S dng k thut phn tch sng cn (survival analysis) tm hiu c im tui dy th v thnh nin ti Ch Linh, Hi Dng

Nguyn Vn Ngh

Trng i hc YTCC

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Ni dung trnh by

t vn Phng php nghin cuKt quBn lun, kt lunKhuyn ngh

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t vn

Tui VTNDy th: Bt u trong khong 9 17 tui ko di 3 - 4 nm vi n v 4-5 nm vi nam (ng h sinh hc)Nghin cu Quan nim, hnh vi tnh dc v SKSS VTN. Mt s bo co, bi vit, trnh by chuyn

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Mc tiu nghin cu

M t c im dy th v thnh nin v mt s yu t lin quan

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Phng php nghin cu

Nghin cu SK thanh thiu nin ti Chililab AH1 vng 1, vng 2, AH2 S liu nh lng s dng trong nghin cuPhn tch nh lngPhn tch m t n binX l s liu mtPhn tch nh bin, a binPhn tch survial analysis

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Kt qu

c im VTN tham gia nghin cu (AH1 vng 1)9220 VTN cha kt hn chim 99%, gm 4720 nam (51,2%) v 4500 n (48,8%). Dn tc Kinh 99,7%, khng tn gio 99,9%, hc sinh 85,1%. Dy th (c xut tinh ln u, kinh nguyt ln u): Tui dy th (th): 15 tui (nam), 14 tui (n)69,3% nam, 77% n dy thX l s liu mt EM (1/5 n, 1/2 nam TDT)Tui dy th hiu chnh: 14,3 t (nam), 13,8t (n) -nhm dy thTui dy th ca ton b VTN 10-19 tnh theo nm ngi (Person year) l: 14t (nam), 13,4t n

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Tui dy th VTN theo gii tnh, ni , kinh t G

NamNS VTNTui dy th TBT l % dy thS VTNTui dy th TBT l % dy thNhm tui 10-14t221213,253,720251353,215-19t250815,783,1247514,596,4Ni Thnh th22531569,221991479,6Nng thn246715,369,4230114,474,5Kinh tNgho131315,167,6125114,371,7Trung bnh178115,168,8168314,376Kh, giu162614,971,1156613,881,6Tng472015,169,3450014,177

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Kim nh T Test tui TB dy thN dy th sm hn namNam v n VTN nhm 10-14 tui c tui dy th TB sm hnNam, n VTN thnh th dy th sm hn nng thn - Bng 1Kim nh One way AnovaN iu kin kinh t kh gi dy th sm hnNam, n hc vn cao hn, tui dy th cao hnCha thy bng chng nam kinh t kh hn dy th sm hnNam, n hc vn cao hn, tui dy th cao hn Biu 1

(Levene v P tng ng, Post Hoc test v P

Phn tch hi qui tuyn tnh a bin yu t lin quan tui dy th

M hnh hi quiM hnh ring cho nam, nCc gi nh hi qui c kim tra tnh ph hpBin s KT c m ha (Dummy variable) nh phnBin hc vn v tui c r > 0,8 (hc vn khng a vo m hnh)R2 hiu chnh = 0,66 (nam) v 0,33 (n)Kt qu hi qui tuyn tnhNam nhm tui tr hn, nam thnh th dy th sm hnN nhm tui tr hn, n thnh th, n KT kh gi, n sc khe tt, dy th sm hn Bng 2

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Tm hiu thay i tui dy th theo thi gian

c lng Kaplan Meier v tui dy th:N dy th sm hn nam (Log Rank -Mantel-Cox 2=256, P

PT Kaplan Meier (tip):

Tui dy th namNam dy th sm hn trong cc on h tui tr hn (Log Rank-Mantel-Cox 2=8030, P

Hi qui Cox yu t lin quan tui dy th:

Yu t lin quan tui dy th nam:Omibus test 2 = 2102, P0.05). Yu t lin quan tui dy th n:Omibus test 2 = 1167, P

Kin thc VTN v c im dy th n

Bng hi lit k 11 c im dy th nDu hiu dy th n c kinh nguyt c bit cao nht vi t l 38,2% VTN (17,2% nam v 60,2% n).Phn tch thnh t chnh PCAKMO-Bartletts test = 0,9, P1Phn tch tin cy thy 1 nhm yu t Cronbach alpha = 0,88T hp bin s thang o Kin thc v c im dy th nPhn tch tn xutT l VTN bit t nht 1 c im dy th n tr ln chim 52,1% (31% nam v 74,3% n). Nh vy c 47,9% VTN (69% nam v 25,7%) n tr li khng bit c im dy th no n - Bng 5

