NHAN THLfC VA NHU CAU CHAM SOC SU'C KHOE SINH SAN PHU NtT TUOI MAN KINH HIEN NAY
(Nghien ciiu trUdng hdp phUdng X u a n L a , T a y Ho, H a Noi)
NGUYEN THI KIM HOA*
PHAM THI TU ANH"
Theo ket qua dieu tra bien dgng dan sd, ngudn lao dgng va KHHGD 1/4/2006, dan s d t o a n qud'c la 85.154,9 nghin ngifdi, nii chiem 50,85%. P h u nii trong do tudi man kinh chiem ty le tUdng doi cao va trong gia dinh hg dang giii vi tri quan trgng.
Nen kinh te thi trifdng vdi da dang boa s i n xua't va nganh nghe da tao nhieu ed hgi cho phu nii phat huy bet nang lUc cua minh tren mgi linh vUc, nbiTng mat khae eiing da trilc tiep hoac gian tiep lam anh bUdng khong nhd tdi SKSS tudi man kinh - giai doan co nhieu bien ddi ve tam, sinh ly va benh ly, can sii quan t a m cham sdc cua nhiing ngUdi than trong gia dinh, ban bo', ddng nghiep.
Hien nay phu nut tudi man kinh v i n eon it diTdc eham sdc scfc khoe sinh san hoac cbinh hg khong biet den viec cham sdc siic khoe sinh sin. Siie khoe sinh san khong ehi can sU quan tam d nhiing ndi vung sau vung xa, d nhiing ndi cd dieu kien song thap kem ma cdn ca d nhiing phu mi man kinh sd'ng b nhiing do thi Idn, sd'ng trong mdi trUdng eo he thong truyen thong td't ve siic khoe va nhieu thong tin mdi trong cham sdc siie khoe sinh san thong qua he thdng phat thanh, sach bao, truyen hinh, mang internet... Den nay tinh trang nay da trd thanh mgt van de xa hgi. 6 Viet Nam, trong 10 nam g i n day thu biit dUdc sU quan tam ciia cae n h i khoa hge ve siic khde ciia phu nii tudi man kinh.
Tuy nhien cac cdng trinh nghien ciiu chu yeu mdi de cap mgt sd van de chuyen sau dudi gdc do y hge. Nghien ciiu nhan thiie va nhu eiu eham sdc sue khde sinh san phu nii tudi man kinh dudi goe do xa hgi hge v i n con la khoang trdng.
Ngi dung bai viet can cii tir sd heu de tai "Thiic trgng chdm soc sdc khde sinh sdn phu na tudi mdn kinh" tren dia ban Phudng Xuan La, Quan Tay Ho, T h a n h phd Ha Ngi, thang 8 nam 2007.
1. N h a n thufc ve c h a m soc sijfc k h d e s i n h s a n cvia p h u ni? t u o i m a n k i n h Nhgn thde ve do tudi mdn kinh
Phu nii Viet Nam d tudi man kinh trung binh khoang 48,5 tuo'i. Tuy nhien d mgt so nguoi dieu nay cd thS xay ra sdm ban tudi 43 va mugn ban tudi 55. Tudi thg trung
• TS. Trirdng Dai hoc Khoa hoc xa hoi & Nhan van Ha Noi
" TnS. Cong ty LGK
Nguyin Thi Kim Hoa - Pham Thi Tu Anh 47
binh eiia phu nii Viet Nam nam 2007 la 73 tuoi. Nghia la trung binh moi phu nii se sd^ng khoang 24 nam sau man kinh.
Ket qua khao sat cho thay 50,5% ngudi duge hoi cho rang do tudi man kinh txi 45 - 50 tuoi va 31% la tren 50 tuoi. Nhu vay nhan thiic eua hg ve do tuoi man kinh la hoan toan diing bdi diidi goe do y hgc: man kinh trude 40 tuoi duge xem I i man kinh sdm, sau 55 tuoi duge xem la man kinh mugn.
Trinh do hgc van cang cao tbi nhan thiic ve do tuo'i man kinh b ngUdi phu nii ciing tot hdn. So ngudi e6 trinh dp trung hgc ca sd eho rang do tuoi man kinh tu 35 - 40 tuoi la 0,7%, tren 60 tuoi chiem 2,1%.
