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

YBOP COMMENTS:

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%

Ziwerengero zomwe zili pamwambapa ndi zapamwamba kwambiri kuposa zomwe zinanenedwa isanafike intaneti . Mwachitsanzo, kuchuluka kwa anthu osakwanitsa zaka 40 omwe anali ndi vuto la erectile dysfunctions kunanenedwa kuti ndi 2% m'maphunziro omwe adachitika chaka cha 2000 chisanafike. M'zaka za m'ma 1940, lipoti la Kinsey linanena kuti kufalikira kwa ED kunali kochepera 1% mwa amuna osakwana zaka 30. Ziwerengero za ED kwa amuna azaka 21 mwina zili pafupi ndi 1%. Ngati ziŵerengero za ana azaka 6-8 izi ndi zolondola, izi zikusonyeza kuwonjezeka kwa 400%-800% kwa amuna azaka 16-21 ! Komabe, ziŵerengero za kafukufukuyu ndizochepa kwambiri kuposa maphunziro ena angapo aposachedwa pa anyamata achichepere (makamaka ziŵerengero za ED). Onani ndemanga iyi kuti mudziwe zambiri ndi maphunziro: Kodi Zithunzi Zolaula za pa Intaneti Zimayambitsa Mavuto Ogonana? Ndemanga ndi Malipoti a Zachipatala (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"

N'zotheka kuti achinyamata sangakhale omasuka mokwanira poyankhulana maso ndi maso kunyumba. Kafukufuku waposachedwapa wopeza kuchuluka kwa mavuto okhudzana ndi kugonana mwa achinyamata anali kafukufuku wosadziwika pa intaneti. Mwachitsanzo, kafukufuku wa 2014 pa achinyamata aku Canada adanena kuti 53.5% ya amuna azaka zapakati pa 16-21 anali ndi zizindikiro zosonyeza vuto la kugonana. Kulephera kugwira ntchito bwino kwa chiberekero kunali kofala kwambiri (27%), kutsatiridwa ndi chilakolako chochepa chogonana (24%), ndi mavuto okhudzana ndi kufika pachimake (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 adagwiritsa ntchito IIEF-5 kapena IIEF-6, yomwe imayesa mavuto okhudzana ndi kugonana pa sikelo, mosiyana ndi inde kapena ayi (m'miyezi itatu yapitayi) yomwe yagwiritsidwa ntchito mu pepala lamakono.

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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 cha akatswiri pa khalidwe la kugonana la achinyamata nthawi zambiri chimayendetsedwa ndi nkhawa yopewa mavuto a kugonana, makamaka mimba yosakonzekera ndi kufalikira kwa matenda opatsirana pogonana (STI) [1] , [2] ndi [3] ndipo, mochulukira, kugonana kosavomerezedwa. Ntchito yodziwika bwino imasonyeza kuti achinyamata nawonso amakhudzidwa ndi nkhani zomwe zimakhudza thanzi lawo la kugonana. Angakhale ndi nkhawa ndi zomwe amakonda kapena umunthu wawo [4] , amamva kukakamizidwa ndi anthu kuti avomereze zochita zomwe sakonda kapena zomwe zimawapweteka [5] , kapena amalimbana ndi miyambo yomwe imapangitsa kuti zikhale zovuta kuvomereza zomwe akumana nazo zomwe sizili bwino [6] ndi [7].

Ngakhale nkhani zokhudza kusankha, kudziwika kwa kugonana, ndi mbiri ya kugonana zalembedwa bwino, zochepa zomwe zimadziwika za mavuto omwe achinyamata angakhale nawo pa momwe amayankhira kugonana ndi magwiridwe antchito awo. Izi zili choncho chifukwa mavuto okhudzana ndi kugonana amaonedwa kuti ndi ofunika kwambiri kwa okalamba. Kugonana kumatanthauzidwa ngati kuthekera kwa munthu kuyankha kugonana kapena kusangalala ndi kugonana [8] ndipo mavuto okhudzana ndi kugonana ndi omwe amasokoneza izi. Kafukufuku wokhudza kuchuluka kwa mavuto okhudzana ndi kugonana nthawi zambiri amaphatikizapo ophunzira azaka zapakati pa 16 kapena 18, koma nthawi zambiri amagwiritsa ntchito magulu akuluakulu azaka, mpaka zaka 29 [9] ndipo nthawi zambiri sapereka tsatanetsatane wa achinyamata osakwana zaka 24 [10] , [11] ndi [12] . Kafukufuku wochepa wayang'ana makamaka pa ukalamba, ndipo izi sizinagwiritse ntchito deta yoyimira dziko lonse [13] ndi [14].

