育龄妇女反复人工流产行为及其影响因素的研究

发布时间：2018-01-21 03:46

本文关键词： 育龄妇女反复人流知识态度两性关系权力　出处：《第二军医大学》2017年硕士论文　论文类型：学位论文

【摘要】：研究目的反复人流是一种不良健康行为,发生率高,威胁育龄妇女健康。文献回顾中所提出的妇女反复人流行为的影响因素,因所用研究工具可靠性不佳,测量条目不一等问题,使得研究结果缺乏可比性甚至存在矛盾。已发表文献所提出的影响因素对妇女反复人流行为的综合解释度较低,提示尚有重要影响因素未被认识,有研究提示两性关系因素可能在妇女反复人流的行为中发挥作用。因此,本研究旨在以知信行理论为框架,性别权力理论为补充,结合文献回顾形成育龄妇女反复人流行为影响因素概念框架,研制相关调查问卷,在育龄妇女中进行反复人流行为及其影响因素的现状调查,探索主要影响因素,以期为减少育龄妇女反复人流行为、提高生殖健康水平提供参考。研究方法基于文献回顾及理论研究形成育龄妇女反复人流行为的影响因素概念框架,以下各部分研究均基于该框架展开:第一部分:育龄妇女反复人流行为影响因素调查问卷的研制。问卷分两部分,首先基于循证指南和文献回顾形成《育龄妇女人工流产知识和态度调查问卷》初稿,经两轮专家咨询修订问卷条目的适切性并评估问卷的内容效度,在同质的样本中进行预调查调试语义,形成调查版问卷。其次是《两性关系权力量表》的汉化,遵从量表汉化指南,结合本研究实际条件通过翻译回译等过程形成汉化后量表初稿,专家咨询及小样本适用调试,达到习语和经验等同性,形成中文调查版量表。第二部分:育龄妇女反复人流行为及其影响因素的横断面调查。以所研制的《育龄妇女人工流产知识和态度调查问卷》及中文版《两性关系权力量表》为调查工具,方便抽取上海市某三级甲等医院妇科诊疗室因非意愿妊娠行人工流产的育龄妇女进行调查,共调查329例妇女。采用项目分析、Cronbach’sα系数、探索及验证性因子分析及条目水平的内容效度指数检验所研制工具的信效度;采用描述性统计分析、单因素分析及二分类非条件logistic回归分析探索育龄妇女反复人流行为的影响因素。研究结果问卷信效度检验结果:《育龄妇女人工流产知识和态度调查问卷》包含11个条目,其中知识分问卷包含2个维度共7个条目,态度分问卷为单维度共4个条目。汉化版《两性关系权力量表》包含两个维度共23个条目。项目分析结果提示知识、态度各分问卷及《两性关系权力量表》各条目均具有较好的鉴别力。探索性因子分析显示累计方差贡献率分别为59.540%、50.739%和42.137%。验证性因子分析结果显示模型整体拟合。所研制问卷各条目水平的内容效度指数在0.88~1.00之间。内部一致性信度结果为知识分问卷的内部一致性信度系数0.764,风险知识维度0.820,生育知识维度0.604,态度分问卷的内部一致性信度系数为0.622。中文版《两性关系权力量表》的内部一致性信度系数为0.858,两维度分别为0.873和0.724。现状调查结果显示:329例人流妇女中反复人流者182例,占55.3%,在反复人流者中人流两次者107例(58.8%),三次者53例(29.1%),四次或以上者22例(12.1%)。调查对象对了解人流相关知识掌握程度较好,对人流持认可态度。二分类非条件logistic回归结果显示,性生活暴露时间长是育龄妇女反复人流行为的危险因素,两性关系权力大是反复人流行为的保护因素。研究结论本研究研制的《育龄妇女人工流产知识和态度调查问卷》和中文版《两性关系权力量表》信效度较理想,可分别作为评估育龄妇女人工流产知识水平、对人工流产所持态度以及在两性关系中权力大小的测量工具。医务人员应对性生活暴露时间长和在两性关系中处于权力弱势的育龄妇女加强关注,尝试采取措施帮助该类妇女提高在两性关系中的权力,或指导她们采取可独立掌控的避孕方法。知识掌握水平高并不能减少反复人流行为,提示单靠健康教育手段促进育龄妇女生殖健康效果不可靠,对育龄妇女反复人流行为的影响因素研究还需进一步探索。
[Abstract]:The purpose of the study is to repeatedly people is a kind of unhealthy behavior, high incidence, threatening the health of women of childbearing age. The influence factors of the proposed review of women repeatedly people's behavior, because the instruments used in the research of poor reliability, not a measurement item and other issues, makes the research results lack of comparability and even contradictions. Factors have been published the influence of the proposed comprehensive interpretation of women repeatedly people behavior is low, there are important factors that influence is not understanding, studies suggest that sex factors may play a role in the women repeatedly people behavior. Therefore, this study aimed at the KAP theory, gender power theory as a supplement, review form repeatedly people behavior of women of childbearing age factors related to the development of a conceptual framework combined with literature, questionnaire, repeated abortion behavior in women of childbearing age and its influencing factors of adjustment The investigation, to explore the main influencing factors, in order to reduce the repeated abortion behavior of women of childbearing age, provides reference for improving the level of reproductive health. Influence of research methods and theoretical research on literature review based on the formation behavior of women of childbearing age and people factors conceptual framework, the following studies were based on the framework: the first part: the research questionnaire repeated abortion the behavior of women of childbearing age. The questionnaire is divided into two parts. Firstly, based on evidence-based guidelines and literature review the formation of artificial abortion in women of childbearing age "survey of knowledge and attitude questionnaire > draft by two rounds of expert consultation questionnaire revised to appropriate and assess the content validity of the questionnaire survey, pre commissioning semantics in the homogeneous sample, the formation of the investigation version the questionnaire. Second is the relationship of power scale < > finished, comply with the scale of Chinese guide, combined with the actual conditions of this