Sihvo S, Hemminki E, Kosunen E
STAKES (National Research and Development Centre for Welfare and Health), Helsinki, Finland.
J Psychosom Obstet Gynaecol. 1998 Sep;19(3):117-25. doi: 10.3109/01674829809025689.
The aim was to study women's concerns about health risks associated with contraceptives, in particular oral contraceptives and intrauterine devices (IUDs), and to investigate what factors are related to these concerns. A questionnaire was sent to a random sample of 3000 women aged 18-44 years in Finland in 1994. After two reminders, the response rate was 74% (n = 2189). Logistical models were used to examine factors that were related to concerns over oral contraceptives and IUDs. Half (n = 1096) of the respondents had at some time been concerned about the risks of contraceptives. Most concerns (71%) were related to oral contraceptives. Cardiovascular effects, cancer, infertility, mood changes and weight gain were the most commonly specified risks related to oral contraceptives, and infections, effects on menstruation and ectopic pregnancy were most mentioned regarding IUDs. Concerns about oral contraceptives were related to higher education [odds ratio (OR) 1.75; 95% confidence interval (CI) 1.38-2.21], past experience with the method (OR 1.81; 95% CI 1.45-2.26) and to a good knowledge about contraception and fertility (OR 1.68; 95% CI 1.29-2.19). Concern over IUD risks were most strongly related to past use of the method (OR 3.11; 95% CI 2.24-4.32) and higher age (35-44 years old, OR 2.99; 95% CI 1.52-5.87). Unlike women concerned about the risks of oral contraceptives, women with concerns about IUDs had had abortions more often than other women (OR 1.79; 95% CI 1.28-2.48). Women with concerns about oral contraceptives or IUDs used condoms or sterilization as their current contraceptive method significantly more often than other women. Results showed that concern about the risks of contraceptives is strongly related to women's past contraceptive experiences and influences their current use of contraceptives. More attention should be paid to information provided by health care professionals, especially that regarding risk probabilities.
研究目的是了解女性对避孕药具,尤其是口服避孕药和宫内节育器(IUD)相关健康风险的担忧,并调查与这些担忧相关的因素。1994年,向芬兰3000名年龄在18至44岁的女性随机样本发放了问卷。经过两次催复,回复率为74%(n = 2189)。采用逻辑模型来研究与口服避孕药和宫内节育器担忧相关的因素。一半(n = 1096)的受访者曾在某个时候担心过避孕药具的风险。大多数担忧(71%)与口服避孕药有关。心血管影响、癌症、不孕、情绪变化和体重增加是与口服避孕药最常提及的风险,而感染、对月经的影响和宫外孕是关于宫内节育器最常被提及的方面。对口服避孕药的担忧与高等教育程度有关[优势比(OR)1.75;95%置信区间(CI)1.38 - 2.21]、过去使用该方法的经历(OR 1.81;95% CI 1.45 - 2.26)以及对避孕和生育的良好了解(OR 1.68;95% CI 1.29 - 2.19)。对宫内节育器风险的担忧与过去使用该方法的关联最为强烈(OR 3.11;95% CI 2.24 - 4.32)以及较高年龄(35 - 44岁,OR 2.99;95% CI 1.52 - 5.87)。与担心口服避孕药风险的女性不同,担心宫内节育器风险的女性比其他女性有更多堕胎经历(OR 1.79;95% CI 1.28 - 2.48)。担心口服避孕药或宫内节育器风险的女性比其他女性更频繁地使用避孕套或绝育作为当前的避孕方法。结果表明,对避孕药具风险的担忧与女性过去的避孕经历密切相关,并影响她们当前的避孕方法使用。应更加关注医疗保健专业人员提供的信息,尤其是关于风险概率的信息。