Pali kuzindikira kwakukulu kuti thanzi la kugonana liyenera kuganiziridwa mozama [15] ndi [16] , ndipo tanthauzo lonse lomwe limavomerezedwa ndi WHO—“mkhalidwe wa thanzi la thupi, malingaliro, maganizo ndi chikhalidwe cha anthu pokhudzana ndi kugonana” [17] —likuchulukirachulukira. Mwa achinyamata, thanzi la kugonana limaphatikizapo “zopereka zabwino pakukula kwa kugonana, komanso kupeza maluso ofunikira popewa zotsatira zoyipa za kugonana” [18] . Pali umboni wakuti zolinga zokhudzana ndi kukhutitsidwa ndi kugonana ndi chisangalalo zimayambitsa njira zodzitetezera ku chiopsezo komanso zochepetsera chiopsezo [16] ndi [19] . Mwachitsanzo, mantha okhudza kugwira ntchito kwa maliseche pakati pa anyamata awonetsedwa kuti amathandizira kukana kugwiritsa ntchito kondomu [20] komanso kugwiritsa ntchito kondomu mosasinthasintha [21] . Thanzi labwino la kugonana mwa achinyamata limagwirizanitsidwa ndi machitidwe ochepetsa chiopsezo, monga kugwiritsa ntchito kondomu ndi kudziletsa kugonana [18] , ndipo ntchito yogonana mwa akuluakulu imagwirizanitsidwa molakwika ndi khalidwe la chiopsezo [22] . Chifukwa chake, njira zotetezera chisangalalo zitha kukhala zothandiza kwambiri kuposa zomwe zimanyalanyaza izi [16] ndi [23] . Kusowa kwa deta yokhudza kugonana kwa achinyamata pakadali pano kumachepetsa khama lothana ndi thanzi la kugonana mokwanira ndipo kumalimbitsa chikhulupiriro chakuti kugonana ndi ubwino sizikugwirizana kwenikweni ndi njira zopewera zomwe zimayang'ana achinyamata [1] ndi [24].

Tanena kale za kufalikira kwa mavuto okhudzana ndi kugonana kwa akuluakulu azaka zapakati pa 16-74 pogwiritsa ntchito deta yochokera ku National Survey of Sexual Attitudes and Lifestyles (Natsal-3) [22] . Pano, tikugwiritsa ntchito deta yomweyi kuti tithetse kusiyana kwa deta yokhudzana ndi mavuto okhudzana ndi kugonana (kuphatikizapo omwe amayambitsa kuvutika maganizo), thandizo lofufuza za moyo wa kugonana, komanso kupewa kugonana chifukwa cha mavuto, mwa achinyamata azaka zapakati pa 16-21 ku Britain.

Njira

Ophunzira ndi ndondomeko

Tikupereka deta kuchokera kwa ophunzira azaka zapakati pa 16 ndi 21 omwe adatenga nawo gawo mu Natsal-3, kafukufuku wa zitsanzo za mwayi wosiyanasiyana wa amuna ndi akazi 15,162 azaka zapakati pa 16-74 ku Britain, womwe unafunsidwa pakati pa Seputembala 2010 ndi Ogasiti 2012. Timayang'ana kwambiri nthawi yoyambirira ya ukalamba ndi magawo oyamba a ntchito zogonana achinyamata asanayambe "kukhazikika" muubwenzi wa nthawi yayitali komanso zizolowezi zogonana. Tinagwiritsa ntchito kapangidwe ka zitsanzo za mwayi wosiyanasiyana, zogawanika, komanso zogawanika, ndi Fayilo ya Adilesi ya Postcode ya UK ngati chimango cha zitsanzo ndi magawo a postcode (n = 1,727) yosankhidwa ngati gawo loyambira la zitsanzo. Mu gawo lililonse loyambira la zitsanzo, maadiresi 30 kapena 36 adasankhidwa mwachisawawa, ndipo mkati mwa banja lililonse, munthu wamkulu woyenerera adasankhidwa pogwiritsa ntchito gridi ya Kish. Pambuyo poyesa kuti asinthe mwayi wosasankhidwa, chitsanzo cha Natsal-3 chinali choyimira anthu aku Britain monga momwe ziwerengero za Census za 2011 zidafotokozera [25].

