PDF(Pubmed)
Abstract：
BACKGROUND: Globally, about half of all induced abortions have been estimated to be unsafe, which results in 13% of maternal deaths yearly. Of these induced abortions, 41% of unsafe abortions have been reported in young women who are dependent on their parents for their livelihood. They are often left in a vulnerable position and may have difficulty in making a decision regarding abortion. This study aimed to (1) characterize and map factors that influence abortion decision-making of adolescents and young women, and (2) identify the care and support that they need in their decision-making process.
METHODS: We conducted a scoping review following the JBI method and PRISMA-ScR checklist. We comprehensively searched MEDLINE (PubMed), Embase, Cochrane Library, CINAHL, and PsycInfo, and hand searched publications in the Google Scholar database between November 2021 and October 2023. The search included all English language qualitative and mixed methods research articles published on the database up to October 2023 that included participants aged 10-24 years. The CASP checklist was used as a guide for the qualitative analysis. NVivo was used to synthesize the findings.
RESULTS: There were 18 studies from 14 countries (N = 1543 young women) that met the inclusion criteria. Three domains and eleven categories were included as follows: personal (desire for self-realization and unwanted pregnancy), interpersonal (parental impact, reaction of partner, roles of peers and friends, existence of own child, and lack of support), and social circumstances (sexual crime, financial problem, limitation of choice, and underutilized healthcare services). Decision-making factors regarding abortions were also found across all three domains.
CONCLUSIONS: The abortion decision-making of young women is influenced by various external factors regardless of country. Parents are especially influential and tend to force their daughters to make a decision. Young women experienced suffering, frustration, and lack of autonomy in making decisions based on their preference. This emphasizes the importance of autonomous decision-making. In this regard, healthcare services should be used. However, there are barriers to accessing these services. To improve such access, the following are required: staff training to provide adolescent and youth-friendly health services, counseling based on women\'s needs, counseling including the parents or guardians that is confidential and ethical, promotion of decision aids, and affordable accessible care.
METHODS: We conducted a scoping review following the JBI method and PRISMA-ScR checklist. We comprehensively searched MEDLINE (PubMed), Embase, Cochrane Library, CINAHL, and PsycInfo, and hand searched publications in the Google Scholar database between November 2021 and October 2023. The search included all English language qualitative and mixed methods research articles published on the database up to October 2023 that included participants aged 10-24 years. The CASP checklist was used as a guide for the qualitative analysis. NVivo was used to synthesize the findings.
RESULTS: There were 18 studies from 14 countries (N = 1543 young women) that met the inclusion criteria. Three domains and eleven categories were included as follows: personal (desire for self-realization and unwanted pregnancy), interpersonal (parental impact, reaction of partner, roles of peers and friends, existence of own child, and lack of support), and social circumstances (sexual crime, financial problem, limitation of choice, and underutilized healthcare services). Decision-making factors regarding abortions were also found across all three domains.
CONCLUSIONS: The abortion decision-making of young women is influenced by various external factors regardless of country. Parents are especially influential and tend to force their daughters to make a decision. Young women experienced suffering, frustration, and lack of autonomy in making decisions based on their preference. This emphasizes the importance of autonomous decision-making. In this regard, healthcare services should be used. However, there are barriers to accessing these services. To improve such access, the following are required: staff training to provide adolescent and youth-friendly health services, counseling based on women\'s needs, counseling including the parents or guardians that is confidential and ethical, promotion of decision aids, and affordable accessible care.
摘要：
背景：在全球范围内，据估计，大约一半的人工流产是不安全的，每年导致13%的产妇死亡。在这些人工流产中，据报道，有41％的不安全堕胎发生在依靠父母谋生的年轻妇女中。他们往往处于弱势地位，可能难以就堕胎做出决定。本研究旨在（1）表征和映射影响青少年和年轻女性堕胎决策的因素，(2)确定他们在决策过程中需要的关心和支持。
方法：我们按照JBI方法和PRISMA-ScR检查表进行了范围审查。我们全面搜索了MEDLINE(PubMed)，Embase,科克伦图书馆,CINAHL,和PsycInfo,并在2021年11月至2023年10月之间手动搜索GoogleScholar数据库中的出版物。该搜索包括截至2023年10月在数据库上发表的所有英语定性和混合方法研究文章，其中包括10-24岁的参与者。CASP检查表被用作定性分析的指南。NVivo用于综合研究结果。
结果：来自14个国家（N=1543名年轻女性）的18项研究符合纳入标准。三个领域和11个类别包括如下：个人（自我实现的愿望和意外怀孕），人际关系(父母的影响，合作伙伴的反应，同伴和朋友的角色，自己孩子的存在，缺乏支持)，和社会环境(性犯罪，财务问题,选择的局限性，和未充分利用的医疗保健服务)。在所有三个领域也发现了有关堕胎的决策因素。
结论：无论在哪个国家，年轻女性的堕胎决策都受到各种外部因素的影响。父母特别有影响力，往往会迫使女儿做出决定。年轻女性经历了痛苦，挫败感,缺乏根据自己的偏好做出决策的自主权。这强调了自主决策的重要性。在这方面,应该使用医疗保健服务。然而,访问这些服务存在障碍。为了改善这种访问，需要以下方面:员工培训，提供青少年和青少年友好型健康服务，根据妇女的需要进行咨询，包括父母或监护人在内的保密和道德的咨询，促进决策辅助，和负担得起的护理。
方法：我们按照JBI方法和PRISMA-ScR检查表进行了范围审查。我们全面搜索了MEDLINE(PubMed)，Embase,科克伦图书馆,CINAHL,和PsycInfo,并在2021年11月至2023年10月之间手动搜索GoogleScholar数据库中的出版物。该搜索包括截至2023年10月在数据库上发表的所有英语定性和混合方法研究文章，其中包括10-24岁的参与者。CASP检查表被用作定性分析的指南。NVivo用于综合研究结果。
结果：来自14个国家（N=1543名年轻女性）的18项研究符合纳入标准。三个领域和11个类别包括如下：个人（自我实现的愿望和意外怀孕），人际关系(父母的影响，合作伙伴的反应，同伴和朋友的角色，自己孩子的存在，缺乏支持)，和社会环境(性犯罪，财务问题,选择的局限性，和未充分利用的医疗保健服务)。在所有三个领域也发现了有关堕胎的决策因素。
结论：无论在哪个国家，年轻女性的堕胎决策都受到各种外部因素的影响。父母特别有影响力，往往会迫使女儿做出决定。年轻女性经历了痛苦，挫败感,缺乏根据自己的偏好做出决策的自主权。这强调了自主决策的重要性。在这方面,应该使用医疗保健服务。然而,访问这些服务存在障碍。为了改善这种访问，需要以下方面:员工培训，提供青少年和青少年友好型健康服务，根据妇女的需要进行咨询，包括父母或监护人在内的保密和道德的咨询，促进决策辅助，和负担得起的护理。
