首次性行为调查资料漏报率及其影响因素

目的 根据两次调查中对象对“您与现在的男友/女友在婚检之前是否发生过性行为？”的回答,计算机阳性回答率和漏报率以分析调查资料的可靠性和真实性。方法 1998-1999年,在上海市6所妇幼保健院（所）对接受婚检的718对男女青年开展调查。4-6周后对其中的市区对象进行随访,随访到399对对象,结果 初访时男女对象的漏报率分别为5.07%和6.19%。漏报率大小随对象特征的不同而有所不同,波动范围在1.42-13.45%。同一对象的复访漏报率明显小于初访。不超过4.00%。多元logistics回归分析发现,初访时,男女已同住,职业为技术管理人员的男性或接受调查时有他人在场的女性倾向于漏报;对初访和复访漏报率的发现,自填问卷,职业为技术管理人员或尚未订婚的对象倾向于漏报。结论 对象对性相关问题的回答受到其本人特征和调查方法的影响。在生殖健康研究中,若资料来自对象的回答,则应充分考虑到对象漏报的可能,并应根据漏报率大小对结果进行校正。     

广东省新婚人群婚前医学检查认知、态度现况调查

目的了解广东省新婚人群对婚前医学检查的认知与需求,为后期制定干预措施提供依据。方法采用自行设计调查问卷,对440名调查对象进行自填式问卷调查,并对调查结果进行描述性分析。结果有23.30%调查对象表示已参加婚检,59.95%表示准备参加,14.56%表示不准备参加。调查对象疾病相关知识总知晓率为68.04%,婚检相关知识总知晓率为54.85%。91.26%的调查对象认为婚检很重要,对婚检好处的认同率均超过85%。在婚检障碍方面,认为婚检手续复杂,工作忙没时间的均超过40%,对妇科和生殖器检查感到尴尬,担心泄露个人隐私的均超过30%。结论加大对婚检相关疾病的大众健康教育,以及婚检目的意义、内容和政策的宣传,并提高婚检服务便利性。     

婚前医学检查及相关因素分析

目的:了解现阶段婚前医学检查(婚检)情况,探讨婚检与出生缺陷的发生有无影响及影响情况。方法:对2003年10月1日新的《婚姻登记条例》出台前后婚检及出生缺陷的情况进行分析。结果:条例出台前两年在该中心婚检门诊接受婚检有6738人,检出疾病370人,检出率为5.49%;同时在洛龙区人口学校新婚培训进行调查问卷新婚夫妇8901人,接受婚检的到达8790人,占98.75%,未接受婚检有111人,占1.25%,出生缺陷发生率为9.65‰。而条例出台后至今,该中心婚检门诊接受婚检有641人,检出疾病23人,检出率3.59%;同时在洛龙区人口学校新婚培训班进行调查问卷新婚夫妇6134人,接受婚检仅有51人,占0.83%,未接受婚检有6083人,占98.17%;出生缺陷发生率为14.23‰。结论:婚检具有重要性和必要性。应加强婚前保健知识的宣传力度,提高婚配青年自我保健意识;医疗保健单位应采取人性化的服务吸引婚配青年自觉接受婚检保健服务,提高其婚姻生活质量,从而达到降低出生缺陷发生率的目的。     

广州市婚前检查现状调查

目的:了解现阶段广州市结婚人群对婚检工作的认识。方法:通过自填式问卷对结婚登记的人群进行调查。结果:86.8%的人认同婚检的必要性,但仅31.9%的人参加了婚检,表现为认知不协调;人群对生殖健康知识的掌握普遍不足;未能婚检的阻碍因素是:没时间、不知道婚检的途径、自信身体好;人们对婚检工作的可接受性评价中等,但同时也表现出对高质量、简便性婚检服务的需求。结论:广州市婚姻登记人员在婚检态度与行为上存在着认知不协调,生殖健康知识不足的问题、人们对婚检的态度及医务人员的服务态度是重要的影响因素。     

