| Abstract | Cilj: Prikazati trenutno stanje u Republici Hrvatskoj u svezi s reproduktivnim zdravljem i planiranjem obitelji te naglasiti važnost javnozdravstvenog problema demografskog starenja i reproduktivnog zdravlja u našoj sredini. Povezati postojeće objavljene rezultate za Republiku Hrvatsku u odnosu na stavove studenata Sveučilišta u Splitu. Posebnu pažnju usmjeriti prema različitim stavovima po spolu i razlikama u stavu u svezi sa znanjem o predmetu istraživanja.
Materijal i metode: Prilikom izrade ovog rada korišteni su podatci objavljeni u Zdravstveno - statističkom ljetopisu HZJZ objavljenom 2014. godine. Temeljem objavljenih podataka izrađene su tablice i grafikoni kako bi prikazali jasnu sliku trenutnih zbivanja u Republici Hrvatskoj povezanih sa zadanim predmetom istraživanja. U drugom dijelu istraživanja stavova studenata o kontracepciji korišten je Upitnik kontracepcijskog stava autorice Kelly J. Black sa Sveučilišta u Washingtonu, objavljenoj u knjizi Sexuality – RelatedMeasures, autori: Terri D. Fisher, Clive M. Davis, William L. Yarber i Sandre L. Davis objavljenoj po treći put 2011. godine, Routledge, New York, SAD. Ispitanici testirani u ovom istraživanju su studenti Sveučilišta u Splitu, Medicinskog i Pomorskog fakulteta. U statističkoj obradi podataka koristili smo T - test za usporedbu nezavisnih varijabli. Nakon analize brojčanih vrijednosti Skale Kontracepcijskog Stava (CAS) željeli smo utvrditi razlike u pojedinim skupinama. Prilikom obrade podataka koristili smo statistički paket Medical filter version 15. Rezultati su interpretirani na razini značajnosti P < 0,0001.
Rezultati: U 2013. godini u skrbi ginekologa u primarnoj zdravstvenoj zaštiti žena bilo je 1.626.373 žena što je za 4,5% više u odnosu na 2012. Od ukupnog broja žena koje su izabrale svog ginekologa u primarnoj zdravstvenoj zaštiti njih 593.336 ili 36,5% je i koristilo usluge što je 2,3% više u odnosu na prethodnu godinu. Najčešći razlozi zbog kojih su žene dolazile u ginekološku ordinaciju odnosilo se na bolesti mokraćnog i spolnog sustava (49%), čimbenike koji utječu na stanje zdravlja i kontakt sa zdravstvenom službom (29%) i najmanji broj intervencija poduzet je u cilju liječenja novotvorina (5,60%) te zaraznih bolesti (4%). Intervencije kontrole trudnoće, porođaja i babinja iznosile su deseti dio od ukupno učinjenih (9,80%) . Prema udjelu pojedinih savjeta vezanih uz kontracepciju u ginekološkoj PZZ u RH u 2013. godini, 90% zatraženih savjeta odnosilo se na primjenu oralnih kontraceptiva, 4% na primjenu intrauterinog uloška, 2% na lokalne kontraceptive, 4% na neke druge oblike kontracepcije, a diafragma kao sredstvo zaštite od neželjene trudnoće je gotovo neprepoznata u ženskoj populaciji Republike Hrvatske.
Prema podatcima dobivenih iz upitnika proizašli su rezultati.
U istraživanju testirano je 274 ispitanika. Najmanji ponuđeni zbroj bio je 41 kao najnegativniji stav prema kontracepciji. Najveći zbroj, a time i najpozitivniji stav, bio je 150. Najveći broj odgovora grupiran je u interval između 102 i 127. Aritmetička sredina je 115,1934, a medijan, kao brojčana vrijednost oko koje je grupirana većina podataka, je 114.
Aritmetička sredina zbroja brojčanih vrijednosti pojedinih odgovora ispitanih studenata Pomorskog fakulteta je 107,755, a aritmetička sredine zbroja brojčanih vrijednosti pojedinih odgovora ispitanih studenata Medicinskog fakulteta je 119,605. Primjenjenim T - testom uočljiva je značajna razlika u stavovima studenata Pomorskog i Medicinskog fakulteta s vjerojatnošću P<0,0001. Aritmetička sredina zbroja brojčanih vrijednosti pojedinih odgovora ispitanih studenata je 112,7089, a aritmetička sredine zbroja brojčanih vrijednosti pojedinih odgovora ispitanih studentica je 118,5776. Primjenjenim T - testom uočljiva je značajna razlika u stavovima studentica i studenata. Aritmetička sredina zbroja brojčanih vrijednosti pojedinih odgovora ispitanih studenata na 1. godini Medicinskog fakulteta je 119,6463, a aritmetička sredina zbroja brojčanih vrijednosti pojedinih odgovora ispitanih studenata na 5. i 6. godini Medicinskog fakulteta je 119,4032. Vidljiva je mala razlika u stavu na kraju studija u odnos na stav studenata koji su na početku edukacijskog procesa.
