目的 了解流动育龄妇女围孕保健服务现状和满意程度,分析其满意度的影响因素,为改善流动育龄妇女的优生健康质量提供依据。方法 利用2005年北京、南京、厦门、深圳和重庆五城市流动人口生殖健康抽样调查数据,描述分析流动育龄妇女围孕保健服务利用及满意程度分布情况,对影响满意度的有关因素进行多因素分析。结果 5 399例有效调查问卷中,流动育龄妇女在流入地的围孕保健服务利用率为41.1%,其中对服务满意者占63.3%。多因素Logistic回归分析发现,流动育龄妇女对围孕保健服务的满意度在调查地区间存在差别,差异有统计学意义;自评健康状况一般(OR=1.79,95%CI:1.43~2.25)或身体状况差(OR=1.87,95%CI:1.10~3.16)、检查婚育证明(OR=1.63,95%CI:1.20~2.22)、未参加计生部门宣教活动(OR=1.28,95%CI:1.04~1.57)、自行前往参与服务(OR=1.54,95%CI: 1.22~1.94)、付费检查(OR=1.36,95%CI:1.08~1.72)、服务态度差(OR=2.33,95%CI:1.81~2.99)、设施环境差(OR=1.54,95%CI:1.20~1.97)与较高的不满意度存在统计学关联。结论 自评健康状况一般或差、无婚育证明、未参加计生部门宣教活动、自行前往孕检、付费检查、服务态度差、设施环境差与较高的不满意度有关,建议将计生服务与围孕保健相结合、积极促进流动育龄妇女社会融入、提供优惠、专业的保健服务,提高流动育龄妇女对围孕保健服务满意度,有助于降低不良妊娠结局发生风险。

Objective To understand current status of periconceptional health care and satisfaction towards the service among floating childbearing age women. Methods Using data from reproductive health survey of floating population from five cities in 2005, we analyzed the distributions of periconceptional health care services and perceived satisfaction among floating women. Results Among 5 399 cases with valid questionnaires, 41.1% of floating women received periconceptional health care in the inflow areas. Among them, 63.3% satisfied with the service. Self-rated health status as “fair” (OR=1.79, 95% CI:1.43-2.25) or “poor” (OR=1.87, 95% CI: 1.10-3.16), without being checked family planning certificate (OR=1.63, 95% CI: 1.20-2.22), not attending outreach activities (OR=1.28, 95% CI: 1.04-1.57), seeking examination by themselves (OR=1.54, 95% CI: 1.22-1.94), self-payment for the examination (OR=1.36, 95% CI: 1.08-1.72), bad service attitude (OR=2.33, 95% CI:1.81-2.99), and poor facilities and circumstance (OR=1.54, 95% CI: 1.20-1.97) were associated with the odd of dissatisfaction. Conclusion Several personal and service-related factors were identified to be associated with dissatisfaction with preconceptional care services. Combining family planning service and periconceptional health care, actively promoting the social integration among floating women of childbearing age, and providing favorable and professional service may help improve service satisfaction.