Kugwira Ntchito Zogonana mu 16- Kwazaka Zaka 21 ku Britain (2016)

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Phunziroli linalemba zotsatirazi zotsatirazi za mavuto ogwiritsira ntchito kugonana kwa amuna a zaka 16-21 (data kuchokera ku 2010-2012):

• Kusakhudzidwa ndi kugonana: 10.5%
• Zovuta kufika pachimake: 8.3%
• Kuvuta kukwaniritsa kapena kusunga erection: 7.8%

Zomwe zili pamwambazi ndizo ndipamwamba kwambiri kuposa zomwe zinanenedwa kusanayambe kubwerakot. Mwachitsanzo, kuchuluka kwa erectile kwa amuna ochepera zaka 40 kunanenedwa kuti 2% muzochitika zomwe zisanachitike chaka cha 2000. Mu 1940s, a Nkhani ya Kinsey inatha kuti kufalikira kwa ED kunali zosakwana 1% mwa amuna aang'ono kuposa zaka 30. Madera ED a amuna 21 akhoza kukhala pafupi ndi 1%. Ngati izi za 6-8 zazaka zapakati izi ndi zolondola izi angasonyeze kuwonjezeka kwa 400% -800% ku ED mitengo ya amuna a zaka za 16-21! Izi zati, kafukufukuyu ndiotsika kwambiri poyerekeza ndimaphunziro ena aposachedwa a anyamata (makamaka mitengo ya ED). Onani ndemangayi kuti mumve zambiri komanso maphunziro: Kodi Zithunzi Zolaula za pa Intaneti Zimayambitsa Mavuto Ogonana? Kuwongolera ndi Zipatala za Zipatala (2016).

Zina mwazifukwa zingakhale zowerengera zowonongeka za amuna ogonana:

1) Momwe data anasonkhanitsira:

"Ophunzira adafunsidwa kunyumba ndi wofunsidwa wophunzitsidwa bwino, pogwiritsa ntchito kuyankhulana kwamakompyuta pamaso ndi pamaso komanso kuthandizidwa ndi makompyuta pamafunso ovuta kwambiri"

Ndizotheka kuti achinyamata azikhala ocheperako pamasom'pamaso pokambirana kunyumba. Kafukufuku waposachedwa wopeza mavuto okwanira okhudzana ndi kugonana mwa achinyamata anali osadziwika pa intaneti. Mwachitsanzo, izi Kafukufuku wa 2014 pa achinyamata a ku Canada adanena kuti 53.5% ya amuna a 16-21 anali ndi zizindikiro zosonyeza vuto la kugonana. Kusokonekera kwa Erectile kunali kofala kwambiri (27%), kunatsatiridwa ndi chilakolako chogonana chochepa (24%), ndi mavuto ndi orgasm (11%).

2) Kafukufukuyu adasonkhanitsa deta yake pakati pa Ogasiti, 2010 ndi Seputembara, 2012. Ndizo zaka 6-8 zapitazo. Kafukufuku wofotokoza zakukwera kwakukulu mu ED wachinyamata adayamba kuwonekera mu 2011.

3) Maphunziro ena ambiri amagwiritsa ntchito IIEF-5 kapena IIEF-6, yomwe imayesa mavuto a kugonana pamlingo wosiyana, kusiyana ndi wophweka inde or ayi (m'miyezi yapitayi ya 3) yomwe ikugwiritsidwa ntchito pamapepala omwe alipo.

Journal of Health Adolescent

Ipezeka pa intaneti 3 August 2016

Kirstin R. Mitchell, Ph.D.^{a, b,,,} ,Rebecca Geary, Ph.D.^c, Cynthia Graham, Ph.D.^d, Soazig Clifton^c, Catherine H. Mercer, Ph.D.^c, Ruth Lewis, Ph.D.^{a, e}, Wendy Macdowall, M.Sc.^a, Jessica Datta, M.Sc.^a, Anne M. Johnson, MD^c, Kaye Wellings, FRCOG^a

yani: 10.1016 / j.jadohealth.2016.05.017

Kudalirika

cholinga

Kuda nkhawa zakugonana kwa achinyamata kumayang'ana kufunikira kopewa zotsatira zoyipa monga matenda opatsirana pogonana komanso mimba yosakonzekera. Ngakhale phindu lakuwona kwakukulu likudziwika, zambiri pazinthu zina zokhudzana ndi kugonana, makamaka zogonana, ndizochepa. Tidayesetsa kuthana ndi kusiyana kumeneku poyesa kuchuluka kwa mavuto azakugonana, kuthandiza kufunafuna, komanso kupewa kugonana kwa achinyamata.

Njira

Natsal-3 (a Natsal-15,162) a amayi a 57.7 ndi abambo ku Britain (mlingo woyankhidwa: 1875%), pogwiritsa ntchito makompyuta othandizira zokambirana. Deta imachokera ku 71.9 (517%) yogonana, ndipo 18.7 imagwiritsa ntchito zolaula (16%), omwe ali ndi zaka 21-XNUMX. Zochita zinali zinthu zosakwatiwa kuchokera muyeso yotsimikiziridwa ya ntchito yogonana (Natsal-SF).

