陕西省农村育龄妇女产前检查影响因素结构方程模型分析  

Factors associated with antenatal care service utilization among women of childbearing age in rural areas of Shaanxi province: a structural equation model analysis

作　　者：朱中海 程悦[1,2] 刘丹丽[1] 杨雪[1] 曾令霞[1] 

机构地区：[1]西安交通大学医学部公共卫生学院流行病与卫生统计学系,陕西西安710061 [2]陕西省营养与食品安全工程研究中心

出　　处：《中国公共卫生》2015年第3期268-272,共5页Chinese Journal of Public Health

基　　金：国家自然科学基金(81202218);教育部新世纪优秀人才支持计划(NCET-11-0417)

摘　　要：目的了解陕西省农村育龄妇女的产前保健现状,探讨其影响因素的直接与间接作用,为进一步制定西部农村妇女围产期保健干预措施提供基线资料和依据。方法采用多阶段分层随机整群抽样方法对在陕西省5个贫困县抽取的4 779名2007—2009年曾分娩过的农村育龄妇女进行围产期保健状况问卷调查,采用确证性因子分析构建测量模型,一般加权最小二乘法(WLS)估计参数,通过评价修正来确定最佳模型。结果陕西省调查分析的4 779名2007—2009年曾分娩过的农村育龄妇女中,有63.5%的育龄妇女在孕12周内完成首次产检,有43.8%的育龄妇女接受过至少5次产检,有30.2%的育龄妇女按要求完成所有产检内容,有89.3%的育龄妇女产检地点在乡级及以上医院,4项均符合要求的育龄妇女占14.2%;结构方程模型分析结果显示,家庭特征、保健知识和育龄妇女社会人口特征等均影响到产前保健服务的利用,其中家庭特征影响最大,占62.1%,个体特征的影响次之,占25.4%,而保健知识占12.5%。结论陕西省农村妇女的产前检查质量有待提高,应重点针对家庭经济差、文化程度低及年龄较大的育龄妇女进行产前保健知识宣教。Objective To study current status and direct and indirect influencing factors of antenatal care service utilization among women of childbearing age in rural areas of Shaanxi province,and to provide evidences for making policy on health care of the women. Methods A population-based cross-sectional survey was conducted with a questionnaire survey about health care of the women during perinatal period in rural areas of Shaanxi province. Stratified multistage random sampling was adopted to obtain a sample of 4 779 women giving birth to their children during 2007- 2009. Confirmatory factor analysis was used to construct measure models. Parameters and final model were fitted and revised by generalized weighted least square technique. Results Of all the women,63. 5% had their first antenatal care check within 12 gestation weeks; 43. 8% received 5 times or more antenatal care checks; 30. 2% of them completed all required examinations; 89. 3% attended township hospitals or higher level health facilities for their antenatal care checks; but only 14. 2%had qualified antenatal care checks. Structural equation modeling analysis showed that family characteristics,women＇s social-demographic characteristics,and health knowledge had effect on antenatal care utilization,with the effectiveness percentages of 62. 1%,24. 4%,and 12. 5%,respectively. Conclusion The quality of antenatal care for pregnant women living in rural areas of Shaanxi province needs to be improved. Health promotion on antenatal care in these areas should target on childbearing women who are from poor families,with lower educational level,and at elder age.

关 键 词：育龄妇女 产前检查 结构方程模型 影响因素 

分 类 号：R173[医药卫生—妇幼卫生保健]