Ophunzirawo anafunsidwa mafunso kunyumba ndi wofunsa mafunso wophunzitsidwa bwino, pogwiritsa ntchito njira zosiyanasiyana zofunsira mafunso okhudza kompyuta ndi kompyuta (CASI) zomwe zinali zovuta kwambiri. Wofunsa mafunso analipo ndipo analipo kuti athandize pamene ophunzirawo anamaliza CASI koma sanawone mayankho. Kumapeto kwa magawo a CASI, mayankho “anatsekedwa” mu kompyuta ndipo sanathe kupezeka kwa wofunsa mafunsoyo. Kuyankhulanako kunatenga pafupifupi ola limodzi, ndipo ophunzirawo analandira £15 ngati chizindikiro choyamikira. Chipangizo chofufuzirachi chinayesedwa bwino ndi kuyezetsa [26].

Chiwerengero chonse cha mayankho chinali 57.7% ya maadiresi onse oyenerera (64.8% pakati pa ophunzira azaka zapakati pa 16-44). Chiwerengero cha mgwirizano (chiwerengero cha omwe adayankha pamaadiresi oyenerera omwe adalumikizana nawo povomereza kutenga nawo mbali mu kafukufukuyu) chinali 65.8%. Tsatanetsatane wa njira yofufuzirayi wafalitsidwa kwina [25] ndi [27] . Natsal-3 idavomerezedwa ndi Oxfordshire Research Ethics Committee A. Ophunzira adapereka chilolezo cha pakamwa pa kuyankhulana.

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 adatenga nawo mbali pazochitika zogonana (omwe adakumanapo ndi zogonana), mosasamala kanthu za zomwe adachita chaka chatha, adapemphedwa kuti aunike moyo wawo wonse wogonana, kuphatikizapo ngati adapewa kugonana chifukwa cha zovuta zogonana zomwe adakumana nazo iwowo kapena mnzawo (akugwirizana nazo kwambiri, akugwirizana nazo, sakugwirizana nazo kapena kusagwirizana nazo, sakugwirizana nazo kwambiri). Ophunzira omwe adavomereza mwamphamvu kapena kuvomereza adapatsidwa mndandanda womwewo wa mavuto ndipo adafunsidwa kuti asonyeze zomwe, ngati zilipo, zidawapangitsa kupewa kugonana. Njira zina zoyankhira zinali motere: "mnzawo anali ndi vuto limodzi (kapena angapo) la kugonana" ndipo "palibe chilichonse mwa izi chomwe chidandipangitsa kupewa kugonana." Mayankho angapo adaloledwa. Ophunzirawo adafunsidwanso ngati adamva kupsinjika kapena kuda nkhawa ndi moyo wawo wogonana pogwiritsa ntchito sikelo ya Likert ya mfundo zisanu. Pomaliza, ophunzirawo adafunsidwa ngati adapempha thandizo kapena upangiri wokhudza moyo wawo wogonana kuchokera pamndandanda uliwonse wa magwero chaka chatha, ndipo ngati inde, sankhani zonse zomwe zikugwirizana. Pambuyo pake zosankhazi zinaikidwa m'magulu monga wachibale/bwenzi, atolankhani/odzithandiza (kuphatikizapo malo odziwitsa ndi othandizira pa intaneti; mabuku odzithandiza/timabuku todziwitsa; magulu odzithandiza; foni yothandizira), ndi akatswiri (kuphatikizapo dokotala wamba/dokotala wa banja; thanzi la kugonana/mankhwala ogonana ndi mkodzo/chipatala cha matenda opatsirana pogonana; dokotala wamaganizo kapena katswiri wa zamaganizo; mlangizi waubwenzi; mtundu wina wa chipatala kapena dokotala), kapena sanapemphe thandizo lililonse. Zinthuzi zimachokera ku Natsal-SF; muyeso wa ntchito yogonana yomwe idapangidwa makamaka ndikutsimikiziridwa kuti igwiritsidwe ntchito mu kafukufukuyu ndi kafukufuku wina wokhudza kuchuluka kwa anthu. Muyeso wa Natsal-SF wazinthu 17 uli ndi kuyenerera bwino (kuyerekeza kuyenerera = .963; Tucker Lewis index = .951; cholakwika chachikulu chapakati cha pafupifupi = .064), imatha kusiyanitsa pakati pa magulu azachipatala ndi magulu a anthu wamba, ndipo ili ndi kudalirika kwabwino kwa mayeso-kubwereza ( 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%) azaka zapakati pa 16-21 adanena kuti anali ndi mnzawo m'modzi kapena angapo chaka chatha ndipo motero adagawidwa m'magulu a amuna omwe anali ndi vuto la kugonana (amuna 854 ndi akazi 1,021). Gome 1 likuwonetsa chiwerengero cha amuna awa omwe adanena za vuto lililonse la magawo asanu ndi atatu a kugonana lomwe lidakhala miyezi itatu kapena kuposerapo chaka chatha. Gawo limodzi mwa magawo atatu a amuna awa (33.8%) adakumana ndi vuto limodzi kapena angapo a kugonana (gawo loyamba la Gome 1 ), ndipo 9.1% adanenanso za vuto limodzi kapena angapo a kugonana (gawo lachiwiri); zomwe zikutanthauza kuti pakati pa amuna omwe adanena za vuto limodzi kapena angapo, kotala limodzi (26.9%) adamva kupsinjika (gawo lachitatu).

