Zapka J G, Pastides H, Rudenberg E
Health Educ Q. 1985 Fall;12(3):245-57. doi: 10.1177/109019818501200303.
Despite dissemination of modern contraceptive techniques among college women, unplanned pregnancy and pregnancy termination rates remain a major health issue. An investigation of 495 college women who use the diaphragm method of contraception was conducted in order to estimate pregnancy occurrence, to better understand factors related to successful use, and to profile service utilization patterns. Data were collected by medical record audit and client survey. Fifteen percent of the diaphragm clients reported a diaphragm-related pregnancy; clinical effectiveness was estimated to be 88% with a rate of 9.75 pregnancies per 100 woman years of diaphragm use. A variety of demographic, personal history, and behavioral variables were found to be related to three dependent variables: pregnancy, consistent diaphragm use, and accurate diaphragm use. Review of clinic service utilization for this group of patients demonstrated considerable resource use, including frequent switching of prescription contraception methods. Considering all pregnancies, diaphragm related or not, 27% of the study subjects reported at least one unplanned pregnancy. Abortion was elected in 98% of these cases. There is general agreement about the need to focus on education, information, and service measures to reduce the incidence of unintended fertility. Many universities have family planning services available, yet unsuccessful outcome continues to be a concern. Specific and practical protocols for service implementation need clearer definition. Thus, the implications of this research for the content and organization of clinic services are discussed with reference to counseling and education and other systems strategies.
尽管现代避孕技术在大学女生中得到了推广，但意外怀孕和终止妊娠率仍然是一个主要的健康问题。为了估计妊娠发生率、更好地了解与成功使用避孕方法相关的因素以及描述服务利用模式，对495名使用子宫帽避孕法的大学女生进行了一项调查。数据通过病历审核和客户调查收集。15%的子宫帽使用者报告了与子宫帽相关的怀孕；临床有效率估计为88%，每100名女性使用子宫帽的年妊娠率为9.75次。发现多种人口统计学、个人史和行为变量与三个因变量相关：怀孕、持续使用子宫帽和正确使用子宫帽。对这组患者的门诊服务利用情况进行审查发现，资源使用相当可观，包括频繁更换处方避孕方法。考虑到所有怀孕情况，无论是否与子宫帽相关，27%的研究对象报告至少有一次意外怀孕。其中98%的情况选择了堕胎。人们普遍认为有必要关注教育、信息和服务措施，以降低意外生育的发生率。许多大学都提供计划生育服务，但结果不尽如人意仍然令人担忧。服务实施的具体实用方案需要更明确的定义。因此，本研究针对门诊服务的内容和组织，参考咨询、教育及其他系统策略进行了讨论。
