Shared negative experiences of long-acting reversible contraception and their influence on contraceptive decision-making: a multi- methods study
Shared negative experiences of long-acting reversible contraception and their influence on contraceptive decision-making: a multi- methods study
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DOI：
10.1016/j.contraception.2019.01.002
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发表时间：
2019-04-01
期刊：
影响因子：
2.9
通讯作者：
Whitaker, Amy K.
中科院分区：
文献类型：
--
作者：
Brown, Benjamin P.;Chor, Julie;Whitaker, Amy K.
目的：我们探讨了有关长效可逆避孕药 (LARC) 的负面故事（定义为直接与研究参与者分享的有关 LARC 的第一手负面经历）如何影响参与者在流产后是否使用 LARC 的决定，以及咨询如何影响负面 LARC 故事对避孕选择的影响。 研究设计：我们进行了一项多方法研究，纳入一项试验，检验基于理论的咨询干预对流产后 LARC 摄取的影响。参与者完成了一项基线调查，以确定负面 LARC 故事的影响。随后，我们邀请自称听过 LARC 负面故事的受访者参加半结构化定性访谈。我们用单变量统计分析了定量数据。我们使用主题内容分析来分析定性数据。结果：在 60 名参与者中，16 名 (27%) 报告曾听到过 LARC 的负面故事。 16 名女性中有两人 (13%) 计划在咨询前启动 LARC，而 44 名女性中有 18 名 (41%) 没有听过 LARC 负面故事 (p=0.06)。在咨询之前，69% 有负面 LARC 故事的参与者表示，这些故事使他们不太可能使用 LARC。在对 9 名女性的定性访谈中，我们确定了几个关键主题：(1) 负面的 LARC 故事阻碍了 LARC 的使用； (2) 朋友和家人是重要的线人； (3)潜在的副作用对LARC决策很重要； (4) 咨询经历的积极和消极特征影响了负面 LARC 故事的效果。结论：负面 LARC 故事在我们机构前来堕胎的女性中很常见，可能会影响患者对这些方法的接受。 (C) 2019 Elsevier Inc. 保留所有权利。
Objectives: We explored how negative stories about long-acting reversible contraception (LARC) - defined as a firsthand negative experience with LARC shared directly with the study participant - were involved in participants' decisions about whether to use LARC following abortion, and how counseling affected the influence of negative LARC stories on contraceptive choices.Study design: We performed a multi-methods study, embedded within a trial examining the impact of a theorybased counseling intervention on LARC uptake post-abortion. Participants completed a baseline survey to determine the influence of negative LARC stories. We subsequently invited respondents who reported having heard negative LARC stories to participate in a semi-structured qualitative interview. We analyzed quantitative data with univariate statistics. We analyzed qualitative data using thematic content analysis.Results: Among the 60 participants, 16 (27%) reported having heard negative LARC stories. Two of the 16 (13%) planned to initiate LARC prior to counseling, compared to 18 of 44 women (41%) who had not heard negative LARC stories (p=0.06). Prior to counseling, 69% of participants with negative LARC stories reported that these stories made them less likely to use LARC. In qualitative interviews with 9 women, we identified several key themes: (1) negative LARC stories deterred LARC use; (2) friends and family were valued informants; (3) potential side effects were important to LARC decision-making; and (4) positive and negative features of the counseling encounter influenced the effect of negative LARC stories.Conclusions: Negative LARC stories are common among women presenting for abortion at our institution and may influence patient uptake of these methods. (C) 2019 Elsevier Inc. All rights reserved.