Gulu 1.

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

	Kufotokozera vuto lililonse la ntchito yogonana		Kufotokozera vuto lililonse ndi zovuta za izo		Mwa iwo omwe amafotokoza vuto lililonse la ntchito yogonana,% moyenera kapena opsinjika kwambiri za izo
Zipembedzo a	854, 610		854, 610		281, 204
	peresenti	95% CI	peresenti	95% CI	peresenti	95% CI
Anasowa chidwi chogonana	10.50	8.1-13.5	1.40	.8-2.5	13.20	7.2-22.8
Kusangalala ndi kugonana	5.40	4.0-7.3	.90	.4-1.7	16.20	8.1-29.8
Ankadandaula panthawi yogonana	4.80	3.5-6.6	1.50	.8-2.7	30.40	17.9-46.6
Kumva kupweteka kwa thupi chifukwa cha kugonana	1.90	1.1-3.4	.20	.1-.9	11.30	2.5-39.1
Palibe chisangalalo kapena kukondwerera panthawi yogonana	3.20	2.1-4.8	.80	.4-2.0	25.90	11.5-48.4
Kuvuta kufika pachimake	8.30	6.4-10.8	1.60	.8-3.0	19.20	10.5-32.4
Ifikira pachimake mofulumira kwambiri	13.20	11.0-15.7	4.50	3.2-6.3	34.20	25.5-44.1
Kuvuta kupeza / kusunga erection	7.80	6.0-10.2	3.30	2.2-4.9	42.10	29.1-56.4
Zomwe zinakuchitikirani kapena zambiri mwa izi	33.80	30.2-37.7	9.10	7.2-11.4	26.90	21.5-33.0
Ankafuna thandizo kapena malangizo pa moyo wa kugonana	26.00	22.9-29.5

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.

Gome 2 likuwonetsa chiwerengero cha akazi achichepere omwe akuchita zogonana omwe akunena za vuto lililonse la kugonana, ndipo mwa iwo omwe akukumana ndi vutoli, chiwerengerocho chinali chodandaula. Osakwana theka (44.4%) mwa akazi awa adakumana ndi vuto limodzi kapena angapo la kugonana lomwe lidatenga miyezi itatu kapena kuposerapo chaka chatha, ndipo 13.4% adanenanso za vuto losautsa; zomwe zikutanthauza kuti mwa iwo omwe adanena za vuto limodzi kapena angapo, ochepa okha mwa atatu (30.2%) ndi omwe adavutika.

