未婚男性青年生殖健康服务需求研究

发布时间：2018-04-12 20:29

本文选题：未婚 + 男性青年　；参考：《北京协和医学院》2012年硕士论文

【摘要】：[研究目的] (1)了解未婚男性青年生殖健康知识的现况； (2)比较其不同背景之间生殖健康知识的差异及影响因素； (3)了解其生殖健康方面行为的状况； (4)比较其不同背景之间生殖健康行为的差异及影响因素； (5)探索其生殖健康行为的成因； (6)探讨现有为其提供的生殖健康服务的可及性与需求之间的差距。 [研究方法] 本研究采用定量研究和定性研究相结合的方法进行资料收集。定量研究采用观察流行病学中的描述性流行病学方法进行调查。定性研究采用个人深入访谈(IDI)和焦点组讨论(FGD)方法,通过收集研究对象的认识、看法、行为和态度等资料,从访谈对象的角度去了解并尽量理解发生的现象,进一步地探索感兴趣的信息。本次研究选择了婚前保健定点医疗机构作为研究现场。研究对象,为在2011年8月至2011年12月之间,所有到选定婚前保健定点卫生机构的符合纳入标准的未婚／初婚的男性青年1680人。应用EpiData2.1软件录入数据和校验,数据采用SAS9.2统计软件包进行分析处理。 [研究结果] 一、定量研究本次研究共回收合格问卷1589份,合格应答率为94.58%。其平均年龄为26.33±3.18岁。63.9%平均月收入在2000-4999元之间。49.13%受教育程度为大专及以下。从事职业的前三位依次为从事体力劳动的工人48.75%,从事脑力劳动的职员28.67%,经商/个体群体10.01%。本地户口占88.67%,外地户口占11.33%。研究对象的居住状况前三位依次为与现女友同住51.49%,与父母同住25.53%,独居14.45%。90.22%的父母为在婚,3.42%为再婚,3.62%为丧偶,2.75%为离异。 1.了解未婚男性青年生殖健康知识的现况 44.7%的研究对象生殖健康知识得分低于60分,生殖健康知识水平整体上尚存在不足。其中关于性健康相关问题的得分率最低,回答正确率最低的题仅有17.75%的研究对象得分。正确率最低的三个问题,有两个来自于性健康相关方面,一个来自于生殖道感染/性传播疾病相关方面。 2.比较不同背景的未婚男性青年之间生殖健康知识的差异及影响因素对不同背景的研究对象知识得分水平进行比较分析,不同地区、不同年龄组、不同文化程度、居住状况的调查对象间知识得分水平不同,且差异均具有统计学意义(P0.05)。进一步分析发现,接受过高等教育的研究对象知识得分更高的可能性比未接受过高等教育的高1.363倍；合租的研究对象生殖健康知识较低(OR=0.428)；在即墨居住的研究对象生殖健康知识得分更高的可能性是黄岛区的2.283倍；25-27周岁组的研究对象生殖健康知识得分更高的可能性是22-24周岁组的1.366倍。 3.了解未婚男性青年生殖健康方面行为的状况 9.03%的研究对象首次性行为对象为非固定伴侣。85.07%的研究对象存在以下威胁生殖健康的行为。23.25%的研究对象表示在过去的1年中,曾经与一个以上性伴侣有过性生活。12.93%的研究对象曾经发生过商业性行为。8.90%的研究对象曾经有过肛交行为。采用的避孕措施中,选择避孕套的占73.42%。研究对象最近一次性行为中未避孕的占30.27%,在采取了避孕措施的人群中,未正确使用避孕措施的达到了23.11%。目前不打算怀孕但有性行为的研究对象中,过去半年内55.04%的人不能够做到一直坚持使用避孕措施。12.52%的研究对象遭受过非意愿性行为,46.34%的研究对象实施过非意愿性行为。34.21%的研究对象明确表示曾经使女伴意外怀孕。 4.比较不同背景的未婚男性青年之间生殖健康行为的差异及影响因素 logistic回归分析显示,研究对象首次性行为对象的选择,与居住地点、平均月收入、居住状况以及父母婚姻状况有关。即墨的研究对象首次性行为对象为非固定的可能性更低(OR=0.197)；平均月收入越高的研究对象,首次性行为对象为非固定的可能性越大,平均月收入10000元以上的研究对象,首次性行为对象为非固定的可能性是2000元以下的4.022倍；合租的研究对象首次性行为对象为非固定的可能性较高(OR=2.242)；父母婚姻状况的为离异的研究对象,首次性行为对象为非固定的可能性是在婚状况父母的3.358倍。而研究对象的生殖健康知识、教育水平、居住状况以及职业与其是否有威胁生殖健康的行为有统计学关联。