西安市纺织城女工生殖健康状况及其影响因素研究

发布时间：2018-03-03 14:02

本文选题：纺织女工　切入点：生殖健康　出处：《北京协和医学院》2013年硕士论文　论文类型：学位论文

【摘要】：研究目的一、总目的了解西安市纺织城女工生殖健康“知信行"的现状,以及探讨工效学因素对纺织女工生殖健康的影响。二、具体目标 1、了解纺织女工生殖健康相关知识水平及其影响因素。 2、了解纺织女工生殖健康相关行为,如避孕节育、人工流产、孕产妇保健、生殖道感染自觉症状及其求医行为的情况。 3、探讨职业噪声暴露对纺织女工生殖健康的影响,包括月经、自然流产、早产和子代出生低体重。研究方法本研究为横断面调查。我们采用分层整群的抽样方法,在西安四棉和五环集团两家纺织工厂对1700名符合入选标准(年龄20-49岁,在所选纺织厂上班,当地常住人口,并自愿参加本次研究)的纺织女工进行自填式面对面问卷调查。运用均数和标准差对定量资料进行描述,运用频数和百分比对定性资料进行描述,影响因素分析采用卡方检验和多因素Logistic回归模型。研究结果本研究期间(2012年5月-7月)共发放问卷1700份,实际回收合格问卷1659份,最终合格率为97.59%。一、基本人口学特征纺织女工平均年龄为38.03±7.21岁。52.4%和41.8%的女工文化程度分别为初中和高中/中专。93.0%的女工为在婚,3.5%为未婚,2.5%为离异,1.0%为丧偶。41.5%的女工家庭成员平均月收入为1000-1499元。本地户口占92.7%,外地户口占7.3%。96.3%的女工参加了医疗保险。82.1%的女工是运转班,17.9%是常日班。女工的工作年限平均为17.43±8.28年。二、生殖健康相关知识 1、生殖健康相关知识基本情况纺织女工生殖健康知识平均得分为14.57±5.43分(满分30分)。满分的60%为及格,即≥18分为及格,及格率仅为31.0%。其中,避孕节育知识平均得分为2.76±1.50分,人工流产知识平均得分为3.29±1.68分,生殖道感染/性传播疾病知识平均得分为2.38±1.27分,性健康知识平均得分为2.76±1.44分,孕产妇保健知识平均得分为3.37±1.52分(上述5个方面满分均为6分)。回答正确率最低的三个问题分别是：“手淫有损身体健康”(13.3%),“叶酸可以预防胎儿神经管畸形,还可以治疗月经不调”(17.8%),“性交后冲洗阴道,可以避免罹患生殖道疾病”(18.8%)。 2、生殖健康相关知识影响因素分析我们采用多因素Logistic回归分析可知,纺织女工生殖健康相关知识水平受到年龄(P=0.024)、文化程度(P0.001)、婚姻状况(P=0.001)、工作单位(P=0.001)的影响。30-39岁女工知识得分及格的可能性是20-29岁的1.516倍；40-49岁女工知识得分及格的可能性是20-29岁的1.085倍,但无统计学意义。文化程度为高中及以上的女工知识得分及格的可能性是初中及以下的1.855倍。在婚的女工知识得分及格的可能性是其它婚姻状况的2.436倍。四厂的女工知识得分及格的可能性是五厂的1.589倍。三、生殖健康相关行为 1、避孕节育的情况调查时过去6个月内,纺织女工的避孕率为93.8%。其主要的避孕方法为：宫内节育器(44.0%)和安全套(35.2%)。另外,还有女工采取安全期避孕(4.1%)和体外排精(3.8%)。50.5%和4.0%的女工对采用的避孕方法的满意度分别为“一般”和“不满意”。未避孕的女工其主要原因为：“怕麻烦”(37.0%)和“侥幸心理”(25.0%)。 2、人工流产的情况 51.4%的纺织女工有过人工流产史,其中,有过2次及以上人工流产史的占15.9%。最后一次人工流产的主要原因为：“避孕失败”(41.2%)和“未避孕”(28.2%)。最后一次人工流产的地点主要是“医院"(81.5%)和“妇幼保健院”(9.5%)。 3、孕产妇保健的情况纺织女工初次怀孕的活产率为86.8%,她们中有96.2%的人接受过产前检查。在做过产检的女工中,83.7%的人初次产检在12周以前,67.6%的人产检总次数大于7次,39.8%的人接受过产后访视。产前检查的地点主要是在“医院"(85.3%)和“妇幼保健院”(11.8%)。 4、生殖道感染自觉症状及求医行为调查时过去6个月内,生殖道感染自觉症状的自我报告率为51.7%,其中,“阴道分泌物增多、异味”(28.3%)和“外阴瘙痒”(26.5%)最常见。