基于健康行为过程取向理论的农村育龄期妇女孕前保健服务利用行为调查分析  

HAPA-based Analysis of Preconception Care Service Utilization of Rural Fertile Women

作　　者：杜敏霞[1] 李春阳 任利华[1] 卢颖[1] 李向青[1] 

机构地区：[1]新乡医学院护理学院临床护理教研室,河南省新乡市453003 [2]开封市妇产医院妇科

出　　处：《中国全科医学》2014年第9期1036-1039,共4页Chinese General Practice

基　　金：河南省教育厅人文社会科学研究项目(2012-QN-407);河南省社科联;经团联调研课题(SKL-2012-474)

摘　　要：目的依据健康行为过程取向(HAPA)理论分析农村育龄期妇女孕前保健服务利用行为阶段转化机制。方法 2012年6—9月采用分层抽样方法选取新乡医学院80名河南农村籍医学本科生原籍所在自然村为样本村,每个自然村采用滚雪球抽样法选取10名已婚育龄期妇女为调查对象进行问卷调查。采用根据HAPA理论设计的调查问卷收集育龄期妇女孕前保健服务利用状况及相关社会认知情况,并进行单因素分析和多因素Logistic回归分析。结果 606例农村育龄期妇女中处于前意向阶段者226例(37.3%)、意向阶段者145例(23.9%)、行动阶段者235例(38.8%)。前意向阶段、意向阶段和行动阶段育龄期妇女的行动自我效能、应对自我我效能、维持自我效能、积极结果预期、风险感知及行为计划得分间差异均有统计学意义(F=8.930、12.800、20.957、3.753、7.044、3.111,P<0.05),消极结果预期得分间差异无统计学意义(F=0.670,P>0.05)。多因素Logistic回归分析结果显示行动自我效能、积极结果预期对前意向阶段具有负向作用(OR=0.277、0.652,P<0.05);应对自我效能对意向阶段具有正向作用(OR=1.706,P<0.05),维持自我效能对意向阶段具有负向作用(OR=0.449,P<0.05);应对自效能、维持自我效能及行为计划对行动阶段均具有正向作用(OR=1.341、1.660、2.283,P<0.05)。结论农村育龄期妇女孕前保健服务利用行为阶段转化的社会心理学机制与HAPA理论相符,HAPA理论适用于农村育龄期妇女孕前保健服务利用的分析。Objective To analyze the transformation mechanism of preconception care service utilization of rural fertile women,based on health action process approach（HAPA）.Methods A longitudinal questionnaire survey was conducted by snowball sampling in married fertile women chosen from 80 villages,from June to September 2012.HAPA-based questionnaire was used to collect the information of preconception care service utilization and relevant social cognition of fertile women.Univariate and multivariate Logistic regression analysis was performed.Results In 606 rural fertile women,226 in pre-intention stage（37.3%）,145 in intention stage（23.9%）,235 were in action stage（38.8%）.There was significant difference in action self-efficacy,maintaining self-efficacy,positive outcome expectation,risk perception and behavior plan between fertile women in stages of pre-intention,intention,action（F=8.930,12.800,20.957,3.753,7.044,3.111,respectively,P〈0.05）,there was not in passive outcome expectation（F=0.670,P〉0.05）.By multivariate Logistic regression analysis,action self-efficacy,positive outcome expectation were of negative effect on pre-intention stage（OR=0.277,0.652,P〈0.05）;Coping self-efficacy was of positive effect on intention stage（OR=1.706,P〈0.05）;Maintaining self-efficacy was of negative effect on intention stage（OR=0.449,P〈0.05）;Action plan,maintaining self-efficacy and coping self-efficacy were of positive effect on action stage（OR=2.283,1.660,1.341,P〈0.05）.Conclusion The social psychological transformation mechanism of preconception care service utilization agrees with HAPA theory in rural fertile women in action stage,HAPA theory can be used to analysis the rural women of childbearing age preconception care service.

关 键 词：计划生育服务 孕前保健 行为支配 育龄妇女 健康行为过程取向理论 

分 类 号：R715.3[医药卫生—妇产科学]