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Patient Perceived Quality of Virtual Group Contraception Counseling. 患者对虚拟集体避孕咨询质量的感知。
IF 1.8 Q3 OBSTETRICS & GYNECOLOGY Pub Date : 2024-07-04 eCollection Date: 2024-01-01 DOI: 10.2147/OAJC.S467537
Keemi Ereme, Kaidee Akullo, Quetzal A Class, Erica Hinz

Introduction: The study examines the feasibility, quality of counseling, and knowledge after a virtual Group Contraception Counseling (GCC) session.

Methods: At an urban academic hospital, we recruited English-speaking pregnant women aged 15-49 who had access to a video-enabled electronic device. Participants engaged in a standardized 45-minute educational session about contraceptive methods in groups of two to five persons conducted over a video conferencing platform. The primary outcome was participant perceived quality of contraception counseling measured by the Person-Centered Contraception Counseling (PCCC) scale. The secondary outcomes were knowledge change before and after counseling, and postpartum contraception uptake. We used an adjusted multivariable linear regression model to analyze knowledge scores.

Results: Twenty-two participants completed the study. Participants identified primarily as Black or Hispanic/Latinx (78%), in a partnership (50%), having completed college (59%), and having an annual income of less than $50,000 (78%). A total of 77% of participants recorded a perfect score for quality of counseling using the Person-Centered Contraceptive Counseling (PCCC) scale. There was an increase in knowledge after counseling (Mean difference (M)=0.07, p<0.01). Notably, certain subsets of participants had decrease in knowledge scores after counseling. Participants who used postpartum contraception were more likely to have increase in knowledge after counseling compared to those who did not (Mean difference (M)=0.09, p<0.01).

Conclusion: Our findings suggest virtual group contraception counseling is feasible for providing high-quality counseling and can possibly increase contraceptive knowledge.

简介:本研究探讨了虚拟集体避孕咨询(GCC)课程的可行性、咨询质量和知识:本研究探讨了虚拟集体避孕咨询(GCC)的可行性、咨询质量以及咨询后的知识掌握情况:方法:我们在一家城市学术医院招募了 15-49 岁、会讲英语且能使用视频电子设备的孕妇。参与者通过视频会议平台,以 2 至 5 人为一组,参加 45 分钟的标准化避孕方法教育课程。主要结果是参与者对避孕咨询质量的感知,采用以人为本的避孕咨询(PCCC)量表进行测量。次要结果是咨询前后的知识变化以及产后避孕率。我们使用调整后的多变量线性回归模型来分析知识得分:22 名参与者完成了研究。参与者的主要身份是黑人或西班牙裔/拉丁裔(78%)、伴侣(50%)、大学毕业(59%)、年收入低于 50,000 美元(78%)。使用 "以人为本的避孕咨询"(PCCC)量表,共有 77% 的参与者在咨询质量方面获得了满分。咨询后,参与者的知识水平有所提高(平均差 (M)=0.07, p结论:我们的研究结果表明,虚拟小组避孕咨询在提供高质量咨询方面是可行的,并有可能增加避孕知识。
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引用次数: 0
Prevalence of Depression Among Women Using Hormonal Contraceptives in Mogadishu, Somalia: A Cross-Sectional Study. 索马里摩加迪沙使用荷尔蒙避孕药的妇女抑郁症患病率:一项横断面研究。
IF 1.8 Q3 OBSTETRICS & GYNECOLOGY Pub Date : 2024-06-19 eCollection Date: 2024-01-01 DOI: 10.2147/OAJC.S444545
Abdirizak Mohamud Yusuf, Mohamed Omar Warsame, Saido Gedi, Naima Abdulkarim Abdullahi, Daud Ibrahim Ahmed

Background: Depression is a global health concern with significant consequences, especially for women. Hormonal changes and gender disparities contribute to its prevalence. Hormonal contraceptives are widely used among women of reproductive age, but some users report mood-related side effects.

Purpose: This study aims to investigate the relationship between hormonal contraceptive use and depression among women in Mogadishu, Somalia.

