Gomez Anu Manchikanti, Freihart Bridget
Sexual Health and Reproductive Equity (SHARE) Program, School of Social Welfare, University of California, 120 Haviland Hall MC 7400, Berkeley, CA, 94720-7400, USA.
Matern Child Health J. 2017 Sep;21(9):1753-1762. doi: 10.1007/s10995-017-2297-9.
Objective To elucidate salient contraceptive preferences and priorities as they relate to young women's interest or lack thereof in intrauterine device (IUD) use. Methods Qualitative data were drawn from a 2012 survey on contraceptive preferences and IUD interest. Among 413 young (ages 18-29) women, open-ended responses describing reasons for interest, disinterest or uncertainty in future IUD use were examined using a thematic analysis approach. Results Most participants were unsure about (49.2%) or not interested in (30.0%) future IUD use. Themes regarding IUD interest related to specific facets of IUD use (e.g., risks and side effects, ease of use), as well as broader influences on contraceptive decision-making (e.g., social influences, alignment with pregnancy intentions). For interested participants, a sense of empowerment pervaded the responses, with many references to the ease of use and lack of requisite maintenance. Uninterested participants were concerned about the internal nature of the IUD, with many describing "horror stories" and fears that the IUD would cause injury or infertility. Unsure participants provided more detailed and complex responses, carefully weighing the advantages and disadvantages of IUD use. Uncertainty was often driven by an acknowledged need for specific information, rather than overall lack of knowledge. Conclusions for Practice In this analysis, many women had a clear sense of their contraceptive preferences, which frequently did not align with IUDs. While continuing to remove barriers to IUD access is critical, patient-centered counseling approaches offer the opportunity to support women in best matching with a method that aligns with their preferences.
目的 阐明与年轻女性对宫内节育器（IUD）使用的兴趣或缺乏兴趣相关的显著避孕偏好和优先事项。方法 定性数据取自2012年一项关于避孕偏好和IUD兴趣的调查。在413名年轻（18 - 29岁）女性中，采用主题分析方法对描述未来使用IUD的兴趣、无兴趣或不确定原因的开放式回答进行了研究。结果 大多数参与者对未来使用IUD不确定（49.2%）或不感兴趣（30.0%）。与IUD兴趣相关的主题涉及IUD使用的特定方面（如风险和副作用、易用性），以及对避孕决策的更广泛影响（如社会影响、与怀孕意愿的契合度）。对于感兴趣的参与者，回答中普遍存在一种赋权感，许多人提到了易用性和无需维护。不感兴趣的参与者担心IUD的体内性质，许多人描述了“恐怖故事”，并担心IUD会导致损伤或不孕。不确定的参与者提供了更详细和复杂的回答，仔细权衡了使用IUD的利弊。不确定性往往是由对特定信息的明确需求驱动的，而不是总体知识的缺乏。实践结论 在本分析中，许多女性对自己的避孕偏好有清晰的认识，而这些偏好往往与IUD不一致。虽然继续消除IUD获取障碍至关重要，但以患者为中心的咨询方法提供了一个机会，以支持女性选择最符合其偏好的方法。
