产后妇女避孕节育知识及避孕应用调查

目的:了解产后妇女避孕节育知识及避孕应用情况,以便为提高产后妇女避孕率,降低意外妊娠提供依据。方法:选取桂林市的191名产后1年内妇女为研究对象,采用问卷调查法调查避孕节育知识及避孕应用情况。结果:①产后1年妇女避孕率为62.8%,使用工具避孕占88.9%,避孕方式夫妻共同选择的占66.5%。②避孕相关知识总体掌握平均(56.7±13.3)分,知识维度得分排名在最后2位的分别是生育能力恢复时间及对人流危害的认知。结论:应采取多种措施加强对产后避孕的宣教,提高产妇避孕相关知识及产后的避孕率,从而避免意外妊娠,保证母婴健康。     

Exploring young women's decisional needs for contraceptive method choice: a qualitative study

Objective

Assisting women with choosing contraceptive methods that meet their needs and preferences is essential to providing patient-centered care, but research to inform interventions supporting method choice is lacking. An assessment of patient decisional needs for contraceptive method choice may provide insight into patient-centered ways to support decision making.

626例少数民族育龄妇女避孕现状分析

目的 :调查苗族、布依族聚居地育龄妇女避孕现状并分析利弊 ,指导合理选择避孕方法。方法 :以问卷调查方式收集相关资料共 6 2 6份 ,统计方法采用行乘列表卡方检验分析。结果 :IUC使用最为普遍约占 5 1.92 % ,有效率为 85 .5 4 % ,同时副作用和 /或并发症最多 ,约 4 0 .0 8% ,约 36 .2 6 %使用结扎术 ,其避孕效果最确切 ,达 98.6 7% ,副作用少 ,仅 10 .18% ,但可逆性差 ,口服药、避孕套、安全期避孕等方式选用者较少 ,合计占 11.82 %。结论 :不同避孕方式的避孕效果之间存在显著性差异 ,不良反应的发生也有较大差异。随着复孕技术及辅助生育技术水平的提高 ,对有二胎生育政策地区的农村妇女 ,结扎术仍不失为一种有效的避孕方法     

A qualitative study of barriers to postpartum sterilization and women's attitudes toward unfulfilled sterilization requests

BACKGROUND: This longitudinal, qualitative study explores barriers to postpartum sterilization from the perspective of low-income minority women. We examine women's feelings and attitudes regarding a canceled or postponed procedure over time. STUDY DESIGN: We conducted structured, in-depth baseline interviews with 34 postpartum women with unfulfilled sterilization requests in a university hospital setting. Follow-up phone interviews were conducted at 6 weeks and 6 months postpartum. RESULTS: Reasons for unfulfilled sterilization requests included last-minute misgivings, maternal medical complications, lack of a valid Medicaid consent form, fear of the procedure and provider influence. Sense of autonomy regarding sterilization decision making and ability to obtain interval sterilization or initiate and/or successfully use reversible contraception influenced subsequent attitudes regarding an unfulfilled request. CONCLUSIONS: Sterilization counseling should include comprehensive information regarding the surgical procedure and associated risks and the development of a backup contraceptive plan, with particular emphasis on increasing contraceptive self-efficacy and autonomy in sterilization decision making.     

Pregnancy preferences and contraceptive use among US women

ObjectivesAn understanding of the relationship between individuals’ pregnancy preferences and contraceptive use is essential for appropriate patient-centered counseling and care. We examined the relationship between women’s pregnancy preferences and contraceptive use using a new prospective measure, the Desire to Avoid Pregnancy (DAP) scale.Study DesignAs part of a study examining women’s suspicion and confirmation of new pregnancies, we recruited patients aged 15 – 45 from seven reproductive health and primary health facilities in Arizona, New Jersey, New Mexico, South Carolina, and Texas in 2016–2017. We used multivariable logistic, multinomial logistic, and linear regression models to examine the associations among DAP scores (range: 0 – 4) and contraceptive use outcomes and identify factors associated with discordance between DAP and use of contraception.ResultsParticipants with a greater preference to avoid pregnancy had higher odds of contraceptive use (aOR = 1.63, 95% CI: 1.31, 2.04) and used contraceptives more consistently (aβ = 8.9 percentage points, 95% CI: 5.2, 12.7). Nevertheless, 63% of women with low preference to avoid pregnancy reported using a contraceptive method. Higher preference to avoid pregnancy was not associated with type of contraceptive method used: women with the full range of pregnancy preferences reported using all method types.ConclusionWhen measured using a rigorously developed instrument, pregnancy preferences were associated with contraceptive use and consistency of use. However, our findings challenge assumptions that women with the highest preference against pregnancy use more effective methods and that women who might welcome pregnancy do not use contraception.ImplicationsWomen’s preferences about pregnancy contribute significantly to their use of contraception. However, health care providers and researchers should consider that contraceptive features besides effectiveness in preventing pregnancy shape contraceptive decision-making and use.     

Sexual activity and contraceptive use among young female students of tertiary educational institutions in Ilorin, Nigeria

Background

A survey was conducted to evaluate the pattern of sexual behavior and contraceptive use among female students aged 15 to 24 years attending tertiary institutions in Ilorin, Nigeria.

