人工流产后关爱的不同随访模式应用及 影响因素的研究

Research on the Application and Influencing Factors of Different Follow-Up Models of Care after Induced Abortion

摘要: 目的：探讨人工流产后关爱(post abortion care, PAC)远程平台随访模式的应用，将其与传统的电话随访模式进行对比，对比两种不同随访模式的有效随访率及影响因素。方法：选择2023.4.1~2024.3.31在通用医疗三六三医院行人工流产术并接受PAC服务的137例女性为研究对象，采用随机抽样的方法，2023.4.1~2023.9.30期间的人工流产患者为对照组，采用电话进行随访，2023.10.1~2024.3.31期间的人工流产患者为观察组，采用随访系统进行随访。随访平台根据受试者加入的时间还有手术日期，就会自动生成术前准备清单，并且可以生成术后各个时间段的电子问卷，1周、1月、3月、6月以及12个月，并且能够随时进行上传储存。当发现有延迟提交的情况时，会通过系统提示通知相关人士补充完整信息，对照组使用传统电话方式开展定期跟踪访谈，在规定时间内正常拨打语音通话即可完成日常的询问过程，对于未及时反馈的对象再次联系确认，把所有随访资料集中起来保存好，研究团队主要对两组样本在不同随访时间的有效回访率做比较分析工作，并对随访平台未完成随访表的对象电话回访，收集影响有效随访率的因素汇总并分析。结果：由研究数据可知，两组样本术后一周随访率均为100%，经统计学检验显示各时间点有效随访率存在显著性差异：术后一个月(87.32% vs 72.73%, P < 0.05)；三个月(84.51% vs 66.67%, P < 0.05)；六个月(83.1% vs 60.61%, P < 0.05)，一年时随访率接近(59.15% vs 51.52%, P > 0.05)。观察周期越长，患者的有效随访比例就越低，且线上平台开展的随访相较于电话方式具有明显优势。此外，分析了不同民族(藏族和汉族)的失访率比较，差异无统计学意义(P > 0.05)。并分析了两种不同随访方式的优缺点。结论：PAC术后随访应提供“电话 + 小程序”的选项，让受访者根据自己的偏好和条件自由选择，这能从根源上降低失访率，从而使PAC能够持续发展，更好地服务于社会大众。

Abstract: Purpose: This study explores the application of a remote platform follow-up model for post-abortion care (PAC) and compares it with the traditional telephone follow-up model. The effective follow-up rates and influencing factors of the two different follow-up models are compared. Methods: A total of 137 women who underwent artificial abortion and received PAC services at the 363rd Hospital of General Medical Services from April 1, 2023 to March 31, 2024 were selected as the research subjects. A random sampling method was used. Patients who underwent artificial abortion from April 1, 2023 to September 30, 2023 were assigned to the control group and followed up by phone. Patients who underwent artificial abortion from October 1, 2023 to March 31, 2024 were assigned to the observation group and followed up through the follow-up system. The follow-up platform automatically generates preoperative preparation lists based on the time of the subjects’ enrollment and the date of the surgery, and can generate electronic questionnaires for different postoperative time periods, namely 1 week, 1 month, 3 months, 6 months, and 12 months. It also allows for real-time upload and storage. When there is a delay in submission, the system will prompt and notify relevant personnel to complete the information. The control group used the traditional phone method for regular follow-up interviews. Normal voice calls were made within the specified time to complete the daily inquiry process. For those who did not respond in a timely manner, they were contacted again for confirmation. All follow-up data were collected and stored. The research team mainly compared and analyzed the effective follow-up rates of the two groups at critical moments and conducted telephone follow-ups for those who did not complete the follow-up forms on the follow-up platform. The factors affecting the effective follow-up rate were collected, summarized, and analyzed. Results: The follow-up rate of the two groups of follow-up subjects one week after the operation was 100%. The comparison of the effective follow-up rate one month after the operation (87.32% vs 72.73%) showed a statistically significant difference (P < 0.05). The comparison of the effective follow-up rate three months after the operation (84.51% vs 66.67%). The difference was statistically significant (P < 0.05). The comparison of the effective follow-up rate at 6 months after the operation (83.1% vs 60.61%) was statistically significant (P < 0.05), and the comparison of the effective follow-up rate at 12 months after the operation (59.15% vs 51.52%). There was no statistically significant difference (P > 0.05). As time goes by, the effective follow-up rate of patients becomes lower. Among them, the effective follow-up rate of the follow-up platform is higher than that of the telephone. And the advantages and disadvantages of two different follow-up methods were analyzed. Conclusion: The follow-up after PAC surgery should offer the option of “telephone + mini-program”, allowing respondents to freely choose according to their preferences and conditions. This can fundamentally reduce the rate of loss to follow-up. Only in this way can PAC achieve sustainable development and better serve the general public.