孕产妇母婴健康素养现况调查及其妊娠结局相关研究

发布时间：2018-06-22 11:58

本文选题：孕产妇 + 健康素养　；参考：《山东大学》2013年硕士论文

【摘要】：研究背景健康素养强调个体运用自身知识、技能,参与健康相关事务的能力。目前,我国剖宫产率、巨大儿出生率居高不下,以及不适宜的婴幼儿喂养等问题非常突出。我国的健康素养研究目前主要集中于健康素养的评估,很少涉及孕产妇健康素养的专科领域。更为重要的是,目前我国的孕产妇健康素养研究缺乏对其影响因素的深入分析,特别是产前、产时、产后三个重要时期的结合。对孕产妇的健康素养水平与妊娠结局的相关性研究更是鲜见。研究目的了解孕产妇健康素养水平及其妊娠结局现状,分析其相关性,并探讨和分析影响孕产妇健康素养水平的相关因素。提出相关对策建议,为增进母婴健康水平提供参考依据。资料与方法本次调查是对在妊娠晚期来济南市某“三甲”教学医院门诊就诊的孕妇,按照既定的纳入标准和排除标准采用整体抽样方法确定调查对象300名,进行横断面调查。问卷是通过孕妇基本信息、母婴健康素养测评和产后母婴状况三个方面来描述健康素养的分布特征、分析对妊娠结局的影响及其相关影响因素。运用spss19.0统计软件分析数据。主要结果 1.263名孕产妇具备基本健康素养的比例为1.52%。基本知识知晓率、健康生活方式及行为和健康技能掌握率分别为50.67%、46.39%、48.41%。具备基本健康知识的孕妇的人口特征：25～29岁、大专以上、以从事行政管理为主。具备健康生活方式及行为的人口特征：35岁以上、大专、农村务工人员。具备健康技能人群特征：25～29岁、本科及行政管理。经线性回归模型分析孕妇文化程度、职业、支付方式、收入水平及产检次数是健康素养水平的重要影响因素。 2.对孕产妇健康素养得分与妊娠结局相关性调查表明：健康素养总得分与孕末期增重超过20Kg、巨大儿、剖宫产、产后出血、合并贫血发生率均呈负相关(p0.01,p0.05)；与希望自然分娩率和实际自然分娩率呈正相关(p0.01)；与妊娠期糖尿病发生率没有统计学意义,但随着得分的降低有增高趋势。35岁以上孕产妇妊娠期糖尿病发生率最高(58.3%),不同年龄组间有统计学意义。健康生活方式及行为得分与希望自然分娩率、实际自然分娩率、阴道助产率呈正相关(p0.01)；与巨大儿、剖宫产及合并贫血发生率呈显著呈负相关(p0.01)。健康技能得分与产前检查次数、自然分娩率及产后半小时内哺乳成功率均呈正相关；与阴道助产率、剖宫产率及合并贫血发生率呈负相关(p0.01)。结论与建议结论： 1.孕产妇健康素养总体水平普遍较低。基本知识知晓率好于健康生活方式及行为和健康技能掌握率。具备基本健康知识和技能的人群集中在25-29岁、大专以上及从事行政管理等脑力劳动为主人群。具备健康生活方式及行为人群以35岁以上、大专及农村务工人员为主。 2.文化程度、职业、支付方式、收入水平及产检次数是健康素养水平的重要影响因素。 3.高健康素养水平的孕产妇妊娠结局良好。卫生服务利用及自然分娩率高,妊娠合并症及并发症发生率低。 4.确定低健康素养的重点人群：25岁以下和35岁以上、受教育程度较低、以体力劳动为主的人群。尤其是健康知识及技能的培训需要重点加强。建议： 1.首先应继续加大政府的主导作用。以多种形式开展孕期健康知识普及宣传。 2.发挥社区门诊的母婴保健作用。医院与社区之间实行双向转诊。 3.突出健康教育内容的可读性。通过降低阅读材料的难度,来提高孕产妇的积极性,从而增加遵医行为的依从性。 4.强调健康技能在提高母婴健康素养水平中的重要作用,给孕妇提供个体化的孕期保健指标。在产前培训和示范母婴必备的健康技能。 5.做好重点人群的母婴健康素养干预。
[Abstract]:Research background
Health literacy emphasizes the ability of individuals to use their own knowledge, skills and participation in health related affairs. At present, the rate of caesarean section in China, the high birth rate of the giant children, and the unsuitable infant feeding are very prominent. The health literacy research in China is mainly focused on the assessment of health literacy, which rarely involves the health literacy of pregnant and lying in women. More importantly, the study of maternal health literacy in our country lacks in-depth analysis of its influencing factors, especially in the three important periods of antenatal, labor, and postpartum. The study of the correlation between the level of maternal health literacy and the outcome of pregnancy is more rare.
research objective
To understand the level of maternal health literacy and the status of pregnancy outcome, analyze its correlation, and discuss and analyze the related factors affecting the level of maternal health literacy, and put forward relevant countermeasures and suggestions to provide reference for improving the health level of mother and child.
Information and methods
This survey was for pregnant women who visited a "three a" teaching hospital in Ji'nan in the late pregnancy. According to the established standards and exclusion criteria, 300 subjects were determined by the overall sampling method, and a cross-sectional survey was carried out. The questionnaire was the three aspects of maternal and infant health literacy assessment and postpartum maternal and infant status. To describe the distribution characteristics of health literacy, analyze the impact on pregnancy outcome and its related factors. Use spss19.0 statistical software to analyze the data.
Main results
The proportion of 1.263 pregnant women with basic health literacy was 1.52%. basic knowledge awareness rate, healthy lifestyle and behavior and health skills mastery rate was 50.67%, 46.39%, 48.41%. with basic health knowledge of pregnant women's demographic characteristics: 25~29 years old, college and above, mainly from the administration. Healthy lifestyle and behavior Population characteristics: 35 years of age, junior college, rural migrant workers. The characteristics of health skilled population: 25~29 years old, undergraduate and administrative management. Through linear regression model analysis of maternal culture, occupation, payment method, income level and the number of production inspection are important factors for the level of health literacy.