Methods: An analytical cross-sectional study was conducted at two hospitals in Mogadishu, targeting married women aged 15-49 using hormonal contraceptives. A sample size of 227 participants was determined, and data was collected using semi-structured questionnaires, including the Patient Health Questionnaire-9 (PHQ-9) to assess depression. The data were analyzed using SPSS version 25, including multivariate logistic regression.

Results: The prevalence of depression among participants was 33.5%, with significant associations observed between depression and occupation, income level, type of hormonal contraceptive used, and duration of contraceptive use. Housewives, individuals with lower income, users of oral pills and implant methods, as well as those with shorter durations of contraceptive use, constituted the high-risk groups for depression.

Conclusion: Depression poses a concern among women using hormonal contraceptives in Mogadishu, Somalia. Healthcare providers should educate women about potential side effects and consider individualized contraceptive recommendations. Mental health support initiatives and awareness campaigns should be introduced. Future research is recommended to further understand and address depression in this context.

背景:抑郁症是一个全球性的健康问题,对人们,尤其是女性造成了严重的影响。荷尔蒙变化和性别差异导致了抑郁症的流行。目的:本研究旨在调查索马里摩加迪沙妇女使用激素避孕药与抑郁症之间的关系:方法:在摩加迪沙的两家医院进行了一项横断面分析研究,研究对象为使用激素避孕药的 15-49 岁已婚妇女。研究确定了 227 名参与者的样本量,并使用半结构式问卷收集数据,包括用于评估抑郁症的患者健康问卷-9(PHQ-9)。数据使用 SPSS 25 版进行分析,包括多变量逻辑回归:结果:参与者的抑郁症患病率为 33.5%,抑郁症与职业、收入水平、使用的激素避孕药类型和避孕药使用时间之间存在显著关联。家庭主妇、低收入者、口服避孕药和皮下埋植避孕法的使用者以及避孕时间较短者是抑郁症的高危人群:结论:在索马里摩加迪沙,使用荷尔蒙避孕药的妇女中存在抑郁症问题。医疗服务提供者应向妇女宣传潜在的副作用,并考虑个性化的避孕建议。应引入心理健康支持措施和宣传活动。建议今后开展研究,以进一步了解和解决这种情况下的抑郁症问题。
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引用次数: 0
Is There Still a Role for Sterilization by Tubal Ligation as a Contraceptive Method? 输卵管结扎绝育作为一种避孕方法还有用吗?
Pub Date : 2024-05-27 eCollection Date: 2024-01-01 DOI: 10.2147/OAJC.S459623
Norman D Goldstuck

Tubal ligation has been used since the late nineteenth century to control undesired fertility in women. Over the years, there have been many improvements to the surgical technique, and the procedure has become a lot safer. Some recent developments, however, appear to make this procedure obsolete. In the first instance, there is now ample evidence that removing the Fallopian tubes rather than ligating them or closing them provides protection against developing ovarian carcinoma. The many surgical approaches and closure methods are therefore no longer appropriate. In the second instance, the use of long-acting reversible contraception has been shown to be as effective in preventing future pregnancy, more cost-effective and with even more health benefits than tubal ligation or tubectomy. This is especially true of the use of intrauterine levonorgestrel. The problem of regret and request for tubal ligation reversal, where that was performed, is eliminated as is the surgical concern of operating on older women with increased body mass index and medical co-morbidities.