Results

Pakati pa azaka 16 mpaka 21 azaka zogonana, 9.1% ya amuna ndi 13.4% ya azimayi adanenanso zowawa zakugonana zomwe zidatenga miyezi 3 kapena kupitilira chaka chatha. Ambiri mwa amuna anali kufika pachimake mofulumira kwambiri (4.5%), ndipo pakati pa akazi zinali zovuta kufikira pachimake (6.3%). Oposa theka (35.5%) la amuna ndi 42.3% ya azimayi omwe amafotokoza zovuta anali atapempha thandizo, koma kawirikawiri kuchokera kwa akatswiri. Mwa iwo omwe sanagonane chaka chatha, 10% yokha ya anyamata ndi atsikana adati adapewa zogonana chifukwa chazovuta zakugonana.

Mawuwo

Mavuto okhudzana ndi ntchito za kugonana amafotokozedwa ndi achinyamata ochepa ogonana. Maphunziro amafunika, ndipo uphungu umayenera kukhalapo, kuteteza kusowa nzeru, nkhawa, ndi manyazi zomwe zimapitilira ku zovuta zogonana.

Keywords

• Achinyamata;
• Kukula msinkhu;
• Mavuto ogwirira ntchito;
• Kusokonezeka kwa kugonana;
• Kukhala ndi chiwerewere;
• Thandizani kufunafuna;
• Pewani kugonana;
• Kukula;
• Kufufuza kwa anthu

Zotsatira ndi Zopereka

Deta yovomerezeka ya dziko lonse ku Britain imasonyeza kuti mavuto ovuta ogwira ntchito za kugonana ndi achilendo kwa achinyamata (zaka za 16-21). Mu maphunziro a kugonana ndi zaumoyo, akatswiri amafunika kuvomereza kufunika kwa uchembere komanso kupereka mwayi kwa achinyamata kuti akweze ndi kukambirana nawo nkhawa zawo.

Chidwi chazogonana pamachitidwe achichepere achichepere nthawi zambiri chimayendetsedwa ndi nkhawa kuti zisawononge mavuto azakugonana, makamaka kutenga mimba kosakonzekera ndi matenda opatsirana pogonana (STI) [1], [2] ndi [3] ndipo, mochulukira, kugonana kosagonana. Ntchito yoyenerera ikusonyeza kuti achinyamata omwe ali ndi nkhawa ndizokhudzana ndi nkhani zokhuza kugonana kwawo. Angakhale akuda nkhaŵa za kugonana kwawo kapena kudziwika kwawo [4], mumamva kuti anthu amakakamizika kuchita zinthu zomwe sakuzikonda kapena kukupwetekani [5], kapena kulimbana ndi zikhalidwe zomwe zimapangitsa kuti zikhale zovuta kuvomereza zochitika zomwe sizili zabwino [6] ndi [7].

Ngakhale zovuta zokhudzana ndi kudzipereka, kudziwika kwakugonana, komanso mbiri yakugonana zalembedwa bwino, zochepa zimadziwika pamavuto omwe achinyamata angakhale nawo poyankha zogonana. Izi ndichifukwa choti mavuto azakugonana amaganiza kuti ndi ofunika kwa okalamba. Kugonana kumatanthauzidwa ngati kuthekera kwa munthu kuyankha kapena kugonana [8] ndipo zovuta zakugonana ndizomwe zimasokoneza izi. Kafukufuku wochuluka wa kuchuluka kwa anthu zokhudzana ndi kugonana amaphatikizapo omwe ali ndi zaka 16 kapena 18, koma nthawi zambiri amagwiritsa ntchito magulu azaka zambiri, mpaka zaka 29 [9] ndipo kawirikawiri amapereka tsatanetsatane wa achinyamata pa zaka za 24 [10], [11] ndi [12]. Kafukufuku wochepa chabe adalankhula makamaka pa msinkhu wokalamba, ndipo izi sizinagwiritsire ntchito deta yoimira dziko lonse [13] ndi [14].

Pali chidziwitso chowonjezereka kuti thanzi labwino liyenera kuganiziridwa mozama [15] ndi [16], ndi chiganizo chonse chovomerezedwa ndi WHO- "chikhalidwe cha thupi, m'maganizo, m'maganizo ndi m'maganizo pankhani ya kugonana" [17]-Kuyamba kupeza ndalama. Achinyamata, thanzi labwino limaphatikizapo "zopereka zabwino zogonana, komanso kupeza maluso othandizira kupewa zotsatira zogonana" [18]. Pali umboni wakuti zolinga zokhudzana ndi kugonana ndi zokondweretsa zimakhala zoopsa komanso zochepetsera chiopsezo [16] ndi [19]. Mwachitsanzo, mantha okhudza ntchito erectile pakati pa anyamata akhala akuwonetsedwa kuti akuthandizira kukana kugwiritsa ntchito kondomu [20] ndi kugwiritsa ntchito kosagwirizana [21]. Thanzi labwino la kugonana kwa achinyamata limakhudzana ndi khalidwe lochepetsa kuchepetsa chiopsezo, monga kugwiritsa ntchito kondomu komanso kudziletsa [18], komanso kugonana kwa anthu akuluakulu kumagwirizanitsidwa ndi khalidwe la chiopsezo [22]. Zomwe zimateteza zosangalatsa zingakhale zothandiza kuposa zomwe zimanyalanyaza izi [16] ndi [23]. Kusadziŵa kumene kulipo pankhani ya kugonana kwa achinyamata kumalepheretsa kuyesetsa kuthetsa thanzi labwino ndi kugwirizanitsa chikhulupiliro chakuti ntchito yogonana ndi umoyo sizikhala zogwirizana ndi njira zopewera achinyamata [1] ndi [24].

