CAJ | 학술논문

目的：评价由医学专业人员参与的对上海市高中、职校学生进行的“性与生殖健康教育”综合性干预的效果，为有效降低青少年的生殖健康风险提供依据。方法本研究选择上海市两个区的4所高级中学、2所职业学校作为研究现场，将研究对象按1：1比例分层（高中和职校）随机分配入干预组（419例）和对照组（688例），对干预组进行为期1年的“性与生殖健康教育”综合性干预，分析干预组和对照组生殖健康行为的差异。结果基线调查时干预组和对照组生殖健康行为无明显差别（P＞0．05），但干预后干预组向父亲、母亲、老师、同性朋友、医学专业人员以及其他途径求助的比例均显著高于对照组，差异具有统计学意义（均P＜0．05）。多因素分析结果显示，考虑了研究对象生殖健康知识和态度的情况下，在两性问题的求助方面，干预组较对照组更愿意寻求帮助（OR＝2．881，95％CI：1．972～4．209），在求助对象和方式上，更愿意倾向父亲（OR＝2．548，95％CI：1．672～3．883）、母亲（OR＝2．094，95％CI：1．496～2．932）、老师（OR＝2．378，95％CI：1．397～4．081）、专业人员（OR＝2．247，95％CI：1．459～3．460）、热线电话（OR＝2．185，95％CI：1．132～4．217）、书刊杂志（OR＝1．165，95％CI：0．632～2．147）。干预组较对照组有恋爱关系或正在恋爱者，以及发生性行为可能性者较少（ OR＝0．628，95％CI：0．445～0．887）。结论“医教结合”的性与生殖健康教育综合性干预模式对改变学生生殖健康行为具有一定效果，值得进一步探索和推广应用。
목적：평개유의학전업인원삼여적대상해시고중、직교학생진행적“성여생식건강교육”종합성간예적효과，위유효강저청소년적생식건강풍험제공의거。방법본연구선택상해시량개구적4소고급중학、2소직업학교작위연구현장，장연구대상안1：1비례분층（고중화직교）수궤분배입간예조（419례）화대조조（688례），대간예조진행위기1년적“성여생식건강교육”종합성간예，분석간예조화대조조생식건강행위적차이。결과기선조사시간예조화대조조생식건강행위무명현차별（P＞0．05），단간예후간예조향부친、모친、로사、동성붕우、의학전업인원이급기타도경구조적비례균현저고우대조조，차이구유통계학의의（균P＜0．05）。다인소분석결과현시，고필료연구대상생식건강지식화태도적정황하，재량성문제적구조방면，간예조교대조조경원의심구방조（OR＝2．881，95％CI：1．972～4．209），재구조대상화방식상，경원의경향부친（OR＝2．548，95％CI：1．672～3．883）、모친（OR＝2．094，95％CI：1．496～2．932）、로사（OR＝2．378，95％CI：1．397～4．081）、전업인원（OR＝2．247，95％CI：1．459～3．460）、열선전화（OR＝2．185，95％CI：1．132～4．217）、서간잡지（OR＝1．165，95％CI：0．632～2．147）。간예조교대조조유연애관계혹정재연애자，이급발생성행위가능성자교소（ OR＝0．628，95％CI：0．445～0．887）。결론“의교결합”적성여생식건강교육종합성간예모식대개변학생생식건강행위구유일정효과，치득진일보탐색화추엄응용。
among students from high and vocational schools in Shanghai , so as to provide evidence for reducing reproduction risk in adolescents . Methods Four high schools and two vocational schools in two districts of Shanghai were included in the study , among which two high schools and one vocational school were selected randomly as intervention group ( n =419 ) , and the others were controls ( n =688 ) according to 1:1 ratio.The intervention group took part in one-year sexual and reproductive health education .The differences in sexual and reproductive health between two groups were analyzed .Results Although the difference was not significant between two groups in baseline investigation (P>0.05), there were more students in the intervention group than the controls asking for help from parents , teachers, homosexual friends, medical professionals and telephone hotline with statistical difference (all P<0.05).Multivariate analysis showed that students in the intervention group were more likely to ask for help in sexual problems when sexual and reproductive knowledge and attitudes were considered (OR=2.881,95% CI:1.972-4.209), and more likely to ask for help from fathers (OR=2.548, 95% CI:1.672-3.883), mothers (OR=2.094, 95%CI:1.496-2.932), teachers (OR=2.378, 95%CI:1.397-4.081), medical professionals (OR=2.247,95%CI:1.459-3.460), telephone hotline (OR=2.185, 95% CI:1.132-4.217) and journals or books (OR=1.165,95% CI:0.632-2.147) in help-seeking ways.Compared with the controls, the intervention group was less likely to have romantic relationship or have love affairs (OR=0.628, 95% CI:0.445-0.887).Conclusion The sexual and reproductive health education conducted by both medical and educational practitioners is effective to students ’ sexual and reproductive behavior , and it is worth to be complemented further .