流产后关爱服务对人流术后女性心理及避孕效果的影响
|
摘要
目的对接受人流术的女性实施流产后关爱服务(PAC),评价该服务项目对女性心理健康和术后及避孕效果的影响。方法选取2016年3月至2017年3月浙江省衢州市妇幼保健院接受人工流产术的妊娠女性2 064例作为主要研究对象,按照随机数字表法分为对照组(n=1 032,采用常规的流产服务),PAC组(n=1 032,实施PAC服务),采用焦虑自评量表(SAS)及抑郁自评量表(SDS)评价术前、术后1h内两组女性的心理状态;随访人流术后1个月性生活及月经恢复人数,术后6个月随访记录两组女性术后避孕措施的落实情况及再次流产情况。结果术后1h两组女性SDS、SAS评分均显著低于术前(t值分别为49.69、50.56、79.23、81.10,均P<0.01);而术后1h研究组SDS评分为(40.54±4.29)分、SAS评分为(42.10±4.96)分,均较对照组的(46.61±5.32)分、(48.02±5.29)分明显降低(t值分别为28.58、26.19,均P<0.01)。术后1个月PAC组女性月经恢复人数613例,占59.75%,明显多于对照组的316例的30.86%(χ~2=172.58,P<0.01),PAC组术后出血时间为(4.18±1.87)d、月经出血量为(47.54±12.73)mL,均较对照组的(5.57±2.12)d、(53.17±13.26)mL显著减少(t值分别为15.143,9.85,P<0.05);术后6个月,PAC组及时落实避孕的概率为88.11%,较对照组的35.40%显著增高(χ~2=597.91,P<0.01),PAC组再次流产概率为0.13%,较对照组的0.8%显著降低(χ~2=5.50,P<0.05)。结论 PAC能够明显改善女性人流术后的心理状况,促进女性生理功能的恢复,提高女性高效避孕措施的使用率,降低再次意外妊娠的发生率,具有临床应用价值。
Objective To apply postabortion care(PAC) service to pregnant women who received abortion and to evaluate the effect of the service on woman's mental health and contraception. Methods Altogether 2 064 pregnant women undergoing artificial abortion in Quzhou Maternal and Child Health-Care Hospital of Zhejiang from March 2016 to March 2017 were selected as main research objects. According to random digital table method, they were divided into control group(n=1 032, receiving routine abortion service) and PAC group(n=1 032, PAC service implemented). Self-rating anxiety scale(SAS) and self-rating depression scale(SDS) were used to evaluate psychological state of women in two groups before abortion and at 1 h after abortion. Sexual life of patients and number of patients who recovered menstruation were followed up at 1 month after operation. Contraceptive practices and repeated abortion were followed up in two groups at 6 months after operation. Results Scores of SDS and SAS at 1 h after operation in two groups were significantly lower than those before operation(t value was 49.69, 50.56, 79.23 and 81.10, respectively, all P<0.01). SDS score at 1 h after operation in PAC group was(40.54±4.29) and SAS score at 1 h after operation in PAC group was(42.10±4.96), which were significantly lower compared with those(46.61±5.32, 48.02±5.29) in control group(t value was 28.58 and 26.19, respectively, both P<0.01). There were 613 cases of menstrual recovery in PAC group at 1 month after operation accounted for 59.75%, which were more than 316 cases(30.86%) in control group(χ~2=172.58, P<0.01). Bleeding time in group PAC was(4.18±1.87)d, and amount of menstrual bleeding was(47.54±12.73) mL, which were significantly lower than those(5.57±2.12 d, 53.17±13.26 mL) in control group(t value was 15.143 and 9.85, respectively, both P<0.05). Implementation rate of contraception at 6 months after operation in PAC group was 88.11%, which was significantly higher than that(35.40%) in control group(χ~2=597.91,P<0.01). Repeated abortion rate at 6 months after operation in PAC group was 0.13%, which was significantly lower than that(0.8%) in control group(χ~2=5.50, P<0.05). Conclusion PAC services can significantly improve psychological status of women after abortion, promote recovery of women's physiological functions, improve the effective use of contraception measures and reduce incidence of accidental pregnancy, which has clinical value.