出现症状后,仅有58.7%的女工选择去医疗机构看病,其中,立即去看病的人较少(39.4%)。而女工未就诊的原因主要是：“每个妇女都会有,没什么关系”(40.1%)和“治疗费用太贵”(17.5%)。四、噪声对纺织女工生殖健康的影响 1、噪声对纺织女工月经的影响纺织女工月经周期平均为29.09±5.67天(16-41天),月经周期异常者占21.1%；行经天数平均为5.42±2.03天(1-13天),行经天数异常者占9.4%；出现痛经情况的占18.0%。上述三种异常情况出现一种即为月经异常,占30.7%。通过多因素Logistic回归调整潜在的混杂因素可知,中噪声暴露的女工月经异常的风险是低噪声暴露的2.419倍；高噪声暴露的女工月经异常的风险是低噪声暴露的4.033倍。 2、噪声对纺织女工自然流产的影响纺织女工自然流产发生率为8.0%。通过多因素Logistic回归调整潜在的混杂因素可知,与高噪声暴露的女工相比,中噪声暴露的女工发生自然流产的风险降低58.8%,低噪声暴露的女工发生自然流产的风险降低77.3%。 3、噪声对纺织女工早产的影响 4.3%的纺织女工初次生产为早产。通过多因素Logistic回归调整潜在的混杂因素可知,中噪声暴露的女工发生早产的风险是低噪声暴露的1.756倍,高噪声暴露的女工发生早产的风险是低噪声暴露的2.162倍,但均无统计学意义。 4、噪声对纺织女工子代出生低体重的影响 10.1%的纺织女工初次生产子代为出生低体重。通过多因素Logistic回归调整潜在的混杂因素可知,中噪声暴露的女工分娩低体重儿的风险是低噪声暴露的3.768倍,高噪声暴露的女工分娩低体重儿的风险是低噪声暴露的5.016倍。结论一、生殖健康相关知识 1、纺织女工的生殖健康相关知识水平较差。生殖道感染／性传播疾病、避孕节育和性健康知识是薄弱环节。 2、年龄小,初中及以下学历,婚姻状况为未婚、离异、丧偶和五厂的纺织女工生殖健康相关知识水平更差。二、生殖健康相关行为 1、纺织女工避孕率较高,但是部分女工未采用有效的避孕措施。纺织女工对避孕药具的满意度也一般。 2、纺织女工人工流产发生水平较高,避孕失败和未避孕是其主要原因。 3、纺织女工孕产妇保健水平一般,特别是产检次数符合率和产后访视率较差。 4、纺织女工生殖道感染自觉症状报告率较高,但是就诊意识淡薄,且就诊不及时。三、噪声对纺织女工生殖健康的影响 1、职业噪声暴露对纺织女工的月经、自然流产和子代出生低体重有影响,且风险随着噪声分贝的增加而增加。 2、本研究尚未发现职业噪声暴露对纺织女工早产有影响。政策建议一、有针对性的开展形式多样、可接受的生殖健康知识宣传活动,宣传内容侧重生殖道感染/性传播疾病、避孕节育和性健康,宣传的重点人群为年龄小、学历低、未婚、离异、丧偶以及五厂的女工。二、加强当地计划生育管理和服务工作。加大管理力度,对女工孕产妇保健服务工作进一步细化、深入,提高计生服务提供者的业务能力,如科普宣传和避孕药具的知情选择推荐能力。三、定期开展健康体检,进行妇科病和生殖道感染疾病的筛查,同时对她们进行健康教育,改善其就诊意识和自我保健意识。四、加强纺织女工工作时的自我保护意识,及时穿戴必要的个体防护措施,合理安排工作和休息。五、工厂领导要重视和做好女工的劳动保护,改善作业环境和强度,妊娠女工应及时调离噪声工作岗位,做好女工经期劳动保护和定期健康监护工作。
[Abstract]:research objective
First, the general purpose
To understand the present status of the reproductive health of women workers in Xi'an Textile City, and to explore the effects of ergonomics on the reproductive health of textile women workers.
Two, specific objectives
1, to understand the knowledge level of the reproductive health of textile women workers and their influencing factors.
