contraception

避孕
  • 文章类型: Journal Article
    由于不安全性行为的不利影响,避孕使用是全世界关注的问题,例如妇女意外怀孕和性传播疾病。
    为了调查奥格博莫索南部地方政府地区有文化的已婚妇女使用避孕药具的影响因素,奥约州。该研究还检查了年龄变量是否,宗教和教育资格会影响受访者的观点。
    本研究采用描述性调查设计。采用目的性抽样技术,共抽取210名受访者。使用问卷收集研究数据。使用均值和等级顺序回答研究问题,而使用方差分析在0.05显著性水平上检验假设。
    研究结果表明,影响有文化的已婚妇女使用避孕药具的因素是学历,健康状况和儿童人数等。研究结果还表明,基于年龄和宗教信仰,有文化的已婚妇女中影响避孕药具使用的因素没有显着差异,而受教育程度则存在显着差异。
    大多数受访者证明了有文化的已婚妇女使用避孕药具的影响因素。根据研究结果,建议考虑背景和文化因素,以全面了解影响尼日利亚妇女使用避孕药具的因素,应建议服务提供者对即使在绝经前年龄较大的情况下也需要持续避孕的必要性进行教育干预.
    UNASSIGNED: Contraceptives uses are issues of concern around the world due to the adverse effects of unsafe sexual behaviours, such as unwanted pregnancies and sexually transmitted diseases among women.
    UNASSIGNED: To investigate the factors influencing use of contraceptives among literate married women in Ogbomoso South Local Government Area, Oyo State. The study also examined whether the variables of age, religion and educational qualification would influence the respondent\'s view.
    UNASSIGNED: Descriptive survey design was adopted for the study. Purposive sampling technique was adopted to draw a total of 210 respondents. A questionnaire was used to collect data for the study. Mean and rank order was used to answer the research question while Analysis of Variance was used to test the hypotheses at 0.05 level of significance.
    UNASSIGNED: Findings revealed that factors influencing contraceptive use among literate married women are educational qualification, health condition and number of children among others. Findings also revealed that there were no significant differences in the factors influencing use of contraceptives among literate married women based on age and religious affiliation while significant difference was found in educational qualification.
    UNASSIGNED: Majority of the respondents attested to the factors influencing contraceptive use among literate married women. Based on the findings of the study, it was recommended that contextual and cultural considerations are recommended for comprehensive understanding of factors influencing contraceptive use among Nigerian women, educative interventions by service providers on the necessity of continuous contraception even at older age before menopause should be recommended.
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  • 文章类型: Journal Article
    感染艾滋病毒/艾滋病的妇女拥有与未感染的妇女相似的生育欲望,随着健康疗法的进步,这些妇女可以现实地拥有和抚养未感染的孩子。孕前保健(PC)是一种专门的干预形式,旨在预防,identification,治疗,和生物医学管理,行为,以及不利于安全孕产和健康后代分娩的社会条件。
    该研究旨在评估在Alimosho的HIV感染者和抗逆转录病毒治疗诊所就诊的妇女的孕前和避孕护理,拉各斯州,尼日利亚。
    这是一项基于设施的描述性横断面研究,对383名育龄妇女感染艾滋病毒/艾滋病并在研究区域的ART诊所就诊。在选择程序中使用了概率抽样方法。数据采用描述性统计分析,卡方检验,和5%显著性水平的单变量逻辑回归。在选择过程中使用了分层抽样和简单随机抽样。
    只有37.4%的受访者获得了最佳的PC服务。20-29岁[OR=1.716(95%CI:1.664,1.769),p=0.020],30-39岁[OR=1.514(95%CI:0.598,3.831),p=0.005],高等教育[OR=8.43。(95%CI:1.41,18.5),p=0.020],并且是单身[OR=2.00(95%CI:1.928-2.072),p=0.002]与避孕药具的使用显着相关。
    有必要提供结构和指导方针,以便为感染艾滋病毒/艾滋病的妇女提供最佳的精简PC和避孕服务。
    UNASSIGNED: Women living with HIV/AIDS possess fertility desires similar to their uninfected counterparts, and with advances in health therapies, these women can realistically have and raise uninfected children. Preconception care (PC) is a specialized form of intervention aimed at the prevention, identification, treatment, and management of biomedical, behavioural, and social conditions that militate against safe motherhood and the delivery of healthy offspring.
