Family Health International, Durham, North Carolina, USA.
J Biosoc Sci. 2010 Jul;42(4):493-509. doi: 10.1017/S0021932010000015. Epub 2010 Mar 8.
Counselling on contraception and contraceptive method provision are key components of post-abortion care (PAC). Some studies have suggested that adolescent PAC patients receive worse care than older women seeking these services. This study aimed to evaluate an intervention whose goal was to improve the counselling and contraceptive uptake of PAC patients, with special attention given to the needs of adolescent patients, in the four public hospitals in the Dominican Republic where PAC services were not being routinely offered. The counselling intervention effort included provider training and the development of adolescent-friendly information, education and communication (IEC) materials. Eighty-eight providers were interviewed at baseline and 6 months after the intervention was implemented. Six months after providers were trained, 140 adolescent PAC patients (< or = 19 years of age) and 134 older PAC patients (20-35 years) were interviewed about the contraceptive counselling messages and contraceptive methods they received before they were discharged from hospital. The adolescent and older PAC patients were matched on study hospital and time of arrival. Significant improvements were noted in provider knowledge and attitudes. No changes were noted in provider-reported PAC counselling behaviours, with close to 70% of providers reporting they routinely assess patients' fertility intentions, discuss contraception, assess STI/HIV risk and discuss post-abortion complications. Adolescent and older PAC patients reported receiving PAC counselling messages at similar rates. Forty per cent of adolescent PAC patients and 45% of older PAC patients who wanted to delay pregnancy were discharged with a contraceptive method. Adolescents were more likely to receive an injectable contraceptive method whereas older women were discharged with a variety of methods. The PAC counselling intervention increased provider knowledge and improved their attitudes and benefited both adolescent and older patients.
避孕咨询和避孕方法的提供是流产后护理（PAC）的关键组成部分。一些研究表明，青少年 PAC 患者接受的护理不如寻求这些服务的老年女性好。本研究旨在评估一项干预措施，该措施的目标是改善 PAC 患者的咨询和避孕效果，特别关注青少年患者的需求，该研究在多米尼加共和国的四家公立医院中进行，这些医院没有常规提供 PAC 服务。咨询干预措施包括提供者培训和开发青少年友好的信息、教育和沟通（IEC）材料。在干预实施前和实施后 6 个月对 88 名提供者进行了访谈。在提供者接受培训 6 个月后，对 140 名青少年 PAC 患者（≤19 岁）和 134 名老年 PAC 患者（20-35 岁）进行了采访，了解他们在出院前接受的避孕咨询信息和避孕方法。青少年和老年 PAC 患者在研究医院和到达时间上进行了匹配。提供者的知识和态度有了显著提高。提供者报告的 PAC 咨询行为没有变化，近 70%的提供者报告他们常规评估患者的生育意愿、讨论避孕措施、评估性传播感染/艾滋病毒风险和讨论流产后并发症。青少年和老年 PAC 患者报告接受 PAC 咨询信息的比例相似。40%的希望推迟怀孕的青少年 PAC 患者和 45%的老年 PAC 患者出院时携带避孕方法。青少年更有可能接受注射避孕方法，而老年女性则携带各种避孕方法。PAC 咨询干预措施提高了提供者的知识，改善了他们的态度，并使青少年和老年患者受益。