Study design

A valid and reliable semistructured questionnaire was self-administered to a sampled population of 600 students aged 15 to 24 years.

Results

Of the 600 students, 562 (93.7%) completed the questionnaire. Most (98.6%) of the respondents were unmarried, 77.6% have had sexual intercourse, 67.8% have had an unwanted pregnancy while 63.5% have had induced abortion. All the respondents were aware of contraceptives, but only 25.4% have ever used any contraceptive method. The most common sources of information about contraception among the respondents were friends/relatives (73.7%), while the fear of side effects of modern contraceptives was the most common reason (77.5%) for nonuse.

Conclusion

The fear of side effects is the main reason for low contraceptive prevalence among young female students of tertiary institutions in Ilorin. Reproductive health services should focus more on delivery of adequate and accurate information about contraceptives to improve use among young women.     

Factors influencing young women's decision making regarding hormonal contraceptives: a qualitative study

Introduction

Discontinuation of hormonal contraceptives is correlated with the experience of unwanted effects and is an important cause of unwanted pregnancy. Previous studies have not identified the factors that influence whether a woman will switch to another hormonal contraceptive, switch back to condom use or stop contraception altogether when side effects are experienced.

Methods

This qualitative study used in-depth interviews to explore factors influencing young women's decision making regarding highly effective hormonal contraceptives in 51 women aged 16-25 years living in or just outside London, UK.

Results

Young women's decision making regarding hormonal contraceptives is not simply determined by the experience of unwanted effects but reflects the meaning of unwanted effects in relation to underlying beliefs regarding the nature of hormones in contraceptives, ‘natural’ menses, menstrual control and the importance of avoiding pregnancy. When unwanted effects were experienced, women with no concerns about the nature of hormones tended to switch to other highly effective hormonal contraceptives. Those with underlying concerns regarding the nature of hormones returned to (inconsistent) condom use or stopped using contraception altogether. This was linked to experiencing unwanted pregnancy.

Conclusions

Eliciting attitudes regarding the nature of hormones in contraceptives, menstrual control and natural menses could enable health care practitioners to offer more tailored advice, interventions and contraceptives to women.     

外来已婚育龄妇女避孕现状调查

目的:了解外来已婚育龄妇女的避孕现状及对避孕节育相关知识的知晓率,为这一特殊人群提供针对性保健服务,降低重复流产,保障外来已婚育龄妇女的身心健康。方法:采用自制问卷,以自填方式为主,选择2011年1月～2011年8月在4所二级医院计划生育门诊要求人工流产的外来已婚育龄妇女进行调查分析,问卷内容包括调查对象的基本情况、人工流产的次数、人工流产的原因、避孕节育相关知识等方面。结果:外来已婚育龄妇女重复人工流产占比55.51%;人工流产的首要原因是避孕失败占56.75%;避孕失败的主要原因是使用安全套避孕占42.35%;未避孕的首要原因是侥幸心理占50.32%;大专及以上的文化程度对相关避孕知识的知晓率得分均数最高。结论:外来已婚育龄妇女重复人工流产比较高,对避孕节育相关知识匮乏。加强对外来已婚育龄妇女避孕节育的指导和宣教,提高这一弱势群体的自我保健意识,降低重复人工流产率,保障他们的生殖健康。     

Delivering the faecal occult blood test: More instructions than shared decisions. A qualitative study among French GPs

ABSTRACT

Background: Colorectal cancer (CRC) is the third most common cancer worldwide. In France, mass screening has been established with FOBT since 2008. The participation rate remains too low. Previous studies were conducted to explore doctors’ and patients’ perspectives.

Objective: This study was conducted to explore GPs’ performance during consultations in which patients ask for FOBT, focusing on two different aspects: the core content of the consultation and the communication style used between GPs and patients.

Methods: Nine purposively sampled GPs were asked to audiotape specific consultations. Content analysis was performed using Nvivo 9 software. Communication between doctors and patients was explored using RIAS coding.

Results: GPs audio taped specific parts of 35 different consultations when they discussed and delivered the FOBT. The core content included primarily biomedical statements with a large portion dedicated to technical aspects. The communication style was not patient-centred.

Conclusion: While the participation rate of mass screening in France is still low, the analysis of recorded consultations by French GPs confirms that the way of delivering FOBT can be improved.     