    UNASSIGNED: The study aimed to assess preconception and contraceptive care among women living with HIV and attending Antiretroviral Therapy Clinics in Alimosho, Lagos State, Nigeria.
    UNASSIGNED: This was a descriptive facility-based cross-sectional study of 383 women of reproductive age living with HIV/AIDS and attending ART clinics in the study area. Probability sampling methods were used in the selection procedures. Data were analyzed using descriptive statistics, Chi-square test, and univariate logistic regression at a 5% level of significance. Stratified and simple random sampling were used in the selection process.
    UNASSIGNED: Only 37.4% of respondents received optimal PC services. Being 20-29 years old [OR =1.716 (95% CI: 1.664, 1.769), p = 0.020], being 30-39 years [OR =1.514 (95% CI: 0.598, 3.831), p = 0.005], tertiary education [OR =8.43. (95% CI: 1.41, 18.5), p = 0.020], and being single [OR =2.00 (95% CI: 1.928-2.072), p = 0.002] were significantly related to the utilization of contraceptives.
    UNASSIGNED: There is a need to provide structure and guidelines for optimal streamlined PC and contraceptive services for women living with HIV/AIDS.
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  • 文章类型: Journal Article
    背景:在确定发展中国家的收缩利用行为方面,缺乏研究夫妻特征的研究。本研究通过分析女性家庭内部议价能力和配偶年龄差异在预测巴基斯坦女性避孕药具使用行为中的作用来填补这一空白。
    方法:从2017-18年巴基斯坦人口与健康调查中提取了13,331个样本,不包括15-49岁的怀孕和性不活跃的已婚妇女。数据集是横截面的。探索性分析用于检查避孕知识的模式,使用避孕药具的类型,并打算在妇女中使用避孕药具。此外,在不考虑所有潜在协变量的情况下,采用二元回归方法来检验妇女家庭内议价能力和配偶年龄差异与避孕药具使用率之间的关系。
    结果:只有33%的女性使用避孕药,而30%的人表示打算在未来使用避孕药具。几乎所有女性(98%)都知道现代避孕药。与同龄夫妇相比,在丈夫比她们大至少20岁或丈夫年轻的妇女中,观察到目前使用避孕药具的可能性更高。打算使用避孕药的几率随着配偶年龄差异的增加而增加。妇女的家庭内部讨价还价是当前避孕药具使用和使用避孕药具意图的重要预测因素。
    结论:研究结果强调了在生殖保健规划和政策中考虑夫妇特征的重要性。
    结论:更高的女性家庭内部议价能力和更小的配偶年龄差异与更高的避孕药具使用率相关。赋予妇女权力并在家庭中提高她们的决策权可以增强生殖健康成果。
    BACKGROUND: There is a dearth of research examining the couple characteristics in determining contractive utilization behavior in developing countries. This study fills the gap by analyzing the roles of women\'s intra-household bargaining power and spousal age differentials in predicting contraceptive utilization behavior in Pakistani women.
    METHODS: A sample of 13,331, excluding pregnant and sexually inactive married women aged 15-49, was extracted from the Pakistan Demographic and Health Survey 2017-18. The dataset is cross-sectional. Exploratory analysis was used to examine the pattern of contraceptive knowledge, types of contraceptive utilization, and intention to use contraceptives among women. Furthermore, binary regressions were employed to examine the association of women\'s intrahousehold bargaining power and spousal age difference with contraceptive utilization without and after accounting for all potential covariates.
