Sami Neelofar, Ali Tazeen Saeed
Department of Community Health Sciences, The Aga Khan University, Karachi, Pakistan.
J Coll Physicians Surg Pak. 2006 Apr;16(4):261-4.
To determine the factors affecting the health-seeking behavior of couples with secondary infertility in Karachi.
A descriptive case series.
The data was collected from women attending infertility clinics in five tertiary care hospitals in Karachi from March to June 2003.
All currently married women, between the age of 15-35 years, with at least one previous conception, irrespective of outcome, attending an infertility clinic and consenting to participate in the study, were included. Women with corrective surgery on vagina and uterus, and cases of primary infertility, were excluded. Multiple logistic regression models were used to determine the association of various factors, affecting the health-seeking behavior, with statistical significance set at p < 0.05 for the covariates and the interaction terms between various factors.
The women consulted multiple health care providers for treatment of secondary infertility. The main reasons for seeking treatment were couple s wish (54.2%), family pressure (22.6%) and want of a son by husbands or in-laws (20.4%). The most commonly sought providers were physicians (74.7%), Traditional Birth Attendants (TBA, 39.5%), Spiritual healers (26%), Hakeems (23%) and Homeopaths (17.2%). Most of the women who consulted non-physicians were illiterate (69.4%) as compared to those who consulted a physician (37.8%, p-value = 0.00). The non-physicians were more commonly consulted by women belonging to low socioeconomic group. The posttreatment complications were more common among women who consulted non-physicians.
Pressure from husbands and in-laws compels women for consulting multiple providers. Health seeking behavior for infertility is affected by the literacy and socioeconomic status of the women.
确定影响卡拉奇继发性不孕夫妇求医行为的因素。
描述性病例系列研究。
2003年3月至6月，从卡拉奇五家三级医疗医院的不孕诊所就诊的女性中收集数据。
纳入所有年龄在15 - 35岁之间、目前已婚、至少有过一次怀孕经历（无论结果如何）、在不孕诊所就诊并同意参与研究的女性。排除接受过阴道和子宫矫正手术的女性以及原发性不孕病例。使用多元逻辑回归模型确定影响求医行为的各种因素之间的关联，协变量和各因素之间的交互项的统计学显著性设定为p < 0.05。
这些女性为治疗继发性不孕咨询了多个医疗服务提供者。寻求治疗的主要原因是夫妇意愿（54.2%）、家庭压力（22.6%）以及丈夫或公婆想要儿子（20.4%）。最常咨询的医疗服务提供者是医生（74.7%）、传统助产士（TBA，39.5%）、精神治疗师（26%）、哈基姆（23%）和顺势疗法医生（17.2%）。与咨询医生的女性相比，咨询非医生的女性大多是文盲（69.4%）（咨询医生的女性为37.8%，p值 = 0.00）。社会经济地位低的女性更常咨询非医生。咨询非医生的女性治疗后并发症更常见。
丈夫和公婆的压力迫使女性咨询多个医疗服务提供者。不孕的求医行为受女性的识字率和社会经济地位影响。
