1.7分和11.3分±2.4分,两组比较差异无统计学意义(P0.05);干预后两组得分分别为20.7分±1.1分和12.5分±2.0分,两组比较差异有统计学意义(P0.01);干预组对避孕及生殖健康知识的掌握情况干预后均较干预前明显提高,尤其是"安全期和最容易怀孕的时间""避孕套能否保证性病和艾滋病不传播""偶尔手淫是否对身体有害""体外射精是否是安全有效的避孕措施""人工流产对女性身心影响是否很大"等问题,干预前回答正确率较低,干预后正确率明显提高,干预前后比较差异有统计学意义(P均0.01);干预后干预组仅有1.1%不懂紧急避孕的方法,而对照组为60.4%,干预组对流产并发症、后遗症的认知明显高于对照组;干预组100.0%和对照组97.1%均认为应从新生入学开始进行避孕及生殖健康知识教育;干预组93.0%认可寝室室友间同伴教育这种方式。[结论]在女大学生中采取寝室室友间同伴教育是较好的避孕及生殖健康知识教育方式,可提高女大学生对避孕及生殖健康的认知评分及正确率。     

人工流产者的孕育及生殖健康状况调查与分析

目的通过对人工流产者孕育及生殖健康状况的调查,寻求提高女性身心健康的有效措施.方法抽取在本院行人工流产的早孕女性108例进行问卷调查,其中未婚55例,占50.9%;已婚53例,占49.1%.结果未婚女性婚前性行为、人工流产呈明显上升趋势.初次做爱、初次人工流产的年龄及避孕状况,未婚与已婚女性有显著差异(P＜0.01).已婚女性患妇科病较未婚女性多.结论女性生殖健康存在诸多问题,社会、学校应关心女性生殖健康,重视健康教育.     

东莞市流动人口未婚女性婚前性行为及生殖健康知识现状的调查

目的了解东莞市流动人口未婚女性生殖健康知识的掌握情况。方法采用自行设计的调查问卷对1300名东莞市流动人口未婚女性婚前性行为及生殖健康知识进行调查。结果流动人口未婚女性性行为发生率与年龄有关,经统计学分析,χ2=8.115,P0.05,差异具有统计学意义;与文化程度和务工时间无关,经统计学分析,均P0.05,差异无统计学意义。未婚女性了解避孕知识的有239名(18.4%),仅有95名(7.3%)知道紧急避孕知识;对生殖道感染症状中的外阴部瘙痒知晓率最高,为45.3%,其次为白带增多,为38.6%,最低为腰酸、腰痛症状的知晓率,仅为1.6%。结论东莞市流动人口未婚女性生殖健康知识欠缺,需开展多种形式的生殖健康知识宣教,以提高她们的生殖健康水平。     

育龄妇女生殖健康状况调查分析及对策

目的了解育龄妇女生殖健康状况,为育龄妇女生殖健康服务措施的制订提供理论依据。方法采用自行设计的问卷调查960例已婚育龄妇女生殖健康现状。结果 59.8%育龄妇女有异常产孕史,58.0%有人工流产(药物流产)史。育龄妇女生殖系统主要疾病为宫颈炎、盆腔炎和子宫肌瘤分别占11.6%、5.4%和4.0%。23.3%育龄妇女接受过避孕知识教育。58.6%育龄妇女最想了解避孕方法的选择,30.0%的育龄妇女生殖健康知识从医院获得。结论开展多种形式健康知识宣教,加强生殖健康知识和避孕知识的指导对提高育龄妇女避孕、节育等生殖健康知识和生殖健康水平具有重要的作用。     

The structure of contraceptive education and instruction within nurse led family planning clinics: a grounded theory study

Aims. This study aimed to explore and analyse how nurses instruct women in contraceptive use during consultations in family planning clinics to produce a grounded theory of contraceptive education. Background. Nurses play a key role in instructing women how to use contraception in family planning clinic consultations. These one‐to‐one situations are encounters where women are taught how to use contraceptive methods effectively. However, very little is known about the nature of these consultations. Design. A qualitative study using a grounded theory approach was used. Results. Three linked ‘core categories’ emerged from the data analysis. Firstly, women are educated about their body and how it responds to contraception: ‘reproductive education’. This core category is closely linked to ‘surveillance’ where women are taught to monitor their reproductive health and to ‘contraceptive regimen’ where women are instructed in techniques to successfully use a contraceptive method. Together these three core categories present a grounded theory of ‘contraceptive education’. Conclusions. Nursing practice in this important area of women’s health care is complex and requires skilled practitioners. This study presents unique empirical data into how nurses conduct one‐to‐one consultations with women – providing a novel insight into how contraception is explained in clinical situations. Key issues for practice from the data were the lack of a balance when discussing side effects, the rigidity of some instructions and the lack of recognition of risk from sexually transmitted infection. Relevance to clinical practice. Nurses working in sexual health need to ensure that women understand the often complex instructions they provide and that rigid instruction be occasionally amended to enable some flexibility. The manner in which side‐effects are discussed should also be balanced. Nurses need to address the risk of sexually transmitted infections more substantially in contraceptive discussions.     