    RESULTS: Only 33% of women use contraceptives, while 30% express an intention to use contraceptives in the future. Almost all women (98%) knew about modern contraceptives. Compared to same-age couples, higher odds of current contraceptive use are observed among women whose husbands are at least 20 years older than them or whose husbands are young to them. The odds of the intention to use contraceptives tend to increase with the increase in spousal age difference. Women\'s intra-household bargaining is a significant predictor of current contraceptive utilization and intention to use contraceptives.
    CONCLUSIONS: Findings underscore the importance of considering the couple\'s characteristics in reproductive healthcare programming and policies.
    CONCLUSIONS: Greater women\'s intra-household bargaining power and smaller spousal age differences are associated with higher contraceptive usage. Empowering women and promoting their decision-making authority within households can enhance reproductive health outcomes.
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  • 文章类型: Journal Article
    背景:个人因素众多,人际关系,社会水平与青少年使用(或不使用)避孕药具有关。关于宗教作为年轻女性使用避孕药具的个人和社区层面影响者的作用知之甚少。
    方法:对24名年龄在18-24岁的年轻避孕药使用者进行深入访谈,布基纳法索两个城市的新教或穆斯林宗教,本研究调查了使用避孕药具的动机和感知后果.通过包括单身和已婚的现代避孕药使用者,提供了一系列的观点。
    结果:一般来说,接受采访的年轻女性信奉自己的宗教并使用避孕药具,她们认为自己的宗教不支持避孕药具的使用。提供了一些例外,包括对已婚妇女出于间隔目的使用某些方法的认可;穆斯林受访者特别认为这是可以接受的。任何宗教都不接受未婚年轻女性的性活动和避孕药具使用。那就是说,年轻女性,已婚和未婚,报告了他们的使用动机,通常与他们和他们的孩子的健康和生活的现实。避孕药具的使用被认为是私事,这意味着宗教界不会发现妇女的使用。
    结论:认识到一些妇女愿意并且能够使用避孕药具,即使没有其宗教团体的认可支持,这可能有助于推动社会规范的改变,并更多地接受符合年轻妇女和家庭情况的避孕药具使用。
    BACKGROUND: Numerous factors at the individual, interpersonal, and societal levels are related to contraceptive use (or non-use) among adolescents and youth. Little is known about the role of religion as an individual and community-level influencer of contraceptive use among young women.
    METHODS: Using in-depth interviews with 24 young contraceptive users ages 18-24 who practice their Catholic, Protestant or Muslim religion in two cities in Burkina Faso, this study examines motivations and perceived consequences of contraceptive use. By including users of modern contraception who were both single and married, a range of perspectives are provided.
    RESULTS: Generally, the young women interviewed who practice their religion and use contraception perceived that their religion was not supportive of contraceptive use. A few exceptions were provided, including perceived acceptance of use of some methods for married women for spacing purposes; this was specifically identified as acceptable among Muslim respondents. Sexual activity and contraceptive use were not acceptable by any of the religions for unmarried young women. That said, young women, both married and unmarried, reported their motivations for use that often related to their and their children\'s health and the realities of life. Contraceptive use was considered a private matter which meant that the religious community would not find out about women\'s use.
    CONCLUSIONS: Recognizing that some women are willing and able to use contraception even without the perceived support of their religious communities might help to push social norms to change and be more accepting of contraceptive use that meets young women\'s and families\' circumstances.
