Ferguson Grace P, Deihl Tiffany, Bell Kimberly, Chang Judy C
Department of Obstetrics, Gynecology and Reproductive Sciences, University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania, USA.
Womens Health Rep (New Rochelle). 2020 Oct 8;1(1):451-458. doi: 10.1089/whr.2020.0048. eCollection 2020.
Prior studies have noted patient reluctance to use contraceptive devices that require insertion into their bodies. We sought to better understand this "foreign body" concern, as well as to clarify how women perceive long-acting reversible contraception (LARC) devices compared with other implanted medical devices. We performed semistructured qualitative individual interviews with female obstetric/gynecologic patients and probed their opinions regarding LARC devices. Trained coders analyzed interview content using an inductive iterative approach and identified key themes. We found three major themes in our analysis. First, women frequently expressed uncertainty about where in the body intrauterine devices reside and the impact of a foreign body in that space. Second, women expressed discomfort with the invisibility of the device itself and the "set and forget" feature of LARCs. Finally, when asked to consider contraceptive devices in the context of other implantable medical devices, patients highlighted that contraceptive devices are elective and have alternative options. When women express concerns about contraceptive devices "up in them," they are expressing concerns about how these devices interact with their anatomy and the possibilities of harm and failure. These perceived risks of LARCs may not compare favorably with other contraceptive methods that are not foreign bodies. Understanding this perspective improves our ability to participate in shared decision-making.
先前的研究指出，患者不愿使用需要插入体内的避孕器具。我们试图更好地理解这种对“异物”的担忧，以及阐明女性如何看待长效可逆避孕（LARC）器具与其他植入式医疗设备的差异。我们对妇产科女性患者进行了半结构化定性个人访谈，并探究了她们对LARC器具的看法。训练有素的编码员采用归纳迭代法分析访谈内容，并确定了关键主题。我们在分析中发现了三个主要主题。首先，女性经常对宫内节育器在体内的位置以及该空间内异物的影响表示不确定。其次，女性对器具本身的不可见性以及LARC的“一劳永逸”特性表示不适。最后，当被要求在其他可植入医疗设备的背景下考虑避孕器具时，患者强调避孕器具是可选择的，并且有其他选择。当女性对体内的避孕器具表示担忧时，她们表达的是对这些器具如何与自身解剖结构相互作用以及伤害和失败可能性的担忧。这些LARC的感知风险可能无法与其他非异物避孕方法相媲美。理解这一观点有助于我们更好地参与共同决策。
