Nursing Department, Guizhou Provincial People's Hospital, Guiyang, China.
School of Nursing, Sun Yat-sen University, 74#, Zhongshan Road II, Guangzhou, 510089, China.
Reprod Health. 2018 May 24;15(1):85. doi: 10.1186/s12978-018-0543-2.
This study aimed to describe the intentions of and barriers to the use of long-acting reversible contraceptives (LARCs) in the post-abortion period among women seeking abortion in mainland China.
A cross-sectional study was conducted from July 2015 to December 2015 using a waiting room questionnaire. A total of 381 women seeking abortions were recruited at a public hospital abortion clinic. The outcome variable was an 'intention-to-use' LARCs in the immediate post-abortion period. Chi-square tests were used to assess associations between categorical variables. Statistically significant variables (p ≤ 0.05) were then further analyzed by logistic regression.
Among 381 respondents, 42.5% intended to use LARCs in the immediate post-abortion period; 35.2% intended to use intra-uterine devices (IUDs); and 13.9% intended to use implants. Previous use of LARC was a predictor for an intention to use LARCs (odds ratio [OR] = 2.41; 95% confidence interval [CI]: 1.06-5.47). Participants with one or no child had reduced odds for an intention to use LARC (OR = 0.32, 95% CI: 0.15-0.47 and OR = 0.29, 95% CI: 0.13-0.68, respectively). Women with a higher sex frequency (at least once per week) showed increased odds for LARC use (OR = 3.34; 95% CI: 1.03-10.78) and married women were more likely to use LARC than single women (OR = 1.57; 95% CI:1.00-2.47). Women who planned to have another baby within two years were more likely not to use LARCs in the immediate post-abortion period (OR = 0.97; 95% CI: 0.43-2.12). Barriers to the use of LARCs were anxiety relating to impaired future fertility (56.2%), LARCs being harmful to health (45.2%), irregular bleeding (44.3%), risk of IUD failure (41.6%) and lack of awareness with respect to LARCs (36.1%).
Intention to use LARCs was predicted by marital status, frequency of sexual activity, number of children, planned timing of next pregnancy, and previous LARC use. Impaired future fertility, being harmful to health, irregular bleeding, risk of complications, and lack of awareness with regards to LARCs were the main barriers in their potential use.
本研究旨在描述中国寻求堕胎的女性在流产后使用长效可逆避孕措施（LARC）的意愿和障碍。
采用横断面研究方法，于 2015 年 7 月至 12 月在一家公立医院堕胎诊所使用候诊室问卷进行研究。共招募 381 名寻求堕胎的女性。结局变量为流产后立即使用 LARC 的“意愿”。采用卡方检验评估分类变量之间的关联。然后，对具有统计学意义的变量（p≤0.05）进一步进行逻辑回归分析。
在 381 名受访者中，42.5%的人表示在流产后立即使用 LARC；35.2%的人表示将使用宫内节育器（IUD）；13.9%的人表示将使用植入物。以前使用过 LARC 是使用 LARC 的意愿的预测因素（比值比[OR] = 2.41；95%置信区间[CI]：1.06-5.47）。有一个或没有孩子的参与者使用 LARC 的意愿降低（OR = 0.32，95%CI：0.15-0.47 和 OR = 0.29，95%CI：0.13-0.68）。性频率较高（每周至少一次）的女性使用 LARC 的几率增加（OR = 3.34；95%CI：1.03-10.78），已婚女性比单身女性更有可能使用 LARC（OR = 1.57；95%CI：1.00-2.47）。计划在两年内再次怀孕的女性在流产后立即使用 LARC 的可能性降低（OR = 0.97；95%CI：0.43-2.12）。使用 LARC 的障碍包括对未来生育能力受损的担忧（56.2%）、对健康有害（45.2%）、不规则出血（44.3%）、IUD 失败风险（41.6%）和对 LARC 缺乏认识（36.1%）。
婚姻状况、性活动频率、子女数量、计划下次怀孕的时间以及以前使用 LARC 是使用 LARC 的意愿的预测因素。未来生育能力受损、对健康有害、不规则出血、并发症风险和缺乏对 LARC 的认识是其潜在使用的主要障碍。
