滨海新区孕产妇剖宫产的影响因素与对策研究
发布时间：2018-09-13 12:44
【摘要】：目的:深入探讨滨海新区剖宫产率的主要影响因素,为进一步降低剖宫产率提供政策依据。方法:本研究通过定性与定量相结合的研究方法对2014年8月-2014年12月在第五中心医院分娩的582名孕产妇进行调查,在孕期各阶段对剖宫产的认知程度和其他相关因素进行问卷调查,并采取对医生护士等相关人员的深入访谈,对获取资料进行统计分析。结果:1.此次调查孕产妇的剖宫产率为55.67%(N=324),要比世界卫生组织建议的10%一15%的水平高出4-5倍。2.影响孕产妇在怀孕的初期选择哪种分娩方式的因素主要是孕产妇对剖宫产和顺产的认知程度有一定关系;影响孕产妇在分娩前选择哪种分娩方式的因素主要是在怀孕期间产科检查医生、孕产妇的家长、丈夫及亲朋好友、书本、报刊杂志对孕产妇选择哪种分娩方式提出的一些建议;影响孕产妇在分娩的最后阶段选择哪种分娩方式的因素主要是孕产妇对自己生产的信心及产科医护人员对孕产妇分娩方式的建议有非常密切的关系。3.最后通过采用多因素logistic回归分析的方法,得出对孕产妇最终选择哪种分娩方式的影响因素主要是以下几种:孕产妇在最开始怀孕的时候选择的分娩方式、产科检查医生对孕产妇分娩方式的建议、孕产妇家长丈夫及亲朋好友的一些建议、孕产妇对自己生产的信心及在住院期间产科医护人员对其分娩方式的建议等影响因素会影响孕产妇最终选择分娩方式。以上的一些因素对孕产妇后选择哪种分娩方式的影响是:1.孕产妇在开始怀孕的时候比较倾向于选择剖宫产的,其最后选择剖宫产分娩方式的比例要最高。2.产科检查医生对孕产妇提出建议其选择剖宫产的,其最后选择剖宫产分娩方式的比例要大于产科检查医生提出建议其选择自然分娩方式的。结论:中国目前剖宫产率持续居于高位,其影响因素主要来自医学的和社会的各方面原因,比如当前突飞猛进的剖宫产手术技术的发展、对于实施剖宫产手术指征的不恰当的进行人为的扩大、受家长丈夫及亲朋好友的影响、孕产妇对于剖宫产手术片面的认识及对自然分娩认知的缺陷、各级医疗机构产科医务人员的助产技术水平不足、社会上的风俗习惯和医疗卫生体制法制建设的不完善。
[Abstract]:Objective: to explore the main influencing factors of cesarean section rate in Binhai New area and to provide policy basis for further reducing cesarean section rate. Methods: a total of 582 pregnant women who gave birth in the Fifth Central Hospital from August 2014 to December 2014 were investigated by qualitative and quantitative methods. The cognitive degree of cesarean section and other related factors were investigated by questionnaire in every stage of pregnancy, and the data were analyzed by in-depth interview with doctors and nurses. The result is 1: 1. The caesarean section rate in the survey was 55.67% (NJ324), 4-5 times higher than the 10% -15% level recommended by the World Health Organization. The main factors that affect the choice of delivery mode in the early pregnancy are the cognitive degree of cesarean section and natural delivery. The factors that influence the choice of delivery mode before delivery are the obstetrical examination doctor during pregnancy, the parents of pregnant women, husband and relatives and friends, books, newspapers and magazines, and some suggestions on which mode of delivery should be chosen by pregnant women; The factors influencing the choice of delivery mode in the final stage of delivery are the confidence of pregnant and lying-in women in their own delivery and the advice of obstetrics and health care workers on the mode of delivery of pregnant and lying-in women. Finally, by using the method of multivariate logistic regression analysis, it is concluded that the main factors influencing the final choice of delivery mode are the following: the mode of delivery that the pregnant women choose at the beginning of pregnancy, Obstetrical examiners' advice on how to give birth to pregnant women, and some advice from parents, husbands, relatives and friends of pregnant women, The influence factors such as maternal confidence in their own delivery and the advice of obstetrics and nurses on their delivery mode during hospitalization will influence the final choice of delivery mode for pregnant women. Some of the above factors on the maternal choice after the birth of the mode of birth is: 1. When pregnant women were more inclined to choose cesarean section at the beginning of pregnancy, the proportion of women who finally chose cesarean section was the highest. 2. The proportion of obstetrical examiners who give advice to pregnant women to choose cesarean section is larger than that of obstetrical examiners who suggest their choice of natural delivery mode. Conclusion: the rate of cesarean section in China continues to be high at present, and the influencing factors mainly come from various reasons of medicine and society, such as the rapid development of cesarean section technology. Under the influence of parents, husbands, relatives and friends, the pregnant and lying-in women have a one-sided understanding of cesarean section and defects in their cognition of natural delivery, because of the improper expansion of the indications of cesarean section, and due to the influence of parents, husbands, and relatives and friends. The technical level of midwifery in obstetrics and obstetrics of medical institutions at all levels is insufficient, and the customs and habits of society and the construction of medical and health system and legal system are not perfect.