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  • 文章类型: Journal Article
    我们的目的是研究COVID-19大流行期间避孕方法的差异。我们在坎皮纳斯大学进行了一项横断面研究,巴西使用谷歌调查问卷,从2021年12月到2022年2月,通过滚雪球技术传播。调查询问了社会人口统计学特征和避孕药具的使用,以及在COVID-19大流行期间对新方法的需求和继续使用避孕药具的困难。我们分析了1018份完整的问卷;总共,742(72.9%)是年龄在20至39岁之间的女性,746(73.3%)为白人,602(59.2%)使用避孕药具。在COVID-19大流行期间,约23%的受访者改变了他们的方法,约20%的受访者寻求新的方法。在后者中,31.3%的受访者表示很难获得有关新方法的指导,而只有5.3%的受访者表示很难继续使用避孕药具。在这两种情况下,主要的困难是获得医疗保健提供者的任命。我们的结果指向特定的流行病学人群,年轻的黑人和混血儿妇女,教育水平较低,收入较低,在COVID-19大流行期间遭受健康差异,并在使用避孕药具和获得计划生育服务方面遇到困难。
    Our objective was to study disparities in access to contraception during the COVID-19 pandemic. We performed a cross-sectional study at the University of Campinas, Brazil using a Google questionnaire applied from December 2021 until February 2022, disseminated via snowball technique. The survey asked about sociodemographic characteristics and contraceptive use, as well as the demand for new methods and difficulties in continuing to use contraceptives during the COVID-19 pandemic. We analyzed 1018 completed questionnaires; in total, 742 (72.9%) were women aged between 20 and 39 years, 746 (73.3%) were White and 602 (59.2%) used contraceptives. During the COVID-19 pandemic, about 23% of respondents changed their method and approximately 20% of respondents looked for new methods. Among the latter, 31.3% reported some difficulty with obtaining guidance on new methods while only 5.3% of the respondents reported some difficulty with continuing their contraceptive. The main difficulty in both cases was the difficulty with getting a healthcare provider appointment. Our results point to a particular epidemiological population, of younger black and biracial women, with lower education and lower income, which suffered health disparities during the COVID-19 pandemic and found difficulties with using contraceptives and accessing family planning services.
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  • 文章类型: Journal Article
    背景:获得按需的口周口服避孕药-用于在性交周围的限定窗口内预防怀孕-可以为女性提供更多的生殖代理。具有这种适应症的避孕药目前在任何市场上都没有。这篇评论旨在了解国际用户对按需口服避孕药的呼吁。
    方法:系统范围审查,包括2014-2023年间发表的30篇同行评审论文。
    结果:来自世界卫生组织五个地区的16个国家的30篇论文的数据表明,用户对可在治疗前后使用的按需口服避孕药具有广泛的吸引力。尤其是年轻的女性,受教育程度更高或性生活频率更低的人。不同年龄的女性,财富,就业或关系状况,以及使用现代避孕药的不同经验,也有兴趣。女性确定了使用和偏爱这些类型产品的明确理由:与女性的无计划性生活密切相关,自发或偶尔发生性行为;感知的便利性和有效性;谨慎使用药丸来协商限制其生殖能力的上下文环境。抑制使用的因素包括服务提供商的知识障碍和态度,最终用户缺乏知识和错误信息,女性对月经副作用的厌恶以及与激素含量对未来生育能力的影响有关的神话。
    结论:采用随需应变的口周口服避孕药可以扩大对现代避孕需求未得到满足以及性和生殖能力受限的不同女性的避孕选择。未来研究的重点包括:扩大证据的地理范围,以包括东南亚和太平洋地区,和国际农村和城市周边环境;记录青少年和未婚青年的观点;确定供应渠道的创新机会,负担得起的按需口服避孕药;以及如何在各种国际环境中将新的口周避孕药推向市场。
    可以根据需要使用口服避孕药来预防怀孕,并在性交周围的特定窗口内服用(即按需的口周口服避孕药)可以为女性提供更多的生殖能力。虽然目前在任何市场上都没有,我们从这篇国际文献综述中进行的分析显示,女性使用这类避孕产品具有广泛的吸引力.支持使用和偏好的明确理由包括:(1)与女性的性生活更紧密地保持一致,包括期望但计划外的生活,自发或偶尔发生性行为,而不是其他避孕药;(2)感知的便利性和有效性,提供超过其他现代避孕药具的好处;和(3)妇女感到能够克服社会价值观和信仰,限制他们的生殖机构。使用这类产品也存在障碍,包括服务提供商的知识差距和态度,最终用户缺乏知识和错误信息,女人不喜欢副作用,以及关于药丸中激素含量对未来生育能力影响的神话和误解。采用按需的口周口服避孕药可以扩大对现代避孕需求未得到满足以及性和生殖机构受限的不同女性的避孕选择。未来研究的重点包括:扩大证据的地理范围,以包括东南亚和太平洋地区,记录青少年和未婚青年的观点;确定供应渠道的创新机会,负担得起的获得这种类型的避孕药;以及如何在各种国际环境中将这种新的避孕药推向市场。
    BACKGROUND: Access to an on-demand pericoital oral contraceptive pill - used to prevent pregnancy within a defined window around sexual intercourse - could offer women more reproductive agency. A contraceptive with this indication is not currently available in any market. This review aims to understand international user appeal for an on-demand pericoital oral contraceptive pill.