Zakljuĉci: Podatci objavljeni u Zdravstveno statističkom ljetopisu HZJZ objavljenom 2014. godine navode nas na zaključak o starenju ženske populacije i sve manjoj mogućnosti obnavljanja demografske slike povećanjem nataliteta. Tek manji broj žena svake godine posjeti ginekologa PZZ, što ukazuje na ne korištenje mogućnosti preventivnih pregleda. Prema udjelu pojedinih savjeta vezanih uz kontracepciju u ginekološkoj PZZ u RH u 2013. godini vidljivo je da se gotovo svi zatraženi savjeti odnose na primjenu oralnih kontraceptiva, a da diafragma kao sredstvo zaštite od neželjene trudnoće je gotovo neprepoznata u ženskoj populaciji Republike Hrvatske.
Studenti Medicinskog fakulteta imaju pozitivniji stav o kontracepciji u odnosu na ispitane studente Pomorskog fakulteta. Uočljiva je značajna razlika u stavu studenata grupiranih po spolu, a pozitivniji stav bio je kod studentica. Prema zbroju odgovora ispitanih studenata Medicinskog fakulteta grupiranih prema godini studija u dvije grupe (početak i kraj studija) nije nađena značajna razlika u stavovima studenata s obzirom na znanje stečeno tijekom studija. |
| Abstract (english) | Objective: To describe the current situation in the Republic of Croatia in relation to reproductive health and family planning and to emphasize the importance of the public health problems of demographic ageing and reproductive health in our community. Link existing published results for the Republic of Croatia in relation to the attitudes of students at the University of Split. Special attention directed to different positions according to gender and differences in attitude with knowledge of the case studies.
Materials and Methods: During the preparation of this study we used data published in Health Statistics Annals HZJZ published in 2014. Based on published data we made tables and graphs to display a clear picture of the current events in Croatia associated with the default subject of research. In the second part of research we used a questionnaire Contraceptive Attitude Scale author Kelly J. Black of the University of Washington, published in the book Sexuality - RelatedMeasures authors: Terri D. Fisher, Clive M. Davis, William L. Yarber and Sandra L. Davis published for the third time in 2011, Routledge, New York, USA. The subjects tested in this study were students of the University of Split (Faculty of the Medicine and Faculty of the Maritime Studies. For statistical analysis we used the T - test to compare independent variables. After analyzing the numerical values Contraceptive Attitude Scale (CAS), we wanted to determine the differences in the groups. During processing the data we used a statistical package version 15 Medical filter. Results were interpreted at the level of significance of P <0.0001.
Results: In 2013, in the care of gynecologists there were 1,626,373 women, which is 4.5% more than in 2012. Of the total number of women who have chosen their gynecologists in primary health care 593,336 women or 36,5% of the total number of women used service which is 2.3% more than in the previous year. The most common reasons why women were in the gynecological clinic were related to diseases of the urinary and genital tract (49%), the factors that influence health status and contact with health services (29%) and the lowest number of interventions have been taken in order to cure neoplasms (5,60%) and infectious diseases (4%). Interventions control of pregnancy, childbirth and puerperium amounted to a tenth part of the total interventions (9.80%). According to the share of individual advice related to contraception in gynecological PHC in Croatia in 2013, 90% of the requested advice related to the use of oral contraceptives, 4% to the application of an intrauterine device, 2% in local contraceptives, 4% to other forms of contraception, and the diaphragm as a means of protection against unwanted pregnancy is almost unrecognized in women in Republic of Croatia.
According to data obtained from the questionnaire results are derived.
In the study were tested 274 subjects. The minimum sum was 41 as the most negative attitude towards contraception. The largest sum, and the most positive attitude, was 150. The largest number of responses is grouped in the interval between 102 and 127. The arithmetic mean is 115.1934, and the median, as a numerical value around which most of the data is grouped, is 114.
The arithmetic mean of the sum of the numerical values of the individual responses of the tested students of Maritime Faculty is 107,755 and the arithmetic mean of the sum of the numerical values of the individual responses of the tested students of the Faculty of the Medicine is 119,605. Applied T - test reveals a significant difference in the attitudes of students of the Maritme Faculty and students of the Faculty of Medicine with a probability P <0.0001. The arithmetic mean of the sum of the numerical values of the individual responses of the tested male students was 112.7089 and the arithmetic mean of the sum of the numerical values of the individual responses of the tested female students is 118.5776. Applied T - test reveals a significant difference in the attitudes of students. The arithmetic mean of the sum of the numerical values of the individual responses of the tested students at 1st year of the Faculty of Medicine is 119.6463 and the arithmetic mean of the sum of the numerical values of the individual responses of the tested students in the 5th and 6th year of the Faculty of Medicine is 119.4032. It is evident little difference in attitude at the end of the study in relation to the attitude of students who are at the beginning of the educational process.
Conclusions: The data published in Health Statistics Annals HZJZ published in 2014 led us to the conclusion of the ageing of the female population and the less opportunities for the revitalization of the demographic picture by increasing the birth rate. Only a small number of women a year visit a gynecologist PHC, which indicates no use of the possibilities of preventive examinations. According to the share of individual advice related to contraception in gynecological PHC in Croatia in 2013 shows that nearly all the requested advice referred to the application of oral contraceptives and the diaphragm as a means of protection against unwanted pregnancy is almost unrecognized in women in Republic of Croatia.
Students of the Faculty of Medicine have a positive attitude about contraception compered to the tested students of the Maritime Faculty. Noticeable is a significant difference in the attitude of students grouped by gender and the positive attitude about contraception was at female students. According to the sum of the responses of the tested medical students grouped according to the year of study in the two groups (1 st and final year of study ( 5th and 6th)) we did not find significant differences in the attitudes of students with regard to the knowledge acquired during their studies. |