Gulu 2.

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

	Kufotokozera vuto lililonse la ntchito yogonana		Kufotokozera vuto lililonse ndi zovuta za izo		Mwa iwo omwe amafotokoza vuto lililonse la ntchito yogonana,% moyenera kapena opsinjika kwambiri za izo
Zipembedzo a	1,021, 553		1,021, 553		449, 242
	peresenti	95% CI	peresenti	95% CI	peresenti	95% CI
Anasowa chidwi chogonana	22.00	19.3-25.0	5.30	4.0-7.0	24.00	18.4-30.6
Kusangalala ndi kugonana	9.80	7.9-12.1	2.80	1.9-4.1	28.40	19.8-39.0
Ankadandaula panthawi yogonana	8.00	6.3-10.2	2.80	1.9-4.1	34.70	24.2-47.0
Kumva kupweteka kwa thupi chifukwa cha kugonana	9.00	7.3-11.0	3.20	2.3-4.5	35.90	26.7-46.2
Palibe chisangalalo kapena kukondwerera panthawi yogonana	8.00	6.2-10.1	2.50	1.6-3.9	31.60	21.2-44.3
Kuvuta kufika pachimake	21.30	18.6-24.3	6.30	4.9-8.2	29.70	23.4-36.9
Ifikira pachimake mofulumira kwambiri	3.90	2.7-5.5	.40	.2-1.1	10.80	4.0-26.3
N'zosakayikitsa kuti mimba yowuma	8.50	6.7-10.6	2.20	1.5-3.4	26.20	17.5-37.2
Zomwe zinakuchitikirani kapena zambiri mwa izi	44.40	41.1-47.8	13.40	11.3-15.9	30.20	25.7-35.1
Ankafuna thandizo kapena malangizo pa moyo wa kugonana	36.30	33.1-39.7

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%.

Pakati pa achinyamata omwe adachita zachiwerewere chaka chatha, 6.3% ya amuna ndi 6.8% ya akazi adati adapewa kugonana chifukwa cha vuto la kugonana. Pakati pa anyamata ( Chithunzi 1 ), zifukwa zodziwika bwino zopewera zinali zovuta kupeza kapena kusunga mbewa, kufika pachimake mwachangu kwambiri, komanso kusowa chidwi (zomwe zanenedwa ndi 26.1%, 24.4%, ndi 25.1%, motsatana, mwa anyamata onse omwe adati adapewa kugonana). Pakati pa atsikana ( Chithunzi 1 ), zifukwa zodziwika kwambiri zopewera zinali kusowa chidwi (zomwe zanenedwa ndi 45.5% ya akazi omwe adapewa kugonana), kutsatiridwa ndi kusowa chisangalalo, nkhawa, ndi ululu (zomwe zanenedwa ndi 21.2%, 25.3%, ndi 23.7%, motsatana, mwa akazi 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

Ponseponse, 26% (22.9–29.5) ya amuna ochita zogonana ndi 36.3% (33.1–39.7) ya akazi ochita zogonana adapempha thandizo pa moyo wawo wogonana chaka chatha (mzere womaliza, Matebulo 1 ndi 2 ). Chithunzi 2 chikuwonetsa kuchuluka kwa magwero osiyanasiyana, ogawidwa malinga ndi zomwe adakumana nazo pa vuto la kugonana. Omwe adanena za vuto limodzi kapena angapo nthawi zambiri amafuna thandizo poyerekeza ndi omwe adanena kuti alibe vuto (35.5% vs. 21% ya amuna; p < .001 ndi 42.3% vs. 31.1%; p = .001). Kumene achinyamata adapempha thandizo, achibale ndi abwenzi anali gwero lodziwika bwino lotsatiridwa ndi atolankhani/kudzithandiza. Thandizo la akatswiri silinali lofunidwa kwambiri. Pakati pa achinyamata omwe adanena za vuto limodzi kapena angapo okhudzana ndi kugonana, 3.6% (1.9–6.8) ya amuna ndi 7.9% (5.8–10.6) ya akazi adafunsa akatswiri za moyo wawo wogonana 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