【学位授予单位】：天津医科大学
【学位级别】：硕士
【学位授予年份】：2017
【分类号】：R719.8
本文编号：2241211
[Abstract]:Objective: to explore the main influencing factors of cesarean section rate in Binhai New area and to provide policy basis for further reducing cesarean section rate. Methods: a total of 582 pregnant women who gave birth in the Fifth Central Hospital from August 2014 to December 2014 were investigated by qualitative and quantitative methods. The cognitive degree of cesarean section and other related factors were investigated by questionnaire in every stage of pregnancy, and the data were analyzed by in-depth interview with doctors and nurses. The result is 1: 1. The caesarean section rate in the survey was 55.67% (NJ324), 4-5 times higher than the 10% -15% level recommended by the World Health Organization. The main factors that affect the choice of delivery mode in the early pregnancy are the cognitive degree of cesarean section and natural delivery. The factors that influence the choice of delivery mode before delivery are the obstetrical examination doctor during pregnancy, the parents of pregnant women, husband and relatives and friends, books, newspapers and magazines, and some suggestions on which mode of delivery should be chosen by pregnant women; The factors influencing the choice of delivery mode in the final stage of delivery are the confidence of pregnant and lying-in women in their own delivery and the advice of obstetrics and health care workers on the mode of delivery of pregnant and lying-in women. Finally, by using the method of multivariate logistic regression analysis, it is concluded that the main factors influencing the final choice of delivery mode are the following: the mode of delivery that the pregnant women choose at the beginning of pregnancy, Obstetrical examiners' advice on how to give birth to pregnant women, and some advice from parents, husbands, relatives and friends of pregnant women, The influence factors such as maternal confidence in their own delivery and the advice of obstetrics and nurses on their delivery mode during hospitalization will influence the final choice of delivery mode for pregnant women. Some of the above factors on the maternal choice after the birth of the mode of birth is: 1. When pregnant women were more inclined to choose cesarean section at the beginning of pregnancy, the proportion of women who finally chose cesarean section was the highest. 2. The proportion of obstetrical examiners who give advice to pregnant women to choose cesarean section is larger than that of obstetrical examiners who suggest their choice of natural delivery mode. Conclusion: the rate of cesarean section in China continues to be high at present, and the influencing factors mainly come from various reasons of medicine and society, such as the rapid development of cesarean section technology. Under the influence of parents, husbands, relatives and friends, the pregnant and lying-in women have a one-sided understanding of cesarean section and defects in their cognition of natural delivery, because of the improper expansion of the indications of cesarean section, and due to the influence of parents, husbands, and relatives and friends. The technical level of midwifery in obstetrics and obstetrics of medical institutions at all levels is insufficient, and the customs and habits of society and the construction of medical and health system and legal system are not perfect.
【学位授予单位】：天津医科大学
【学位级别】：硕士
【学位授予年份】：2017
【分类号】：R719.8
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