江苏省流动妇女避孕现状研究

目的:了解流动妇女避孕现状,保障流动妇女享有计划生育/生殖健康服务的合法权益。方法:对"江苏省流动妇女生存与发展状况研究"问卷调查数据的进行分析。结果:已婚流动妇女的综合避孕率为93.1%,避孕方法仍然以宫内节育器为主,在流入地获得避孕方法的比例为37.2%,28.9%的流动妇女不知道自己使用的避孕方法的不良作用。结论:流动妇女尚未充分享有计划生育/生殖健康服务的合法权益,需从多方面加强干预。     

Depression and coping strategies among Vietnamese women living with HIV: A qualitative study

ABSTRACT

Women living with HIV (WLWH) are more likely to suffer from depression than seronegative women and are also more likely to suffer from depression than men living with HIV. There is limited depression research with WLWH in Vietnam. Twenty in-depth interviews with WLWH were conducted to identify pathways leading to depression and coping strategies for depression. Participants were recruited from an antiretroviral treatment clinic in northern Vietnam. Audio-recorded interviews were transcribed, translated, and analysed to identify key themes. All participants reported sudden loss of social support, debilitating depression, and suicidal ideation in the first six months after HIV diagnosis. While some were able to cope with their status after several months, others continued to struggle due to HIV-related stigma that was perceived as more isolating for WLWH than for men. Women who were able to effectively cope with depression found ways to re-establish connections to family and community. Interventions to improve mental wellbeing should link WLWH to mental health services immediately after diagnosis and address loss of support and stigma, as they contributed to the onset and persistence of depression after HIV diagnosis. Community-level HIV stigma reduction interventions may also help repair broken social bonds and foster new ones.     

广西农村女性HIV病毒感染者社会心理健康状况的质性研究

目的:探讨广西农村地区女性H IV感染者的心理状态,为进一步的心理干预提供参考。方法:采用半结构化访谈的方法,对18位女性H IV感染者进行调查,了解其情绪状态、人际关系和应对心理问题的方式。结果:女性H IV感染者的负性情绪主要有担心、害怕、悲伤、愤怒、内疚、抑郁等。感染者家庭的夫妻之间大多数缺乏交流。亲朋好友的歧视依然存在,主要表现为猜疑、孤立、漠视和拒绝。感染者需要进行同伴交流,应对方式以倾诉和自我宣泄为主。结论:女性H IV感染者的心理健康问题不容忽视,需要采取合理有效的心理干预措施,在个人和家庭两个层面为女性感染者提供心理支持,改善其人际关系,提高其应对心理问题的能力。     

Early predictors of daily smoking in young women: the national heart,lung, and blood institute growth and health study

BACKGROUND: Smoking is highly prevalent in young women and little is known about early multilevel independent risk or protective factors that are predictive of daily smoking in young women. METHODS: Multiple logistic regression was conducted on data from NGHS, a 10-year cohort study of Black (1,213) and White (1,166) girls recruited from three clinical centers in the United States, ages 9-10 years on entry to ages 18-19. RESULTS: Compared with never smokers, White girls were at higher risk than Black girls of being daily smokers at ages 18-19. Early predictors of daily smoking at ages 18-19 years included lower parental education, one parent in the household, drinking alcohol at ages 11-12, higher drive for thinness at ages 11-12, lower behavioral conduct at ages 11-12, and lower stress at ages 10-11 and higher stress at ages 12-13. For both Black and White girls weight-related variables were significant. Stress, behavioral conduct, and one-parent household were also important predictors for White girls. CONCLUSIONS: There is evidence that childhood and adolescent factors are related to young adult smoking behavior. Body weight concerns as well as family, social environment, and behavioral factors are important issues in determining which girls will become daily smokers.     

Incidence of violence against HIV-infected and uninfected women: Findings from the HIV epidemiology research (HER) study

The effect of human immunodeficiency virus (HIV) infection on the incidence of violence against women was addressed in a prospective cohort of HIV-infected and uninfected women. Participants were enrolled between 1993 and 1995 in four US cities and followed up semiannually through 1998. Among 1,087 women with a total accrual of 2,988 person-years (PY) of follow-up, there were 185 reports of abuse (incidence rate=6.19 per 100 PY). The rate of abuse among HIV-infected women with a CD4+count less than 350 cells/μL was lower than that among HIV-infected women with more CD4+ cells/μL or among uninfected women (4.87, 6.92, and 6.44 per 100 PY, respectively). In multivariate analysis, being separated or divorced, having a history of abuse in adulthood, using marijuana, using crack, and having multiple sex partners were each significantly associated with an elevated abuse rate; being older was inversely associated with abuse. Among HIV-infected women, those with fewer CD4+ cells/μL continued to show a decreased abuse rate (bazard ratio=0.55, 95% CI=0.36, 0.82) after adjustment for these factors. It is important to complement existing and future HIV prevention and intervention strategies with efforts to reduce violence against women.     

育龄妇女避孕知识知晓率调查及影响因素分析

目的:了解山东省育龄妇女避孕知识知晓率及其影响因素。方法:采用问卷调查,对4 828名20-49岁育龄妇女的避孕知识得分及其影响因素进行分析。结果:①大部分育龄群众的避孕知识得分在10-30分(满分50分),占65%,及格率只有13.1%。调查对象大多知道IUD、避孕套、输卵管结扎术、输精管结扎术及避孕药。②影响避孕节育知识得分的因素有年龄、文化程度、村分类、是否参加计生宣传培训、读报刊、看电视听广播、上网、个别查询、是否了解现采用避孕措施、技术服务人员是否提供宣传资料、是否知道知情选择的含义、能否自主选择避孕方法等。结论:采取有针对性的干预措施和开展健康教育,促进生殖健康,推动育龄妇女避孕方法知情选择,可提高育龄妇女避孕知识知晓率。