| Objective: This study aimed to investigate the hepatitis B knowledge among parturients in some areas in Gansu Province,to investigate the stigma and mental health of parturients with hepatitis B surface antigen(HBs Ag)-positive,to investigate the willingness of their children to undergo Post Vaccination Serologic Testing(PVST),and to explore the relevant influential factors,so as to provide references for the development of targeted hepatitis B education strategies and the effective implementation of PVST.Methods: Lintao County,Ganzhou District and Liangzhou District of Gansu Province were selected as the survey areas.Parturients who delivered between March1,2019 and September 30,2019 were selected for the study,and a one-to-one anonymous questionnaire survey was conducted.All questionnaire data was entered using Epi Data 3.1,processed in SPSS 22.0 and R 4.2.3.Logistic regression,generalized linear regression,least absolute shrinkage and selection operator(Lasso)regression,and random forest decision tree models were constructed for statistical analysis,and the Bootstrap test in the Process 3.3 plug-in was used to construct a mediating effect model,with P < 0.05 as the test criterion.Results:(1)The influential factors of hepatitis B knowledge among parturients.A total of440 valid questionnaires were collected,with a 100% return rate.The awareness rate of hepatitis B was 62.50%,which was lower than the requirement that the awareness rate reach more than 80% in China’s hepatitis B prevention and treatment plan.The mean score of hepatitis B knowledge was 5.92 ± 1.91,of which the mean scores of HBs Agpositive and HBs Ag-negative parturients were 6.03 ± 1.89 and 5.81 ± 1.92,respectively.There were statistically significant differences in hepatitis B knowledge scores with respect to age,education,occupation,per capita monthly household income,and parity(P < 0.05).The results of multiple ordered logistic regression suggested that education and occupation were the influential factors for the awareness of hepatitis B(P < 0.05).Compared to farmers,hepatitis B knowledge scores were significantly higher among medical personnel(OR = 7.55,95% CI: 2.27,30.19).The results of the survey on the need for health education methods showed that direct health education by medical staff was the most effective way for parturients to obtain knowledge regarding hepatitis B currently and in the future.(2)The influential factors of mental health status among parturients.The mean score of mental health was 18.05 ± 6.23 among parturients.The mean score in HBs Agpositive parturients(18.75 ± 6.20)was significantly higher than that in HBs Ag-negative parturients(17.35 ± 6.20),indicating that the mental health in HBs Ag-positive parturients was worse.On each dimension,the scores of depressions(P < 0.05)and anxiety symptoms(P < 0.01)were significantly higher in HBs Ag-positive parturients.The generalized linear model suggested that HBV infection was an influential factor of mental health status,and the scores of mental health status were significantly higher in HBs Ag-positive parturients(β = 1.22,95% CI: 0.24,2.55).(3)The influential factors of hepatitis B discrimination among HBs Ag-negative parturients.The mean score of hepatitis B discrimination in HBs Ag-negative parturients was 5.78 ± 3.24.Only 1.82%(4)of parturients did not discriminate against HBV-infected individuals at all;23.63%(52)of parturients held greater prejudices against HBV-infected individuals;and 3.18%(7)of parturients held completely discriminatory attitudes towards HBV-infected individuals.There were statistically significant differences in the scores of hepatitis B discrimination by occupation,parity,and per capita monthly household income(P < 0.01).The results of the general linear model suggested that occupation was an influential factor of the scores of hepatitis B discrimination in HBs Ag-negative parturients.The scores of hepatitis B discrimination were significantly lower among housewives compared to farmers(β = 1.438,95% CI:2.656,0.179).(4)The influential factors of stigma and mental health status of HBs Ag-positive parturients.The mean score of stigma was 1.32 ± 1.29 in HBs Ag-positive parturients.There were statistically significant differences in the scores of stigma in terms of occupation,income levels,awareness of hepatitis B,and whether or not to receive treatment during pregnancy/postpartum(P < 0.05).Regression analysis showed that income levels,awareness of hepatitis B,whether or not to experience discrimination,and whether or not to receive treatment during pregnancy/postpartum were influential factors in the scores of stigma in HBs Ag-positive parturients(P < 0.05).The differences in the scores of mental health status among HBs Ag-positive parturients were statistically significant(P < 0.05)in terms of occupation,feeding methods,awareness of hepatitis B,whether or not to experience discrimination,and the levels of stigma.The results of generalized linear regression showed that feeding methods,awareness of hepatitis B,whether or not to experience discrimination,and levels of stigma were influential factors of the scores of mental health status in HBs Agpositive parturients(P < 0.05).The scores of mental health were lower among parturients who adopted the breastfeeding method(β = 2.49,95%CI: 1.04,3.95).The scores of mental health status were significantly higher among parturients with previous discrimination(β = 1.45,95%CI: 0.39,3.29).The results of the random forest model suggested that the level of stigma was the most important influencing factor.The scores of hepatitis B knowledge were negatively correlated with the scores of stigma(r =-0.15,P < 0.05)and the scores of mental health status(r =-0.27,P < 0.01)in HBs Ag-positive parturients.The scores of stigma were positively correlated with the scores of mental health status(r = 0.38,P < 0.01).Stigma partially mediated the relationship between hepatitis B knowledge and mental health,with a mediating effect of 17.72%.(5)Investigation of the willingness of PVST in HBs Ag-positive parturients.The awareness rate of PVST among HBs Ag-positive parturients was 29.55%.The differences in the awareness of PVST were statistically significant in terms of education,delivery methods,awareness of hepatitis B,whether or not to experience discrimination,and whether or not to receive treatment during pregnancy/postpartum(P < 0.05).Awareness of hepatitis B knowledge,whether or not to receive treatment during pregnancy/postpartum,and delivery methods were influential factors of the awareness in PVST among HBs Ag-positive parturients(P < 0.05).94.55%(208)of the parturients were willing to undergo PVST after full vaccination,while 5.45% refused PVST.The young age of children,the perceived lack of necessity,and the fear of privacy disclosure were the reasons why HBs Ag-positive parturients refused PVST.There were statistically significant differences in the willingness of the PVST in terms of age,resident population,and feeding methods(P< 0.05).Feeding methods were influential factors for the willingness of PVST(P <0.05).The acceptance of PVST was better among HBs Ag-positive parturients who adopted breastfeeding practices(OR = 6.96,95%CI: 1.06,45.59).In terms of the choice of blood collection method,68.75%(143)of HBs Agpositive parturients wished to collect blood by vein,and 31.25%(65)chose fingertip collection.In terms of the choice of testing time,64.90%(135)of HBs Ag-positive parturients wished to undergo PVST within the prescribed time frame,while 35.10%(73)had the desire to postpone.In terms of the choice of testing location,75.48%(157)of HBs Ag-positive parturients chose to be tested by the Centers for Disease Control and Prevention,while 23.08%(49)of parturients chose to bring their children for testing on their own.Conclusion:(1)The awareness rate of hepatitis B among parturients in some areas of Gansu Province was relatively poor,and did not meet the minimum requirements in China’s hepatitis B prevention and treatment plan in 2019.Education and occupation were influential factors in the awareness of hepatitis B among parturients.(2)There were significant anxiety and depression in HBs Ag-positive parturients.Low awareness of hepatitis B and high stigma were influential factors in the mental health of HBs Ag-positive parturients.(3)The awareness of hepatitis B was an influential factor of stigma in HBs Agpositive parturients,and stigma exerted a mediating effect between hepatitis B knowledge and mental health.(4)The willingness of PVST was higher among HBs Ag-positive parturients,and feeding methods were the influential factors of the willingness for PVST. |
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