Department of Family and Social Medicine, Montefiore Medical Center/Albert Einstein College of Medicine, Bronx, New York 10461, USA.
J Womens Health (Larchmt). 2010 Apr;19(4):735-40. doi: 10.1089/jwh.2009.1549.
Improper and inconsistent contraceptive use contributes to the unintended pregnancy rate. The intrauterine device (IUD) is an effective, safe method of contraception that cannot be used improperly or inconsistently. However, it is relatively underused in the United States. We developed a qualitative study to better understand patient beliefs and attitudes that may act as a barrier to acceptance or use of an IUD.
We conducted semistructured interviews with a convenience sample of 40 reproductive aged women from two Bronx, New York, family medicine practices. Self-report of having heard of the IUD was the main eligibility criterion. We used an iterative process of data collection and analysis.
Although respondents appreciate the advantages of an IUD, they express a number of conceptual concerns and fears about the device. These are primarily related to voluntarily placing a device inside the body for a prolonged period of time and to a knowledge gap about internal female reproductive anatomy. The IUD is viewed as a contraception option to use when other methods have failed or after childbearing. Additionally, respondents report a lack of discussion and information about the IUD from healthcare providers, the media, and informal networks.
Directly addressing patient reservations that might otherwise be left unsaid could potentially increase acceptance of the IUD. The issues elucidated in this study begin to shed light on specific patient concerns that providers or public health messages may address during IUD contraception counseling. Given the high efficacy and safety of IUDs, increasing use could impact rates of unplanned pregnancy.
避孕方法使用不当和不规范是导致意外妊娠的原因之一。宫内节育器（IUD）是一种高效、安全的避孕方法，不会出现使用不当或不规范的情况。然而，它在美国的使用率相对较低。我们开展了一项定性研究，以更好地了解可能成为接受或使用宫内节育器障碍的患者信念和态度。
我们对来自纽约布朗克斯区两家家庭医疗诊所的 40 名育龄妇女进行了半结构式访谈。主要入选标准为自述听说过宫内节育器。我们采用数据收集和分析的迭代过程。
尽管受访者欣赏宫内节育器的优势，但他们对该设备表达了一些概念上的担忧和恐惧。这些担忧主要与自愿将设备长时间放置在体内以及对女性内部生殖解剖结构缺乏了解有关。宫内节育器被视为在其他方法失败或生育后使用的避孕选择。此外，受访者报告称，他们从医疗保健提供者、媒体和非正式网络中获取有关宫内节育器的讨论和信息较少。
直接解决可能未被提及的患者保留意见，可能会提高对宫内节育器的接受程度。本研究阐明的问题开始阐明提供者或公共卫生信息可能在宫内节育器避孕咨询中解决的具体患者关注点。鉴于宫内节育器的高效性和安全性，增加其使用率可能会影响意外妊娠率。