Ve dau hieu bitdc vdo tuoi mdn kinh
Man kinh ty nhien la sy eham diit hoan t o i n ehu ky kinh nguyet do mat boat dgng eiia nang trung. Neu sau 12 t h i n g hen tiep khdng ed kinh nguyet thi ed the nhan biet la da man kinh. Ket qua nghien ciiu cho thay chi co 24,8% phu nii tra ldi diing da'u hieu khi phu nii budc vao tudi man kinh la 12 thang lien tue khong eo kinh.
45,5% cho rang bien tUdng kinh nguyet that thiidng, 5% eho hien tiidng rong kinh la dau hieu danh dau bude vao thai ki man kinh, 24,8% khong ro phiidng an tra ldi, hg phan van doi vdi tat ca nhiing dau hieu tren. Dieu nay cho thay phu nut nhan bie't ve da'u bieu bude vao tudi man kinh rat thap.
"That ra, toi khong hieu ddu hieu nhU the ndo Id phu nH ehung toi bUdc vdo tuoi mdn kinh, cU thdy vdi thdng khong co kinh thi nghi la het kinh, nhUng vdi thdng sau lgi thdy kinh, nen chdng hieu la the ndo." (Nii, 61 tuoi, hge van Idp 5, lam vUdn).
Ve hgu qud cua man kinh
Ket qua nghien eUu cho thay kha quan hon: 64,4% so' ngUdi dUdc hdi eho rang viem nhiem dUdng sinh due de mac phai trong thdi ky man kinh do thieu hut ngi tiet buong trUng, 57,4% eho biet se hi loang xUdng, de hi benh tim mach la 55,0%, 52%
giam tri nhd, 50.0% cho r i n g hi benh ung thU neu khong CSSKSS.
Nhu vay p h i n Idn phu nii tudi man kinh khong co kien thUe, nhan biet da'u hieu ciia tudi man kinh, vo'n dUdc eoi la nhiing kien thUe ed ban, quan trgng va c i n thiet dUde biet den ddi vdi tudi man kinh, nhUng hg lai biet rd ve hau qua d tudi man kinh.
Ve boat dong cham soc siic khoe sinh s i n tuoi man kinh: 82,7% cho r i n g e6 bie't ve cham soc sUe khoe sinh s i n eiia phu nii b do tuoi man kinh va 86.6%) cho biet neu khong eham sdc siie khoe sinh s i n do tuoi nay tdt thi sUc khoe se bi anh hudng rat 16n. Vay hgc van eiia phu nii eo mdi quan he gi vdi nhan thUc eiia hg ve viee CSSKSS cho ehinh minh hay khong?
Bang 1: Tuong quan giOa hQC vdn vd si;hidu bidt vd chdm sdc sOc khod sinh s6n tu6i mdn l<lnhC%;
Hoc vdn Tieu hoc THCS
Co biet v§
CSSKSS man l<inh 10
66.7 120
82.8
Khong biet v§
CSSKSS man l<inh 4
26.7 19
13.1
Khong ro phai trd loi the ndo 1
6.7 6
4 1
Tong 15
100.0 145
100.0
Hpc vdn
•PTTH CO, DH
Co biet ve CSSKSS mdn l<inh 21
87.5 16
88.9
Khong biet ve CSSKSS mdn kinh 2
8,3 1
5.6
Khong ro phdi tra loi the ndo 1
4 2 1
5.6
Tong 24
100.0 18
100.0
Qua bang sd lieu tren cho thay phu nii ed trinh do hgc van cao ed kien thUc tot hdn ve eham s6e sUc khoe sinh s i n tuoi man kinh. Tuy nhien, qua cae phdng van sau, nhieu phu nU trinh do hgc van thap ed kien thUe td't vi hg t h a m dU d i y du cae budi noi chuyen eua chuyen gia ve chii de nay.
"Khi di tham gia mgt sd chUdng trinh vd cdc buoi noi chuyen ehung toi rdt ngac nhien Id chi em ldm nghi nong nghiep, nhiing ngUdi chi co trinh do hgc van tieu hgc, trung hoc ccrsd lgi tham gia rdt hda hiing, vi hg co tdm sii Id gap kho khdn nhiing cha bie't hoi d ddu, di chUa benh thi khong co diiu kien nen khi co chUdng trinh chdm soc sdc khoe sinh sdn ndy chi em rdt vui vd cdm thdy dugc gidi ddp rdt nhiiu nhiing vdn di bay ldu nay chi em thde mdc, lo lang" (Nir, 51 tuoi, can bg UBND phUdng Xuan La).
