武汉市社区产后家庭访视失访原因调查分析

Analysis of the Lost Cause of Follow-up of Postpartum Home Visits in Wuhan Community

目的分析社区产后家庭访视失访原因,制定干预措施,进一步提高产后访视率。方法利用武汉市妇幼保健信息系统,采用整群抽样方法,抽取2013年10月1日—2014年9月30日期间在武汉市分娩且产后休养居住在江岸区的2 006名产妇,调查相关资料进行分类统计,分析产后失访原因。结果访视率72.13%;失访率27.87%,失访主要原因为转外地、拒访和无法联系;单因素分析结果显示,产妇的教育程度、产次、产检次数、系统管理、常住人口、新生儿健康情况对产后访视的影响差异有统计学意义(P<0.05);多因素Logistic回归分析结果显示产妇的教育程度高、产检次数多、接受系统管理是提高产后访视率的保护因素;流动人口、产次多、新生儿分娩结局异常情况是产后访视拒访率的危险因素。结论产妇文化程度越高,越重视产后访视;接受系统管理的产妇产后访视率高;常住人口比流动人口产后访视率高;新生儿分娩结局正常比异常产后访视率高;随着产次增多,失访率反而升高。

Objectives To analyze the lost cause of follow-up of postpartum home visits in Wuhan community,and to provide intervention measures to further improve the follow-up rate of postpartum visits.Methods Cluster sampling method was used to choose 2 006 puerperas who delivered from 1.10.2013 to 30.09.2014 in Wuhan and lived in the riverbank area.The data was analyzed to explore lost causes of follow-up.Results The lost rate of postpartum follow-up was 27.87 %,and which were mainly due to going out of town,refusing to be interviewed and losing contact.Univariate analysis showed that maternal education level,parity,number of check-ups,system management,being resident population or not,and newborn child health could affect the postpartum visits（P〈0.05）.Multivariate logistic regression analysis showed that highly educated mothers,more often check-up,accepting system management would improve the rate of postpartum follow-up,while the floating population,more parity,abnormal neonatal birth could reduce the rate of postpartum follow-up.Conclusions Higher education,accepting system management,being resident population and being with normal neonatal birth will improve the rate of postpartum follow-up,while more parity will reduce the rate of postpartum follow-up.