Onse pamodzi, amuna 262 ndi akazi 255 adakumana ndi vuto la kugonana (adakumanapo ndi vuto la kugonana) koma sananene kuti adagonana chaka chimodzi asanafunse mafunso ( Gome 3 ). Amuna oposa mmodzi mwa asanu ndi mmodzi (17.4%) ndi akazi pafupifupi mmodzi mwa asanu ndi atatu (12%) adanena kuti adavutika ndi moyo wawo wogonana, ndipo amuna ndi akazi pafupifupi mmodzi mwa khumi (10%) adati adapewa kugonana chifukwa cha mavuto ogonana omwe iwo kapena anzawo adakumana nawo. Panalibe kusiyana pakati pa amuna ndi akazi pofotokoza za mavuto kapena kupewa.

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

	Men		Women
Zipembedzo	262, 165		255, 138
	peresenti	95% CI	peresenti	95% CI
Kusokonezeka kapena nkhawa pa moyo wa kugonana	17.40	12.8-23.4	12.00	8.3-17.2
Kupewa kugonana chifukwa cha zovuta zomwe mumachita kapena zogonana	10.10	5.5-17.9	10.70	5.4-20.1
Wokhutira ndi moyo wa kugonana	34.60	28.5-41.3	32.20	26.2-38.7

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 ya kafukufukuyu ndi yakuti imachokera pa chitsanzo chachikulu cha kuthekera kwa anthu ndipo imayang'ana kusiyana kwakukulu mu umboni wovomerezeka pamavuto okhudzana ndi kugonana pakati pa achinyamata. Ngakhale kuti kuchuluka kwa mayankho a kafukufukuyu (57.7%) kukuwonetsa kuti ndi gwero la tsankho, kuchuluka kwa mayankho pakati pa azaka zapakati pa 16 ndi 44 kunali kokwera, pa 64.8%. Tawona kale kuchepa kwaposachedwa kwa kuchuluka kwa mayankho a kafukufuku, kuphatikiza njira zolimba kwambiri zowerengera, ndipo tawonanso kuti kuchuluka kwa mayankho athu kukugwirizana ndi kafukufuku wina waukulu ku United Kingdom [25] ndi [27] . Komabe, tsankho lokhazikika povomereza kutenga nawo mbali ndizotheka, ndipo tidagwiritsa ntchito zolemera za kafukufuku kuti tichepetse tsankholi (onani Njira ). Zinthu zokhudzana ndi mavuto okhudzana ndi kugonana ndizovuta, ndipo deta yodzidziwitsa yokha ikhoza kukhala ndi tsankho lokumbukira ndipo imakonda kupereka malipoti ochepa. Tinayesetsa kuchepetsa tsankho pofotokoza mavuto okhudzana ndi kugonana ngati "zovuta zofala" [22] , poyesa zinthu mwanzeru [28] , komanso pogwiritsa ntchito mafunso odzifunsa okha omwe amathandizidwa ndi kompyuta [25].

