深圳和眉山地区人工流产妇女对流产服务的评价及其比较

目的:评价深圳和眉山两地区不同部门和不同等级医疗机构人工流产服务质量,为进一步干预研究提供依据。方法:2005年10月~2006年3月,分别在深圳市和四川省眉山市对计划生育及卫生部门的市、县、乡三级开展人工流产服务机构,对完成流产手术离院前的妇女进行半结构式问卷调查,了解她们获得的相关服务及其对服务的评价。结果:术前医生对服务过程解释的比例为79%,术中对受术者不适进行处理的比例(61%),流产后避孕指导(67%)以及提供相应的宣教材料(52%)的水平均较低。深圳市流产服务在术后随访、性生活和避孕指导以及提供宣教材料方面高于眉山市,计划生育系统的人性化服务和流产后避孕服务好于卫生系统,县级机构术后指导和宣教以及人性化服务好于市级机构。总体上,流产妇女对服务的满意度为83%,其中对计划生育服务机构满意度(89%)高于卫生机构(76%),县级机构(93%)高于市级机构(72%)。结论:我国流产服务质量仍有很大的改善余地,尤其要加强以服务对象为中心的人性化服务和流产后避孕服务。经济欠发达地区和市一级服务机构是改进的重点。

Clients' Appraisement on the Quality of Abortion Care in Shenzhen and Meishan: a Comparative Cross - Sectional Study

Objective: To evaluate the service quality of abortion care among different departments and levels of medical institutes in Shenzhen and Meishan in order to provide a basis for the further intervention studies.Methods: Semi-structured questionnaire survey was adopted.The medical institutes of family planning and public health system in Shenzhen and Meishan were included in this study,and the clients suffering abortion operation were investigated to get the information about the related service they obtained and the appraisement for these services,from October 2005 to March 2006.Results: The proportions and the doctors' behavior were as follows: explanation of the abortion procedure(79%),positive management for the clients' discomfort during abortion(61%),contraception counseling(67%),and the provision of IEC materials(52%).The ratios collected in this study were relatively low.Compared with Meishan,the service quality of Shenzhen was higher in the following aspects: post-operation follow-up,instruction of sex life and contraception,and provision of IEC materials.Humanized services and post-abortion contraceptive services of family planning system were better than the health system,and the post-abortion counseling,instruction and humanized service of county agency were better than the municipal-level institute.The overall clients' satisfaction with abortion care was 83%,with the higher satisfaction for family planning system(89%) than the health system(76%),and higher satisfaction for county agency(93%) than the municipal-level institute(72%).Conclusion: The quality of abortion care is still need to be improved in China.Particular attention should be paid to promote the clients-centered service and the post-abortion contraceptive counseling.The undeveloped region and municipal-level health institute will be the focus of improvement.