2, to understand the reproductive health related behaviors of textile women workers, such as contraception, abortion, maternal health care, conscious symptoms of reproductive tract infection and the behavior of seeking medical treatment.
3, the effects of occupational noise exposure on the reproductive health of textile women workers were investigated, including menstruation, spontaneous abortion, premature birth and low birth weight of the offspring.
research method
This study is a cross-sectional survey. We use stratified cluster sampling method, in Xi'an four cotton textile factory in two group five and 1700 met the inclusion criteria (age 20-49 years old, work in the selected textile factory in the local resident population, and volunteered to participate in this study) of textile workers self-administered face-to-face questionnaire survey. The mean and standard deviation to describe quantitative data, using qualitative data to describe the frequency and percentage, the influential factors were analyzed by chi square test and multiple Logistic regression model.
Research results
During the period of this study (-7 month of May 2012), a total of 1700 questionnaires were issued, and 1659 qualified questionnaires were actually recovered. The final pass rate was 97.59%.
First, basic demographic characteristics
Textile workers with an average age of 38.03 + 7.21 years.52.4% and 41.8% women culture respectively the junior and senior high school / secondary school.93.0% women got married in 3.5%, unmarried, 2.5% divorced, 1% were widowed women.41.5% family average monthly income of 1000-1499 yuan. Local accounts accounted for 92.7% of the field accounts for 7.3%.96.3% of women in the medical insurance.82.1% women running class, 17.9% is often the day. Women work for an average of 17.43 + 8.28 years.
Two, reproductive health related knowledge
1, basic knowledge of reproductive health related knowledge
Textile workers reproductive health knowledge average score was 14.57 + 5.43 points (out of 30). Out of the 60% pass, which is more than 18 for a pass, the pass rate was 31.0%. the average contraceptive knowledge score was 2.76 + 1.50, artificial abortion average knowledge score was 3.29 + 1.68, reproductive tract infection knowledge of sexually transmitted diseases, the average score was 2.38 + 1.27, health knowledge average score was 2.76 + 1.44, maternal health knowledge average score was 3.37 + 1.52 (the above 5 aspects are out of 6 points). The rate of correct answers three questions: "the lowest are detrimental to the health of her hand" (13.3%), "folic acid can prevent fetal neural tube defects, but also can treat menstruation" (17.8%), "wash the vagina after sexual intercourse, can avoid suffering from genital tract disease" (18.8%).
2, analysis of influencing factors of reproductive health related knowledge
We used multivariate Logistic regression analysis, reproductive health related knowledge level of textile workers by age (P=0.024), education (P0.001), marital status (P=0.001), the work unit (P=0.001) the possibility of.30-39 years old women influence the knowledge score is 1.516 times the 20-29 year old 40-49 year old female workers; possibility of knowledge score of 1.085 times at the age of 20-29, but had no statistical significance. The possibility of education for senior high school and above the workers knowledge score is 1.855 times. In the junior middle school and married women the knowledge score can be 2.436 times the other marital status. The possibility of four factory worker knowledge score is 1.589 times five factory.
Three, reproductive health related behavior
1, the situation of contraception
In the past 6 months, textile workers the contraceptive rate of 93.8%. the main methods of contraception: IUD (44%) and condom (35.2%). In addition, there are women take the rhythm (4.1%) and in vitro ejaculation (3.8%).50.5% and 4% women pregnant with the method of obstacle of satisfaction the "general" and "not satisfied". Do not use contraceptive women the main reason is: "trouble" (37%) and "luck" (25%).
2, the situation of abortion
51.4% textile workers had a history of artificial abortion, which is the main reason for more than 2 times and the history of artificial abortion accounted for 15.9%. of the last abortion: "contraceptive failure" (41.2%) and "without contraception" (28.2%). The last abortion place is mainly "hospital" (81.5%) and "maternal and child health hospital" (9.5%).
3, the situation of maternal health care
Textile workers first pregnancy live birth rate was 86.8%, 96.2% of them received antenatal examination. After prenatal women, 83.7% of the initial production inspection in 12 weeks ago, 67.6% people total number is more than 7 times, 39.8% people had received prenatal postpartum visits. The place is mainly in the "hospital" (85.3%) and "maternal and child health hospital" (11.8%).
