目的 了解产妇产后避孕健康信念状况及影响因素,为改善产后避孕服务提供依据。方法 以健康信念模式(health belief model,HBM)为框架,采用横断面研究,以2023年6—11月在上海市长宁区妇幼保健院住院分娩的产妇及其配偶为研究对象,于产妇产后住院期间在经过培训的专职医护人员指导下完成线上问卷填写,问卷内容包括产妇产后避孕健康信念及其产后避孕认知及态度,并调查配偶的产后避孕认知与态度,以分析其对产妇健康信念的影响。采用二元logistic回归分析对影响产妇产后避孕健康信念得分、自我效能得分的因素进行分析。结果 共调查产妇及其配偶846对,以100分为满分标化各量表得分,产妇产后避孕健康信念得分中位数为80.0(72.4,88.0)分,其中自我效能得分中位数74.4(64.4,82.2)分。二元logistic回归分析结果显示,本地户籍、家庭年可支配收入20万元以上的产妇产后避孕健康信念优良率(得分≥80分)更高(均P<0.05);产妇产后避孕自我效能除受本人认知、态度影响外,还受其配偶产后避孕态度影响,差异均有统计学意义(均P<0.05)。结论 产妇产后避孕健康信念总体良好,但应关注低“自我效能”对产后避孕实际落实的影响。同时,应重视男性产后避孕态度对产妇产后避孕自我效能的影响,提升男性避孕态度,从而改善产妇产后避孕行为的采取情况。

Objective To investigate the status quo of postpartum contraceptive health beliefs among puerperae in Shanghai and identify their influencing factors, thereby providing references for further optimizing postpartum contraception services in China.Methods A cross-sectional study based on Health Belief Model(HBM) was conducted to administer an online questionnaire survey among puerperae who were hospitalized for delivery at Shanghai Changning Maternal and Child Care Health Hospital from Jun 2023 to Nov 2023, along with their spouses. The online questionnaires—completed during the puerperae's postpartum hospital stay under the guidance of trained full-time medical staff—included the postpartum contraceptive health belief scale of puerperae, as well as the the puerperae's knowledge and attitude toward postpartum contraception. Additionally, this study investigated the spouses' knowledge and attitude toward postpartum contraception to analyze their influence on the health beliefs of puerperae. Binary logistic regression analysis was used to identify the factors affecting the postpartum contraceptive health belief scores and self-efficacy scores of puerperae. Results A total of 846 puerperae and their spouses were included in the study. All scale scores were standardized to a 100-point scale. The postpartum contraceptive health belief median score was 80.0(72.4, 88.0) points, while the self-efficacy median score was 74.4(64.4, 82.2) points. Binary logistic regression analysis showed that puerperae with local household registration and an annual disposable income of more than 200 000 RMB had significantly higher prevalence of favorable postpartum contraceptive health belief(score ≥ 80)(all P < 0.05). In addition to the the puerperae's own knowledge and attitudes toward contraception, their self-efficacy scores were also influenced by their spouses' attitudes toward postpartum contraception, and these associations were statistically significant(all P < 0.05). Conclusions Postpartum contraception health beliefs are generally positive among puerperae, but the influence of low self-efficacy on actual contraceptive practice warrants attention. Additionally, it suggest to realize the influence of spouses' attitudes toward postpartum contraception on puerperae's postpartum contraceptive self-efficacy, and enhance men's contraceptive attitudes, to improve the adoption of postpartum contraceptive behaviors among puerperae.