    METHODS: Systematic scoping review, comprising 30 peer-reviewed papers published between 2014-2023.
    RESULTS: Data from 30 papers reporting on research from 16 countries across five World Health Organisation regions suggests widespread user appeal for on-demand oral contraceptive pills that can be used peri- or post-coitally, especially among women who are younger, more educated or who have less frequent sex. Women of varying age, wealth, employment or relationship status, and with different prior experience of using modern contraceptives, were also interested. Women identified clear rationale for use and preference of these types of product: close alignment with women\'s sexual lives that comprised unplanned, spontaneous or occasional sex; perceived convenience and effectiveness; discreet use of pills to negotiate contextual circumstances that constrained their reproductive agency. Factors inhibiting use included knowledge barriers and attitudes of service providers, a lack of knowledge and misinformation among end-users, women\'s dislike of menstrual side effects and myths related to the effects of hormone content on future fertility.
    CONCLUSIONS: Introduction of an on-demand pericoital oral contraceptive pill could expand contraceptive choice for diverse women experiencing unmet need for modern contraception and constrained sexual and reproductive agency. Priorities for future research include: broadening the geographical scope of evidence to include SE Asia and the Pacific, and international rural and peri-urban settings; documenting the perspectives of adolescents and unmarried young people; identifying opportunities for innovation in the supply channels to enhance appropriate, affordable access to on-demand oral contraceptives; and unpacking how to bring new pericoital contraceptives to the market in a variety of international settings.
    Access to an oral contraceptive pill that is used as needed to prevent pregnancy and taken within a defined window around sexual intercourse (i.e. an on-demand pericoital oral contraceptive pill) could offer women more reproductive agency. Though not currently available in any market, our analysis from this review of international literature reveals widespread appeal among women for using this type of contraceptive product. Clear rationale supporting use and preference included: (1) closer alignment with women’s sexual lives that comprised desired but unplanned, spontaneous or occasional sex than other contraceptives; (2) perceived convenience and effectiveness, offering benefits over other modern contraceptives; and (3) women feeling able to overcome social values and beliefs that constrained their reproductive agency. There were also barriers to use of this type of product, including knowledge gaps and attitudes of service providers, a lack of knowledge and misinformation among end-users, women’s dislike of the side effects, and myths and misconceptions about the impact of the hormone content in pills on future fertility. Introduction of an on-demand pericoital oral contraceptive pill could expand contraceptive choice for diverse women experiencing unmet need for modern contraception and constrained sexual and reproductive agency. Priorities for future research include: broadening the geographical scope of evidence to include SE Asia and the Pacific, and rural and peri-urban settings; documenting the perspectives of adolescents and unmarried young people; identifying opportunities for innovation in the supply channels to enhance appropriate, affordable access to this type of contraceptive; and unpacking how to bring this new contraceptive to the market in a variety of international settings.