自十九世纪末以来,输卵管结扎术一直被用于控制妇女的不良生育。多年来,手术技术有了许多改进,手术也变得更加安全。然而,最近的一些发展似乎使这种手术过时了。首先,现在有充分的证据表明,切除输卵管而不是结扎或封闭输卵管可以防止卵巢癌的发生。因此,许多手术方法和闭合方法已不再适用。其次,事实证明,使用长效可逆避孕药在预防未来怀孕方面同样有效,而且比输卵管结扎或输卵管切除术更具成本效益,对健康的益处甚至更大。使用宫内左炔诺孕酮尤其如此。如果进行了输卵管结扎手术,就不会再有后悔和要求进行输卵管结扎复通的问题,也不会再有为体重指数增加和患有并发症的高龄妇女进行手术的顾虑。
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引用次数: 0
Contraception in Medically Complex Adolescents and Young Adults 病情复杂的青少年和青年的避孕措施
Pub Date : 2024-05-01 DOI: 10.2147/oajc.s424068
Jessica Addison, Areej Hassan, A. DiVasta
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引用次数: 0
Demographic, Sociocultural, and Behavioral Predictors of Modern Contraceptive Uptake Among Couples in Northern Ghana [Response to Letter] 加纳北部夫妇使用现代避孕药具的人口、社会文化和行为预测因素 [对信函的答复]
Pub Date : 2024-04-01 DOI: 10.2147/oajc.s470794
N. Allotey, S. Bosoka
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引用次数: 0
Contraceptive Utilization and Its Associated Factors Among Married Women in West African Countries: A Population-Based Survey Using Multinomial Logistic Regression 西非国家已婚妇女的避孕药具使用情况及其相关因素:利用多项式逻辑回归进行的人口调查
Pub Date : 2024-04-01 DOI: 10.2147/OAJC.S451908
B. Terefe, M. Jembere, E. Enyew, Bogale Chekole
Background The international development agenda emphasizes universal access to family planning, as seen in Sustainable Development Goal 3.7. However, the use of modern contraceptive methods remains low in developing countries, specifically in West Africa. This study aimed to assess the current status of contraceptive use in the region, focusing on different methods. Methods We analyzed Demographic and Health Survey data from 13 West African nations (2012–2022) involving 117,165 married women. Using binary and multiple multinomial logistic regression, we identified key factors associated with contraceptive use. Adjusted odds ratios with 95% confidence intervals were utilized, and significance was determined at p ≤ 0.2 for binary regression and p < 0.05 for multiple multinomial regression. Results About 80.86% of women did not use any method, while 16.56% of women used modern methods. Maternal age of 35–49 years (RRR=0.77, 95% CI, 0.72,0.82), had given first birth after 20 years (RRR=0.80,95% CI, 0.77,0.83), cohabitation after 20 years old (RRR=1.24,95% CI, 1.18,1.29), being employed (RRR=1.38,95% CI, 1.33,1.43), women who have from 3–5, and more than five living children (RRR=2.06,95% CI,1.97,2.16, and (RRR=2.57, 95% CI, 2.42,2.74), primary(RRR=1.59, 95% CI, 1.52,1.66), secondary/higher education (RRR=2.08, 95% CI, 1.99,2.18), antenatal visit (RRR= 1.38, 95% CI 1.28,1.49), institutional delivery(AOR=1.42, 95% CI, 1.35,1.49), husband working status (RRR=1.39, 95% CI, 1.28,1.51), media exposure(RRR=1.23, 95% CI, 1.19,1.28), visited health facility more than once (RRR=1.09, 95% CI, 1.05,1.13), rural women (RRR=0.89,95% CI,0.85,0.93), female households (RRR=0.79, 95% CI,0.76,0.83), richer (RRR=1.42, 95% CI,1.33,1.51), and richest wealth indexes (RRR=1.69,95% CI,1.58,1.82) were associated. Conclusion This study revealed a low level of contraceptive use among women in West Africa. Strengthening maternal reproductive health services, such as antenatal care, institutional delivery, and health visits, while also targeting mass media and disadvantaged women, has the potential to significantly increase the adoption of modern contraception techniques.
背景 可持续发展目标 3.7 强调普及计划生育。然而,在发展中国家,特别是在西非,现代避孕方法的使用率仍然很低。本研究旨在评估该地区避孕药具的使用现状,重点关注不同的避孕方法。方法 我们分析了 13 个西非国家(2012-2022 年)的人口与健康调查数据,涉及 117 165 名已婚妇女。通过二元和多元多项式逻辑回归,我们确定了与避孕药具使用相关的关键因素。二元回归的显著性以 p≤0.2 为限,多元多项式回归的显著性以 p < 0.05 为限。结果 约 80.86%的妇女未使用任何方法,16.56%的妇女使用现代方法。产妇年龄为 35-49 岁(RRR=0.77,95% CI,0.72,0.82),20 岁后生育第一胎(RRR=0.80,95% CI,0.77,0.83),20 岁后同居(RRR=1.24,95% CI,1.18,1.29),有工作(RRR=1.38,95% CI,1.RRR=2.57,95% CI,2.42,2.74),小学(RRR=1.59,95% CI,1.52,1.66),中学/高等教育(RRR=2.08,95% CI,1.99,2.18),产前检查(RRR=1.24,95% CI,1.18,1.29)。18)、产前检查(RRR=1.38,95% CI,1.28,1.49)、住院分娩(AOR=1.42,95% CI,1.35,1.49)、丈夫工作状况(RRR=1.39,95% CI,1.28,1.51)、媒体接触(RRR=1.23,95% CI,1.19,1.28)、去过医疗机构一次以上(RRR=1.09,95% CI,1.05,1.13)、农村妇女(RRR=0.89,95% CI,0.85,0.93)、女性家庭(RRR=0.79,95% CI,0.76,0.83)、较富裕(RRR=1.42,95% CI,1.33,1.51)和最富有指数(RRR=1.69,95% CI,1.58,1.82)相关。结论 本研究显示,西非妇女的避孕药具使用率较低。加强孕产妇生殖健康服务,如产前保健、住院分娩和健康检查,同时针对大众传媒和弱势妇女,有可能显著提高现代避孕技术的采用率。
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引用次数: 0
Erratum: United States Government-Supported Family Planning and Reproductive Health Outreach in the Democratic Republic of the Congo: Lessons Learned and Recommendations [Corrigendum]. 勘误:美国政府支持的刚果民主共和国计划生育和生殖健康外联活动:经验教训和建议[更正]。
Pub Date : 2024-03-23 eCollection Date: 2024-01-01 DOI: 10.2147/OAJC.S470015

