Clark L R, Brasseux C, Richmond D, Getson P, D'Angelo L J
Department of Adolescent and Young Adult Medicine, Children's National Medical Center, Washington, DC, USA.
J Adolesc Health. 1997 Aug;21(2):91-6. doi: 10.1016/s1054-139x(97)00042-6.
Many surveys of adolescent behavior are dependent on self-reported data. We sought to assess the accuracy of adolescent self-report of sexually transmitted diseases (STDs) and pregnancies.
We randomly selected 149 (118 females, 31 males) adolescents to participate in this accuracy study. Follow-up questionnaires were administered to the 126 patients (99 females, 27 males) who returned after enrollment. Patients were asked about STDs and pregnancies during the follow-up period which ranged from 6 months to 1 year. All patient charts were reviewed to validate post-testing history.
Return visits were made by 126 patients (84%). Fifty-one (40%) denied having had an STD at all during the follow-up period but were found to have had at least one STD. Another 11 (9%) admitted having had an STD but had multiple STDs in excess of what they reported. Only 46% of the patients provided accurate information on the follow-up questionnaire. Of the 99 girls who returned for follow-up, the inaccurate patients (10%) consisted of 9 who reported no visits for a pregnancy but had a pregnancy documented in their charts and 1 who underreported her number of pregnancies. Reliability analysis of the accuracy of STD and pregnancy self-report for our patients showed kappas ranging from 0.185 to 0.413 (slight and fair to moderate, respectively). Pearson correlation coefficients were 0.3107 and 0.4364 for STD and pregnancy, respectively.
Our patients' histories of visits for STDs and pregnancies are often not substantiated by review of their medical records. The reason for the inaccuracies in self-report of sexual behaviors is unclear. Further research in this area should be done. Physicians must confirm patient history concerning sexual practices through appropriate record review and medical evaluation.
许多关于青少年行为的调查依赖于自我报告的数据。我们试图评估青少年对性传播疾病（STD）和怀孕情况自我报告的准确性。
我们随机挑选了149名青少年（118名女性，31名男性）参与这项准确性研究。对登记后返回的126名患者（99名女性，27名男性）进行了随访问卷调查。询问患者在6个月至1年的随访期内的性传播疾病和怀孕情况。查阅了所有患者的病历以核实检测后病史。
126名患者（84%）进行了回访。51名（40%）患者在随访期内完全否认患有性传播疾病，但经检查发现至少患过一种性传播疾病。另外11名（9%）患者承认患有性传播疾病，但实际患有的性传播疾病种类比他们报告的要多。只有46%的患者在随访问卷中提供了准确信息。在99名返回接受随访的女孩中，信息不准确的患者（10%）包括9名报告未因怀孕就诊但病历中有怀孕记录的患者，以及1名少报怀孕次数的患者。对我们患者性传播疾病和怀孕情况自我报告准确性的可靠性分析显示，卡帕值范围为0.185至0.413（分别为轻微、一般到中等）。性传播疾病和怀孕情况的皮尔逊相关系数分别为0.3107和0.4364。
我们患者的性传播疾病和怀孕就诊史经病历审查后往往无法得到证实。性行为自我报告不准确的原因尚不清楚。该领域应开展进一步研究。医生必须通过适当的病历审查和医学评估来确认患者有关性行为的病史。