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  • 文章类型: Journal Article
    意外怀孕是美国青少年的主要健康风险,青少年在获得有效和可靠的避孕方法方面面临许多障碍。
    为了衡量和描述避孕的使用,妊娠风险指数(PRI),以及进入急诊科(ED)进行护理的女性青少年的紧急避孕(EC)处方。
    这项横断面研究是对2021年4月至2022年4月的多中心试验的计划二次分析,该试验使用基于平板电脑的,内容验证,6个城市的机密性健康调查,附属于儿科急诊应用研究网络的儿科三级护理ED。参与者是向ED提交的15至21岁的个人,他们完成了机密的性健康调查,并指出在出生时和先前的阴茎阴道性交中分配了女性。从2023年1月至2024年2月进行数据分析。
    主要结果是使用避孕药具的类型和比例,PRI,并提供欧共体。使用单独的多变量逻辑回归模型来识别与这些结果相关的社会人口统计学因素。
    共有1063名参与者(年龄中位数[IQR],17.5[16.5-18.3]年)被纳入本分析;219(20.8%)被确定为西班牙裔,464(44.1%)被确定为非西班牙裔黑人,308(29.3%)被确定为非西班牙裔白人,61(5.8%)被确定为其他种族和种族。总的来说,756名参与者(71.1%)报告了在最后一次性接触期间使用避孕药具。长效可逆避孕(LARC)使用最少(164名参与者[15.4%]),和307(28.9%)报告没有使用避孕。与整体避孕使用相关的社会人口统计学因素,和LARC特别使用,包括保险和种族和民族。总体PRI为7.89,或预期每年每100名女性8次怀孕。尽管108名参与者(10.2%)符合EC的资格,只有6名(5.6%)符合条件的人被订购了EC。
    在这项针对向ED就诊的性活跃青少年的横断面研究中,大多数参与者报告使用至少一种避孕方式;然而,LARC是使用最少的选择,28.9%的参与者报告没有使用避孕药具.在研究人群中,意外怀孕的风险几乎为8%。很少有符合EC条件的患者接受了它。这些数据表明,在ED环境中提供避孕服务的需求和潜在机会很高。
    UNASSIGNED: Unintended pregnancy is a major health risk for adolescents in the US, and adolescents face many barriers to obtaining effective and reliable contraception.
    UNASSIGNED: To measure and describe the use of contraception, pregnancy risk index (PRI), and emergency contraception (EC) prescriptions among female adolescents accessing the emergency department (ED) for care.
    UNASSIGNED: This cross-sectional study is a planned secondary analysis of a multicenter trial from April 2021 through April 2022 that used a tablet-based, content-validated, confidential sexual health survey at 6 urban, pediatric tertiary care EDs affiliated with the Pediatric Emergency Care Applied Research Network. Participants were individuals aged 15 to 21 years presenting to the ED who completed the confidential sexual health survey and indicated female sex assigned at birth and prior penile-vaginal sexual intercourse. Data analysis was performed from January 2023 to February 2024.
    UNASSIGNED: The primary outcomes were the type and proportion of contraception use, the PRI, and provision of EC. Separate multivariable logistic regression models were performed to identify sociodemographic factors associated with these outcomes.
    UNASSIGNED: A total of 1063 participants (median [IQR] age, 17.5 [16.5-18.3] years) were included in this analysis; 219 (20.8%) identified as Hispanic, 464 (44.1%) identified as non-Hispanic Black, 308 (29.3%) identified as non-Hispanic White, and 61 (5.8%) identified as other races and ethnicities. In total, 756 participants (71.1%) reported contraception use during their last sexual encounter. Long-acting reversible contraception use (LARC) was the least used (164 participants [15.4%]), and 307 (28.9%) reported no contraception use. Sociodemographic factors associated with overall contraception use, and LARC use specifically, included insurance and race and ethnicity. The overall PRI was 7.89, or an expected 8 pregnancies per 100 female individuals per year. Although 108 participants (10.2%) were eligible for EC, EC was ordered for only 6 (5.6%) of those eligible.