Nhu vay viee nang cao nhan thUe tudng ehUng nhU r i t khd doi vdi doi tUdng co trinh do hge van thap nhUng tren thUe te lai r a t de dang thdng qua eae each tuyen truyen phu hgp va dap Ung diing nhu e i u cua hg.
2. Nhu cau ve c h a m soc site k h o e s i n h s a n ciia p h u niif t u o i m a n k i n h Nhu e i u dUde eham sdc sUe khoe tinh due, eham sdc dUdng sinh due
Su thay ddi ve hormon eiia ngUdi phu nU chinh la nguyen n h a n d i n den nhiing khd khan trUdc m i t cung nhU lau dai khi hg bUdc vao tudi m a n kinh vdi cae trieu chUng nhu: quan he tinh due khd khan, cd quan sinh due viem n h i i m do anh hudng eiia ngi tiet va nghiem trgng hdn dd la eae benh loang xUdng, ung thU, ma't tri nhd, tim mach...
" Co ngudi hdi: Het kinh rdi thi "chuyen day" vdi chdng the ndo? Toi vdn binh thudng trong quan he vd chdng co nghla Id vdn co doi hoi ehd khong phdi bi dgng, chu dgng hdn hoi (NU, 54 tudi, can bg nha nUde, dai hgc).
Het kinh ndm 45 tudi, ndm nay 60 tudi, toi het Id het luon, khoe mgnh khong bi ldm sao, nhUng dgo ndy toi hdi dau lUng, ngiic vdn cdng, vdn binh thudng nhUng co mgt dieu Id khong thich gdn ddn ong (NU, 60 tudi, hUu tri, PTTH).
Toi ndm nay dd 62 tudi, nhUng noi that toi vd ong nhd toi khong the xa nhau dUdc, ehung toi vdn quan he binh thudng trong mgi chuyen, md noi that cha bie't gia dinh cdc bd the ndo nhUng rieng nhd toi dd "di ehd' Id phdi mua dUdc "mgt biia cd"
chii khong phdi ddo qua ehd mua rau Id di vi ddu. Tii hdi tre dd the ehd khong phdi Id bay gid mdi the (NU, 62 tudi, trdng dao, THCS).
Mgt sd phu nii mac du da man kinh nhieu nam, nhung quan he tinh due v i n nhu nhiing phu nii trong do tudi sinh de, bg khdng gap bat eu khd k h a n ve tinh due, sd phu nu nay rat It. Do thieu hut ngi tiet, co quan sinh due eiia phu nU tudi man kinh bat d i u thoai boa, viee thoai hoa nhanh hoac cham phu thuge vao QHTD d phu n u tudi man kinh. Khi budc vao tuoi man kinh khoang 75% phu nu gap cac khd khan can ed su
Nguyin Thi Kim Hoa - Pham Thi Tu Anh 49
can thiep ciia hie si, trong sd do khoang 70% phu nii gap true trac ve quan he tinh due:
"Ldc cdn tre, chuyen quan he vgchdng h^ sdc vd tu, nhUng bay gidtdi ma, mdn kinh cd 3 ndm, md quan he vgchdng hit sdc khd khdn, tdi gdn nhu chang cd khoai cam gi cd, hdm viia rdi dUdc tU vdn diing thudc trg giup... bdy gid tdi cdm thdy cd the dap ving dUgc nhu cau cua dng xd, gid md phu nU ehung tdi cd cdc thdng tin nhU vdy thi tdt qud"(N\i, can bg bUu tri, 60 tudi).
Qua phong v i n tren t h i y rang phu nii tuoi man kinh co rat nhieu kho khan trong quan he tinh due, nbung neu dugc tu v i n va trg giup thi phu nU giam hot dugc kho khan:
" TrUdc day, phu nU ehung tdi truyin mieng nhau rdng, khi ndo mdn kinh Id minh dugc ngu yen, nhUng bdy gid qud met vi ehung tdi bi nhUng cdn bdc hod ldm ngUdi dau moi nhii, khd tinh, budn... rdt khd ngu chi thich yen tinh, ngay nhin bgn tre con cUdi dua toi cdng khd chiu, chdng thiet gi (NU, 58 tudi, lam vUdn, THCS).