Tanena kale za kuchuluka kwa mavuto a kugonana kwa anthu akuluakulu omwe ali ndi zaka 16-74 omwe akugwiritsa ntchito deta kuchokera kufukufuku wachitatu wa zokhudzana ndi kugonana ndi moyo (Natsal-3) [22]. Apa, tikugwiritsa ntchito zomwezi kuti tithandizire kuthana ndi zovuta zokhudzana ndi kugonana (kuphatikiza zomwe zimabweretsa mavuto), kuthandizira kufunafuna moyo wokhudzana ndi kugonana, komanso kupewa kugonana chifukwa cha zovuta, kwa achinyamata azaka za 16-21 ku Britain.

Njira

Ophunzira ndi ndondomeko

Tikuwonetsa zambiri kuchokera kwa omwe ali ndi zaka 16- mpaka 21 omwe ali nawo ku Natsal-3, kafukufuku wazitsanzo za amuna ndi akazi 15,162 azaka 16-74 ku Britain, omwe adafunsidwa pakati pa Seputembara 2010 ndi Ogasiti 2012. Tikuyang'ana kwambiri ukalamba Nthawi ndi magawo oyambilira a ntchito zogonana achinyamata asanakhazikike mgulu lanthawi yayitali komanso zizolowezi zogonana. Tidagwiritsa ntchito mitundu ingapo, yophatikizika, komanso yopangidwa mwaluso, ndi UK Postcode Address File ngati gawo lazitsanzo ndi magawo a postcode (n = 1,727) osankhidwa ngati gawo loyambirira lazitsanzo. Pakati pazoyeserera zoyambira, ma adilesi a 30 kapena 36 adasankhidwa mwachisawawa, ndipo m'banja lililonse, munthu wamkulu woyenera amasankhidwa pogwiritsa ntchito gridi ya Kish. Pambuyo poyesa kusintha kuti pakhale mwayi wosagwirizana pakusankhidwa, mtundu wa Natsal-3 udayimira anthu aku Britain monga akufotokozera ziwerengero za 2011 Census [25].

Ophunzirawo anafunsidwa kunyumba ndi wophunzira ophunzitsidwa bwino, pogwiritsira ntchito pulogalamu yothandizidwa ndi makompyuta pamasom'pamaso (CASI) kwa mafunso ovuta kwambiri. Wofunsayo analipo ndipo akupezeka kuti athandize pamene ophunzira adatsiriza CASI koma sanayankhe mayankho. Kumapeto kwa zigawo za CASI, mayankho "adatsekedwa" mu kompyuta ndipo sankatha kufika kwa wofunsayo. Kuyankhulana kwadatha pafupifupi ola limodzi, ndipo ophunzira adalandira £ 15 ngati chizindikiro cha kuyamikira. Chida chofufuziracho chinayesedwa bwino ndi kuyesa [26].

Chiwerengero cha mayankho onse chinali 57.7% ya onse adayenera (64.8% mwa anthu a zaka 16-44 zaka). Kugwirizana kwa mgwirizano (chiwerengero cha anthu omwe anafunsidwa kuti adziwe kumene amalumikizidwa kuti atenge nawo mbali mufukufuku) anali 65.8%. Zambiri za njira zofufuzira zimafalitsidwa kwina kulikonse [25] ndi [27]. Natsal-3 inavomerezedwa ndi Komiti ya Oxfordshire Research Ethics Committee. Ophunzirawo anapereka chilolezo chovomerezeka kwa mafunso.

Zotsatira za zotsatira

Ophunzira omwe anena zogonana, mkamwa, kapena kumatako ndi m'modzi kapena angapo mzaka zapitazo adadziwika kuti ndi "ogonana" ndipo adafunsidwa ngati adakumana ndi mndandanda uliwonse wamavuto asanu ndi atatu ndi moyo wawo wogonana womwe umatha miyezi itatu kapena kupitilira apo m'mbuyomu chaka. Awa analibe chidwi chogonana, analibe chisangalalo chogonana, anali ndi nkhawa panthawi yogonana, ankamva kuwawa chifukwa chakugonana, sanasangalale kapena kukondweretsedwa panthawi yogonana, sanafike pachimake (adakumana ndi vuto) kapena adatenga nthawi yayitali kuti afike pachimake ngakhale anali wokondwa kapena woukitsidwa, anafika pachimake (adakumana ndi vuto) mwachangu kuposa momwe mungafunire, anali ndi nyini yowuma bwino (yofunsidwa ndi akazi okha), ndipo anali ndi vuto lopeza kapena kusunga erection (kufunsa amuna okha) . Pa chilichonse, adavomereza (adayankha inde), ophunzirawo adafunsidwa momwe akumvera ndi vutoli (zosankha: osakhumudwa konse, kukhumudwa pang'ono, kusokonezeka pang'ono; kukhumudwa kwambiri). Tidafunsanso kuti adakumana ndi mavutowa komanso kuti zizindikilo zimachitika kangati (zomwe sizinafotokozedwe m'nkhaniyi).

