基层医院开展人工妊娠终止术后计划生育服务干预实施效果评价

目的 探讨基层医院开展人工妊娠终止术后计划生育服务(PAFPS)的实施效果.方法 随机选择2010年1月至12月在青岛大学医学院附属医院海阳分院妇产科门诊行人工妊娠终止术患者400例为研究对象.采用本研究自行设计的《人工妊娠终止术情况调查》在术前进行初始问卷调查;按就诊顺序将其分为干预组(n=200)和对照组(n=200)(本研究遵循的程序符合青岛大学医学院附属医院海分院人体试验委员会制定的伦理学标准,得到该委员会批准,分组征得受试者的知情同意),对干预组患者术后进行PAFPS,对照组仅提供常规人工妊娠终止术后医疗服务.随访1年后,对所有受试者采用初始问卷再次调查,重点调查避孕节育相关知识知晓情况,避孕措施实施情况及再次非意愿妊娠情况.结果 随访1年后,收回有效问卷386份,其中干预组为194份,对照组为192份.干预组和对照组的避孕相关知识得分分别为(9.31±1.74)分,(6.11±1.81)分,两组比较,差异有统计学意义(t=17.70,P＜0.01).干预组采取主动避孕措施者(78.87％)高于对照组(62.50％),两组比较,差异有统计学意义(x2=38.76,P＜0.01).干预组与1年前比较,采取较为可靠的避孕措施避孕套、避孕药、放置宫内节育器(IUD)]比例更高(74/109,x2=12.67,P＜0.01).干预组1年内非意愿妊娠为5.73％(11/192),对照组为18.75％(36/192),两组比较,差异有统计学意义(x2=24.36,P＜0.01);干预组1年内再次行人工妊娠终止术发生率为2.58％ (5/194),对照组为10.94％(21/192),两组比较,差异有统计学意义(x2=10.74,P＜0.01).结论 在基层医院开展PAFPS,对育龄妇女避孕节育相关知识的掌握,提高避孕措施使用比例,降低非意愿妊娠和人工妊娠终止术发生率,提高生殖健康水平有一定的效果.

Effects of Post-Abortion Family Planning Service in the Primary Hospital

Objective To study the effects of post-abortion family planning service ( PAFPS ) in the primary hospital.Methods From January to December 2010 , a total of 400 women who underwent pregnancy termination were recruited in this study.They were randomly divided into PAFPS group ( n= 200 ) and control group ( n=200 ) according to the visiting sequence.PAFPS group received PAFPS knowledge , and control group only received routine medical service.All of the women were surveyed by Questionnaire of Pregnancy Termination.The main contents were about awareness of contraceptive knowledge , the occurrence of unwanted pregnancy , and so on.After one-year′s follow-up , the same questionnaire survey was conducted again.Results A total of 386 ( 96.5% , 386 / 400 ) validated questionnaires were recovered after one-year′s follow-up , including 194 ( 97.0% , 194 / 200 ) in PAFPS group and 192 ( 96.0% , 192 / 200 ) in control group.The scores of contraceptive awareness of PAFPS group and control group were ( 9.31±1.74 ) score and ( 6.11±1.81 ) socre , respectively , with significant difference ( t=17.70 , P<0.01 ) .The women turned to initiative contraceptive use in the PAFPS group ( 78.87% ) were more than those in control group , which showed significant difference ( 62.50% , χ 2 =38.76 , P< 0.01 ) .And the incidence of unwanted pregnancy in PAFPS group ( 5.73% ) was lower than that in control group ( 18.75% )( χ 2 =24.36 , P<0.01 ) .Conclusions PAFPS is an effective way for reproductive women to improve their awareness of contraceptive knowledge and initiative contraception.Reduce unwanted pregnancy and pregnancy termination rate , resulting in promoting the reproductive health.