P h i n 16n phu nU bude vao tudi man kinh van eo nhu e i u duy tri quan he tinh due tuy nhien sU thieu hut ngi tiet sinh due lai la mgt van de can trd phu nU lam cho hg trd thanh "lUe bat tong tam". Phu nU thieu hut ngi tiet khien cho quan he tinh due trd nen kho khan, bg phan sinh due bi teo di va day ehinh la nguyen nhan lam cho phu nU rat de nhiem khuan. Chinh vi vay phu nfl r a t c i n dUdc tU van de co nhUng each thUc lam giam di nhUng khd khan ma hg gap phai.
"Tdi dd sdn sdng vdi nhiing cdn bdc hod vd dd md hdi dem, nhUng thiic sU khdng ai cdnh bdo tdi rdng ham mudn tinh due lgi tut gidm nhU vay. Toi dd khong con quan tdm ldm den chuyen ndy, quan he tinh due mdt cdch may mdc khdng lay gi ldm thu vi. Tdi tu nhgn thdy minh rdt khd khan. Dieu ndy dd gay dau khd rdt nhiiu cho tdi vd ngUdi bgn ddi cua tdi. Vi con cdi khdng con d nhd, rdt cudc ehung toi da cd thdi gian tu do trong tay vd ndng long mong moi dUdc sd'ng rieng tU, nhUng roi ehung tdi phdi CO gdng ldm de duy tri mdt cudc sdng tinh due tdm tdm. Ban ddu tdi chi nghi rdng day chi Id vdn de thdi gian, nhUng that ra nd khdng cdi thien. Tdi khdng the hieu ddu Id nguyen nhdn tiem dn vd ldm the ndo de ndi ra chuyen ndy". [18;3,4]
Phu nU rat c i n duge quan tam, eham soc tU phia gia dinh, cgng ddng, xa hgi.
Tinh due vo'n la mgt pham tru khong de ehia se, vi vay nhu e i u dUdc tU van eham soc cua phu nU ve van de nay ndi rieng va nhUng khd khan ndi ehung eua tuoi man kinh la rat 16n. Khi dUde hoi ve nhUng kho khan gap phai phu nU tuoi man kinh td ra rat bdi roi hg rat e i n cgng ddng quan tam den lUa tudi eua hg, hg thieb tham gia eae buoi noi chuyen de trao ddi thong tin va dac biet bg rat c i n duge t u van eua bae si chuyen khoa ve sUe khoe sinh san tuoi man kinh (86,7%), hg c i n ed trung tam tU van ve sUe khoe sinh san tuoi man kinh (84,2%), vi theo hg, nhU vay se ed ndi den de dUde giai dap nhiing t h i c m i c cua hg (55,0%), hg ed the tham gia cae budi ndi chuyen eua tU van vien theo dinh ky (58,9%)
Qua sd lieu tren cho thay da so' phu nil cd nhu e i u ve eham sdc SKSS, va nhu eiu ehii yeu tap trung vao hinh thUc dUde trao ddi thong tin chuyen sau ve lUa tuoi cua hg, hg mong muon ed bae si chuyen khoa ve linh vUe nay va dUde giai dap nhUng kho
khan eiia tudi man kinh. Nhu eau dUdc cham soe sUe khoe sinh san ciia phu nfl tudi man kinh dugc the hien ro qua tUdng quan nghe nghiep. TU ngudi nong dan den can bg doan the, can bg bUu tri, nhUng ngUdi lam nghe buon ban deu mong muo'n cd mgt ndi CO trinh do chuyen mon cao de hg ed the den de kiem t r a sUc khoe ba't cU luc nao hoac theo dinh ki. Trong so' dd chiem ti le cao n h a t la nhUng ngUdi lam cong tac can bg doan the (100%), nhUng ngUdi dang hudng che do hUu tri (89,2%), nhflng ngUdi lam nghe buon ban va eong chUc (88,2%), thap n h i t nong dan (75,9%). .
