Tomaszewski Jacek, Paszkowski Tomasz, Debski Romuald, Kotarski Jan, Skrzypulec-Plinta Violetta, Spaczyński Robert Z, Pawelczyk Leszek
II Katedra i Klinika Ginekologii UM w Lublinie, Polska.
Ginekol Pol. 2012 Jun;83(6):417-23.
The aim of the study was to develop an optimal educational model for contraceptive counseling, to analyze conditions influencing choice of hormonal contraception, to study patients' opinions on present, planned and proposed contraceptive methods and to link these data with socioeconomic and demographic conditions.
One thousand eight hundred fifty women (mean age 26.8 +/- 5.9 yrs) willing to use hormonal contraception were presented with essential information on combined hormonal contraception and asked to fill the anonymous questionnaire investigating factors influencing contraceptive choice and patients' opinion on alternative forms of birth regulation. The study was conducted in selected 185 centers in Poland and was a part of a larger survey (CHOICE) conducted on 11 216 women in Europe and Israel.
Majority of the studied women were in stable relationship (85,5%), had higher or incomplete higher education (54.8%) and permanent job (54%). The purpose of the visit was to start/change contraception (64.2%), a routine gynecologic check-up (36.7%) or the need for a prescription for the continued contraceptive medication (18.7%). The most commonly used contraceptive methods were oral contraceptive pills (OCP 38.7%) and condom (24.9%). Majority of women highly valued contraceptive counseling and more than 90% were eager to get familiarized with information leaflets. Before the counseling majority of subjects stated that were convinced to use OCP (52.7%; major advantages named: easy to use, favorable bleeding profile, amelioration of menstrual discomfort, comfortable, discrete) and contraceptive patch (22%; major advantages named: applied once a week, comfortable, simple, low risk for noncompliance, favorable bleeding profile). After the counseling there was an increase in proportion of women interested in contraceptive hormonal ring (by 19%; major advantages named: applied once a month, comfortable, very low risk for noncompliance, high efficacy and positive recommendation from a physician). In 58 women no hormonal contraception was recommended, predominantly due to medical contraindications.
Appropriate patient counseling on all forms of combined hormonal contraception, with special attention paid to benefits and safety issues, suited to women's expectations and education is fundamental for the selection of an optimal birth control method.
本研究旨在开发一种最佳的避孕咨询教育模式，分析影响激素避孕选择的因素，研究患者对现有、计划使用和建议使用的避孕方法的看法，并将这些数据与社会经济和人口状况相关联。
向1850名愿意使用激素避孕的女性（平均年龄26.8±5.9岁）提供复方激素避孕的基本信息，并要求她们填写一份匿名问卷，调查影响避孕选择的因素以及患者对其他节育方式的看法。该研究在波兰选定的185个中心进行，是在欧洲和以色列对11216名女性进行的一项更大规模调查（CHOICE）的一部分。
大多数参与研究的女性处于稳定关系（85.5%），拥有高等教育或高等教育未完成（54.8%）以及有固定工作（54%）。就诊目的是开始/更换避孕方法（64.2%）、进行常规妇科检查（36.7%）或需要继续使用避孕药物的处方（18.7%）。最常用的避孕方法是口服避孕药（OCP，38.7%）和避孕套（24.9%）。大多数女性高度重视避孕咨询，超过90%的女性渴望了解信息手册。在咨询前，大多数受试者表示确信会使用口服避孕药（52.7%；主要优点：使用方便、出血情况良好、缓解经期不适、舒适、隐秘）和避孕贴片（22%；主要优点：每周使用一次、舒适、简单、不依从风险低、出血情况良好）。咨询后，对激素避孕环感兴趣的女性比例有所增加（增加了19%；主要优点：每月使用一次、舒适、不依从风险极低、高效且有医生的积极推荐）。在58名女性中未推荐使用激素避孕，主要原因是医学上的禁忌。
针对所有复方激素避孕形式进行适当的患者咨询，特别关注益处和安全问题，符合女性的期望和教育水平，对于选择最佳的节育方法至关重要。