生殖健康知识高的研究对象,发生威胁生殖健康的行为的可能性较低(OR=0.413)；接受过高等教育的研究对象,发生威胁生殖健康的行为的可能性较低(OR=0.471)；合租的研究对象,发生威胁生殖健康的行为的可能性是独居研究对象的3.421倍；从事经商活动的研究对象发生威胁生殖健康的行为的可能性是体力劳动的工人的1.888倍。二、定性研究 5.探索未婚男性青年生殖健康行为的成因在不愿采用避孕套的人群中,主要理由是“就是不爱用(安全)套子,影响感觉”,“拿(安全)套之类的多麻烦啊,还不舒服”,“不是有这个(安全)期嘛,从没出过事,比那个(安全套)痛快多了”。研究对象对避孕药的副作用认识上存在很大的误区“听说过的(避孕药),那个要影响生孩子吧……”,“是药三分毒”。很多研究对象尚不能很好的了解多性伴对于生殖健康的可能造成的影响,“更容易(造成)怀孕了”,“做好保护措施是最主要的,其他也没什么……”。另一方面,研究对象实施危险性性行为,易受不良影视剧的影响,“就是看见网上有嘛……所以尝试一下,应该挺安全的”,“不是(色情)电影里有嘛……”。对于非意愿性行为的讨论存在一定的忌讳,“反正她也没有很厉害地拒绝,估计她也想,也不能算完全拒绝吧”,“她没有反对就是了,半推半就吧”,“都夫妻了,其实没什么”。研究对象依然无法清楚的认识到意外怀孕对女伴的影响,“有两个(人流手术),那个无痛的(流产手术)比较好,不怎么伤身体”；“影响肯定是有的,应该不大吧. 6.探讨现有为未婚男性青年提供的生殖健康服务的可及性与需求之间的差距研究对象表现出了愿意去公立医院就诊的态度,“肯定去正规的大医院”,“看病会去中医院的,是我们这里最大的医院了”,“真要有(性病),肯定去县中医院,是医保(在那里)……”。同时也有很多人承认私立医院的存在有一定的合理原因,尤其是良好的私密性,对于隐私的保护是研究对象倾向于选择私立医院的首要原因,“听说过有人去私人门诊的,最主要不容易有人知道啊……”,“对,得了这种病,不好开口(告诉周围的人),就会去私人(门诊)的”。其次是医院就诊流程引起的看病难、医务人员态度差以及价格因素,“(正规医院)看个病不容易,(医生)态度又不好,感觉欠他的似的”,“对,那天我就看见(医生和患者)差点打起来”“(私人医院)那里态度可好了,而且超市都有打折卡(发放)”,“(私人医院)小护士都满脸微笑的,还经常有人发免费的体检卡”。对于避孕药具获得的可及性方面,绝大多数的研究对象表明了明确的会选择正规商店超市购买避孕药具的意愿,“商店也有卖的”,“超市啊,还能是哪里……”,“我们那里有卖这些(卖避孕药具)的药店”。之所以会选择非正规的成人用品店购买避孕药具与所处地理环境有相当大的关系,同时也与营业时间的安排有一定的关系,“我们那儿地方小,(超市)都不进这个的,都得去市里才有”,“想要(购买避孕药具)的时候方便”,“感觉最难的是找不到买(避孕药具)的地方……正规的关门早”。 [研究结论] 未婚男性青年对生殖健康知识的掌握总体较差。未接受过高等教育、年龄小、与非亲属合租的研究对象,生殖健康相关知识的水平较低。同时即墨市的研究对象生殖健康知识水平要相对较高。未婚男性青年避孕节育选择避孕套的占据绝对多数。在不愿采用避孕套的人群中,主要理由是不喜欢使用避孕套后对同房感受的影响。首次性行为是与非固定性伴发生、曾经发生过商业性行为的比例较高。研究对象对于非意愿性行为原因的访谈多采取回避的态度,同时非意愿性行为发生率很高。其致使女伴意外怀孕的比例高,且无法清楚的认识到意外怀孕对女伴的影响。
[Abstract]:[Objective]
(1) understand the status of unmarried young male reproductive health knowledge;
(2) to compare the difference of reproductive health knowledge and influence of different background factors;
(3) to understand the reproductive health behavior;
(4) the difference between the different background factors of reproductive health behavior and influence;
(5) to explore the causes of reproductive health behavior;
(6) to investigate the existing provides reproductive health services accessibility and demand gap.