"Tren dia bdn qudn Tdy Ho chicd mdt trung tdm tU vdn sdc khoe sinh sdn tgi Uy ban Ddn so, gia dinh vd tre em, vi vay khdng the ddp iing dugc md Trung tdm ndy chi tu van khdng khdm vd chdn dodn benh. Cdn tgi Trung tdm y tequan vd phdng khdm da khoa, cdc trgm y tephudng diu co bdn tU vdn vi SKSS, nhung khong cd bdc si vd nii hd sinh ndo cd the tU vdn vd cdc xet nghiem chudn dodn ddnh cho phu nit tudi mdn kinh" (Can bg Uy ban Dan sd, gia dinh va tre em, Quan Tay Hd).
Nhu vay, nhu e i u dUde tU van va eham sdc eiia phu nU tuoi man kinh hien nay la rat Idn nhung ehua thuc hien duge vi noi t u v i n , c h i n doan vdi cac trang thiet hi khdng ddng bg, dgi ngu can bg khdng cd chuyen mdn sau. Day la khd khan khach quan ma ca ngudi dan va ehinh quyen dia phuong ehua the sdm khae phue.
Ngoai nhu e i u dUde tham kham phu nU tudi m a n kinh cdn mong muon tham gia nhUng boat dgng doan the td chuc tai dia phucmg. Cd 86.6% thich tham gia cau lae bg the due the thao; thieh tham gia eae budi chuyen gia ndi chuyen ve cham soc sUc khoe sinh san chiem ti le 75,2%; tham gia eau lae bg thd, van nghe la 43,6%. Cau lae bg the due the thao duge phu nu man kinh hudng iing t h a m gia mgt cich tu nguyen va hg s i n sang d i u t u kinh phi neu ed su hudng d i n ciia co quan chuyen mon.
"Khi budc vdo tudi mdn kinh, mdi sdng ngii day tdi gap rdt nhieu khd khdn cdc ngdn tay cua tdi md ra, ndm vdo khdng theo y mudn ciia bdn thdn, nhung tir khi tdi tap mdn bdng ly tdm bdn tay tdi mim vd rdt kheo leo. Hien tdi tap luyen thudng xuyen, mgt sd trieu ehung ve dau mdi khdp gdi, te bdn chdn dd gidm nhieu. Niu phu nir chiing tdi dime trang bi kien thuc ve chdm sdc SKSS trude khi budc vdo tudi mdn kinh thi tdt qud"(Nu, 62 tudi, hUu tri, THCS).
Tuy man kinh cd nguyen nhan sau xa la nhUng thay do'i ngi tiet va ed anh hudng den sUe khoe the lite nhUng nd eung gay ra nhUng anh hudng khong nhd den siic khoe tam ly.
Nhu cdu ve tdm ly xd hgi cua phu nU tuoi mdn kinh
TrUde day, phu nu quan niem man kinh la benh eua hg va thUdng am tham chiu dung khong ehia se. Khi tinh tinh thay ddi, t r i m cam lo au, eau kinh, bde hoa, rong kinh, sd set quan he tinh due... mgt s d p h u nU lai qua lo l i n g eho tinh trang sUe khoe ciia minh, mgt sd khae thd d nen de xay ra hau qua dang tiec. Neu khdng cd kien thUe, khong du thong tin hoac hi de nang bdi nhUng quan niem phong kien lac hau...
phu nU thUdng ed tam trang chan nan, mac cam, lo au, thieu tU tin, d i n den anh hUdng xa'u den sflc khoe, hanh phue gia dinh, hieu qua cdng t i c va d l dang bi suy
Nguyin Thi Kim Hoa - Pham Thi Tu Anh 51
sup ca ve the cha't va tinh t h i n . Viec tim hieu nhu cau e i n su quan tam eua cgng dong, cua gia dinh va nguoi than ddi voi phu nii tudi man kinh la r i t quan trgng
Ket qua nghien ciiu eho thiy 91,1% so'ngUdi dUde hdi c i n su quan tam eua egng dong, 88,6% phu nfl ein co sU quan tam tU gia dinh va ngUdi than khi bUdc vao tudi man kinh. Co nhieu ly do ma ngUdi phu nfl d do tudi man kinh mudn gia dinh quan tam.
"Theo tdi, phu nU thUe sii khd khdn khi bUdc vao tudi mdn kinh, ehung tdi mudn nhiiu ngUdi biei den nhiing kho khdn cua tudi ndy nhU chdng tdi, con tdi, chdu tdi vd bdn thdn chdng tdi mudn dugc nghe tuyen truyin, tU vdn, trao doi, giao luu, chdm sdc, dac biet Id chdng tdi dUdc khdm phu khoa mien phi" (NU, 53 tudi, PTTH, cdng nhdn nghi hiiu).