山西省未婚男女免费婚检知信行现状调查

目的:了解山西省免费婚检实施后未婚男女知信行现状,为政府进一步改善婚检工作提供决策依据和政策建议。方法:采用目的抽样方法,抽取山西省3个地市700名未婚男女进行问卷调查,内容包括调查对象基本情况、对免费婚检政策的知晓度、婚检行为相关认知态度、影响参加婚检的原因等。结果:调查对象对山西省免费婚检政策知晓程度不高,非常了解仅占9.4%;参加婚检障碍感得分为(28.7±10.7)分(总分45分),对婚检的总体评价得分为(24.6±4.6)分(总分30分),对婚检行为益处感认知得分为(23.6±2.8)分(总分25分);影响参加婚检的原因第一顺位为“双方相互信任就好,婚检没有必要”,占27.3%。结论:进一步加强婚检政策宣传力度,改善婚检服务内容,加强多部门统筹协作,降低参与婚检的障碍感,吸引更多未婚男女参与婚检。     

成都市婚前医学检查现状分析

目的:了解成都市婚检现状及影响婚检率的相关因素,为政府出台提高城市婚检率的改革措施提供数据及资料。方法:通过自填问卷及访谈形式对成都市9个区的婚检医师进行调查。结果:成都市9个区的婚检医师共有16位,仅7位取得《母婴保健技术考核合格证书》,医师参加婚检工作学习交流和培训机会较少,普遍认为强制性婚检取消后婚检人数下降,大部分医师认为目前的婚检项目能有效地筛查疾病,群众对婚检认识不足成为当前婚检工作的主要问题;大部分医师认为应实行强制婚检,绝大部分赞成免费婚检。结论:成都市婚检医生服务水平有待提高,婚检工作存在较多困难需要解决,应从新途径加大宣传力度,提高婚检的知晓率;免费婚检效果并不显著,应根据目前疾病谱的变化调整婚检项目,以提高婚检率。     

广西大学生婚前医学检查认知情况分析

目的 调查广西大学生对婚前医学检查(婚检)的认知、态度及需求状况,为制定有效婚检宣传策略和改善婚检服务提供依据.方法 采取分层整群随机抽样方法,抽取广西壮族自治区7所高校2 154名在校大学生进行匿名问卷调查.结果 回收有效问卷2 072份,有效率96.2％;大学生对婚检比较了解的占7.4％,大致了解的占35.9％,不太了解的占53.9％,没听说过的占2.8％;女性、高年级、医学类、无男/女朋友的学生对婚检知识的回答正确率较高(均P＜0.05);65.1％的大学生表示今后结婚愿意参加婚检,46.8％表示一定会进行免费婚检;对于婚检的需求状况,1.7％认为费用应该＜ 200元,其中希望免费的占34.8％.结论 大学生对于婚检的认知水平普遍偏低,尤其是男性、低年级以及文史类学生.     

2019年江西省南昌市婚检人群孕期保健相关知识掌握状况及影响因素分析

目的 分析2019年江西省南昌市婚检人群孕期保健相关知识掌握状况并探讨其影响因素。方法 利用南昌市妇幼保健计划生育服务中心婚检中心,以婚检人群为研究对象,发放问卷,收集其基本资料、孕期保健知识掌握情况。采用单因素和多因素logistic回归分析性别、文化程度、职业、月收入及生育情况对婚检人群孕期保健相关知识掌握状况的影响。结果 研究期间,共纳入适婚青年905名,男性447名(49.39%),女性458名(50.61%)。20～29岁适婚人群占66.80%;汉族占96.90%;初中及以上文化程度84.31%。孕产期保健相关知识掌握情况,问卷应答率超过92.00%。何时服用叶酸回答正确率最高,为60.13%,产前筛查诊断知识回答正确率最低,为30.10%。不同文化程度、职业、收入及生育情况调查对象孕期保健相关知识得分比较,差异均有统计学意义(均P<0.05)。多因素logistic回归分析结果显示,孕期保健知识知晓率的主要影响因素为文化程度、职业及生育情况(均P<0.05)。结论 南昌市婚检人群孕期保健相关知识点掌握程度差异较大,影响孕期保健知识知晓率的主要因素为文化程度、职业...     

