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目的:了解广州地区未婚女青少年关于安全流产服务需求的障碍,探索影响她们安全流产需求实现的因素。方法:调查133名在医院妇科门诊和计划生育门诊就诊的未婚女青少年关于安全流产服务需求状况以及障碍原因。结果:133名对象中25.6%是学生,97.0%均有过婚前性行为,31.5%有过怀孕流产经历。关于获取安全流产服务需求的障碍主要表现为:学生获知安全流产服务需求的咨询方式相对非学生来说较单一,学生遇到生殖系统卫生保健问题、性病预防和治疗以及怀孕流产等问题时不去获取相关咨询服务的障碍原因与非学生有显著差别(P<0.05)。对象关注的生殖健康治疗问题集中在月经、怀孕流产、其他问题或生殖系统感染,通常因其他原因或者认为问题不严重而放弃寻求治疗。学生与非学生放弃寻求治疗的原因分布差异无统计学意义(P>0.05)。结论:影响未婚女青少年实现安全流产需求障碍主要源于对生殖健康损害的认识不足、具有羞耻感、担心和害怕等心理困扰以及较少提供专门针对青少年或未婚青年性与生殖健康问题的服务等。服务提供机构需加强并支持相关教育,并注重个体特征,尽量使内容与个体需求相适应,即提供以人为本的健康服务。
OBJECTIVE: To understand the barriers of unmarried girl and adolescent in Guangzhou on the demand for safe abortion services and to explore the factors that affect their safe abortion needs. Methods: The situation of the demand for safe abortion service and the cause of the obstacle among 133 unmarried female adolescents attending gynecological clinic and family planning clinic in the hospital were investigated. Results: Of the 133 subjects, 25.6% were students, 97.0% had premarital sex, and 31.5% had pregnancy abortion experience. Barriers to accessing safe abortion services are mainly as follows: Students are advised that the safe abortion service needs are more consultative than non-students. Students do not go to problems of reproductive system health care, STD prevention and treatment, and pregnancy miscarriage Obstacles to obtaining relevant counseling services were significantly different from those of non-students (P <0.05). Reproductive health treatment issues of concern to the subject focus on menstruation, pregnancy miscarriage, other problems or reproductive system infections, which are often abandoned for treatment for other reasons or not considered serious. There was no significant difference in the distribution of reasons why students and non-students gave up seeking treatment (P> 0.05). CONCLUSIONS: Barriers to demand for safe abortion affecting unmarried girls and adolescents stem mainly from under-recognition of reproductive health impairments, psychological distress such as shame, fear and fear, and less provision of services specifically addressing adolescent or unmarried youth sexual and reproductive health issues . Service providers need to strengthen and support related education, and pay attention to individual characteristics, try to make the content and individual needs to adapt, that is, to provide people-centered health services.