Bang 2: Nhung ly do ma ngudi phu nu a do tudi man l<lnh muon gia dinh quan tam (%) Phuong dn tra loi
Co Khong
Khong phu hop Tong so
Cdm thd'y le loi CO qugnh 17
8.4 162
80.2 23
11.4 202
700.0
Muon chia se tu chong con 173
85.6 6
3.0 23
11.4 202
100.0
Ly do khdc 0
0.0 179
88.6 23
11.4 202
100.0
P h i n 16n mgi ngUdi khdng earn thay le loi eo quanh b tudi nay ma ehi mudii co sU chia se tU chdng eon (85,6%). Phai chang hien nay gia dinh va cu the la chdng va eon cua nhflng phu nfl tuoi man kinh chUa ed d i y dii kien thfle ve van de nay nen ngUdi phu nfl van ehUa dUde ehia se va thong cam dung mUe. Nhirng ngudi cang eo hge van cao thi nhu e i u dUde chia se nhUng kho khan tU chdng eon cang Idn, tieu hgc eo ti le 80,0%, THCS ed ti le 84,4%, PTTH la 87,5%, cao dang dai hgc chiem 94,4%.
Bang 3: Tuong quan giua hoc vdn va su chia se cua chdng con (%) Hpc vdn
Tieu hoc PTCS PHH CO, OH Tdng sd
Cdn su chia se tu chdng con Co
12
80.0%
123
84.4%
21
87.5%
17
94.4%
173
85.6%
Khong 1
6.7%
5
3.4%
0
0.0%
0
0.0%
6
,3.0%
Khong phu hpp 2
13.3%
17
11.7%
3
12.5%
1
5.6%
23
11.4%
Thyc t l cho thiy, viec chia se eung nhfl trang hi kien thfle eho nhflng ngUdi chong, ngUdi con la bet sflc c i n thiet. Nhu e i u eiia phu nfl tudi man kinh mud^n chong CO kien thfle ve thdi ki man kinh la rat Idn, chiem 80.7% .
"Dgo ndy tdi rdt khd ngu khodng 8h tdi Id budn ngii, den llh,12h khdng ngii duac, den 2h, 3h sdng thi thirc trdng. Khdng ngii dugc thi hay budn tieu vl vdy anh hudng den giac ngii ciia dng dy, sau khi duac tu vdn tdi dd dieu chinh giac ngu. Gid ddy chong tdi dd hieu ra, vg chdng tdi rdt "tdm ddu y hgp". Tdi nghi rdng tdt cd phu nir
tudi mdn kinh nen tim hiiu vd cung chia se vdi chdng. Ngudi chdng se hieu vd ciing chiing ta gidi quyet. Vi vdy, theo cd nhdn tdi viec trang bi kien thirc cho chdng vd cdc thdnh vien trong gia dinh Id thuc sir cdn thiet"(Nii, 50 tudi, can bg, PTTH).
"Khodng 6 thdng trd lgi, toi khdng biet vd tdi bi ldm sao, mdc benh gi, gia dinh nhd tdi ddng trUdc nguy cd tan vd, tdi bdt ddu udng rUdu... tdm sii vdi may dng bgn vd dugc biet vd tdi dang cd ddu hieu cua tudi mdn kinh, tdi da dUdc tU van qua mgt so' bdc sl quen bie't. Khi ddt van di chia se vdi vg, bd dd ndi ndng vd khdc loc Id tdi khdng quan tdm den bd dy vdi cdc khd khdn md bd dy gap phdi... Id che bd dy gid, mudn cd bd. Tdi khdng the chiu ndi, sao phu nd ddu dc cua hg tudng tUdng gioi the, sau dd tdi cd nhd bdc sl lay thud'c cua My cho vg tdi udng. Hien mdi thdng 1,5 trieu ddng/vi, that tuyet, sau khodng 1 thdng gia dinh nhd tdi lgi trd vi trgng thdi binh thudng, cd nhd ciing vui ve. NhUng ndi nho chi nhe, tdi chi ndi Id cd 100 ngdn thoi. Neu biei, bd dy se tiec tien, khdng udng." (Nam, 60 tudi, can bg hUu tri, dai hge).
