计划生育服务机构开展流产后计划生育服务的干预效果研究

目的:探讨计划生育服务机构开展人工流产后计划生育服务(PAFPS)的干预效果。方法:在福建省3家计划生育服务机构选取愿意参加本研究的625例人工流产妇女,随机分为干预组和对照组,分别于术前和术后6个月进行内容相同的"避孕及相关知识"的问卷调查。干预组术后发放专门针对人工流产妇女编印的《避孕及相关知识宣传手册》,同时采取知情选择的原则指导落实一项"高效"(除外安全期、体外排精和紧急避孕药)的避孕措施,免费提供3个月的避孕药具,于术后2周、1个月、3个月进行跟踪随访,填写《干预随访表》;对照组常规处理。随访6个月后,两组妇女均填写统一的"6个月随访表"。结果:①术前两组的基本情况、"避孕及相关知识"分值、术前6个月的避孕措施使用率、"高效"避孕措施使用率、非意愿妊娠率差异均无统计学意义(P均0.05)。②术后6个月干预组避孕措施使用率、避孕知识分值、"高效"避孕措施使用率、坚持使用率和正确使用率均高于对照组(P均0.01);干预组非意愿妊娠率低于对照组(P0.01)。③术前与术后6个月自身比较:知识分值均有提高,但对照组提高幅度低于干预组(P0.01);避孕措施使用率对照组术前(59.3%),干预组术后6个月(90.7%),干预组术前(66.4%),术后(96.3%)两组均有提高,但对照组提高的幅度低于干预组(P0.01);非意愿妊娠率对照组术后6个月和术前差异无统计学意义(P0.05);干预组术后6个月低于术前(P0.01)。结论:在计划生育服务机构开展PAFPS可以充分利用计划生育服务网络优势进行培训、宣传、指导和随访,显著提高人工流产妇女的生殖健康知识水平和避孕效果、降低非意愿妊娠率,干预措施取得了明显的成效,值得推广。

Intervention effect of post--abortion family planning service provided by family planning institution

Objective： To explore the intervention effect of post--abortion family planning service （PAFPS） provided by family planning institution. Methods： A total of 625 women seeking for induced abortion recruited from three family planning institutes in Fujian Province were randomly assigned to intervention group and control group. All of the women were surveyed with the same questionnaire on knowledge of contraception before the operation and 6 months after operation. Women in the intervention group were given particular counseling and guidance on contraception, and used a kind of high--effective contraceptive with informed consent. Results： There were no significant differences in basic characteristics （age, marriage status, birth place, occupation and education）, scores of ＂contraception and rele- vant knowledge＂, the utilization rate of high--effective contraceptives and unwanted pregnancy rate between two groups before the operation （P all 〉0.05）. Scores of ＂contraception and relevant knowledge＂ as well as the utilization rate, rates of continuous use and correct use of high- effective contraceptives 6 months after operation in the intervention group were higher than those of the control group （P all 〈0.05）. While higher unwanted pregnancy rate was found in the control group （P〈0.01）. After the operation, scores of ＂contraception and relevant knowledge＂, utilization rates of contraceptives were increased in two groups, while there were significant differences in the degree of change between two groups （P〈0.05）. Higher unwanted pregnancy rate was found in the intervention group 6 months after operation （P〈0.01）, while there was no significant difference in the unwanted pregnancy rate before and after the operation in the control group （P〉0.01）. Conclusion： Implementation of PAFPS in family planning institutes can take the advantages of the service network for instruction, training, and follow-- up. It can improve post-- abortion women on their knowledge about reproductive health and the effect of contraception, resulting in the decrease of unwant.ed pregnancy rate.