Cicerchia Gaia, Reid Lawrence D, Carvajal Diana N
Department of Family and Community Medicine, University of Maryland School of Medicine, Baltimore, Maryland, USA.
Womens Health Rep (New Rochelle). 2022 Jan 31;3(1):78-84. doi: 10.1089/whr.2021.0115. eCollection 2022.
U.S. Latinas have lower rates of contraceptive use and report more negative counseling experiences compared to non-Latina white women. Patient-centered approaches to contraceptive counseling are desired among Latinas and are also associated with patient satisfaction; yet, clinicians may not always use counseling methods that best support decision-making among marginalized groups. To examine Latinas' expectations of physician communication about contraceptive side effects, reported importance of personal knowledge about side effects, and the association of these with contraceptive use and use consistency. One hundred three self-identified Latinas aged 15-29 years at two urban federally qualified health centers completed a survey measuring factors associated with contraceptive use and consistency. Bivariate analysis was used to assess demographic and contraceptive information preferences. Associations between categorical variables were assessed using two-sided Fisher's exact tests. Continuous variables were compared using two-sided -test. The majority of respondents (85%) expected physicians to tell them about birth control side effects and reported that this information is important to use contraception, regardless of current contraceptive use. Among inconsistent and nonusers, importance of knowledge of side effects depended on expectations of information-sharing from physicians ( < 0.05). Expectations regarding side effect information-sharing by physicians and patient knowledge of side effects are important for the contraceptive decision-making process of this Latina group, regardless of contraceptive use. Clinicians engaging in contraceptive counseling should focus on providing clear and accurate information about side effects of discussed methods to facilitate informed decision-making and equitable, patient-centered contraceptive care for this vulnerable population.
与非拉丁裔白人女性相比，美国拉丁裔女性的避孕使用率较低，且报告称有更多负面的咨询经历。拉丁裔女性希望采用以患者为中心的避孕咨询方法，这种方法也与患者满意度相关；然而，临床医生可能并不总是使用最能支持边缘化群体决策的咨询方法。为了研究拉丁裔女性对医生关于避孕副作用沟通的期望、报告的副作用个人知识的重要性，以及这些与避孕使用和使用一致性的关联。在两个城市的联邦合格健康中心，103名年龄在15 - 29岁的自我认同为拉丁裔的女性完成了一项调查，该调查测量了与避孕使用和一致性相关的因素。采用双变量分析来评估人口统计学和避孕信息偏好。使用双侧Fisher精确检验评估分类变量之间的关联。使用双侧t检验比较连续变量。大多数受访者（85%）期望医生告知她们避孕副作用，并报告称这些信息对于使用避孕措施很重要，无论当前是否使用避孕措施。在避孕措施使用不一致者和未使用者中，副作用知识的重要性取决于对医生信息共享的期望（P < 0.05）。无论避孕使用情况如何，医生关于副作用信息共享的期望以及患者对副作用的了解对于这个拉丁裔群体的避孕决策过程都很重要。从事避孕咨询的临床医生应专注于提供所讨论方法副作用的清晰准确信息，以促进明智决策，并为这个弱势群体提供公平、以患者为中心的避孕护理。