Vdi thdi dai thong tin nhU hien nay, viee tim hieu kien thfle ve bat cU linh vUc nao cung khong qua khd khan, nhUng quan trgng phu nfl phai biet chia se vdi gia dinh dae biet la ngUdi chdng, va eon cai da trUdng thanh. Phu nfl nen tfl bd y nghi khong muon phien eon cai.
"Thdi gian gdn ddy me tdi tinh tinh thdt thudng, kem theo Id dau moi khdp ngUdi, lo lang... Tdi dUa bd di khdm vdphdt hien hien tUdng dau moi ngUdi vd hay bi chugt rut, xd rdng, chay mdu chdn rdng... cua bd, day Id hdu qud cua mdn kinh do loang xUdng, vi vdy sau khi ldm cdc xet nghiem vd udng thud'c. Hien tgi me tdi dd gidm rdt nhiiu viec dau moi... vd bd tham gia cdu lgc bd dUdng sinh. Theo tdi cdc bd, me da cdng hien tudi tre cho gia dinh, xin diing nghi Id ldm phiin con cdi, hay chu ddng cho con biet. Thdi dgi nay viec cdi thien sdc khoe eho ngUcfi cao tudi Id trdch nhiem cua gia dinh vd todn xd hdi" (Nfl, 28 tudi, DH).
P h i n Idn phu nfl b tudi man kinh deu gap phai nhflng trieu ehUng khd chiu nhfl bdc boa, met mdi, do md hoi. Nhflng trieu chflng nay thUdng gay nhflng khd chiu vi vay khi bi nhflng edn bUng ndng bat chdt ed the ngUdi phu nfl cam thay ed nhflng budn hue vo ed.
"Mgi chuyen vdn binh thUdng chi cd khdc la tinh khi hdi bdt thudng nhUng nd khdng lan vdi bdc hod ddu. Toi di khdm bdc sl vd hoi bdc hod Id the ndo hd anh? Bdc sl ndi vdi tdi Id em may mdn ddy. Tdi chi nhdn thdy Id tinh minh cd cdu bdn hdn thdi, vi du nhu ve nhd md thdy nhd bdn thi minh cung cd the cdu ngay. Nhiiu khi phdi ndi vdi chdng vd con de thdng cdm cho tdi day" (NU, 56 tudi, hUu tri, cao dang).
'Budi dem thde giac ngUdi cd ndng hiing hUc, nhiiu hdm cdm Ignh vi tdm dem nhUng khdng chiu dUdc, sau day thi todt md hdi, met vd kho chiu ldm" (Nfl, 46 tudi, nong nghiep, Tieu hgc).
'TrUdc luc mdn hdn thi kinh thdt thUdng. Ngodi ra ddi luc cd cdn cdu bdt thinh linh, vd ly, vd cd, tdi phdi mdt den hai ndm true trac vi kinh nguyet, de'n ndm thd ba thi may thdng mdi cd mgt lan ddu hieu cua bdng kinh ba ngdy, sau do chdm dUt.
TrUdc khi cd trgn ddy la sau 4 thdng khdng cd" (NU, 56 tuo'i, hUu tri, Cao ding).
Nguyin Thi Kim Hoa - Pham Thi Td Anh 53
K^tlu^n
Phan Idn phu nU b dia ban nghien ciiu deu co nhan thfle khong dung ve sflc khoe sinh san, hg eho rang do! tUdng eiia sUe khoe sinh san khong phai la phu nU tudi man kinh. Kien thUe ve thdi ky man kinh ciia hg rat thap nhU kien thfle ve nhan bie't tudi budc vao man kinh va dau hieu eiia kinh nguyet khi bUde vao tuoi man kinh. Tuy nhien hg lai c6 kien thfle tUdng ddi tot ve nhflng anh hudng lau dai tdi sflc khoe khi bude vao tuoi man kinh. Phu nfl bgc v i n cang cao thi kien thfle ve eham soe sUe khoe sinh s i n tuoi man kinh cang tot.
