產婦特性對其生產方式的選擇之影響

Influence of maternal factors toward the mode of delivery

許家敏(Hsu Chia Min)

指導教授 ： 湯澡薰 博士

臺北醫學大學/公共衛生暨營養學院/醫務管理學研究所/碩士(2004年)

摘要

我國剖腹產率近年來平均高達33%，相較於世界衛生組織建議之理想剖腹產率15%以下，還有很大的努力空間。過高的剖腹產率不只增加母親的死亡率與併發症的機率，也會增加住院天數且花費更多醫材與人力照顧而增醫療保險預算的負擔。 台灣雖然有探討剖腹生產的文獻，不過較少篇幅針對產婦對生產議題之態度與認知方面的探討。本研究目的，在於探討產婦對於其生產方式的選擇之相關影響因素。 本研究採橫斷性研究，以台北市某區域醫院教學醫院生產過的婦女為對象，以結構式問卷進行自填調查，研究樣本數為119人，分剖腹生產者33位，自然生產者86位。 本研究之主要結果如下： 1) 相對於沒有商業保險的產婦，有商業保險的產婦比較傾向於剖腹生產。 2) 年齡也是產婦選擇生產方式的重要原因之一。 3) 家庭收入的差異會影響婦女選擇剖腹生產或自然生產。 4) 對於自然生產議題的認知較高者，採用自然生產的機率也比較高。 5) 有工作的產婦比無工作或家管者更傾向於剖腹生產。 6) 有東方宗教信仰者比無宗教信仰或西方宗教信仰者更傾向於剖腹生產。 儘管衛生行政單位非常努力的降低剖腹產率，不過離理想的剖腹產率還是有偏高的現象。從研究結果可以發現，產婦生產知識的高低會影響其生產方式，若衛生主管及其他相關團體能積極推動衛生教育，建立醫療網路教育專欄、提供相關的生產知識及推廣生產之相關議題的宣傳廣告，使產婦對生產的知識充分了解，相信對剖腹產率能有相當的影響。

關鍵字

剖腹生產 ； 母親要求

並列摘要

Abstract The cesarean section rate in Taiwan was maintained above 33% for the past five years, which is significantly higher than the 15% maximum recommended by the World Health Organization. High cesarean section deliveries are associated with higher maternal mortality and mobility, in addition it also requires longer hospital stays, more surgical materials, personnel and place, overloading the already strained health care budget. Although several studies have appeared in literature regarding the mode of delivery, very little research is available pertaining to measure women’s knowledge and opinion in the decision making of delivery by caesarean section. The purpose of this study was to measure the influence of maternal factors toward the mode of delivery. This study used a cross-sectional survey, focusing on delivered woman, which were asked to fill out a self-administered questionnaire. A sum of 119 cases wes enrolled. The following are the major findings of the research: 1) Woman with private insurance had cesarean sections more often than the others. 2) Age is one of the factors associated with the mode of delivery. 3) Income differences are likely to affect maternal preference for cesarean delivery. 4) Delivered woman with highest scores of knowledge assessment about complications of labor and vaginal delivery were largely preferred a vaginal delivery. 5) Cesarean sections were more common among women who had work. 6) Woman with oriental religions had cesarean sections more often than the others. Despite the effort from government health institute, cesarean rate remained far from ideal in Taiwan. From the result of this study, we can see the importance of knowledge assessment concerning complications of labor and vaginal delivery. The education and the resource information should be provided via multiple pathways.

並列關鍵字

cesarean section ； maternal request

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