    UNASSIGNED: In this cross-sectional study of sexually active adolescents presenting to the ED, the majority of participants reported using at least 1 form of contraception; however, LARCs were the least used option, and 28.9% of participants reported no contraceptive use. The unintended pregnancy risk was almost 8% in the study population. Few patients eligible for EC received it. These data suggest a high need and potential opportunity for provision of contraception services in the ED setting.
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  • 文章类型: Journal Article
    随着医疗保健结果的改善,成人先天性心脏病患者的优先事项已转变为更全面地关注生活质量和福祉。尽管医疗保健已经接受了这一点,仍有建议不足的领域,allyship,和宣传。这些缺陷之一是性健康和福祉领域。健康的性生活具有无数的身体和心理社会益处。然而,患有成人先天性心脏病的人可能在他们生活的这一方面对实现福祉有重大障碍。本文概述了这些障碍及其潜在的解决方案。
    As health care outcomes improve the priority for those living with adult congenital heart disease have changed to a more holistic focus on quality of life and well-being. Although health care has embraced this, there are still areas where there is a deficit in advice, allyship, and advocacy. One of these deficits is in the area of sexual health and well-being. A healthy sexual life has a myriad of physical and psychosocial benefits. However, individuals with adult congenital heart disease may have significant barriers to achieving well-being in this aspect of their lives. These barriers and their potential solutions are outlined in this paper.
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  • 文章类型: Journal Article
    尽管人们越来越担心避孕方面的胁迫,很少有研究描述了它的频率和表现。Further,没有确定的定量方法来测量这种结构。我们开始通过详细说明避孕胁迫经历的细微差别并测试一种新颖的措施来填补这一空白:避孕护理清单中的胁迫。在2023年初,我们调查了美国生育年龄的人,他们在出生时被分配给女性,了解他们的避孕护理。我们在样本中描述了避孕胁迫的频率(N=1197),并使用开放式描述来证明这些经验中的细微差别。最后,我们首次发布了检查表,并提供了心理测试结果。在曾经与医疗保健提供者谈论避孕的人中,超过六分之一(18.46%)的参与者报告说,在他们上次的避孕咨询中经历了胁迫,超过三分之一(42.27%)的人在他们一生的某个时候报告了这一情况。使用或继续使用避孕药是患者报告的最常见的胁迫形式(终生频率为14.62%)。因子分析支持避孕护理清单中强制的双因素维度。项目间相关性有统计学意义(p<0.001),提供可靠性的证据。该清单还与计划生育护理的质量指标有关(向下胁迫:t[1194]=7.54,p<0.001;向上胁迫:t[1194]=14.76,p<0.001)和医疗保健中的歧视(向下胁迫:t[1160]=-14.77,p<0.001;向上胁迫:t[1160]=-18.27,p<0.001),提供结构效度的证据。研究结果提供了有关避孕胁迫的频率和表现的关键信息。心理测试揭示了避孕护理清单中强制性有效性的证据,可靠性,和维度,同时也为未来的测试和改进提供了途径。
    Despite growing concerns over coercion in contraceptive care, few studies have described its frequency and manifestations. Further, there is no established quantitative method of measuring this construct. We begin to fill this gap by detailing nuance in contraceptive coercion experiences and testing a novel measure: the Coercion in Contraceptive Care Checklist. In early 2023, we surveyed reproductive-aged people in the United States who were assigned female at birth about their contraceptive care. We describe the frequency of contraceptive coercion in our sample (N = 1197) and use open-ended descriptions to demonstrate nuances in these experiences. Finally, we debut our checklist and present psychometric testing results. Among people who had ever talked to a healthcare provider about contraception, over one in six participants (18.46%) reported experiencing coercion during their last contraceptive counseling, and over one in three (42.27%) reported it at some point in their lifetime. Being made to use or keep using birth control pills was the most common form of coercion reported by patients (14.62% lifetime frequency). Factor analysis supported the two-factor dimensionality of the Coercion in Contraceptive Care Checklist. Inter-item correlations were statistically significant (p < 0.001), providing evidence of reliability. The checklist was also related to measures of quality in family planning care (downward coercion: t[1194] = 7.54, p < 0.001; upward coercion: t[1194] = 14.76, p < 0.001) and discrimination in healthcare (downward coercion: t[1160] = -14.77, p < 0.001; upward coercion: t[1160] = -18.27, p < 0.001), providing evidence of construct validity. Findings provide critical information about the frequency and manifestations of contraceptive coercion. Psychometric tests reveal evidence of the Coercion in Contraceptive Care Checklist\'s validity, reliability, and dimensionality while also suggesting avenues for future testing and refinement.