[This corrects the article DOI: 10.2147/OAJC.S446263.].

[此处更正了文章 DOI:10.2147/OAJC.S446263]。
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引用次数: 0
Migration of Intra-Uterine Devices. 宫内设备的迁移。
Pub Date : 2024-03-12 eCollection Date: 2024-01-01 DOI: 10.2147/OAJC.S458156
Victoria Verstraeten, Karlien Vossaert, Thierry Van den Bosch

Intrauterine devices (IUDs) are a widely used contraceptive. Possible complications from IUDs include failed insertion, pain, vasovagal reaction, infection, abnormal bleeding, and expulsion. Uterine perforation and migration of the IUD are rare complications occurring in approximately 1-2 per 1000 insertions. We executed a systematic review by reviewing all case reports and case series on IUD migration, published between December 2002 and December 2022. Our review indicates that about half of these patients present with pain and that a third are completely asymptomatic. The most common sites of migration are the intestine, bladder, and omentum. We found that the preferred method for removing the migrated IUD is laparoscopy. Generally, there are no lasting injuries after the removal of the migrated IUD, but occasionally, severe complications have been reported. Healthcare providers should be vigilant about this rare complication, especially in cases of painful insertion or the presence of other risk factors for perforation. When uterine perforation is diagnosed, it is advisable to remove the IUD to prevent severe complications.

