| Objective:To complete the questionnaire on the influencing factors of the second child ’s fertility desire of clinical nursing staff in the 3A hospitals and apply it to the actual investigation and study,to learn the current situation of the clinical nursing staff of3 A general hospitals in Nanchang at the background of the policy of "comprehensive two children",and to explore the influencing factors.To provide some references for the development of hospital nursing management work,the rational allocation of medical resources,the promotion of maternal and child health and better care for women and children,to serve the community.to provide empirical and scientific basis for our country to carry out fertility policy researches.Methods:1.Document analysis: Based on collecting and summarizing the relevant literatures at home and abroad,combined with the timeliness of the new policy,the purpose of this investigation and the questionnaire of the survey contents were initially determined.2.Semi-structured interview: used semi-structured interviews of qualitative research to collect the information of fertility desire of the interview object and build the initial content framework of the fertility desire about second child of the clinical nursing staff of 3A hospitals child.3.Delphi method : chose long-term engaged in nursing education experts,gynecology and obstetrics clinical experts,obstetrics and gynecology nursing experts and three first-class hospital care managers a total of 16 people as the assessment of the questionnaire experts,Letter to determine the "three general hospital clinical care workers in the two child fertility desire questionnaire".4.Questionnaire survey: 526 clinical nurses in Nanchang Sanjia GeneralHospital were selected by stratification and cluster sampling method.The self-made questionnaire was used in the "Three-child Fertility Willingness Questionnaire" General situation,fertility intention and influencing factors.5.Statistical methods: All valid data collected were analyzed by SPSS 17.0statistical software.The measurement data were described by mean ± standard deviation.The counting data were calculated by frequency and composition ratio.The factors influencing fertility were investigated by single factor chi-square test and multivariate logistic regression.Results:(1)literature analysis and semi-structured interviewsIntegrated literature and the results of the group discussion,the preliminary development of the three general hospital clinical care workers in the second child fertility willingness questionnaire content framework,including four content dimensions that: personal circumstances,marriage and the situation and the external environment and fertility desire.In order to make the contents of the questionnaire more complete and complete,after the analysis of further qualitative interviews,access to six themes: theme one:fertility will be affected by the needs of husband and elders;theme two: fertility will be affected by economic factors;theme three: Birth and child status affect fertility;theme four: care work to reduce fertility;theme five: personal ideas in the fertility of autonomy;theme six: fertility behavior will affect the work.Combined with literature review,group discussion and semi-structured interviews,the preliminary formulation of a questionnaire containing four dimensions and 33 entries,the Delphi expert letter.(2)Delphi expert letter resultsThe recovery rate of the two rounds of the questionnaire is 100%,of which the first round of the proposed amendments to the experts a total of 16,accounting for100%,the second round of the proposed amendments to a total of four experts,accounting for 25.00%,expert positive coefficient.Expert authority factor Cr = 0.866.The final secondary entry has a Kendall coefficient of 0.229,and the expert opinion isbetter coordinated.The reliability of the questionnaire is good.The Cronbach’s alpha coefficient for the first round of the questionnaire is 0.709 and the Cronbach’s alpha coefficient for the secondary index is 1.000.The Cronbach’s α coefficient is 0.742,and the Cronbach’s α coefficient of the secondary index is 0.861.The content level index(I-CVI)of the entry level is 0.895.At the end of the letter,the final formation of a questionnaire containing six dimensions,a total of 60 items of fertility desire questionnaire.(3)Questionnaire results(1)Nanchang three general hospital clinical nursing staff personal basic situationThe survey of 526 Nanchang Sanji General Hospital in marriage clinical care staff,aged 22~48 years old,the average age(32.52 ± 5.71)years,mainly in the Han nationality,local non-farm households accounted for 85.2%,with college and undergraduate,The first marriage age and initial age of age concentrated in the 25~27 years old,a child sex distribution is more uniform,male to female ratio of about1.11,monthly income concentrated in 3000~5000 yuan,formal workers accounted for 47.1%,of which 78.7% care Personnel for the division of nurses,mainly in the internal and external women and women and other major clinical departments,work6 ~ 10 years are the most,and there is a large work pressure,mainly from nurse-patient relationship,health care relations and colleagues.(2)The basic situation of fertility willingness of clinical nursing staff in the 3A General Hospital in NanchangThe number of ideal children,79.5% of the respondents the best number of children for the two children;but fertility is not high,only 40.1% want to have two children.Willingness to sex,boy preference weakened,girls prefer to enhance.In the case of fertility planning,the implementation of the policy of "comprehensive two children" in the short term will not cause the phenomenon of population accumulation,and the total birth population is controllable.81.9% of the people because of the cost is too high,the economic burden of life is not willing to give birth to two children.The traditional idea of "more children and more blessing","raising children" and "increasing labor force" has gradually weakened,and the motive of fertility has been changed to the love of children,and the growth of children has been promoted.(3)the influencing factors of fertility desire of second childAccording to the logistic regression analysis of fertility willingness,it can be seen that the nursing work and the "working form","patient requirement","doctor’s request","colleague understanding degree" and "job satisfaction degree" in the external environment level are significant influences."The level of childbirth","the type of household registration","husband’s fertility","monthly income" on whether or not two children have an impact;"first-child sex" "Husband age","husband’s education level" had a significant effect on the sex of the two wives.The influence of husband’s age and health status on the two-child birth plan was statistically significant.Conclusion:The self-made questionnaire has good reliability and validity and can be used for investigation and study.the policy of "comprehensive two children" has inspired the fertility desire of clinical nursing staff in the Nanchang 3A hospitals,boys preference has become weaker,but the gender preference still exists,and biased towards girls.Second child’s fertility plan urgency is not high,which will not cause the phenomenon of population accumulation in Nanchang.The role of economic factors in fertility is obvious,the role of non-economic factors continue to strengthen.Faced the fertility behavior in the future,clinical care workers,departments and hospitals should be under the premise of accurate prediction to do self-management,care management and care for women and children.Clinical care workers should pay attention to their own health,care management should manage scientifically,and create a comfortable working environment,the hospitals should be a reasonable allocation of obstetric resources,the state also need to establish a complementary policy to promote the work of women and children to promote the work,but also do statistical research work which is related comprehensive two children policy for better scientific decision-making in the future. |
