摘要
Objective To survey the current situation of fertility intention to have a third child among childbearing age women in Wanzhou District of Chongqing Municipality under the background of the new fer-tility policy,and to analyze its influencing factors.Methods The convenience sampling method was adopted to conduct the survey on the third child fertility intention by the self-designed questionnaire and the Question-naire Star platform among the childbearing women with one child or two children in Wanzhou District of Chongqing Municipality from September to October 2022.The multiple linear regression analysis and two-step cluster analysis were used to explore the influencing factors.Results A total of 632 questionnaires were re-ceived,32 invalid questionnaires were excluded,and the effective recovery rate was 94.9％.The score of fertili-ty intention to have a third child in the respondents was(12.81±2.83)points.The multiple linear regression analysis showed that the age,marital status,place of residence,spouse cultural degree,family rearing child model,whether the family can provide support and previous vaginal delivery history were the influencing fac-tors of fertility intention to have a third child among the childbearing age women in this place(P＜0.05).The two step cluster analysis showed that"obstetrician/midwife's help"was the most important predictive factor for the childbearing age women to choose to have a third child.Conclusion The current situation of childbear-ing age women's fertility intention to have a third child in Wanzhou District of Chongqing Municipality is not optimistic.It is necessary to create the positive factors that encourage childbearing age women to make deci-sion about having a third child.
摘要
Objective To investigate the pathological escalation after cervical cone resection in postmenopausal women, and analyze the related influencing factors. Methods A retrospective cohort study was conducted at the Sir Run Run Shaw Hospital,School of Medicine, Zhejiang University between July 2013 and January 2015. Seven hundred and fifty cases of cervical cone-cut were enrolled in this study, 129 cases of them were postmenopausal women, and 621 were premenopausal women. All results of patients'liquid-based thin-layer cytology(TCT), HPV test, colposcopy and biopsy pathology, cervical cone resection and postoperative pathological examination were collected. Then the compliance with the pathological examination results after colposcopic cervical biopsy and cervical cone resection, and the related factors affecting the pathological escalation after cervical cone resection were analyzed. The pathological escalation of patients with different menopausal conditions after cervical cone resection was also analyzed. Results (1)Of the 750 patients, there were 329 patients had the same pathological examination results after colposcopic cervical biopsy and cervical cone resection, which accounted for 43.9％(329/750). And 216 cases demonstrated pathological escalation after cervical cone resection, which accounted for 28.8％(216 / 750). The results of TCT examination and menopause were significantly correlated with the pathological escalation after cervical cone resection(P<0.05). However, the condition of HPV infection was unrelated to pathological escalation after cervical cone resection(P>0.05).(2)Compared with the different results of TCT examination [including non-intrusive load monitoring(NILM), atypical squamous cell of undetermined signification (ASCUS), low-grade squamous intraepithelial lesion (LSIL), high-grade squamous intraepithelial lesion(HSIL)], the ratio of pathological escalation after cervical cone resection was not statistically significant difference between postmenopausal and non-menopausal patients(P>0.05). The proportion of pathological escalation of patients with >5 years of menopause was significantly higher than that of patients with menopause time ≤5 years(40.3％ vs 27.7％, OR=1.8, 95％CI: 1.1-2.8, P=0.029). Among them, when the result of TCT examination was LSIL, the rate of pathological escalation in patients >5 years of menopause was significantly higher than that in menopause time ≤5 years(6/10 vs 26.3％, OR=4.2, 95％CI: 1.1-15.8, P=0.033). While the results of TCT examination were NILM, ASCUS or HSIL showed there was no statistically significant difference between two groups(P>0.05).(3)Among the 143 cases, of which the result of TCT examination was LSIL, 9 cases of the pathological examination results after cervical resection were escalated to cervical cancer, which accounted for 6.3％ (9 / 143). Among 10 cases of menopause time >5 years, 2 cases(2 / 10)of the pathological examination results after cervical cone resection were escalated to cervical cancer. Among 133 cases with menopause time ≤ 5 years, 7 cases (5.3％)were upgraded to cervical cancer after cervical cone resection. The ratio of pathological escalation to cancer in postmenopausal patients with >5 years was higher than that of menopause time ≤5 years. Due to the data volume limitation, the comparison was not statistically significant difference(χ2=0.460, P>0.05). Conclusions In postmenopausal women, especially when menopausal time is > 5 years, the proportion of pathological escalation after cervical cone resection following colposcopic cervical biopsy is increased. And the pathological escalation after cervical cone resection is significantly correlated with the results of TCT examination and menopausal status. Therefore, doctors should treat the colposcopic biopsy pathological results with caution during clinic. Depending on TCT results, loop electrosurgical excision procedure (LEEP) sampling could be administrated directly in case of avoid missing diagnosis.
摘要
Objective To investigate the attitude of PhD nursing students towards clinical work. Methods A qualitative research was made to ten full-time PhD students in nursing from six universities in a semi-structured interview,with the data so acquired analyzed using Colaizzi phenomenological methedology. Results Four themes were extracted from the analysis.They are their evaluation on nursing career and clinical work;their role in clinical work;their concerns for engaging in clinical work;and their expectations for clinical work.Conclusions Some of the nursing PhD students intend to engage in clinical nursing work after graduation, yet not without concerns, namely decent positions and career development.In this consideration,nursing administrators should take into full account of the students′career expectations and value their important role in this field.In addition, a scientific hierarchical management system should be established,suitable positions should be set up, and new fields of clinical nursing practice explored, in order to fully leverage their talents and promote disciplinary progress to the field of nursing.