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  • 文章类型: Journal Article
    背景:考虑到印度文化中这种行为的敏感性,对青少年性健康和生殖健康(ASRH)行为的现有估计可能是严重的低估。这项研究的目的是评估拉贾斯坦邦的ASRH行为,印度使用直接问题和最好的朋友方法来减少社会期望偏见。
    方法:我们使用了2022年9月至12月收集的拉贾斯坦邦15-19岁青少年的基于人群的数据。数据包括受访者和她最亲密的女性朋友是否有过伴侣,有过性行为,曾经使用过避孕药,目前正在使用避孕药。我们分别估计了受访者和最好的朋友ASRH的结果,总体而言,在未婚青少年中,我们预计社会期望偏见最大。
    结果:最好的朋友方法表现良好,即使在调整之前,方法假设也基本上得到了满足。除了目前使用避孕药具之外,所有青少年的受访者和最好的朋友估计都相似。这对朋友来说是更高的(尽管不是很明显)。然而,我们观察到未婚受访者和朋友之间的ASRH行为存在很大差异,有伴侣的朋友比例明显更高(4.3%的受访者,11.6%的朋友),有过性行为的比例略高(2.4%,3.8%)和目前使用避孕药具(17.0%,19.7%的人需要避孕)。
    结论:我们观察到使用最好的朋友方法估计婚前性行为的潜在好处,但在更大的研究样本中,还需要进一步的工作来完善基于社交网络的青少年敏感行为衡量标准,以更好地了解ASRH的需求.
    BACKGROUND: Existing estimates of adolescent sexual and reproductive health (ASRH) behaviors may be a gross undercount given the sensitivity of this behavior in Indian culture. The objective of this study was to estimate ASRH behaviors in Rajasthan, India using direct questions and the best friend approach that seeks to reduce social desirability bias.
    METHODS: We used population-based data of adolescents aged 15-19 in Rajasthan collected between September and December 2022. Data include whether the respondent and her closest female friend ever had a partner, ever had sex, ever used contraception, and were currently using contraception. We estimated respondent and best friend ASRH outcomes separately, overall and among unmarried adolescents for whom we anticipate social desirability bias is greatest.
    RESULTS: The best friend approach performed well, with method assumptions largely met even before adjustments. Respondent and best friend estimates were similar among all adolescents except for current contraceptive use, which was higher for friends (though not significantly so). However, we observed large differences in ASRH behaviors between unmarried respondents and friends, with a significantly higher percentage of friends who ever had a partner (4.3% respondents, 11.6% friends), and a slightly higher percentage who ever had sex (2.4%, 3.8%) and who were currently using contraception (17.0%, 19.7% among those in need of contraception).
    CONCLUSIONS: We observed potential benefits of using the best friend methodology in estimating premarital sexual activity, but further work is needed to refine social network-based measures of sensitive adolescent behaviors in larger study samples to better understand ASRH needs.
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