Nurses' discourse in contraceptive prescribing: an analysis using Foucault's 'procedures of exclusion'

AIM: This paper is a report of an analysis of the discourse about contraceptive efficacy and side effects used by nurses when prescribing contraception. BACKGROUND: All women seeking contraception should be informed of the efficacy and potential adverse effects of the particular method they are considering. This information facilitates an informed choice. Women also require this information in order to monitor for any side effects. Paradoxically, side effects are also a key factor in reducing adherence with contraceptive regimens. However, there is no literature that explores specifically how this issue is addressed in clinical consultations, or places these practices in a theoretical context. METHOD: Forty-nine consultations between nurses and women in sexual health clinics were audio-recorded during 2002. Data were subject to a discourse analysis using Foucault's 'procedures of exclusion' to explore the discursive construction of contraceptive efficacy and side effects FINDINGS: The nurses employed specific discursive strategies when discussing contraception. When addressing efficacy, discourse centred on medico-statistical facts, but side effects were described in lay terms that minimized their severity. Nurses contextualized contraceptive side effects within potential problems that women might experience in pregnancy, and also attempted to 'normalize' contraceptive-related problems. CONCLUSION: Discourse and its deployment play a key role in practitioner-client relationships that sexual health nurses need to become more aware of how they discuss clinical issues about contraception with women. Clinical data on contraceptive side-effects are present in the literature, and it is important that sexual health nurses use this to help women make truly informed decisions.     

Issues in Reproductive Health and Empowerment in Perinatal Women with Substance Use Disorders

This article describes perinatal drug dependent women's perspectives on pregnancy, contraception, knowledge of reproductive health, and communication with sexual partners. In this qualitative study, semi-structured interviews were conducted with perinatal residential substance abuse treatment participants (n = 36) regarding their life experiences in the time just prior to drug treatment. Using an analytic framework to examine life dimensions, analysis of the biological and socio-cultural dimensions and their effects was conducted and indicated that pregnancy and motherhood were motivational for women to enter treatment and to seek prenatal care. In addition, the data showed that the women were poorly informed about their reproductive health status and contraception, and experienced difficulty communicating about these issues with male partners. Recommendations for drug treatment and health care systems include strategies for: 1) expansion of women's “empowerment” in recovery to include knowledge and decision-making skills regarding their reproductive health status and 2) development of cross-disciplinary activities aimed at outreach, screening, and assessment of drug dependent women.     

Adolescent patterns of communication about the menstrual cycle, sex, and contraception

For this investigation, a sample survey of 179 black women representing 53 family units provided data to examine familial patterns in the amounts of information received about the menstrual cycle, sex, and contraception among adolescent daughters, mothers, and grandmothers; the major source of information about these three topic areas; and the impact of that information on the sexual behavior of adolescent women. Significant relationships were found within the triads (of daughter, mothers, and grandmothers) in the amount of information received about the three topic areas, suggesting familial patterns in the amount of information transmitted intergenerationally. This sample was more likely to report mothers as the source of information on the three topics under study. A significant negative relationship existed between the amount of information received about sex and the experience of a pregnancy before age 18 years among the sample group mothers only. Although this sample received large amounts of information about the menstrual cycle, sex, and contraception from their mothers, the information was ascertained through qualitative responses about the lack of information necessary for sexual health and informed decision-making. The very young mean age (12.3 years) at first intercourse and the low proportion (24.2%) of teenagers using a method of birth control at first intercourse suggested that, intergenerationally, communication about sex and contraception may not be meeting adolescent needs. Consequently, attention should be focused on mothers as agents of sexual socialization of teenagers, and concern must be generated among family planning educators and practitioners for the quality of the information mothers are disseminating about sexually related matters and the impact of that information on the sexual health of teenagers.     

Nursing Mirror midwifery forum. 3. Planning a pregnancy

38 hospitals in and around London, England were approached to learn the amount and type of family planning knowledge available to women in maternity units. 35 hospitals responded. The questionnaire asked if family planning was discussed during the antenatal and postnatal periods and whether this was verbal and/or leaflet information. It also asked what facilities were available in the area to fit contraceptive devices and whether patients were referred to these facilities. The aim was to cover all aspects of pregnancy and the puerperium when information could be given. The potential contact for family planning information occurs at least 14 times during the pregnancy. Following delivery the mother may remain in the ward for 48 hours or up to 10 days; she is referred to the community midwife or health visitor and returns for a checkup by a doctor 6 weeks after delivery. Some hospitals inquire if the pregnancy was planned and what form of contraception was used before the pregnancy. This could lead to a discussion of the methods of contraception available. As some women are embarrassed to talk about contraception, the midwife should take the initiative. Leaflets and posters displayed on the walls can give discreet information. 1 of the parentcraft classes could be devoted to family planning education, using films or slides. There are many opportunities for family planning discussions with patients on bed rest. With the introduction of the nursing process to midwifery, family planning could be included in the antenatal program. Family planning could be included in a checklist of items to tell the mother before she leaves the hospital. Family planning can be reveiwed in a group on the ward or methods can be displayed and discussed as in the parentcraft class. Following group discussion, some mothers will dicuss family planning among themselves. There may be some who have already used these methods successfully and others will be interested to try themselves. The 6-week visit is an ideal time to discuss family planning, and the follow-up visit should be at a family planning clinic in the hospital where the delivery took place. The doctor can discuss family planning, and an appointment can be made for the women before she leaves the clinic, or the physician could prescribe oral contraception for use until her appointment. Pregnancy and the puerperium is an excellent time to introduce contraceptive methods. Few hospitals find it appropriate to discuss family planning during the antenatal period, unless there was a definite contraindication to future pregnancies.     