4, the conscious symptoms of genital tract infection and the behavior of seeking medicine
In the past 6 months, self-reported symptoms of reproductive tract infection rate was 51.7%, among them, "vaginal secretions, smell" (28.3%) and "vulva itch" (26.5%). The most common symptoms, only 58.7% of women choose to go to the doctor, medical institutions, go to the doctor immediately there are fewer people (39.4%). And the reason of unpregnancy treatment mainly is: "each woman will have, not what relationship" (40.1%) and the cost of treatment is too expensive "(17.5%).
Four, the effect of noise on the reproductive health of textile women workers
1, the effect of noise on the menstruation of textile female workers
Menstrual cycle for an average of 29.09 + 5.67 days (16-41 days), menstrual cycle abnormalities accounted for 21.1%; the average number of days was 5.42 + 2.03 days (1-13 days), the number of abnormalities accounted for 9.4%; appear dysmenorrhea accounted for 18.0%. of the above three kinds of abnormal situation is an abnormal menstruation, accounted for the 30.7%. Logistic regression adjusted for potential confounding factors by multiple factors, the risk of abnormal noise exposure workers menstruation is 2.419 times of low noise exposure; risk of abnormal noise exposure workers menstruation is 4.033 times of low noise exposure.
2, the effect of noise on spontaneous abortion of textile female workers
Textile workers and the rate of spontaneous abortion was 8.0%. by multivariate Logistic regression showed that adjusting for potential confounding factors, compared with the high noise exposure workers in noise exposure workers, the risk of spontaneous abortion decreased 58.8%, low noise exposed workers of spontaneous abortion in lower risk 77.3%.
3, the effect of noise on the preterm labor of textile women workers
4.3% of the initial production for textile workers. Premature by multiple factor Logistic regression showed that adjusting for potential confounding factors, the risk of noise exposure workers preterm delivery is 1.756 times the risk of low noise exposure, high noise exposure workers preterm delivery is 2.162 times of low noise exposure, but no statistical significance.
4, the effect of noise on the low birth weight of the female textile worker
The first 10.1% production of textile workers on behalf of low birth weight. By multivariate Logistic regression showed that the adjustment for potential confounders, the risk in noise exposure workers low birth weight children is 3.768 times of low noise exposure, high noise exposure workers low birth weight children is 5.016 times the risk of low noise exposure.
conclusion
First, reproductive health related knowledge
1, the level of knowledge related to reproductive health of textile women workers is poor. Reproductive tract infection / sexually transmitted diseases, contraception and sexual health knowledge are weak links.
2, young age, junior high school and below, the marital status of unmarried, divorced, widowed and five factories of textile women's reproductive health related knowledge level is worse.
Two, reproductive health related behavior
1, textile workers contraception rate is higher, but some women not using effective contraception. Textile workers satisfaction of contraceptives in general.
2, the high level of artificial abortion of textile women workers, the failure of contraception and the failure of contraception are the main reasons.
3, the health level of pregnant and lying in women of textile women workers is general, especially the rate of compliance and the rate of postpartum visits.
4, the report rate of female textile women's reproductive tract infection is higher, but the awareness of medical treatment is weak and the medical treatment is not timely.
Three, the effect of noise on the reproductive health of textile women workers
1, occupational noise exposure affects the menstruation of textile women, spontaneous abortion and offspring birth weight, and the risk increases with the increase of noise decibels.
2, the study has not found that occupational noise exposure has an impact on the preterm labor of textile women workers.
policy suggestion
First, there are targeted ways to carry out various forms of reproductive health knowledge publicity activities, focusing on reproductive tract infections / sexually transmitted diseases, contraception and sexual health. The focus of publicity is age, education, marriage, widowhood, and five factory women workers.
Two, strengthen the local family planning management and service work. Strengthen the management of maternal health care service workers to further refinement, further improve family planning service provider business ability, such as propaganda and contraceptive informed choice is recommended.
Three, regular physical examination should be carried out for gynecological diseases and reproductive tract infections. Meanwhile, health education should be carried out to improve their awareness and self-care consciousness.
Four, to strengthen the self-protection awareness of the work of the textile women workers, to wear the necessary individual protection measures in time, and to arrange the work and rest reasonably.
Five, factory leaders should pay attention to and improve the labor protection of female workers, improve the working environment and intensity. Pregnant women workers should be removed from the noise jobs in time, and the labor protection and regular health care for women workers can be done during the menstrual period.

【学位授予单位】：北京协和医学院
【学位级别】：硕士
【学位授予年份】：2013
【分类号】：R173

【参考文献】