2. the correlation between the health literacy score and the pregnancy outcome of pregnant and lying in women showed that the total score of health literacy and the weight gain in the end of pregnancy exceeded 20Kg, the incidence of giant children, cesarean section, postpartum hemorrhage and anemia were negatively correlated (P0.01, P0.05); it was positively correlated with the natural delivery rate and the actual natural childbirth rate (P0.01); and gestational diabetes mellitus (GDM). There was no statistical significance, but the incidence of gestational diabetes in pregnant women over.35 years was the highest (58.3%), and there was statistical significance in different age groups. The healthy lifestyle and behavior scores were positively correlated with the natural birth rate, the actual natural delivery rate and the vaginal delivery rate (P0.01). There was a significant negative correlation between the incidence of caesarean birth and the incidence of anemia (P0.01). The score of health skills was positively correlated with the frequency of antenatal examination, the rate of natural delivery and the success rate of lactation within half an hour postpartum, and there was a negative correlation with the rate of vaginal delivery, the rate of caesarean section and the incidence of anemia (P0.01).
Conclusions and suggestions
Conclusion:
The overall level of health literacy of the 1. pregnant women was generally lower. The awareness rate of basic knowledge was better than that of healthy lifestyle and behavior and health skills. The population with basic health knowledge and skills was concentrated at the age of 25-29, college and above and mental labor, such as administrative management. The healthy lifestyle and behavior population were 35 years old. On the other hand, junior college and rural workers are the main workers.
2. education level, occupation, payment method, income level and frequency of production inspection are important factors affecting health literacy level.
3. the pregnancy outcome of pregnant women with high health literacy level is good. The utilization rate of health services and natural childbirth is high, and the incidence of pregnancy complications and complications is low.
4. determine the key population of low health literacy: under 25 years of age and over 35 years of age, low education level, people with physical labor, especially health knowledge and skills training needs to be strengthened.
1., first of all, we should continue to increase the leading role of the government and carry out publicity and promotion of health knowledge in pregnancy in various forms.
2. play the role of maternal and infant health care in community out-patient clinics. Two-way referral between hospitals and communities is carried out.
3. highlight the readability of the contents of health education. By reducing the difficulty of reading materials, we can improve the enthusiasm of pregnant women and increase the compliance of compliance.
4. emphasize the important role of health skills in improving the level of maternal and child health literacy, and provide pregnant women with individualized prenatal health indicators. Pre birth training and demonstration of the necessary health skills for mothers and babies.
5. do a good health literacy intervention for the mother and baby of the key population.
【学位授予单位】：山东大学
【学位级别】：硕士
【学位授予年份】：2013
【分类号】：R195

【参考文献】