Objective To apply postabortion care(PAC) service to pregnant women who received abortion and to evaluate the effect of the service on woman's mental health and contraception. Methods Altogether 2 064 pregnant women undergoing artificial abortion in Quzhou Maternal and Child Health-Care Hospital of Zhejiang from March 2016 to March 2017 were selected as main research objects. According to random digital table method, they were divided into control group(n=1 032, receiving routine abortion service) and PAC group(n=1 032, PAC service implemented). Self-rating anxiety scale(SAS) and self-rating depression scale(SDS) were used to evaluate psychological state of women in two groups before abortion and at 1 h after abortion. Sexual life of patients and number of patients who recovered menstruation were followed up at 1 month after operation. Contraceptive practices and repeated abortion were followed up in two groups at 6 months after operation. Results Scores of SDS and SAS at 1 h after operation in two groups were significantly lower than those before operation(t value was 49.69, 50.56, 79.23 and 81.10, respectively, all P<0.01). SDS score at 1 h after operation in PAC group was(40.54±4.29) and SAS score at 1 h after operation in PAC group was(42.10±4.96), which were significantly lower compared with those(46.61±5.32, 48.02±5.29) in control group(t value was 28.58 and 26.19, respectively, both P<0.01). There were 613 cases of menstrual recovery in PAC group at 1 month after operation accounted for 59.75%, which were more than 316 cases(30.86%) in control group(χ~2=172.58, P<0.01). Bleeding time in group PAC was(4.18±1.87)d, and amount of menstrual bleeding was(47.54±12.73) mL, which were significantly lower than those(5.57±2.12 d, 53.17±13.26 mL) in control group(t value was 15.143 and 9.85, respectively, both P<0.05). Implementation rate of contraception at 6 months after operation in PAC group was 88.11%, which was significantly higher than that(35.40%) in control group(χ~2=597.91,P<0.01). Repeated abortion rate at 6 months after operation in PAC group was 0.13%, which was significantly lower than that(0.8%) in control group(χ~2=5.50, P<0.05). Conclusion PAC services can significantly improve psychological status of women after abortion, promote recovery of women's physiological functions, improve the effective use of contraception measures and reduce incidence of accidental pregnancy, which has clinical value.
引文
[1]蒋媚,朱秀梅,周晓飞,等.产后关爱保健措施对阴道分娩初产妇角色转换的影响[J].中国妇幼健康研究,2019,30(01):119-122.
[2] Zulu J M,Ali J,Hallez K,et al.Ethics challenges and guidance related to research involving adolescent post-abortion care:a scoping review[J].Reproductive Health,2018,15(1):71.
[3] Wendot S,Scott R H,Nafula I,et al.Evaluating the impact of a quality management intervention on post-abortion contraceptive uptake in private sector clinics in western Kenya:a pre- and post-intervention study.[J].Reproductive Health,2018,15(1):10-25.
[4] Ushie B A ,Izugbara C O ,Mutua M M ,et al.Timing of abortion among adolescent and young women presenting for post-abortion care in Kenya:a cross-sectional analysis of nationally-representative data[J].BMC Women’s Health,2018,18(1):41-48.
[5] Chiweshe M,Macleod C.‘If You Choose to Abort,You Have Acted As an Instrument of Satan’:Zimbabwean Health Service Providers’ Negative Constructions of Women Presenting for Post Abortion Care[J].International Journal of Behavioral Medicine,2017,24(6):856-863.
[6]郎晓林,徐京晓,阮锡琴,等.人流后即刻放置曼月乐的临床效果分析[J].中国妇幼健康研究,2018,29(10):1327-1330.
[2] Zulu J M,Ali J,Hallez K,et al.Ethics challenges and guidance related to research involving adolescent post-abortion care:a scoping review[J].Reproductive Health,2018,15(1):71.
[3] Wendot S,Scott R H,Nafula I,et al.Evaluating the impact of a quality management intervention on post-abortion contraceptive uptake in private sector clinics in western Kenya:a pre- and post-intervention study.[J].Reproductive Health,2018,15(1):10-25.
[4] Ushie B A ,Izugbara C O ,Mutua M M ,et al.Timing of abortion among adolescent and young women presenting for post-abortion care in Kenya:a cross-sectional analysis of nationally-representative data[J].BMC Women’s Health,2018,18(1):41-48.
[5] Chiweshe M,Macleod C.‘If You Choose to Abort,You Have Acted As an Instrument of Satan’:Zimbabwean Health Service Providers’ Negative Constructions of Women Presenting for Post Abortion Care[J].International Journal of Behavioral Medicine,2017,24(6):856-863.
[6]郎晓林,徐京晓,阮锡琴,等.人流后即刻放置曼月乐的临床效果分析[J].中国妇幼健康研究,2018,29(10):1327-1330.
© 2004-2018 中国地质图书馆版权所有 京ICP备05064691号 京公网安备11010802017129号 地址：北京市海淀区学院路29号 邮编：100083 电话：办公室：(+86 10)66554848；文献借阅、咨询服务、科技查新：66554700 |