Onse omwe adachitapo zachiwerewere (omwe adagonanapo), mosasamala kanthu zogonana zawo chaka chatha, adapemphedwa kuti ayese moyo wawo wogonana, kuphatikiza ngati adapewa zogonana chifukwa cha zovuta zakugonana zomwe iwowo kapena wokondedwa wawo adakumana nazo. (kuvomereza mwamphamvu, kuvomereza, kuvomereza kapena kutsutsa, kutsutsana, kutsutsana mwamphamvu). Ophunzira akuvomereza mwamphamvu kapena kuvomereza kenako amapatsidwa mndandanda womwewo wamavuto ndikufunsidwa kuti afotokoze, ngati alipo, omwe awapangitsa kuti azipewa zogonana. Mayankho owonjezera anali motere: "Mnzanga anali ndi vuto limodzi (kapena kupitilira) kugonana" ndipo "palibe chimodzi mwazinthuzi zomwe zidandipangitsa kuti ndipewe kugonana." Mayankho angapo amaloledwa. Ophunzira adafunsidwanso ngati akumva kukhala opsinjika kapena kuda nkhawa ndi moyo wawo wogonana pogwiritsa ntchito sikelo ya Likert ya mfundo zisanu. Pomaliza, ophunzirawo adafunsidwa ngati adapempha thandizo kapena upangiri wokhudzana ndi moyo wawo wogonana kuchokera pamndandanda uliwonse wazaka zapitazo, ndipo ngati inde, asankhe zonse zomwe zingagwire ntchito. Zosankhazi zidasankhidwa kukhala achibale / abwenzi, atolankhani / zodzithandizira (kuphatikiza masamba azidziwitso ndi malo othandizira pa intaneti; mabuku othandizira / timapepala todziwitsa; magulu othandizira; foni yothandizira), komanso akatswiri (kuphatikiza akatswiri / achibale ambiri dokotala; zaumoyo / mankhwala opatsirana pogonana / chipatala cha opatsirana pogonana; wodwala matenda amisala kapena wama psychology; mlangizi wamaubwenzi; chipatala china kapena dokotala), kapena sanafunefune thandizo lililonse. Zinthu izi zimachokera ku Natsal-SF; muyeso wakugonana wopangidwa mwapadera komanso wovomerezeka kuti ugwiritsidwe ntchito pakafukufukuyu komanso kuchuluka kwa anthu ena. Muyeso wa 17-Natsal-SF uli woyenera (kuyerekezera koyenera index = .963; Tucker Lewis index = .951; muzu kutanthauza cholakwika chachikulu cha pafupifupi = .064), amatha kusankha pakati pa magulu azachipatala ndi anthu ambiri, ndipo ali ndi mayeso abwino Kudalirika kwambiri (r = .72) [22] ndi [28].

Kusanthula kusanthula

Kusanthula konse kunachitika pogwiritsa ntchito zovuta zowunika za Stata (mtundu wa 12; StataCorp LP, College Station, TX) kuwerengera kulemera, kuphatikiza, ndi kusanja kwa deta. Kusanthula kumangolembedwa kwa amuna ndi akazi onse azaka zogonana azaka za 16-21. Kusagwiritsa ntchito Natsal-3 kunali kotsika (pafupifupi nthawi zonse <5%, ndipo nthawi zambiri 1% -3%), chifukwa chake odwala omwe akusowa sanapezedwe pakuwunika. Mwa omwe amatenga nawo mbali pazogonana (omwe amafotokoza osagonana nawo m'modzi chaka chatha asanayankhulidwe), timapereka ziwerengero zofotokozera za zovuta zakugonana (zokhalitsa miyezi 3 kapena kupitilira apo mchaka chatha), komanso kuchuluka komwe kwakhumudwitsidwa ndi vuto lawo. Tikuwunikiranso kuchuluka komwe kukufunafuna thandizo kuchokera kumagwero osiyanasiyana, omangika pofotokoza vuto limodzi kapena angapo ogwirira ntchito. Kwa omwe sanachite zachiwerewere chaka chatha, timafotokoza ziwerengero zofotokozera zotsatira zitatu: kukhutira ndi kugonana, kukhumudwa pa moyo wakugonana, komanso kupewa kugonana chifukwa chazovuta zakugonana.

Results

Amuna ndi akazi ambiri (72%) a zaka zapakati pa 16-21 adanena kuti ali ndi mmodzi kapena ambiri ogonana nawo chaka chatha ndipo amagawidwa ngati amuna (854 amuna ndi akazi a 1,021). Gulu 1 ikuwonetsa kuchuluka kwa amuna awa omwe amafotokoza zovuta zilizonse zisanu ndi zitatu zogonana zomwe zimakhala miyezi itatu kapena kupitilira apo chaka chatha. Gawo limodzi mwa atatu mwa amunawa (3%) adakumana ndi vuto limodzi kapena angapo ogwirira ntchito (gawo loyamba la Gulu 1), ndipo 9.1% adatinso vuto limodzi kapena angapo okhumudwitsa (gawo lachiwiri); kutanthauza kuti mwa amuna omwe amafotokoza vuto limodzi kapena angapo, kupitirira kotala (26.9%) adakhala ndi nkhawa (gawo lachitatu).

Gulu 1.