宫内节育器(IUD)是一种广泛使用的避孕药具。宫内节育器可能出现的并发症包括:放置失败、疼痛、血管迷走神经反应、感染、异常出血和脱出。子宫穿孔和宫内节育器移位是罕见的并发症,每 1000 次放置宫内节育器中约发生 1-2 例。我们对 2002 年 12 月至 2022 年 12 月间发表的所有有关宫内节育器移位的病例报告和系列病例进行了系统回顾。我们的研究表明,这些患者中约有一半伴有疼痛,三分之一完全没有症状。最常见的移位部位是肠道、膀胱和网膜。我们发现,取出移位宫内节育器的首选方法是腹腔镜手术。一般来说,移位的宫内节育器在取出后不会造成永久性损伤,但偶尔也会出现严重并发症。医疗服务提供者应警惕这种罕见的并发症,尤其是在插入疼痛或存在其他穿孔风险因素的情况下。一旦确诊为子宫穿孔,建议取出宫内节育器以防止严重并发症的发生。
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引用次数: 0
Demographic, Sociocultural, and Behavioral Predictors of Modern Contraceptive Uptake Among Couples in Northern Ghana. 加纳北部夫妇使用现代避孕药具的人口、社会文化和行为预测因素。
Pub Date : 2024-03-11 eCollection Date: 2024-01-01 DOI: 10.2147/OAJC.S430288
Naa-Korkor Allotey, Samuel Adolf Bosoka

Background: Despite efforts to increase modern contraceptive use in Ghana, prevalence rates remain low; particularly in Northern Ghana. This study, therefore, sought to determine the predictors of modern contraceptive use among couples in Northern Ghana. This research was the baseline assessment for a broader study aimed at determining the effect of an intervention to improve outcomes of modern contraception.

Methods: The study was a cross-sectional design. Data was collected from 508 couples (1016 participants), using a multistage sampling technique; both members of each couple were interviewed separately. Univariate and stepwise multivariate logistic regression were used to identify predictors associated with modern contraceptive use. Qualitative data were analyzed to triangulate the findings from the quantitative data.

Results: More than 97% of couples were Muslims. Qualitative data indicates that Muslims are less inclined to use Modern Contraceptives. Most participants had no education. The regression model shows that all demographic characteristics were not significant in Model 3 for men. Socio-culturally, men who gave the reason of "unconcerned" for men's non-involvement in contraceptive adoption, had less odds of using modern contraception (AOR=0.19). Men with high subjective norms were more than 15 times more likely to use modern contraception. Female farmers were less likely to use contraceptives (AOR= 0.45). Women who reported that "nothing prevented men" from getting involved in contraceptive adoption had greater odds of adopting modern contraception (AOR= 11.15). Women with good perceived behavioral control were more likely to use modern contraception (AOR=5.03). Women with high enacted stigma and men and women with high interspousal communication were more likely to adopt modern contraception.

Conclusion: Taking cognizance of demographic and sociocultural characteristics and behavioral constructs is needed when determining the predictors of modern contraceptive use among couples in Northern Ghana.

背景:尽管加纳努力提高现代避孕药具的使用率,但其普及率仍然很低,尤其是在加纳北部。因此,本研究试图确定加纳北部夫妇使用现代避孕药具的预测因素。这项研究是一项更广泛研究的基线评估,该研究旨在确定一项干预措施的效果,以改善现代避孕措施的成果:研究采用横断面设计。采用多阶段抽样技术从 508 对夫妇(1016 名参与者)中收集数据;每对夫妇的两名成员分别接受访谈。采用单变量和逐步多变量逻辑回归来确定与现代避孕药具使用相关的预测因素。对定性数据进行了分析,以三角测量定量数据的结果:97%以上的夫妇是穆斯林。定性数据表明,穆斯林不太愿意使用现代避孕药具。大多数参与者未受过教育。回归模型显示,在模型 3 中,男性的所有人口统计学特征均不显著。从社会文化角度看,以 "不关心 "为由认为男性不参与避孕的男性使用现代避孕药具的几率较低(AOR=0.19)。主观规范高的男性使用现代避孕方法的几率是主观规范低的男性的 15 倍以上。女性农民使用避孕药具的几率较低(AOR=0.45)。认为 "没有什么能阻止男性 "参与避孕的女性采用现代避孕方法的几率更高(AOR= 11.15)。行为控制感知良好的女性更有可能使用现代避孕方法(AOR=5.03)。已颁布成见较高的女性和配偶间交流较多的男性和女性更有可能采用现代避孕方法:结论:在确定加纳北部夫妇使用现代避孕药具的预测因素时,需要认识到人口和社会文化特征以及行为结构。
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引用次数: 0
United States Government-Supported Family Planning and Reproductive Health Outreach in the Democratic Republic of the Congo: Lessons Learned and Recommendations. 美国政府支持的刚果民主共和国计划生育和生殖健康外联活动:经验教训与建议》。
Pub Date : 2024-03-05 eCollection Date: 2024-01-01 DOI: 10.2147/OAJC.S446263
Sahra Ibrahimi, Bamba Youssouf, Christine Potts, Alexandre Dumouza, Rani Duff, Landry-Serges Malaba, Bettina Brunner

