Community Health Nursing Department, School of Nursing, Muhimbili University of Health and Allied Sciences, P.O. Box 65004, Dar es Salaam, Tanzania.
Department of Midwifery, Graduate School of Nursing Science, St. Luke's International University, 10-1 Akashi-Cho, Chuo, Tokyo, 104-0044, Japan.
Reprod Health. 2021 Aug 9;18(1):170. doi: 10.1186/s12978-021-01216-6.
The use of a decision aid in clinical settings has been beneficial. It informs and educates patients about the available treatment options that can help them reduce decision-making conflicts related to feeling uninformed compared with routine care. There is a scarcity of published data about using a decision aid during family planning counseling with postpartum women focusing on long-acting reversible contraception in Tanzania. Therefore, we developed a "postpartum Green Star family planning decision aid" and assessed its feasibility. The study outcomes were practicality, usefulness, and acceptability perceived by pregnant adolescents and nurses/midwives.
We used an exploratory qualitative in-depth interview involving six nurses/midwives with three or more years of experience in family planning services and 12 pregnant adolescents aged 15-19 years. Purposive sampling was used to select the participants, and selection relied on the saturation principle of data collection. We used a semi-structured interview guide translated into the Kiswahili language. Data were transcribed and analyzed following inductive content analysis.
The amount of information presented was just right, with the time of reading the data ranging from 20 min to 1 h. The study participants perceived the flow of information to be good, with small significant changes suggested. Kiswahili language was used and reported to be appropriate and well elaborated. However, a few words were told to be rephrased to reduce ambiguity. The nurses/midwives said that the decision aid included most of the vital information the participants wanted to know during their family planning counseling. Pregnant adolescents stated that the decision aid improved their knowledge and provided new details on the long-acting reversible contraception methods (intrauterine copper devices and implants) offered immediately after childbirth. The participants stated that the decision aid addressed long-acting reversible contraception methods' benefits and side effects and dispelled myths and misconceptions. The study participants considered the decision aid helpful in complementing the family planning counseling offered and improving pregnant adolescents' knowledge.
The postpartum Green Star family planning decision aid was practical, useful, and acceptable in enhancing the objectivity of counseling about long-acting reversible contraception methods. It improved the knowledge of pregnant adolescents in Tanzania about the available contraception methods (i.e., the use of intrauterine copper devices and implants), which can be immediately used postpartum. Further research is needed to assess the effects of the decision aid on long-acting reversible contraception postpartum uptake among pregnant adolescents in Tanzania.
在临床环境中使用决策辅助工具是有益的。它可以为患者提供有关可用治疗方案的信息和教育，帮助他们减少因感到信息不足而产生的决策冲突，这比常规护理更有优势。坦桑尼亚在为产后妇女提供计划生育咨询时使用决策辅助工具的相关数据非常匮乏，尤其是关于长效可逆避孕方法的相关数据。因此，我们开发了一种“产后绿星计划生育决策辅助工具”，并评估了它的可行性。研究结果是青少年孕妇和护士/助产士感知到的实用性、有用性和可接受性。
我们采用探索性定性深入访谈的方式，邀请了六名具有三年以上计划生育服务经验的护士/助产士和 12 名 15-19 岁的青少年孕妇参加。采用目的性抽样选择参与者，选择依赖于数据收集的饱和原则。我们使用了翻译成斯瓦希里语的半结构化访谈指南。数据转录后，采用归纳内容分析法进行分析。
呈现的信息量恰到好处，阅读数据的时间从 20 分钟到 1 小时不等。研究参与者认为信息的流动很好，只是有一些小的显著变化需要调整。使用斯瓦希里语并报告说它是合适的，并且阐述得很好。但是，有几个词被要求重新措辞以减少歧义。护士/助产士表示，决策辅助工具包含了参与者在计划生育咨询中想要了解的大部分重要信息。青少年孕妇表示，决策辅助工具提高了他们的知识水平，并提供了关于产后立即提供的长效可逆避孕方法（宫内铜装置和植入物）的新细节。参与者表示，决策辅助工具介绍了长效可逆避孕方法的好处和副作用，并消除了神话和误解。研究参与者认为决策辅助工具有助于补充提供的计划生育咨询，并提高青少年孕妇的知识水平。
产后绿星计划生育决策辅助工具在增强有关长效可逆避孕方法咨询的客观性方面具有实用性、有用性和可接受性。它提高了坦桑尼亚青少年对现有避孕方法（即宫内铜装置和植入物的使用）的了解，这些方法可以在产后立即使用。需要进一步研究来评估决策辅助工具对坦桑尼亚青少年产后长效可逆避孕方法使用的影响。