Preconception,Pregnancy, Birthing,and Lactation Needs of Transgender Men

Planned and unplanned pregnancies are occurring among transgender men. Although the literature highlights the fact that many transgender men retain their reproductive pelvic organs and desire pregnancy, there is a dearth of information on best practices and standards of care guiding perinatal care for this population. A literature review was conducted to explore the reproductive health needs of transgender men related to reproductive desires, contraception, family planning, fertility preservation, pregnancy, birth, and lactation. Findings show that pregnant and birthing transgender men are reporting feelings of invisibility, isolation, and loneliness in highly gendered perinatal care environments. A lack of gender-affirming perinatal environments and experienced providers is contributing to the avoidance of care by transgender men and further discrimination in an already marginalized population. More research attention is needed to understand the reproductive health needs of pregnant and birthing transgender men and to optimize the care they receive.     

Community health nurses and family planning services for men

Current concerns about sexually transmitted diseases (STDs) and acquired immunodeficiency syndrome (AIDS), as well as unintended pregnancy, have drawn increasing attention to reproductive health services for men. This report presents information about responses by 844 community health nurses (CHNs) to a self-administered mailed questionnaire that included questions about the extent of the nurses' involvement in delivering or administering family planning services to men, their knowledge and attitudes about men and family planning, and their preparation for working with men. Our sample included CHNs in practice in five states and a sample of CHNs belonging to a national organization of public health nursing, in order to gain information about CHNs in practice in the field and CHNs more likely to be in an educational or administrative position and thus able to influence or to set policy. Two thirds of the nurses surveyed work with men in their reproductive years but only 17.8% delivered or administered family planning services to men (23% of the state sample and 12.5% of the organization sample). Deficits in knowledge about male birth control methods were identified; for example, only 32% knew the use-effectiveness rate of the condom. However, 90% of the CHNs knew the condom has to be put on before any genital contact is made. The CHNs' attitudes were positive; more than 90% said they felt men had equal responsibility with their partners in preventing unwanted pregnancies, using contraception, and contraceptive decision making. Yet, only 9.6% of the CHNs felt men have as much knowledge about contraception as women do. Seventy percent of the nurses felt tha sex education in schools was directed more to female students than to male students. More than 90% said they believed that family planning providers have a responsibility to provide services to men; but two thirds felt that nurses are not as well prepared to work with male as with female clients. Increased educational preparation may improve CHNs' knowledge about men and family planning and enable them to feel professionally prepared to deliver and administer the services they feel are necessary for male as well as female clients. There are 101,430 CHNs in the United States, working in public health departments or other service agencies in almost every community across the country. These CHNs are a major resource for the family planning field.     

The social construction of 'reproductive vulnerability' in family planning clinics

AIM: The aim of this paper is to report a study exploring the discursive construction of contraceptive use within nurse consultations with women in family planning clinics. BACKGROUND: This paper takes as its starting point the lack of a contraceptive 'strand' to the literature on the discursive construction of the female body generally, and the female reproductive system specifically, within health care practice. The literature in this field concentrates on pregnancy, menstruation and menopause, and the manner in which contraceptive use is discursively constructed is under-explored. Furthermore, the literature on nurse-women consultations in family planning clinics is also limited, with the current literature concentrating on assessing clinical skills rather than discourse. METHODS: Using a grounded theory methodology to explore how nurses educate women about contraception in family planning clinic, 49 consultations were audio-taped in two large family planning clinics in the United Kingdom (UK). FINDINGS: Open coding and subsequent axial coding resulted in the emergence of three elements of contraceptive education. One concerned reproductive anatomy, another reproductive physiology and a third education about contraceptive functioning. These three axial codes were formed into a core category: 'body education/reproductive vulnerability'. Within the consultation, nurses linked the 'vulnerable' reproductive system with the requirement for contraceptive 'protection'. This approach seems linked to ensuring women's future contraceptive use. CONCLUSION: The discourse employed by nurses differs from the body discourse aimed at menopause and menstruation. These areas of women's health were constructed as disintegrating, malfunctioning and failing, whereas reproductive vulnerability suggests a fully functioning, active system, in need of restraint. However, this discourse still constructs the female body as fundamentally weak and unstable, requiring contraception to protect it and prevent transgression.