关爱服务对女性流产后避孕方法选择的影响

Influence of post abortion care to decision-making for contraceptive method in females

目的研究流产后关爱服务(PAC)对患者流产后避孕方法选择的影响。方法采用方便抽样法抽取2015年4月至2016年2月于西安交通大学第一附属医院接受人工流产的患者154例,对进行人工流产的患者按来院顺序编号并按奇偶数分为干预组和对照组各77例。在流产前,对干预组患者提供流产后关爱服务,为对照组患者实施常规健康教育;两组患者接受人工流产后,通过返院咨询和电话咨询等形式,对其避孕方法和是否再次意外妊娠情况于流产后1、3、6、9个月共进行4次随访。结果干预前,两组患者采用的避孕方法主要是不安全避孕法(干预组占71.4%,对照组占61.0%)及常规避孕法(干预组占27.3%,对照组占39.0%),差异均无统计学意义(均P>0.05)。干预后1、3、6、9个月时,干预组患者的常规避孕率由干预前的27.3%迅速降低到2.6%,并在之后的随访中逐渐提高;而对照组患者的常规避孕率由干预前的39.0%增加到81.8%,并维持较高水平。干预组患者的高效避孕率由干预前的1.3%显著增长到97.4%,并保持较高水平;对照组患者的高效避孕率缓慢增长到5.2%。干预组患者的不安全避孕率由干预前的71.4%显著降低到1.3%,并保持较低水平,而对照组患者的不安全避孕率由干预前的61.0%缓慢降低到15.6%。两组患者的3种避孕方法在1、3、6、9个月随访时差异均有统计学意义(χ~2=12.48~138.45,均P<0.05)。结论流产后关爱服务能提高患者的高效避孕率。经过流产后关爱服务咨询,在后续的随访中,需要巩固女性的科学避孕知识和强化其意识,维持避孕效果。

Objective To explore the influence of post abortion care（PAC）on the choice of contraceptive method.Methods Convenient sampling was used to extract 154 patients who performed artificial abortion in the First Affiliated Hospital of Xi＇an Jiaotong University from April 2015 to February 2016.Patients were divided into intervention group and control group according to their visit order number and odd-even number,and each group included 77 patients.Normal health education was given to the control group while PAC service was given to the intervention group before abortion.After abortion patients＇ contraceptive methods and occurrence of unintended pregnancy were accessed by the form of outpatient consultation and telephone follow-up at 1,3,6 and 9 month.Results Before intervention,contraceptive methods that patients in intervention group and control group mainly used were non-safe contraceptive method（71.4%,61.0%）and normal contraceptive method（27.3%,39.0%）without statistical difference（P〈0.05）.One month,3 months,6 months and 9 months after intervention,conventional contraceptive rate increased from39.0%to 81.8%in the control group,and it maintained relative high.High-efficient contraceptive rate increased from 1.3% to 97.4% in the intervention group,and kept relatively high level.In the control group,high-efficient contraceptive rate gradually increased to 5.2%.Non-safe contraceptive rate of the intervention group decreased from 71.4% to 1.3% and maintained a low level,while that of the control group decreased from 61.0%to 15.6%.Differences in three contraceptive methods at 1,3,6 and 9 months in follow-up were statistically significant between two groups（χ~2 value ranged 12.48-138.45,all P〈0.05）.Conclusion PAC service can improve high-effective contraceptive rate of patients.It is necessary to consolidate scientific contraceptive knowledge,strength awareness and maintain contraceptive effect in females in the following-up process after PAC consult service.