虹口区新婚对象婚前保健现况调查

目的:分析上海市虹口区免费婚检现状,为制定相关措施、提高婚检率以及提供后续服务提供依据。方法:对虹口区2008年5～11月、2009年5～11月结婚登记领证的新人随机发放1 201份调查问卷并进行统计汇总分析。结果:参加婚检530人,占问卷的44.13%,其中60.3%认为达到了预期目的,38.7%认为基本达到目的,0.4%认为没有达到目的。未参加婚检671人,占问卷的55.87%,没有参加婚检的原因78.9%为没时间,16.3%认为没必要,7.6%害怕查出问题。81.6%的调查对象希望在准备生育前接受孕前保健服务。结论:虹口区提供的免费婚检基本上能满足大多数参加婚检者的需求,今后应加大鼓励措施和政策以提高婚检率,同时开展孕前保健服务,进一步满足广大结婚对象的后续服务需求。     

986对婚姻登记男女对婚前医学检查认识的调查及婚前医学检查结果分析

目的:为了解婚姻登记男女对婚前医学检查(婚检)的认识及婚检者疾病情况,以便有针对性地进行宣传教育,转变和树立“要我婚检”为“我要婚检”的观念。对检出疾病及病情指导,矫正治疗,确保子代健康。方法:固定男女专职医师,按拟定调查表格,于民政局婚姻登记处,妇幼保健院婚检处,分男女专室询问对婚检的认识,婚检者全面体检,检测有无遗传、性传播及传染性等七类疾病。对疾病和异常,以科学的态度分别给于矫正和治疗。结果:986对婚姻登记男女,27.18%自愿婚检,24.54%宣传动员后婚检,48.28%不接受婚检。婚检者文化水平较高,经济条件较好,认识到婚检可以查清影响身体健康、婚后感情、家庭幸福、子代健康的不良因素。不愿意婚检者,文化水平较低,对婚检意义认识不够,甚至存有旧的婚姻、生育观念。婚检510对男女,疾病总检出率为12.16%,HBsAg阳性检出率为8.73%,生殖器管疾病检出率为1.28%,性传播疾病检出率均为0.20%。生殖器官异常男性检出为4.90%,女性为3.53%。结论:广泛开展婚检意义的宣传教育,提高全社会民众的认识,转变“要我婚检”为“我要婚检”的观念,让欲婚男女自愿婚检,对提高生殖健康水平及出生人口素质具有现实意义。     

Measuring Women's Covert Use of Modern Contraception in Cross‐Sectional Surveys

A proportion of women in couples use contraception without their partners’ knowledge. There are two principal ways to measure this covert use in cross‐sectional surveys like the Demographic and Health Surveys (DHS). First is a direct question, “Does your husband/partner know that you are using a method of family planning?” Second is an indirect method: the reports of both partners to the question on contraceptive use are matched, and if the woman reports a modern contraceptive method and the male partner reports nonuse, her use is considered covert. For 21 DHS surveys for which both estimates could be made, there are large discrepancies between the two. We found that a proxy variable—responses to the question, “Would you say that using contraception is mainly your decision, mainly your husband's/partner's decision, or did you both decide together?”—has high sensitivity and specificity for classifying those in the open category for both methods and those in the covert category for both methods. Recommendations are that the direct question be reinstated in the DHS and that the indirect method not be used by itself but in conjunction with the decision‐making variable.     

