CAJ | 학술논문

目的：了解天津市妇产科医务人员对孕前和孕期保健（PAPC）的知识、态度和行为（KAP）现状，为制定有效的干预措施提供参考依据。方法分层整群随机抽样方法抽取天津市各级医疗机构的妇产科医务人员382例，采用自填式孕前和孕期保健KAP问卷进行调查，调查内容包括：一般情况、PAPC知识知晓情况、PAPC相关态度、提供PAPC服务的情况及相关培训需求。结果本次调查回收有效问卷364份，被调查者对补充叶酸、孕前必查项目和传统产前检查的知晓程度较高；对补钙补铁、孕前备查项目和新兴产前检查的知晓程度较低。一级医疗机构者的PAPC知识得分高于三级和二级医疗机构者，医生高于护士，低年龄组和低工作年限组的得分较高，差异有统计学意义。91.21%的被调查者认为PAPC意义重大，但86.54%对自身能否提供全面的PAPC咨询缺乏信心。分别有63.74%、54.67%、38.74%和32.42%的被调查者能提供有不良妊娠史、甲状腺功能异常、生殖道感染和糖尿病等特殊情况的PAPC指导。被调查者最需要的培训内容为存在合并症或高危因素时的PAPC知识、产前诊断的新进展、孕期营养和咨询沟通技巧。结论建议通过一系列干预措施，进一步提高妇产科医务人员的PAPC认知水平，使其增强服务信心，改进相关行为，从而提供更科学、全面的PAPC服务。
목적：료해천진시부산과의무인원대잉전화잉기보건（PAPC）적지식、태도화행위（KAP）현상，위제정유효적간예조시제공삼고의거。방법분층정군수궤추양방법추취천진시각급의료궤구적부산과의무인원382례，채용자전식잉전화잉기보건KAP문권진행조사，조사내용포괄：일반정황、PAPC지식지효정황、PAPC상관태도、제공PAPC복무적정황급상관배훈수구。결과본차조사회수유효문권364빈，피조사자대보충협산、잉전필사항목화전통산전검사적지효정도교고；대보개보철、잉전비사항목화신흥산전검사적지효정도교저。일급의료궤구자적PAPC지식득분고우삼급화이급의료궤구자，의생고우호사，저년령조화저공작년한조적득분교고，차이유통계학의의。91.21%적피조사자인위PAPC의의중대，단86.54%대자신능부제공전면적PAPC자순결핍신심。분별유63.74%、54.67%、38.74%화32.42%적피조사자능제공유불량임신사、갑상선공능이상、생식도감염화당뇨병등특수정황적PAPC지도。피조사자최수요적배훈내용위존재합병증혹고위인소시적PAPC지식、산전진단적신진전、잉기영양화자순구통기교。결론건의통과일계렬간예조시，진일보제고부산과의무인원적PAPC인지수평，사기증강복무신심，개진상관행위，종이제공경과학、전면적PAPC복무。
Objective To better understand the knowledge, attitudes, practice (KAP) and relative demand of precon?ception and prenatal care (PAPC) in medical staffs of obstetrics and gynecology department in Tianjin. Methods Using ran?dom, stratified and clustered sampling approach, we selected 382 obstetrics and gynecology personnels in Tianjin. A self-ad?ministered questionnaire on PAPC KAP was employed to survey their general characteristics, their awareness of PAPC knowledge, their attitudes to PAPC, their service capabilities of PAPC and their request of continuing education. Results The respondents were lacking of KAP in Calcium and Iron supplementation, alternative preconception examination and emerging prenatal examination but present good KAP in folic acid supplemen, necessary prenatal items and classic prenatal examination. Doctors′average knowledge score was higher than nurses′. The scores in primary health care institutions was significantly higher than that in tertiary and secondary medical institutions. Young and junior medical respondents showed higher awareness than older and senior ones. Most (91.21%) respondents believe that PAPC is necessary. But 86.54%of re?spondents are not confident enough to provide comprehensive PAPC services. There were 63.74%, 54.67%, 38.74% and 32.42%of the respondents who could provide special PAPC advisory of adverse pregnancy history, thyroid dysfunction, re?productive infections and diabetes respectively. The most urgent training contents include PAPC knowledge in presence of complications or risk factors, advances in prenatal diagnosis, nutrition during pregnancy and consulting skills. Conclusion It′s necessary to intervent obstetrics and gynecology personnels to improve their cognitive level to PAPC, as well as to amelio?rate relative attitudes and behavior so they can provide more scientific and comprehensive PAPC service.