Division of Community Health and Human Development, University of California Berkeley-University of California San Francisco, Joint Medical Program, Berkeley, CA, USA.
J Adolesc Health. 2013 Mar;52(3):293-300. doi: 10.1016/j.jadohealth.2012.07.004. Epub 2012 Aug 25.
To describe the intrauterine contraception (IUC) adoption process among nulliparous adolescents and to identify the role of the medical provider in this trajectory.
We conducted semistructured interviews with a clinic-based sample of 20 nulliparous adolescents (aged 15-24 years) with a history of IUC use. Interviews were analyzed using modified grounded theory and cross-case analysis to reveal a process model for IUC adoption, with a focus on the role of the medical provider.
The model includes the following stages: first awareness, initial reaction, information gathering, adoption, and adjustment and reassessment. It is influenced by personal preferences and experiences, friends, family, sexual partner(s), and medical providers. Interactions with medical providers that study participants found helpful in navigating the adoption process included the use of visuals; tailored counseling to address specific contraceptive needs; assurance that IUC discontinuation was an option; information on a wide range of side effects; medical provider self-disclosure regarding use of IUC; and addressing and validating concerns, both before and after IUC insertion.
Nulliparous adolescents in this study described a complex IUC adoption process in which the medical provider plays a substantial supportive role. Findings from this study may be used to counsel and support future nulliparous adolescents regarding IUC use.
描述未育青少年宫内节育器（IUC）的使用过程，并确定医疗服务提供者在这一过程中的作用。
我们对 20 名有 IUC 使用史的未育青少年（15-24 岁）进行了基于诊所的半结构式访谈。采用改良扎根理论和跨案例分析对访谈进行分析，以揭示 IUC 采用的过程模型，重点关注医疗服务提供者的作用。
该模型包括以下阶段：最初的认识、初始反应、信息收集、采用以及调整和重新评估。它受到个人偏好和经历、朋友、家人、性伴侣和医疗服务提供者的影响。研究参与者发现，医疗服务提供者在帮助他们进行采用过程中提供了一些有用的互动，包括使用视觉辅助工具；根据特定的避孕需求进行定制化咨询；保证 IUC 可以随时停用；提供广泛的副作用信息；医疗服务提供者对自己使用 IUC 的自我披露；以及在 IUC 插入前后解决和验证相关顾虑。
本研究中的未育青少年描述了一个复杂的 IUC 采用过程，医疗服务提供者在其中发挥了重要的支持作用。本研究的结果可用于为未来的未育青少年提供关于 IUC 使用的咨询和支持。