Self-Selection Bias in an Epidemiological Study of Respiratory Health of a Rural Population

ABSTRACT

A common source of bias in epidemiological studies is self-selection or volunteer bias. The self-selection into cohorts for further investigation or for participation in a substudy may be an important source of selection bias. The objectives of this paper were to identify differences in selected demographic characteristics, individual and contextual factors, and variables related to respiratory health between study participants who were willing to participate in subsequent clinical and allergy testing and those who were not willing to participate. One hundred and fourteen households (207 individuals) from a small town and 54 households (99 individuals) from a nearby rural municipality participated in this study. One key informant from each household provided information about each adult in that household. The question being studied was: “We wish to find out more about respiratory health of rural people. We would like to invite you to perform breathing and allergy tests. Would you be willing to be contacted for breathing and allergy tests in a nearby location?” One hundred and four participants said “Yes” they would participate in the clinical studies, 144 said “No” they would not participate in the clinical studies, and 52 said “Would like more information” about the clinical studies. More than one half (53.8%) of male participants and 46.2% of female participants indicated that they would like to participate in breathing and allergy tests. A higher proportion of study participants (26.1% males, 30.8% females) in the lowest income category requested more information compared to those answering either “Yes” (15.7% for males, 20.5% for females) or “No” (18.5% males, 23.3% females) to the question being studied. Study participants who were willing to participate in further breathing and allergy tests had a higher proportion of self-reported chronic phlegm and ever had allergic reaction to things eaten than those who either said “No” or “Would like more information.” Among male study participants who said “Yes” to further participation, a higher proportion was exposed to one of the occupational exposures of interest compared to those who said either “No” or “Would like more information.” This pattern was not observed for females.     

A comparison of health care utilization by husbands and wives

A chart review of married couples seen in family practice compared husband-wife visit rates. Wives were found to utilize services significantly more often: for all visits, for all visits excluding those related to pregnancy, for well-care visits, for psychological support visits, and for somatic illness visits (including sex-related illnesses), but not for non-sex-related somatic illness visits. There was no significant correlation in visit-rate frequencies within husband-wife pairs.The authors are with the Division of Primary Medical Care, Departments of Community Medicine and Medicine, University of California, San Diego, and School of Medicine at La Jolla, California 92037. The authors would like to acknowledge the assistance of Drs. Sam Smith, Thomas Early, and Simon Brumbaugh in this study.     

Child Wanted and When? Fertility Intentions,Wantedness, and Child Survival in Rural Northern Ghana

Panel survey data collected in rural northern Ghana asked women about the “wantedness” status of their children. Parous women were asked whether they wanted more children, while those who had never had a child were asked whether they wanted to have children in the future; those who said that they did not want to have any more children in the future were asked whether they wanted to become pregnant when they last became pregnant and, if so, whether they wanted to become pregnant at the time, or would have preferred to be pregnant earlier or later. This article analyzes longitudinal responses to these questions over a 10‐year period. Birth and survival histories of subsequently born children linked to preference data permit investigation of the question: are “wanted” children more likely to survive than “unwanted” children? Hazard models are estimated to determine whether children born to women who indicated that they did not want to have a child at the time they did, or did not want any more children in the future, have a higher risk of mortality relative to children who were reported wanted at the time of pregnancy. Results show no significant differences in adjusted mortality risks between children who were reported to be wanted and those reported to be unwanted.     

Self-reporting versus parental reporting of physical activity in adolescents: the 11-year follow-up of the 1993 Pelotas (Brazil) birth cohort study

The aim of this study was to verify the agreement between different approaches for estimating levels of physical activity in adolescents. One questionnaire was administered to parents and two were administered to the adolescents. This was a cross-sectional analysis of data collected in the 2004-2005 follow-up of the 1993 Pelotas (Brazil) birth cohort study. Parents or guardians answered the following question: "Compared to most children the same age, would you say that your child exercises more, less, or the same amount?" A similar question was addressed to adolescents, as was a detailed questionnaire on physical activity. Agreement between the questionnaires was measured by the weighted kappa statistic. A total of 4,254 adolescents and parents/guardians answered the questionnaires. Kappa values indicated low agreement for all comparisons (kappa < 0.33 for all analyses). Measurement of physical activity in adolescents is complex, and available instruments should be validated prior to their use.     

