2021-2022年妇产科医生复方短效口服避孕药处方知信行网络调查  

A network survey on knowledge,attitude,and practice toward combined oral contraceptives among obstetriciangy necologists from 2021 to 2022

作　　者：武冰雪 张妍 丁璟 车焱 WU Bingxue;ZHANG Yan;DING Jing;CHE Yan(Shanghai Institute for Biomedical and Pharmaceutical Technologies,Key Lab of National Health Commision for Family Planning and Contraceptives,Shanghai,200237;School of Public Health,Fudan University,Shanghai)

机构地区：[1]上海市生物医药技术研究院,国家卫生健康委员会计划生育药具重点实验室,200237 [2]复旦大学公共卫生学院

出　　处：《中国计划生育学杂志》2023年第3期505-511,共7页Chinese Journal of Family Planning

基　　金：上海市生物医药技术研究院(原上海市计划生育科学研究所)资助项目(K2022-36)。

摘　　要：目的:了解妇产科医生对复方短效口服避孕药(COC)的认知、态度和行为,为我国COC的应用和推广提供参考。方法:2021年6月-2022年4月,经全国计划生育工作网络招募调查对象,在全国21个省份招募自愿参加的妇产科医生为研究对象,用自制问卷进行线上调查。问卷内容主要包括调查对象基本信息和COC知信行情况。采用潜在类别分析、Cochran-Mantel-Haenszel检验、两水平二分类logistic回归分析等方法对数据进行统计分析。结果:共发出1600份调查问卷,回收有效问卷1450份,回收率90.63%。调查对象的COC总体认知得分集中趋势为[73.2(60.6,80.3),COC]优缺点、作用机制、禁忌证和非避孕应用的认知得分依次为[72.9(52.1,77.1)]、[80.0(80.0,100.0)]、[77.8(66.7,88.9)]、[88.9(77.8,100.0)]。针对COC应用的态度,阻碍因素中“老百姓对COC不了解”(85.2%)和“增加静脉血栓等心血管疾病风险”(75.5%)占比较高,促进因素中“对象有避孕需求且无禁忌证”(89.9%)、“对象有治疗需求且无禁忌证”(86.9%)和“对象不适合上环”(84.9%)占比较高。两水平二分类logistic回归分析显示,COC知识掌握较好(OR=1.74,95%CI 1.25~2.44)、高推荐意愿(OR=4.33,95%CI 2.77~6.76)的妇产科医生在临床实践中推荐COC用于避孕需求的频率较高。结论:我国妇产科医生对COC的认知、态度存在不足,并影响其对COC的临床实践行为。建议加强对妇产科医生避孕药具知识的培训,以为服务对象提供高质量的避孕咨询和指导服务。Objective:To investigate the knowledge,attitudes,and practices(KAP)towards combined oral contracep-tives(COCs)among obstetrician-gynecologist in China,and to provide the evidences for the application and extension of COCs in China.Methods:The study subjects were recruited via the national family planning practitioner network.The eligible obstetrician-gynecologists were invited to complete a self administered questionnaire between June 2021 to April 2022.The information of the background and KAP about COCs of the respondents was collected.Category analysis,Cochran-Mantel-Haenszel test,latent class analysis,and two-level binomial logistic regression were used for data analysis.Results:A total of 1600 subjects were screened.Of them,1450(90.63%)were eligible and completed questionnaires.The median of COC knowledge scores of the subjects was 73.2(60.6-80.3)points.The scores of COC advantages and disadvantages,mechanisms,contraindications,and non-contraceptive indications of the subjects were 72.9(52.1-77.1)points,80.0(80.0-100.0)points,77.8(66.7-88.9)points,and 88.9(77.8-100.0)points,respectively.Re-garding the attitude towards COCs of the subjects,"users lack of awareness of COCs"(85.2%)and"increasing risk of venous thrombosis"(75.5%)were the top two reasons for reluctant using COCs."clients having contraceptive needs without contraindication"(89.9%),"clients having treatment needs without contraindication"(86.9%),and"clients choosing COCs due to ineligible for the use of intrauterine devices"(84.9%)were the top three reasons for using COCs.The results of two-level binomial logistic regression indicated that the good COC knowledge(OR=1.74,95%CI 1.25-2.44)and the positive attitude towards COCs(OR=4.33,95%CI 2.77-6.76)of the obstetrician gynecologists had significantly associated with their clinical application of COCs.Conclusion:The insufficient knowledge and the negative attitude toward COCs of obstetrician-gynecologists in China are found in this survey,and which impact the obstetrician-gynecologists in their clinic

关 键 词：复方短效口服避孕药 妇产科医生 知信行 网络调查 

分 类 号：R169.41[医药卫生—公共卫生与预防医学]