自我效能和生育意愿与孕中期妇女剖宫产意愿的相关性研究

目的:探讨阴道分娩自我效能、生育意愿及其他已知因素对上海市某区孕中期初产妇剖宫产意愿的影响。方法:对2010年12月～2011年5月到上海市某区仅有的2所接产医院建立大卡(初次产检)的482名孕中期初产妇进行问卷调查,调查内容包括自我效能、生育意愿、个人基本情况、对分娩方式的认知和分娩意愿等。结果:孕中期初产妇剖宫产意愿比例达12.1%。三个多因素Logistic回归模型的对比发现,阴道分娩自我效能和一胎意愿是剖宫产意愿的两个独立的相关因素。孕妇阴道分娩自我效能得分每增加1分,阴道分娩意愿可能性增至1.198倍(P<0.01);打算只生1个孩子的孕妇剖宫产意愿是不打算或未考虑过者的2.143倍(P<0.05)。此外,年龄大、有生育保险、对分娩方式有错误认知的孕妇更倾向于有剖宫产意愿。结论:卫生保健服务提供者应努力帮助孕妇提高阴道分娩的自我效能。建议可进一步研究计划生育政策与剖宫产意愿及行为的关系。

Study on the correlation between self-efficacy,fertility desire and intention of cesarean section of the women during the second trimester of pregnancy

Objective:To explore the effects of self-efficacy,fertility desire of vaginal delivery and other known factors on the intention of cesarean section of primiparous women during the second trimester of pregnancy in a certain district of Shanghai city.Methods:A total of 482 primiparous women during the second trimester of pregnancy who went to the only two childbirth hospitals in a certain district of Shanghai city to establish health cards(receiving pregnant examination for the first time) from December 2010 to May 2011 were surveyed by a questionnaire,the contents included self-efficacy,fertility desire,individual general conditions,cognition to delivery modes,delivery intention,and so on.Results:The proportion of intention of cesarean section among the primiparous women during the second trimester of pregnancy was 12.1%.The comparison of triple-factor logistic regression model showed that self-efficacy of vaginal delivery and one-child intention were two independent factors related to the intention of cesarean section.When the score of self-efficacy of vaginal delivery increased by one,the probability of cesarean section intention increased to 1.198 times(P<0.01).The cesarean section intention of pregnant women who intended to have one child was 2.143 times more than the cesarean section intention of pregnant women who didn’t intend or consider(P<0.05).Besides,the pregnant women with advanced age,maternity insurance,incorrect cognition to delivery modes were more likely to have cesarean section intention.Conclusion:Health care providers should try to improve the self-efficacy of vaginal delivery among the pregnant women,it is recommended to further research the relationship between family planning policy and cesarean section intention and behavior.