Shared Decision Making and the Use of Screening Mammography in Women Younger Than 50 Years of Age

Current breast cancer screening guidelines promote the use of shared decision making for women younger than 50 years of age, yet their effect on mammography utilization is largely unknown. This study aimed to examine the effect of two elements of shared decision making on the use of mammogram screening: patient-perceived choice and patient–provider communication. Data were obtained from HINTS 4, a nationally representative survey of the U.S. population, administered from 2011 to 2013. Choice was measured with the question “Has a doctor ever told you that you could choose whether or not to have a mammogram?” Communication was measured using a 7-item scale (range: 7–28; higher scores denote better communication). Binary logistic regression models assessed the effect of patient choice and communication on ever having a mammogram using weighted sample data. The sample included 1,085 women younger than 50 years of age: 31% of women perceived having a choice to undergo mammography. The mean patient–provider communication score was 22.8. Those who thought they were given a choice regarding mammography were more likely to have a mammogram relative to those who did not think a choice was given by the provider. Patient–provider communication had no significant association with mammography utilization. Patient perceived choice, but not patient-provider communication, is positively associated with mammography utilization in women younger than 50 years of age.     

Women Know Best—Findings from a Thematic Analysis of 5,214 Surveys of Abortion Care Experience

ObjectivePatient experience is an essential component of quality care. Few studies have comprehensively evaluated patient experiences of abortion care. The objectives of this study were to describe women's experiences of abortion care in their own words, and to determine themes across patient experiences.Study DesignData for this thematic analysis, a qualitative method that allows for the identification, analysis, and report of patterns or themes within data, come from a larger study of safety and quality of aspiration abortion care across 22 clinical sites. Participants completed an abortion experience survey including fixed choice questions and an open-ended question: “Is there anything you would like to tell us about your experience?” The data were then categorized by responses to another survey question: “Overall, was your experience about, better, or worse than you expected?”ResultsA total of 5,214 responses were analyzed. Women reported positive abortion care experiences with the majority of women rating their experience as better than expected (n = 3,600). Two major themes that emerged from the data include clinic- and patient-level factors that impact how patients rate their experiences. Analysis of the responses categorized in the worse than expected group (n = 136) found that women primarily faulted clinic-level factors for their negative experiences, such as pain control and management, and wait time for appointments and in clinic.ConclusionThis analysis highlights specific areas of abortion care that influence patients' experience. The few women who were disappointed by care in the clinic tended to fault readily modifiable clinical factors, and provided suggested areas of improvement to enhance positive experiences related to their abortion care.     

Innovative Practices in Comprehensive Health Education Programs for Elementary Schools

Christopher Wren, one of the greatest English architects, walked one day unrecognized among the men who were at work upon the building of St. Paul's cathedral in London that he designed. “What are you doing?” he asked one of the workmen, who replied, “I am cutting a piece of stone.” Wren asked the same question to another man, who replied, “I am earning five shillings two pence a day.” He asked the same question to yet another man, who answered, “I am helping Sir Christopher Wren build a beautiful cathedral.”₁     

Agreement between self-reported and health insurance claims on utilization of health care: A population study

ObjectiveTo investigate the agreement between self-reported and insurance claim of the utilization of health care.Study Design and SettingData were from the Taiwan National Health Interview Survey, conducted in 2001. There were 22,121 (94.2%) individuals who completed the interview, 18,143 of them aged 12 and above. Among them, 87% signed a consent form to allow us linking their interview with data with the National Health Insurance database. After deleting those with illegible identification code or date of birth, 15,660 subjects were included in the study. Kappa (κ) was used to describe the visit concordance, whereas the intraclass correlation coefficient was used to describe frequency consistency. Logistic regression was used to investigate factors associated with the agreement.ResultsAll had reasonable visit and frequency agreements. Logistic regression showed that males and those living in rural areas tended to have a lower likelihood of agreement in reporting outpatient visits compared with others. In reporting emergency room visits, males and those with a higher education level, self-perceived health of “not good,” chronic disease, or at least one difficulty with activities of daily living (ADL) had higher chances of agreement.ConclusionAgreement between self-reported utilization and insurance claims were fairly good in general population.