產後性生活衛教需求評估研究：教育及行政診斷

Needs Assessment of Postpartum Sexual Health Education: Based on Educational and Administrative Diagnostic of PRECEDE Model

本研究旨在評估產婦性生活衛教需求，參考PRECEDE模式，分別依教育及行政政策診斷面向進行評估研究，以助於研擬符合產婦性健康需求與實務現況之產後性生活衛教策略。教育診斷係針對產婦之「人口學特性」、「產後性知識」與「產後性態度」進行評估，以台灣北部一所醫學中心婦產科病房為取樣場所，取得260名產婦，以自填式問卷進行調查。行政及政策診斷層面則以12位臨床專家為對象，以「專家意見問卷」，請專家針對產後性生活衛教執行現況與建議提供意見。 結果顯示產婦對「預防陰道鬆弛之運動」與「男性輸精管結紮對生理之影響」有錯誤認知；對「產後性知識可減少產後性生活壓力」以及「夫妻性溝通」在產後性生活扮演的角色多持肯定態度。行政診斷結果發現，產後性生活衛教主力以「產後病房護理人員」為主，教材則多採「衛教單張或手冊」，而綜合「教學訊息內容不一」、「教材缺乏」及「統籌與負責規劃的專責單位不一」等專家意見，本研究提出未來產後性生活衛教發展策略建議。

This study examines the demand for sexual health education among postpartum women to develop appropriate strategies for sexual health education in line with the actual situation. This article describes the use of educational and administrative diagnostic from the PRECEDE model as a conceptual framework for needs assessment for postpartum sexual health education. Educational diagnosis is aimed at women's “demographic characteristics”, “postpartum sexual health knowledge” and “sexual health attitudes”. Two hundred and sixty participants were recruited at a medical center in Northern Taiwan to fill in a self-report questionnaire. The administrative and policy diagnosis is designed to understand the current hospital implementation of postpartum sexual health education as well as the expert' opinions. Twelve clinical experts were recruited at six teaching hospitals to fill in a self-report “expert opinion questionnaire”, to offer advice for the postpartum sexual health education program. The data were processed through the SPSS Window's 11.0 package. The results showed that women have cognitive errors in “the prevention of vaginal movement relaxation” and “men with vasectomies on the physiological effects”. In sexual attitude, women still have a conservative attitude toward the timing of sexual life resumption. However, most of the women had a positive attitude in “obtaining postpartum sexual health knowledge to reduce the pressure from postpartum life” and “good communication relationship between the couple can promote postpartum quality of life”. The administrative diagnostic results showed that “the postpartum ward nurses” were the major clinical teaching force and “health education leaflets or manuals” were the major teaching material on postpartum sexual health education. According to the research findings, “the contents of teaching were not consistent unified”, “there was not enough teaching material”, and “The level of the unit responsible for integrating and planning is not unified” offered by experts, a development strategy for postpartum sexual health education is suggested to help develop postpartum sexual health education strategies and clinical plans.