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中国产科医生在产妇要求剖宫产方面的态度、信念和临床实践。

Chinese obstetricians' attitudes, beliefs, and clinical practices related to cesarean delivery on maternal request.

机构信息

Department of Social Medicine and Health Management, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, PR China.

Department of Social Medicine and Health Management, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, PR China.

出版信息

Women Birth. 2020 Feb;33(1):e67-e71. doi: 10.1016/j.wombi.2019.03.001. Epub 2019 Mar 29.

Abstract

BACKGROUND

Obstetricians' beliefs, attitudes, and clinical practices related to cesarean delivery on maternal request appears particularly important in the context of high cesarean section rate. However, few relative studies have been conducted.

AIM

To examine Chinese obstetricians' attitudes, beliefs, and clinical practices with regard to cesarean delivery on maternal request, and to explore influencing factors associated with their practices of cesarean delivery on maternal request.

METHODS

A cross-sectional design was used. Self-administered anonymous questionnaires were distributed to eligible obstetricians at the Congress of the Shanxi Society of Gynecology and Obstetrics as well as the Congress of the Hainan Society of Gynecology and Obstetrics. The overall response rate was 526/649 (81.05%). Multivariate logistic regression models were used to examine independent effects on obstetrician's clinical practices related to cesarean delivery on maternal request.

FINDINGS

Obstetricians who agreed with pregnant women's decision to choose cesarean section directly and believed the benefits of this procedure outweigh the risks had higher odds of performing cesarean delivery on maternal request. In addition, measures to decrease cesarean section at hospitals were associated with reduced likelihood to perform cesarean delivery on maternal request.

CONCLUSIONS

The present study showed a strong correlation between obstetricians' attitudes, beliefs, as well as interventions to decrease cesarean section at hospitals and their clinical practices of cesarean delivery on maternal request. Measures to enhance the training of obstetricians and reduce CS at hospitals are essential to decrease the overall cesarean section rate in China.

摘要

背景

在剖宫产率居高不下的情况下,产科医生对产妇要求剖宫产的信念、态度和临床实践显得尤为重要。然而,相关研究较少。

目的

探讨中国产科医生对产妇要求剖宫产的态度、信念和临床实践,并探讨与他们行剖宫产术相关的影响因素。

方法

采用横断面设计,对山西省妇产科协会和海南省妇产科协会大会上符合条件的产科医生进行了自我管理的匿名问卷调查。总回复率为 526/649(81.05%)。采用多变量逻辑回归模型来检验与产科医生行剖宫产术相关的独立影响因素。

结果

直接同意孕妇选择剖宫产的决定,并认为该手术的益处大于风险的产科医生,更有可能行剖宫产术。此外,医院减少剖宫产的措施与降低行剖宫产术的可能性有关。

结论

本研究表明,产科医生的态度、信念以及减少医院剖宫产的干预措施与他们行剖宫产术的临床实践密切相关。加强产科医生培训和降低医院剖宫产率的措施对于降低中国剖宫产率至关重要。

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