Deta yathu ikuwonetsa kuti mavuto okhudzana ndi kugonana si achilendo m'gulu la anthu azaka izi. Ziwerengero za kuchuluka kwa amuna ndi akazi ogonana azaka zapakati pa 16 ndi 21 omwe akunena za mavuto okhudzana ndi kugonana sikotsika kwambiri kuposa anthu onse a Natsal-3, 41.6% kwa amuna ndi 51.2% kwa akazi [22] . Kafukufuku wochuluka wokhudza anthu waphatikizapo ndi kunena za magulu a achinyamata [10] , [11] , [12] ndi [29] ngakhale kufananiza kuli kochepa chifukwa cha kusiyana kwa njira zofufuzira komanso kugawa mavuto okhudzana ndi kugonana komanso kuopsa kwawo. Mwachitsanzo, kafukufuku waposachedwapa wa ku Canada [13] , adapeza kuti 50% ya amuna ndi akazi ogonana azaka zapakati pa 16 ndi 21 adanena za vuto la kugonana, omwe theka lawo linanena za kuvutika komwe kumakhudzana ndi kugonana, ngakhale kuti chitsanzo chaching'ono, chosasinthika komanso kusiyana kwa matanthauzidwe kukusonyeza kufunika kosamala potanthauzira. Pakati pa anyamata, kuyerekezera kwathu kwa kuchuluka kwa mavuto okhudzana ndi kugonana (7.8%) kuli pakati pa 4.3% komwe kwapezeka mu kafukufuku wa ku Australia wa achinyamata azaka 16 mpaka 19 [10] ndi 11% pakati pa achinyamata azaka 16 mpaka 24 omwe amachita zogonana mu kafukufuku ku Portugal [12] . Kuyerekeza kwathu kwa 13.2% kwa kusamba msanga kwa umuna ndi kotsika pang'ono kuposa kafukufuku wa ku Australia (15.3%) komanso kotsika kwambiri kuposa kafukufuku wa ku Portugal (40%). Pakati pa atsikana, kuyerekezera kwathu kwa kusakhala ndi chidwi (22%) ndi kuvutika kufika pachimake (21.3%) ndi kotsika pang'ono kuposa komwe kwachitika mu kafukufuku wa ku Australia (36.7% ndi 29%, motsatana) ndipo kuli kofanana ndi kuchuluka kwa pafupifupi 20% ndi 27% mu kafukufuku wa ku Sweden wa akazi azaka 18-24 [11].

Zanenedwa kuti mavuto ambiri mwa achinyamata amachokera ku "zotsatira za chizolowezi" ndipo amatha pakapita nthawi pamene achinyamata akupeza chidaliro komanso chidziwitso. Pothandizira izi, O'Sullivan et al. [13] adapeza kuti mwa anyamata, nthawi yayitali yogonana imagwirizanitsidwa ndi kugwira ntchito bwino kwa erectile komanso kukhutira kwambiri ndi kugonana. Kumbali ina, chiwerengero cha akuluakulu omwe ali ndi mavuto okhudzana ndi kugonana amanena kuti zizindikiro za moyo wawo wonse, mwa kuyankhula kwina, zizindikiro zomwe zidawonekera nthawi yoyamba kugonana kapena isanafike nthawi yawo yoyamba kugonana ndipo sizinathe [8] ndi [30] . Zinthu zingapo zomwe zimayambitsa mavuto okhudzana ndi kugonana nthawi zambiri zimapangidwa muubwana ndi unyamata. Izi zikuphatikizapo maphunziro osakwanira okhudzana ndi kugonana, kuvutika kulankhulana za kugonana, nkhawa za thupi la munthu kapena kugonana, komanso chisokonezo kapena manyazi okhudza chilakolako cha kugonana kapena chilakolako cha munthu [31] . Mavuto okhudzana ndi kugonana angasonyezenso kulimbana kuti akwaniritse kugonana kwabwino mkati mwa miyambo yoletsa komanso yokhudzana ndi amuna ndi akazi, mwachitsanzo, kuvomereza komwe akazi ayenera kuyembekezera ndikupirira ululu [5] . Muyezo wofanana pakati pa kugonana komwe akazi amaletsedwa ndipo amuna amapatsidwa mphotho chifukwa cha chilakolako chawo chogonana ukuoneka kuti sungathe kusintha chikhalidwe [32] , ngakhale kuti kafukufuku waposachedwapa akusonyeza kusiyana kwa momwe achinyamata amagwiritsira ntchito zilembo zachikhalidwezi muubwenzi wawo [33].

