中国4城市青少年生殖健康就诊意愿及影响因素分析  

Influential Factors on the Intention of Seeking Medical Reproductive Health among Adolescents in Four Chinese Municipal Cities

作　　者：余小鸣[1] 张佳持[1] 宫露霞[2] 张淑平[2] 卓乐雯 曾芳玲 杨勤[4] 徐育松[4] 王梅 于海莲 

机构地区：[1]北京大学儿童青少年卫生研究所,北京100083 [2]山东省济南市妇幼保健院 [3]广州市妇幼保健院 [4]湖北省妇幼保健院 [5]北京市西城区妇幼保健所

出　　处：《中国预防医学杂志》2004年第5期333-336,共4页Chinese Preventive Medicine

基　　金：世界卫生组织西太区资助

摘　　要：目的　探讨青少年对青春期健康服务利用的意愿以及相关影响因素 ,为发展和改善相应的保健服务提供依据。方法　选取生殖健康状况与保健水平为中等及以上的北京市、济南市、广州市、武汉市作为研究现场。采用整群分层抽样和入户调查方法 ,对 4市 4980名 10～ 2 4岁青少年进行研究。结果　研究发现在被调查总体人群中 ,5 2 9%的青少年表示愿意“因青春期健康问题去医院就诊” ,而不愿意寻求服务者达 47 1%。青少年“不愿意就诊”的原因依次是“自认为没有必要” (4 2 2 % ) ,“不好意思” (4 0 7% ) ,“时间不合适” (14 2 % ) ,“地点不合适”(12 6% ) ,“服务内容不能满足个人需要” (9 8% ) ,“医务人员态度不好” (8 9% )等。青少年就诊意愿明显受青少年的个体特征、青少年对生殖健康的认知、态度、经历、父母的文化婚姻状况以及环境和社会支持等因素影响。结论建议加强青少年的性与生殖健康教育 ,提高其对自身生殖健康的关注 ,自觉自愿地利用正规的卫生保健资源。同时改善卫生服务方式和内容 ,提高服务的人员整体素质 ,发展更加适合青少年需求的友好服务。Objectives To explore the influential factors on adolescents’seeking for medical care. Methods According to the region partition of China,four municipalities,Beijing,Jinan,Guangzhou,Wuhan were selected as the research sites,whose reproductive health services are ranked good or better of chinese cities.The research adopted the cluster stratification sampling and used household survey among 4 980 adolescents aged from 10 to 24 in these four cities. Results There are 52.9% adolescents investigated who expressed they would intent to see doctor when having reproductive health problems,while 47.1% of adolescents wouldn’t.Further reasons why not to go to hospital for medical help ranked“think it unnecessary”(42.2%),“feel embarrassment”(40.7%),“time is inappropriate”(14.2%),“place is inappropriate”(12.6%),“the services provided cannot meet their needs”(9.8%),and“the manners of service providers are not good”(8.9%),etc.The service utilization among adolescents associated with many factors,the adolescent individual character,such as their knowledge,attitude and experience of seeking medical service all directly influenced their intention and behaviors of seeking for medical service.The response from their families and society,especially the peer’s pressure,as well as the factors from medical organizations and service staff also influenced the service utilization of adolescents. Conclusions In order to improve existent service for adolescents,the sexual and reproductive health education should be strengthened,and make adolescents get necessary knowledge and skills to help them utilize the health resources consciously.Meanwhile,orientating medical services including capacity building of medical providers should be paid more attentions to develop friendly service appropriate to adolescents.

关 键 词：就诊 生殖健康状况 青少年 意愿 青春期 保健服务 卫生服务 中国 发展 需求 

分 类 号：R179[医药卫生—妇幼卫生保健]