Kukumana ndi zovuta zakugonana, komanso kukhumudwa pamavuto awa, mwa anyamata ogonana, azaka 16-21

CI = nthawi yodzidalira.

a

Chipembedzo chimasiyanasiyana ndi vuto lililonse la ntchito yogonana mu ndimeyi. Chiwerengero chopanda mphamvu ndi cholemerera chomwe chilipo ndi omwe adakumana ndi mavuto amodzi kapena angapo.

Zosankha pazithunzi

Mwa amuna, kufika pachimake mwachangu kwambiri linali vuto lodziwika bwino (13.2%). Oposa theka la amuna omwe ali ndi vutoli (34.2%) adamva kupsinjika ndi izi, ndikupangitsa kuti likhale vuto lofala kwambiri pakati pa amuna azaka 16 - 21 azaka 4.5 (7.8%). Kuvuta kupeza ndi kusunga erection sikunafotokozeredwe kwenikweni (42.1%), koma nthawi zambiri kumayambitsa mavuto (pakati pa 3.3%) ndipo potero linali vuto lachiwiri losautsa kwambiri (mwa 10.5% ya amuna azaka zambiri). Ngakhale kusowa chidwi pa kugonana linali vuto lachiwiri lodziwika bwino (lodziwika ndi 13.2%), 1.4% yokha ya amuna omwe amafotokoza zavutoli adakhumudwa nalo, ndipo kwathunthu, 1% adakumana nalo ngati vuto. Mavuto atatu okhumudwitsa adanenedwa ndi <XNUMX% ya anyamata ogonana: kupweteka, kusowa chisangalalo / kukondweretsedwa, ndikusowa chisangalalo.

Gulu 2 ikuwonetsa kuchuluka kwa azimayi achichepere ogonana omwe amafotokoza zovuta zilizonse zogonana, ndipo mwa iwo omwe akumana ndi vutoli, kuchuluka kwakukhumudwitsidwa. Pafupifupi theka (44.4%) mwa azimayiwa adakumana ndi vuto limodzi kapena zingapo zogonana zomwe zidatenga miyezi itatu kapena kupitilira apo chaka chatha, ndipo 3% adatinso vuto; kutanthauza kuti omwe akuti ali ndi vuto limodzi kapena angapo, ochepera gawo limodzi (13.4%) adavutika.

Gulu 2.

Kukumana ndi zovuta zakugonana, komanso kukhumudwa pamavutowa, pakati pa atsikana ogonana, azaka 16 mpaka 21

CI = nthawi yodzidalira.

a

Chipembedzo chimasiyanasiyana ndi vuto lililonse la ntchito yogonana mu ndimeyi. Chiwerengero chopanda mphamvu ndi cholemerera chomwe chilipo ndi omwe adakumana ndi mavuto amodzi kapena angapo.

Zosankha pazithunzi

Mavuto omwe amapezeka kwambiri pakati pa azimayi anali osowa chidwi chogonana (22.0%) ndipo anali kukumana ndi zovuta kuti afike pachimake (21.3%), ndipo awa analinso mavuto ovuta kwambiri (5.3% ndi 6.3%, motsatana). Mavuto omwe amakhudzana kwambiri ndi nkhawa anali kumva nkhawa panthawi yogonana (34.7%), kumva kupweteka kwakuthupi chifukwa chogonana (35.9%), ndikusowa chisangalalo kapena chidwi (31.6%), koma mavutowa sananenedwe kawirikawiri, zomwe zimapangitsa kuyerekezera kwakachulukidwe kwamavuto okhumudwitsa ku 2.8%, 3.2%, ndi 2.5%, motsatana. Kufika pachimake mwachangu kwambiri sikunafotokozeredwe kwenikweni (3.9%) ndipo adakumana ndi zopweteka ndi 10.8% yokha ya azimayi omwe amawafotokozera, zomwe zidapangitsa kuti pakhale pachimake pachimake chomaliza cha <1%.

Mwa achinyamata omwe adagonana nawo chaka chatha, 6.3% a amuna ndi 6.8% azimayi adanena kuti adapewa kugonana chifukwa cha vuto la kugonana. Mwa anyamata (Chithunzi 1), zifukwa zowonjezereka zopewa kupezeka zinali zovuta kupeza kapena kusunga chiwongoladzanja, kufika pachimake mofulumira, ndi kusowa chidwi (zomwe zinalembedwa ndi 26.1%, 24.4%, ndi 25.1%, mwachindunji, mwa anyamata onse omwe adanena kuti adapewa kugonana). Pakati pa atsikana (Chithunzi 1), chifukwa chodziwika bwino chopewa kupezeka chinalibe kusowa chidwi (zomwe zinafotokozedwa ndi 45.5% ya amayi omwe adapewa kugonana), potsatira zotsatira zosakhala zosangalatsa, nkhawa, ndi ululu (zomwe zinalembedwa ndi 21.2%, 25.3%, ndi 23.7%, motero, a amayi omwe adapewa kugonana).

Chithunzi 1.

Zifukwa zopewera kugonana pakati pa achinyamata ogonana omwe adanena kuti amapewa kugonana chifukwa cha vuto la kugonana.