Kwa zaka zoposa 25 kuyambira pamene nkhani ya Fine ndi McClelland [34] inalembedwa pa nkhani yokhudza chilakolako chofuna kugonana, achinyamata akupitirizabe kuona kusiyana kwa chidziwitso chawo chokhudzana ndi nkhani zamaganizo zokhudzana ndi kugonana ndipo nthawi zambiri amanena kuti sangakwanitse kuthana ndi chibwenzi. Deta ya Natsal-3 ikusonyeza kuti 42% ya amuna ndi 47% ya akazi amafuna kuti akadadziwa zambiri za nkhani zokhudzana ndi kugonana panthawi yomwe adamva kuti ali okonzeka kugonana, kuphatikizapo pafupifupi 20% ya amuna ndi 15% ya akazi omwe amafuna kuti akadadziwa momwe angapangire kugonana kukhala kosangalatsa kwambiri [35] . Mofananamo, mu kafukufuku wosakanikirana wochokera ku New Zealand, ophunzira azaka zapakati pa 16-19 adayika "momwe mungapangire kugonana kukhala kosangalatsa kwa okondedwa onse awiri" ndi "malingaliro muubwenzi" pakati pa mitu isanu yapamwamba yomwe amafuna kudziwa zambiri za maphunziro a kugonana kusukulu [24] . Ngakhale achinyamata akunena kuti akufuna kulankhula za chisangalalo, njira zina zosalowerera m'malo mogonana, ndi maubwenzi amphamvu muubwenzi wogonana, maphunziro ogonana kusukulu nthawi zambiri amanyalanyaza mitu iyi, m'malo mwake zomwe zili mkati mwake zikuwonetsa nkhawa za akuluakulu omwe ali ndi udindo [36].

Kupempha kuti chisangalalo chiphatikizidwe mu maphunziro a kugonana sikwatsopano [37] . Chete pa ubwino wa kugonana kuchokera ku magwero ophunzitsira amadzazidwa ndi magwero ena monga abwenzi ndi atolankhani; ndipo, malinga ndi Natsal-3, pafupifupi kotala la anyamata achinyamata amanena kuti zolaula ndi imodzi mwa magwero awo odziwitsa za kugonana [35] . Ngakhale ogwiritsa ntchito ena amaona kuti zimakhudza moyo wawo wogonana [38] , zolaula zingayambitse ziyembekezo zosayembekezereka komanso zovulaza za kugonana pakati pa anyamata [39] , zomwe zingawonjezere mavuto okhudzana ndi kugonana. Maphunziro a kugonana angathandize kwambiri kutsutsa nthano, kukambirana za chisangalalo, kulimbikitsa ubale wofanana pakati pa amuna ndi akazi, ndikugogomezera ntchito zofunika kwambiri zolumikizirana ndi ulemu mkati mwa maubwenzi kuti athetse mavuto okhudzana ndi kugonana.

Chiŵerengero chochepa cha achinyamata omwe ali ndi mavuto ovutitsa omwe amafunafuna thandizo kapena upangiri mwina sichingadabwe. Kufunafuna thandizo sikwachilendo, ngakhale pakati pa akuluakulu omwe ali ndi mavuto okhudzana ndi kugonana [40] . Maphunziro okhudza kugonana angathandize kwambiri kuthetsa nkhawa, (1) pokwaniritsa zosowa za chidziwitso; (2) potsimikizira achinyamata kuti mavuto ndi ofala komanso ovomerezeka; ndi (3) polimbitsa maulalo opita ku mautumiki othandiza achinyamata. Opereka chithandizo, nawonso, ayenera kudziwa kuti achinyamata omwe amapita kukapeza zosowa zina zokhudzana ndi thanzi la kugonana (monga kulera ndi kuyezetsa matenda opatsirana pogonana) akhoza kukhala akukumana ndi nkhawa zokhudzana ndi kugonana kwawo. Popeza nkhawazi zafala, zingakhale zoyenera kuti opereka chithandizo ayambitse kukambirana mwa kufunsa za kugonana mkati mwa mbiri ya wodwala, ndipo maphunziro amtsogolo angawunikenso phindu la njira imeneyi.

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

Kafukufukuyu adathandizidwa ndi ndalama zothandizira kuchokera ku Medical Research Council ( G0701757 ) ndi Wellcome Trust ( 084840 ), ndi zopereka kuchokera ku Economic and Social Research Council ndi Dipatimenti ya Zaumoyo. Kuyambira Seputembala 2015, KRM yakhala ikuthandizidwa ndi UK Medical Research Council (MRC); MRC/CSO Social & Public Health Sciences Unit, University of Glasgow ( MC_UU_12017-11 ).

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Mikangano ya Zofuna: AMJ ndi Bwanamkubwa wa Wellcome Trust. Olemba ena onse amanena kuti alibe mikangano ya zofuna.

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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