study through the translation back translation process As a Chinese draft scale, expert consultation and a small sample for debugging, to idioms and experience the same form Chinese survey version scale. The second part: a cross-sectional survey of repeated people behavior and its influencing factors in women of childbearing age. The development of the "women of childbearing age abortion knowledge and attitude questionnaire" and "gender Chinese version the relationship between power scale" as the survey tool, gynecological clinic a grade three hospital of Shanghai City, convenient extraction of unwanted pregnancy induced abortion for women of childbearing age were investigated, investigated a total of 329 cases of women. By project analysis, Cronbach s coefficient of reliability and validity, content validity index test exploring and confirmatory factor analysis and item the level of the developed tool; descriptive statistical analysis, single factor analysis and two classification of non conditional logistic regression analysis to explore the influencing factors of women of childbearing age. People repeated behavior research Results the questionnaire test results: "women of childbearing age abortion knowledge and attitude questionnaire" contains 11 entries, of which knowledge questionnaire contains 2 dimensions and 7 items, divided into single dimension attitude questionnaire consists of 4 items. The finished version of < sex power scale > contains two dimensions and 23 items project analysis showed that knowledge, attitude of the questionnaire and power relationships scale < > items are with good discrimination. Exploratory factor analysis showed that the cumulative variance contribution rates were 59.540%, 50.739% and 42.137%. confirmatory factor analysis showed that the model fit. The content validity index of questionnaire for each item level in the range of 0.88~1.00. The internal consistency reliability the internal consistency reliability coefficient of knowledge questionnaire 0.764, 0.820 dimensions of risk knowledge, knowledge of family 0.604 dimensions, the internal consistency of letter attitude questionnaire Coefficient of internal consistency coefficient 0.622. Chinese version < relationship power scale > 0.858, two dimensions respectively 0.873 and 0.724. survey results showed: 329 cases of women's status in people in 182 cases, accounting for 55.3%, 107 cases of abortion in repeated people in two times (58.8%, 53) three times (29.1%), 22 cases of four or more (12.1%). The object of investigation to understand better grasp the flow of knowledge, hold a recognized attitude towards people. Two classification logistic regression results showed that life long exposure time are risk factors for the prevalence of women of childbearing age who repeatedly, the protective factors of gender the relationship between big powers is repeatedly people's behavior. The research conclusions of this study developed "induced abortion knowledge and attitude questionnaire > and < Chinese version relationship power scale > ideal reliability and validity, can be used as evaluation of induced abortion The level of knowledge, attitude and the relationship in the power size measurement tool on artificial abortion. The medical staff to deal with life and exposed for a long time in a relationship in the power of vulnerable women of childbearing age should pay attention, try to take measures to help the women increase in two in a relationship of power, or help them take contraceptive methods independent control. Knowledge level is high and should not reduce the repeated people behavior, suggesting that only by means of health education to promote women's reproductive health effect is not reliable, the impact of repeated abortion behavior of women of childbearing age factors still need further exploration.

【学位授予单位】：第二军医大学
【学位级别】：硕士
【学位授予年份】：2017
【分类号】：R473.71

【参考文献】