Zosankha za zithunzi

Thandizo kapena uphungu pakati pa anthu ogonana

Powonjezera, 26% (22.9-29.5) ya amuna ogonana ndi 36.3% (33.1-39.7) a amayi ogonana omwe adafuna thandizo pa moyo wawo wa kugonana chaka chatha (mzere wotsiriza, Matebulo 1 ndi 2). Chithunzi 2 amasonyeza kukula kwake kumagulu osiyanasiyana, omwe amadziwika ndi vuto la ntchito yogonana. Anthu amene amawauza vuto limodzi kapena ambiri amafunsira thandizo poyerekeza ndi omwe amawauza kuti alibe mavuto (35.5% vs. 21% kwa amuna; p <.001 ndi 42.3% vs. 31.1%; p = .001). Kumene achinyamata anafunsira chithandizo, achibale awo ndi abwenzi anali gwero lodziwika kwambiri lotsatiridwa ndi atolankhani / chithandizo. Nthaŵi zambiri anthu ankafuna thandizo lachithandizo. Pakati pa achinyamata omwe amafotokoza vuto limodzi la ntchito zogonana, 3.6% (1.9-6.8) ya amuna ndi 7.9% (5.8-10.6) azimayi adafunsira akatswiri okhudza moyo wawo wa kugonana chaka chatha.

Chithunzi 2.

Kuwonetsa kwa achinyamata omwe ankafuna thandizo kapena uphungu pa moyo wawo wa kugonana pogwiritsa ntchito vuto la ntchito yogonana ndi abambo. SF = ntchito yogonana.

Zosankha za zithunzi

Kusokonezeka ndi kupezeka pakati pa achinyamata omwe sanagonane chaka chatha

Ambiri, amuna a 262 ndi azimayi a 255 anali ndi chidziwitso chogonana (anali atagonanapo) koma sananene kuti agonana chaka chimodzi asanalankhulane (Gulu 3). Ambiri mwa amuna asanu ndi mmodzi (17.4%) ndi amayi asanu ndi atatu (12%) adanena kuti akuvutika maganizo pa moyo wawo wa kugonana, ndipo pafupifupi a 10 (10%) a abambo ndi amayi adati adapewa kugonana chifukwa cha zovuta zogonana zomwe iwo kapena wokondedwa wawo anakumana nazo. Panalibe kusiyana kwakukulu pakati pa amuna ndi akazi pa nkhani yosautsa kapena kupeŵa.

Gulu 3.

Kuchuluka kwa kugonana kwa 16 - kwa a 21 a zaka zachisanu chodetsa nkhawa za moyo wa kugonana, kukhutira ndi kugonana, ndi kupeŵa kugonana

CI = nthawi yodzidalira.

Zosankha pazithunzi

Kukambirana

Dera lovomerezeka la dzikoli likusonyeza kuti pafupifupi mmodzi mwa achinyamata a 10 ogonana ndi mmodzi mwa atsikana asanu ndi atatu ogonana akufotokoza vuto losautsa la kugonana la miyezi 3 kapena kuposa chaka chatha. Vuto lalikulu lomwe lidawavutitsa pakati pa amuna onse ogonana anali kufika pachimake mofulumira (4.5%), ndipo pakati pa atsikana, kunali kovuta kufika pachimake (6.3%). Oposa atatu pa amuna ndi amayi oposa anayi m'mayi a 10 amawauza kuti vuto limodzi kapena ambiri okhudza kugonana anali kufunafuna chithandizo, koma kawirikawiri amachokera kwa akatswiri. Mwa anthu omwe sankagonana chaka chimodzi asanakambirane, mmodzi mwa anyamata ndi atsikana a 10 adati adapewa kugonana chifukwa cha zovuta zogonana.

Mphamvu za phunziroli ndizoti zimachokera pazitsanzo zazikulu zowonjezera chiwerengero cha anthu ndipo zimatchula kusiyana kofunikira pa umboni wovomerezeka wa mavuto a ntchito za kugonana pakati pa achinyamata. Ngakhale chiwerengero cha mayankho a kafukufukuyu (57.7%) chimaimira chitsimikiziro chotsutsana, chiwerengero cha omvera pakati pa 16-kwa zaka za 44 chinali chachikulu, pa 64.8%. Tawonapo kale kuchepa kwakukulu kwa mawerengedwe a kafukufuku, kuphatikizapo njira zovuta kuziwerengera, ndipo tawonanso kuti mayankho athu akugwirizana ndi masewero ena akuluakulu ku United Kingdom [25] ndi [27]. Ngakhale zili choncho, kusagwirizana kovomerezeka kuti tigwirizane nawo ndi kotheka, ndipo tinagwiritsa ntchito miyezo yofufuzira pofuna kuchepetsa chisankho ichi (onani Njira). Zinthu zokhudzana ndi kugonana zimakhala zovuta, ndipo deta yomwe imadziwika kuti ikhoza kukumbukira mwina ikhoza kukumbukira kukondera kwanu ndipo imakhala yosawerengeka. Tinayesetsa kuchepetsa kukonda malipoti pofotokoza mavuto a ntchito za kugonana monga "zovuta" [22], pogwiritsa ntchito zinthu zogwiritsira ntchito mwanzeru [28], komanso pogwiritsa ntchito makompyuta [25].