Background: In response to limited contraception availability and a lack of knowledge about family planning (FP) in the Democratic Republic of the Congo (DRC), the United States Agency for International Development (USAID) Integrated Health Program (IHP) in the DRC has been providing FP services, including outreach programs in the DRC. Our study aims to assess the FP outreach program by understanding the participants' perception of the campaign, its impact on their behavior, and their feedback regarding the campaign. Additionally, we draw insights from lessons learned and provide recommendations.

Methods: Between July and August 2022, we conducted 47 in-person participant interviews with women of reproductive age who used the outreach services provided by USAID IHP. Participants were randomly selected from Sud-Kivu, Kasai-Oriental, Haut-Katanga, and Tanganyika provinces. Consent and confidentiality were assured, and responses were recorded and transcribed in a Word document. We used Excel for data coding and analysis.

Results: The campaign reached 95.7% of women interviewed; however, some participants could not recall specific message details. Most respondents (89.3%) reported that the campaign motivated them to make FP decisions and change their behaviors. While 14.8% of women reported making FP decisions independently, 85.1% reported making the decision jointly with their partners. Our analysis resulted in three emerging themes: 1) Increased FP outreach and improved perception of FP, 2) Improved perceived behavioral changes due to FP outreach, and 3) The need for program improvement by including men and providing additional information about possible FP side effects.

Implications: Our study provides insights into how women receive information and whether they find it useful and share it with other women in their community. In particular, women's feedback about the FP outreach program and our recommendations can inform future policies and interventions.

背景:刚果民主共和国(刚果(金))的避孕药具供应有限,而且对计划生育(FP)缺乏了解,为此,美国国际开发署(USAID)在刚果(金)的综合卫生项目(IHP)一直在提供计划生育服务,包括在刚果(金)开展外展项目。我们的研究旨在通过了解参与者对宣传活动的看法、宣传活动对其行为的影响以及参与者对宣传活动的反馈意见,对计划生育宣传项目进行评估。此外,我们还将总结经验教训并提出建议:2022 年 7 月至 8 月间,我们对使用美国国际开发署国际水文计划提供的外展服务的育龄妇女进行了 47 次面对面访谈。访谈对象从南基伍省、东开赛省、上加丹加省和坦噶尼喀省随机抽取。我们确保了同意和保密性,并将回答记录和转录在 Word 文档中。我们使用 Excel 进行数据编码和分析:95.7% 的受访妇女都收到了宣传活动的信息,但有些受访者无法回忆起具体的信息细节。大多数受访者(89.3%)表示,宣传活动促使她们做出了计划生育决定并改变了行为。14.8%的妇女表示是独立做出计划生育决定的,85.1%的妇女表示是与伴侣共同做出决定的。我们的分析得出了三个新出现的主题:1)增加了 FP 宣传并提高了对 FP 的认识;2)由于 FP 宣传,提高了对行为改变的认识;3)需要通过将男性纳入其中并提供更多关于 FP 可能产生的副作用的信息来改进计划:我们的研究有助于了解妇女如何接收信息,以及她们是否认为这些信息有用并与社区中的其他妇女分享这些信息。特别是,妇女对 FP 宣传计划的反馈以及我们的建议可以为未来的政策和干预措施提供参考。
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引用次数: 0
期刊
Open access journal of contraception
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