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Kim nh T test khc nhau kin thc VTN v dy th nNam, n nhm 15-19 tui bit nhiu hn nhm 10-14 tui v c im dy th n (t= 21, P

Kt qu hi qui tuyn tnh kin thc v dy th n

Yu t lin quan nam v kin thc dy th nNam nhm tui cao hn bit nhiu hn v c im dy th n (B ta hiu chnh = 0,2, t = 10,7, P

Bn lun v kt lun

Chililab l c s thc a o to, nghin cuC mu ln, x l s liu mt, tip cn k thut khc nhauVTN dy th l 69,3% nam v 77% nTui dy th VTNTui dy th (hiu chnh) 14,3 t (nam), 13,8t (n) - nhm DTTui dy th VTN 10-19t tnh theo nm ngi (Person year) l: 14t (nam), 13,4t n, thp hn SAVY 2003 (15,6t nam, 14,5t n)VTN 13 tui dy th l 53,1% nam v 61,4% nVTN 16 tui dy th l 85% nam v 98% nVTN 19 tui dy th l 94% nam v 99,4nN dy th sm hn nam, VTN thnh th dy th sm hn nng thnVTN tr tui hn, kinh t kh hn, sc khe tt hn dy th sm hnNghin cu khc: Tui dy th gim t 2-3 thng cho mi khong 10 nm v gim 3 nm tnh t th k 19 (CARE International, 1997)

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VTN thiu ht ln kin thc v c im dy th n VTN bit t nht 1 c im dy th n tr ln chim 52,1% (31% nam v 74,3% n). C 47,9% VTN (69% nam v 25,7%) n khng bit c im dy th no nDu hiu dy th n in hnh l c kinh nguyt c bit nhiu nht: 38,2% VTN (17,2% nam v 60,2% n)VTN nhm tui cao hn, VTN thnh th, VTN kinh t kh gi c kin thc tt hn v c im dy th n

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Khuyn ngh

Tui dy th VTN ngy cng sm hn v vy gio dc gii tnh v SKSS cho VTN cn ch sm hn tng ng tui VTN chun b dy th (t cui cp I).T l cao VTN khng bit c im dy th n. V vy ni dung gio dc gii tnh, SKSS cho VTN cn y , c th hn, ph hp vi la tui v tng cp hc ca VTN v ch ti VTN tr, VTN nng thn, VTN ngho.Kt qu nghin cu tham kho cho cc chng trnh can thip nng cao kin thc v dy th, SKSS cho VTN a phng. Cn c nghin cu y hn cc vn v dy th sm, dy th mun v dinh dng, pht trin th cht, tinh thn

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Li cm n:

Tc gi xin chn thnh cm n

Ban lnh o trng i hc YTCC

Ban iu hnh v Vn phng C s thc a Chililab

GS.TS Michael Dunne, TS Diana Battistutta trng i hc tng hp k ngh QUT

Thng tin lin h:

Nguyn Vn Ngh, MD, MPH:

T 0912232404. Email: ntn3@hsph.edu.vn

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Cc bi bo ng

1. Nguyn Vn Ngh (2009): Nhn thc v thi ca v thnh nin v HIV/AIDS: iu tra sc kho thanh thiu nin ti huyn Ch Linh, Hi Dng. Tp ch Y hc d phng tp XIX, s 2(101), trang 54-672. Nguyn Vn Ngh, L C Linh (2008): c im dy th, kin thc v tnh dc v bin php trnh thai ca thanh thiu nin: Kt qu iu tra ban u nghin cu sc kho v thnh nin v thanh nin ti Ch Linh, Hi Dng. Tp ch Y hc d phng tp XVIII, s 6(98), trang 25-373. Nguyn Vn Ngh, V Mnh Li, L C Linh (2009): Quan im v hnh vi tnh dc v thnh nin: iu tra sc kho v thnh nin, thanh nin ti huyn Ch Linh, Hi Dng. Tp ch Y hc d phng tp XIX, s 1(100), trang 24-364. Nguyn Vn Ngh, V Mnh Li, L C Linh (2009): S dng k thut phn tch dc v phn tch nh bin tm hiu c im tui dy th v quan h tnh dc v thnh nin ti Ch Linh, Hi Dng. (Tp ch YTTCC s 13(13), trang 17-26.

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Thanks for your attention!

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