[Methods]
This research adopts the method of quantitative and qualitative research data were collected. The quantitative study used observation method of descriptive epidemiology in the epidemiology investigation. By qualitative in-depth interviews and focus group discussions (IDI) (FGD) method, through the understanding, collected opinions, behavior and attitude of the data from the interview the way to learn and try to understand the occurrence of the phenomenon, to further explore the information of interest.
This study chose the premarital care fixed-point medical institutions as the research field. As the research object, between August 2011 and December 2011, all to the selected point of premarital care health institutions in accordance with the inclusion criteria of unmarried young men first / 1680. Application of EpiData2.1 software for data entry and verification, data packets for analysis by SAS9.2 statistical software.
[results]
A quantitative study.
This study collected 1589 valid questionnaires, the response rate is qualified with the average age of 94.58%. was 26.33 + 3.18 years.63.9% the average monthly income of 2000-4999 yuan between the.49.13% level of education for college and the following occupation. The first three were manual workers in 48.75%, mental labor staff of 28.67%, business individual / group 10.01%. local Hukou accounted for 88.67%, the field accounts for 11.33%. study of the living conditions are the top three with current girlfriend live 51.49%, live with their parents living alone 25.53%, 14.45%.90.22%'s parents got married in 3.42%, remarried, 3.62% widowed, 2.75% were divorced.
1. understand the unmarried young men in reproductive health knowledge
The study of 44.7% reproductive health knowledge score is below 60, the overall level of reproductive health knowledge is still insufficient. The related problems about sexual health score was the lowest, the lowest rate of correct answer on question only 17.75% of the three lowest score. The correct rate of two, from sexual health. One from RTIs / STDs related aspects.
Comparison between 2. different backgrounds between unmarried young men of reproductive health knowledge and its influencing factors
Through the comparison and analysis of different regions of the research object level knowledge scores of different backgrounds, different age groups, different cultural degree, survey of living conditions between different levels of knowledge scores, and the differences were statistically significant (P0.05). Further analysis showed that the possibility of the research object received higher education knowledge score higher than before have received higher education 1.363 times higher; the research object flat-share reproductive health knowledge was low (OR=0.428); the possibility of health knowledge score research object of Jimo live germ is 2.283 times higher in Huangdao district; the possibility of health knowledge score research object under the age of 25-27 group was 1.366 times higher reproductive age group 22-24.
3. understand the unmarried young men reproductive health behavior
Study 9.03% of the first sex object as the research object of non regular partner.85.07% has the following threats to reproductive health behavior of.23.25% said in the past 1 years, and had more than one sexual partner to have research objects of life.12.93% once had sex business had.8.90% anal sex. The choice of contraception, condoms without contraception accounted for 73.42%. study the latest sexual behaviors accounted for 30.27%, to take contraceptive measures among contraceptive measures were not using the right to 23.11%. does not currently intend to pregnancy but the research object of sexual intercourse in the past six months, 55.04% people can not insist on the research object of the contraceptive use.12.52% suffered from unwanted sexual behavior, 46.34% conducted the unwanted behavior of.34.21% As expressly made the companion with an unwanted pregnancy.
