医护人员对剖宫产的认知及影响因素研究
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世界银行贷款/英国政府赠款“中国农村卫生发展项目”(7551-CN)


Investigation of cesarean section and the influence factors from the perspective of medical staff
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    摘要:

    目的:从63名从事妇产工作医护人员的视角,了解江苏省南京市高淳区剖宫产现状?剖宫产率的变化情况以及医护人员的态度,分析其影响因素,提出针对性的建议和有效降低非医学需要剖宫产率的策略,为高淳卫生行政部门推进“促进自然分娩,保障母婴安康”项目提供参考依据?方法:对南京市高淳区妇康医院(民营)和区人民医院从事妇产工作的63名医护人员,采用自行设计的调查表进行现场问卷调查,用EpiData3.0?SPSS 17.0软件对数据进行统计学分析?结果:93.7%的医护人员在一般情况下,会更倾向于选择自然分娩,6.3%更倾向于选择剖宫产;在选择剖宫产的考虑因素方面,临床指征是考虑的重点(96.8%),其次是产妇及其家人意见(69.8%),医疗风险是第三考虑因素(57.1%);相比公立高淳区人民医院,民营妇康医院医护人员选择剖宫产术对增加本人收入影响更为明显(P=0.019),选择剖宫产术更容易引发医疗纠纷(P=0.002)?结论:临床指征?产妇及其家人意见是医护人员选择剖宫产术的主要考虑重点;二孩政策的实施,使产妇的依从性更高,对分娩方式的选择存在影响?

    Abstract:

    Objective: Under the perspective of 63 medical staff working in obstetrics and gynecology, this paper sought to understand the situation of cesarean section and changes in the rate of cesarean section and staff attitude in Gaochun District from Nanjing, to analyze its influencing factors, and to put forward for suggestions and strategy of effectively reduce non medical need cesarean section rate, in order to provide a reference for the project of “promoting natural childbirth, protecting maternal and child health” from Health Administrative Department of Gaochun. Methods: A total of 63 medical staffs from the Department of Obstetrics and Gynecology in People’s Hospital of Gaochun District and Fukang Hospital were investigated by field questionnaire survey. Data were analyzed using the EpiData and SPSS. Results: In general situation, 93.7% of medical staff chose natural childbirth, and 6.3% chose cesarean section. In the selection factors of cesarean section, clinical indication played the most important role (96.8%), followed by maternal and family advice (69.8%), then medical risk (57.1%). Compared to the medical staff in People’s Hospital of Gaochun District, those who select cesarean section in Fukang Hospital had more significant increase in private income (P=0.019<0.05) and were more easily lead to medical disputes (P=0.002<0.01). Conclusion: The focus considerations on the selection of the medical staff are clinical indication and advice of maternal and familly. The implementation of the two child policy makes higher women’s compliance, which affect the choice of delivery mode.

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曹毅芊,陆 方.医护人员对剖宫产的认知及影响因素研究[J].南京医科大学学报(社会科学版),2016,(5):380~383

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  • 收稿日期:2016-05-27
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  • 在线发布日期: 2016-10-26
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