Deta yathu ikuwonetsa mavuto a ntchito za kugonana ndi achilendo m'zaka izi. Kuchuluka kwa chiwerengero cha 16 - kwa amuna ndi akazi a zaka za 21 omwe akufotokoza mavuto ogwira ntchito za kugonana sali otsikirapo kusiyana ndi anthu onse a Natsal-3, 41.6% kwa amuna ndi 51.2% kwa akazi [22]. Kafukufuku wowerengeka wa anthu akuphatikizirapo ndipo adafotokoza za achinyamata [10], [11], [12] ndi [29] ngakhale kuyerekezera kuli kochepa mwa kusintha kwa njira zafukufuku ndi kugawidwa kwa mavuto onse okhudzana ndi kugonana ndi kuuma kwawo. Kafukufuku waposachedwapa ku Canada [13]Mwachitsanzo, anapeza kuti 50% ya 16 ya amuna ndi akazi omwe ali ndi zaka 21, inanena za vuto la kugonana, omwe amachititsa kuti nthendayi ikhale yovuta, ngakhale kuti zochepa, zosagwirizana ndi zosiyana ndi zomwe zimakhala zosiyana pazofotokozera zimasonyeza kufunika kosamala mukutanthauzira. Pakati pa anyamata, kuchuluka kwa chiwerengero chathu chokwanira kwa Erectile (7.8%) ndi pakati pa 4.3% yomwe inapezeka mu phunziro la Australia la 16 - kwa zaka 19 [10] ndi 11% pakati pa 16 ya kugonana - kwa zaka zapakati pa 24 mu phunziro ku Portugal [12]. Chiwerengero chathu cha 13.2% pa kuyambira koyambirira kumakhala kochepa kwambiri kuposa kuphunzira kwa Australia (15.3%) komanso mozama kwambiri kuposa kuphunzira Chipwitikizi (40%). Pakati pa atsikana, chiwerengero chathu chokhala ndi chidwi choposa chiwerengero (22%) ndi zovuta zowonjezereka (21.3%) zimakhala zochepa kwambiri kuposa zomwe zili ku Australia (36.7% ndi 29%), ndipo zikufanana ndi mitengo pafupifupi 20% ndi 27% mu maphunziro a Swedish omwe ali ndi zaka zapakati pa 18-24 zaka [11].

Adanenedwa kuti kuchuluka kwamavuto mwa achinyamata kumachokera ku "zoyeserera" ndikuti amasowa pakapita nthawi pomwe achinyamata amadzidalira. Pochirikiza izi, O'Sullivan et al. [13] adapeza kuti mwa anyamata, nthawi yayitali yakugonana idalumikizidwa ndi magwiridwe antchito a erectile ndikukhutira kwambiri ndi kugonana. Kumbali ina, kuchuluka kwa achikulire omwe ali ndi mavuto azakugonana amafotokoza zizindikiritso za moyo wawo wonse, mwanjira ina, zizindikilo zomwe zidawonekera nthawi yoyamba kugonana isanakwane [8] ndi [30]. Zinthu zingapo zomwe zimayambitsa zovuta zakugonana nthawi zambiri zimapangidwa muubwana komanso unyamata. Izi zikuphatikiza maphunziro osakwanira pankhani zakugonana, kuvuta polankhula zakugonana, kuda nkhawa ndi thupi lanu kapena zachiwerewere, komanso kusokonezeka kapena manyazi pazogonana kapena zilakolako. [31]. Mavuto ogonana angasonyeze kuti kulimbana kulimbana ndi kugonana kwabwino pakati pa chikhalidwe chokhazikika ndi chikhalidwe, monga kuvomereza kuti amayi ayenera kuyembekezera ndi kupirira ululu [5]. Kugonana kwachiwiri komwe amai amawunika ndikuwonekeratu chifukwa cha chilakolako chawo cha kugonana kumawoneka makamaka osagwirizana ndi kusintha kwa chikhalidwe [32], ngakhale kuti kafukufuku waposachedwapa akusonyeza kusiyana kwa momwe achinyamata amachitira zikhalidwezi m'maukwati awo [33].

Zaka zopitilira 25 kuyambira pomwe nkhani ya Fine ndi McClelland [34] pa nkhani yosowa ya chilakolako cha maphunziro a kugonana, achinyamata amapitiriza kuona kusiyana kwa chidziwitso chawo chokhudzana ndi chikhalidwe cha kugonana komanso nthawi zambiri amamva kuti alibe zida zogonana. Natsal-3 deta imasonyeza kuti 42% ya amuna ndi 47% azimayi amafuna kuti adziwe zambiri zokhudza nkhani za kugonana pa nthawi yomwe poyamba ankamverera okonzekera kugonana, kuphatikizapo pafupifupi 20% ya amuna ndi 15% azimayi omwe akufuna kuti adziwe momwe mungapangire kugonana kukhala kosangalatsa kwambiri [35]. Mofananamo, pophunzira njira zosiyanasiyana kuchokera ku New Zealand, ophunzira a zaka zapakati pa 16-19 adayika "momwe angagwirire ntchito zogonana kukhala zokondweretsa kwa onse awiri" komanso "maganizo mu maubwenzi" pakati pa nkhani zisanu zokhudzana ndi kugonana maphunziro [24]. Ngakhale achinyamata akunena kuti akufuna kukambirana za zosangalatsa, njira zina zowonjezera kugonana, ndi ubale wamphamvu pakati pa kugonana, maphunziro a kugonana kwasukulu amalephera kunyalanyaza nkhanizi, zomwe zili mmalo mwake kusonyeza zodetsa nkhawa za akuluakulu akuluakulu [36].