The difference between 4. different background factors of unmarried young male reproductive health behavior and influence
Logistic regression analysis showed that the research object for the first time sex selection of objects, and place of residence, the average monthly income, the living status and marital status of parents. The research object of Jimo first sex object is non fixed less likely (OR=0.197); the average monthly income of the object more high, for the first time for non sexual behavior fixed the more likely, the average monthly income of 10000 yuan more than the research object, the first sex object is non fixed 4.022 times more likely to be less than 2000 yuan; the research object flat-share first sex object for non high probability fixed (OR=2.242); marital status of parents divorced as the research object, for the first time. The behavior object is non fixed possibility is 3.358 times in the marriage status of parents.
The study of reproductive health knowledge, education level, occupation and living conditions, if there is a threat of reproductive health behavior was significantly associated with high reproductive health knowledge. The object of study, the possibility of threats to reproductive health behavior of the lower (OR=0.413); received the research object of higher education, the possibility of threatening the reproductive health behavior the lower (OR=0.471); the research object flat-share, possibility of threat to reproductive health behavior is 3.421 times of solitary object; possibility research object of business activities threatening the reproductive health behavior is 1.888 times the physical labor of workers.
Two, qualitative research
To explore the causes of 5. unmarried young men of reproductive health behavior
In the crowd to use condoms, the main reason is that "love is not used (safety) covers, effect of feeling", "take (safety) sets such as much trouble ah, still not comfortable", "not this (safety) well, never been out of things, than the more happy (An Quantao)". Side effects study on Contraceptive Awareness of the existence of big misunderstanding "heard that (CA), will affect the child.", "three drug". A lot of research object is not a very good understanding of sexual partners for reproductive health may cause, "more easily (cause) pregnant", "is the most important protection measures to do a good job, the other did not. What". On the other hand, the object of study the implementation of sexual risk behaviors, are easily affected by the bad TV drama, "is to see the Internet. So try, should be very safe," not "(porn movie) There. ". to discuss the unwanted behavior there is a taboo," she is not very powerful to estimate, she wants to, can not be completely rejected. "" she did not oppose it, half hearted "," husband and wife, is not what the research object ". Still unable to clearly recognize the unexpected effect of pregnancy on women," two (abortion), the painless (abortion) is good, do not hurt the body ";" is definitely some impact, it should not.
6. of existing for unmarried young men's reproductive health services accessibility and demand gap
Study shows a willingness to go to public hospital's attitude, "must go to the regular big hospital", "the doctor will go to the hospital, the largest hospital is here", "there will be (STD), certainly to the county hospital of traditional Chinese medicine, health insurance (there). At the same time. There are a lot of people admitted to private hospitals have some reasonable reasons, especially good for privacy, privacy protection is the primary cause of the research object tend to choose private hospitals," heard of people go to private clinics, the most important is not easy to have people know. "" yes, got the disease not open (tell people), will go to the private (outpatient) ". The hospital process caused by the difficulty and attitude of medical personnel and price factors," (the regular hospital) to see a sick easily, (Doctor) attitude is not good, you owe him. "", I saw that day (doctors and patients) and almost hit "(private hospitals) where the attitude of these days, and supermarkets have discount card (issued)", "(private hospital) small nurses are smiling, but people often send free medical card". For the availability of contraceptives the vast majority of subjects showed a clear will choose a regular store supermarket to buy Contraceptives will, "stores have sold", "where is the supermarket ah, but also." "we have to sell these (sell contraceptives) pharmacy." why choose to buy non regular contraceptives the Adult supplies store and geographical environment have significant relationship, but also have a certain relationship with Business Hours arrangements, "we are there in small places (supermarkets) are not into this, have to go to the city", "want to (buy Contraceptives) when Convenient "," feel the most difficult is to find a place to buy (contraceptive). Regular closed early.
[Conclusion]
Unmarried young men of reproductive health knowledge is poor. Not received higher education, age, research object and non relatives flat-share, level of reproductive health related knowledge is low. At the same time, the level of health knowledge in Jimo as research object to the reproduction is relatively high. The young unmarried male contraceptive choice condom has an absolute majority. In the crowd to use condoms, the main reason is not love to use condoms after intercourse feeling. First sex with non regular sexual partners, had a higher proportion of commercial sex. The research object interview for reasons of unwanted sexual behavior to take a more evasive attitude, and non volitional behavior the incidence rate is very high. It resulted in a high proportion of pregnant women, and can not be aware of the impact of her pregnancy.

【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】：2012
【分类号】：R169.1

【参考文献】