Nhu cau dUdc eham soe sUc khoe sinh san eiia phu nfl tudi man kinh la rat Idn ve ca the chat va tam ly. Nbu cau ve the chit bao gom nhu eiu ve sU boa hgp tinh due vdi ngudi chong, cae benh hen quan dUdng sinh sin, dUdc kham ehua benh thudng xuyen, dugc trao doi vol bae si chuyen khoa. Nhu eau ve mat tam ly bao gdm sU quan tam hieu bie't va ehia se eua gia dinh, egng ddng va nhflng kho khan hg gap phai trong thdi ky nay. Mong muon eua phu nir la muon ngudi chong eiing nhu eon cai ed kien thiie ve SKSS tuoi man kinh de giiip da hg trai qua nhflng kho khan b lUa tudi nay.
Nghien cflu ed lien quan den van de eham sdc sflc khoe sinh s i n phu nfl tuoi man kinh hien nay la mgt nhu eiu cap thiet, cin ed nhiing nghien eiiu sau hon gdp phin luan giai diy du cd sd khoa hge va thfle tien eho van de nay. Xa hgi, gia dinh, egng ddng va ban than phu nii tuoi man kinh nhan thiic tdt ve nhiing thay doi tam, sinh ly se cd nhiing hanh dgng thiet thuc dap iing nbu eiu ve the chat v i tam ly xa hgi ciia phu nu tuoi man kinh, giiip hg vugt qua nhiing khd khan trong giai doan nay de cd the nhanh chong on dinh tam, sinh ly va sue khoe phue vu xa hgi va gia dinh dugc tdt hon./.
Tai lieu tham khao
1. Benh vien phu san trung uong, Kiem soat eie yeu to nguy co tim mach d phu nir man kinh, Ha Ngi, 2005.
2. Bg Y te, Chien luac qude gia ve chdm sdc sire khoe sinh sdn giai dogn 2001- 2010, Ha Ngi, 2001.
3. Bg y tS - Vu BVSKBMTE/KHHGD, Vdn bdn phdp quy phgm hien hdnh trong linh vuc chdm sdc sire khoe sinh sdn, NXB Quan dgi nhan dan.
4. Vu Dinh Chinh, Nghien cim loang xuong vd mgt sd yeu td lien quan tdi loang xuong d phu nit sau mdn kinh thudc huyen Cdm Binh tinh Hdi Hung, Tdm tat luan an phd tien si khoa hgc y duge, 1996
5. Dio Xuan Dung (2000),Trurrg tdm nghien ciru gidi, gia dinh vd mdi trudng trong phdt trien, Hdi ddp sire khoe sinh sdn sue khoe tinh due, NXB Thanh nien, 2001.
6. Pham Thi Minh Bvic,"Sinh ly sinh sdn", "Sinh ly hgc",2, NXB Y hge,2000.
7. Pham Gia Dire - Pham Thj Phuong Lan, 150 Cdu hdi ddp ve tudi mdn kinh, NXB Phu nu, 2004.
8. Pham Thj Minh Due, Bdo cdo tdng kit de tdi doc lap cap''Nhd nudc, Nghien cim thuc trgng sire khoe sinh sdn cua phu nir Viet Nam mdn kinh vd de xudt cdc gidi phdp can thiep nhdm ndng cao chdt luang sdng cua phu nir lira tudi ndy, chu nhiem de tai, Trudng Dai hge Y Ha Ngi, 2004.
9. Vuong Hdng - Duong Ngge, 350 Ldi khuyen phdng chdn benh (Hdi vd ddp), NXB Y Hge, 2004.
10. Trin Minh Man va Le Ngge, Bdo Kinh vd mdn kinh cdch khdc phue, NXB Y hgc, 1999.
11. Trjnh Lgi Nham - Luong Hge Lam, Phu nir thudc chira benh vd nhirng benh thudng mdc, NXB Y Hgc, 2005.
12. Nguyin Thi Ngge Phugng, Phdc do dieu tri mdn kinh, NXB Y Hgc, 2002.
13. Nguyen Thj Ngge Phugng, Menopaus - Thdng tin mdi ve diiu tri mdn kinh, NXB Y Hgc, 2005.
14. Nguyin Thj Ngge Phugng, Vdn hgnh phue sau tudi 50, NXB Y Hgc, 2006.
15. Dang Quan Thanh, Cdm nang chdm sdc sire khoe tudi trung nien, NXB Phu nir, 2002.
16. Le Thj Thanh Van, Dae diem lam sang va can lam sang ciia rong kinh rong huyet ea nang tudi day thi v i tuoi tiln man kinh, Luan an tien si y hgc, 2003