倪泽敏 ,　王姽，　周莉 ,　李岚,　李纯,　王齐



武汉市社区产后家庭访视失访原因调查分析

倪泽敏1，2,王姽1，周莉1,李岚1,李纯1,王齐2

【摘要】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。

【关键词】社区;产后访视失访;原因分析

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

NI Zemin, WANG Gui, WANG Qi, et al.HospitalofMonternalandChildHealthCareofJiang’anDistrict,Wuhan, 430016,China

【Abstract】ObjectivesTo 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.MethodsCluster 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.ResultsThe 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.

【Key words】 Community;Postpartum visits;Lost to follow-up;Cause analysis

产后访视是指社区卫生服务机构在接到分娩医院信息，得知产妇和新生儿出院后，要在3-7天内到产妇家访视，进行产褥期的保健服务[1]。产后家庭访视工作是社区孕产妇健康管理工作的重要部分，通过产后访视，能够对产妇、婴儿常见病的诊断、治疗、预防起到积极作用[2-3]，高质量的产后访视可极大地保护和促进产褥期的母婴健康[4]，提高产后访视率，能促使产妇顺利康复及新生儿健康成长。

1对象与方法

利用武汉市妇幼信息系统，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，均按产后访视时间要求进行上门访视，收集产妇的基本信息、产前检查、分娩记录、产后访视等情况。

运用SPSS 18.0 统计软件包处理数据，采用χ2检验、单因素方差分析等统计方法。……