Kuitanitsa chisangalalo mu maphunziro a kugonana siwatsopano [37]. Kukhala chete pa chiwerewere kuchokera kuzipangizo zamaphunziro kumadza ndi zinthu zina monga abwenzi ndi ofalitsa; ndipo, malinga ndi Natsal-3, pafupifupi theka la anyamata amatchula zolaula monga imodzi mwazodziwitsa za kugonana [35]. Ngakhale ogwiritsa ntchito ena amadziwa kuti zimakhudza moyo wawo wa kugonana [38], zolaula zingayambitse ziyembekezo zosaganizira ndi zovulaza pakati pa anyamata [39], zowonjezera mavuto okhudza kugonana. Kuphunzira za kugonana kungathandize kwambiri kufotokozera nthano, kukambirana zokondweretsa, kulimbikitsa maubwenzi ogwirizana pakati pa amai, ndikugogomezera maudindo akuluakulu a kuyankhulana ndi kulemekeza mu maubwenzi kuti athetse mavuto a kugonana.

Chiwerengero chochepa cha achinyamata omwe ali ndi mavuto ovuta omwe amafuna thandizo kapena uphungu mwina mosakayikira. Thandizo lofunafuna ndilosazolowereka, ngakhale pakati pa akuluakulu omwe ali ndi mavuto ogonana [40]. Kuphunzira za kugonana kungathandize kwambiri kuthetsa nkhaŵa, (1) mwakumvana mipata yodziwa; (2) polimbikitsa achinyamata kuti mavuto ndi ofala komanso olondola; ndi (3) polimbikitsa kulimbikitsa maubwenzi othandiza achinyamata. Osowetsa, amafunikanso kuzindikira kuti achinyamata omwe amapita ku zofuna zina zokhudzana ndi kugonana (monga kupatsirana pogonana ndi kuyesera matenda opatsirana pogonana) angakhale akulimbana ndi nkhaŵa zokhudzana ndi kugonana kwawo. Chifukwa cha kuchuluka kwa mavutowa, zingakhale zoyenera kuti opereka kukambirana akambirane za ntchito yogonana kudzera m'mbiri ya odwala, ndipo maphunziro amtsogolo angayese kuthandizira njirayi.

Popanda chidziwitso chodalirika chokhudzana ndi kugonana kwa achinyamata ndi thanzi lawo, kuyitanitsa chidwi cha mbali iyi yokhudza kugonana kumangokhala kopusitsa. Pali chosowa chachikulu chofufuzira china chokhudza achinyamata chofufuza kuchuluka kwa mavuto, malingaliro awo ndi zokulitsa. Makamaka, pakufunika zida zoyesera zovomerezeka zomwe zakonzedwa molingana ndi mavuto a achinyamata.

Pomaliza, ngati tikufuna kukonza chisangalalo pakati pa anthu, tifunika kufikira anthu ndi mabanja pamene akuyamba ntchito zawo zogonana, kuti tipewe kusowa chidziwitso, nkhawa, komanso manyazi zomwe zingasinthe kukhala zovuta zogonana kwanthawi zonse. Zambiri zathu zimapereka chilimbikitso champhamvu pakuchitapo kanthu podzitchinjiriza.

Kuvomereza

Natsal-3 ndi mgwirizano pakati pa University College London (London, UK), London School of Hygiene and Tropical Medicine (London, UK), NatCen Social Research, Public Health England (yomwe kale inali Health Protection Agency), ndi University of Manchester (Manchester, United Kingdom). Omwe amapereka ndalama analibe nawo gawo pakupanga ndi kafukufukuyu; kusonkhanitsa, kasamalidwe, kusanthula, ndi kutanthauzira deta; ndikukonzekera, kuwunikanso, kapena kuvomereza nkhaniyo; ndi chisankho cholemba nkhaniyi kuti isindikizidwe. Olembawo amathokoza omwe atenga nawo mbali phunziroli, gulu la omwe adafunsidwa mafunso kuchokera ku NatCen Social Research, magwiridwe antchito, komanso ogwira ntchito pamakompyuta a NatCen Social Research.

Zopereka Zothandizira

Phunziroli linathandizidwa ndi mabungwe ochokera ku Medical Research Council (G0701757) ndi Wellcome Trust (084840), Ndi zopereka kuchokera ku Economic and Social Research Council ndi department of Health. Kuyambira Seputembara 2015, KRM idalandiridwa ndi UK Medical Research Council (MRC); MRC / CSO Social & Public Health Science Unit, Yunivesite ya Glasgow (MC_UU_12017-11).

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Mikangano ya chidwi: AMJ ndi Kazembe wa Wellcome Trust. Olemba ena onse amanena kuti alibe kusiyana.

Mndandanda wa mauthenga kwa: Kirstin R. Mitchell, Ph.D., MRC / CSO Unit of Health and Public Sciences Unit, Institute of Health ndi Wellbeing, University of Glasgow, 200 Renfield Street, Glasgow, Scotland G2 3QB, United Kingdom.

© 2016 Society for Adolescent Health and Medicine. Lofalitsidwa ndi Elsevier Inc.

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