Helsepersonells prevensjonsveiledning : en kvalitativ studie av unge kvinners erfaringer med prevensjonsveiledning og valg av prevensjonsmiddel

Caroline Norheim Rosten; Siri Dammen; Ingvild Aune

doi:10.7557/14.6717

Authors

Caroline Norheim Rosten Oslo universitetssykehus, Ullevål. https://orcid.org/0009-0005-0224-2091
Siri Dammen Universitetssykehuset Nord-Norge HF, Tromsø. https://orcid.org/0009-0006-3994-1053
Ingvild Aune NTNU - Norges teknisk-naturvitenskapelige universitet. UiT - Norges Arktiske universitet https://orcid.org/0000-0002-0951-3043

DOI:

https://doi.org/10.7557/14.6717

Keywords:

Qualitative research design, guidance, birth control, unintended pregnancy, decision making

Abstract

Purpose: The purpose of the study was to gain an in-depth knowledge of young women’s experiences with receiving contraceptive counselling from healthcare professionals, and to examine which factors that influence their choice of a contraceptive method. Methods: The study has a qualitative research design. Ten individual semi-structured interviews were conducted. The participants were young women aged 18-25 who used contraceptives and lived in Norway. Data were analysed using systematic text-condensation. Results: Some women were satisfied with the contraceptive counselling they received, and experienced being cared for. Others experienced the counselling as deficient and received limited information about the safety of contraceptives, side-effects and alternative methods. Furthermore, they did not experience the counselling to be tailored to their individual needs. Women’s choices of contraceptives were influenced by factors such as the safety of the method, administration, potential side-effects, friends and healthcare professionals. Conclusion: The study revealed a potential for improvement in the counselling the young women received. The women experienced being met by healthcare professionals who showed little interest, and who lacked the knowledge to give them the information they needed. Furthermore, the women's decisions were influenced by several factors, which may be an advantage for healthcare professionals to be aware of. The study contributes knowledge that is relevant to midwives, health nurses and doctors in their future work with contraceptive counselling of young women.

Metrics

Metrics Loading ...

Author Biographies

Caroline Norheim Rosten, Oslo universitetssykehus, Ullevål.

Jordmor

Siri Dammen, Universitetssykehuset Nord-Norge HF, Tromsø.

Jordmor

Ingvild Aune, NTNU - Norges teknisk-naturvitenskapelige universitet. UiT - Norges Arktiske universitet

Fakultet for medisin og helsevitenskap, Institutt for klinisk og molekylær medisin, NTNU/
Det helsevitenskapelige fakultet, Institutt for helse- og omsorgsfag, UiT. MPH, Dosent, Jordmor/Dosent II

References

Anderson, N., Steinauer, J., Valente, T., Koblentz, J. & Dehlendorf, C. (2014). Women's social communication about IUDs: a qualitative analysis. Perspectives on sexual and reproductive health, 46(3), 141-148. https://doi.org/10.1363/46e1814 https://doi.org/10.1363/46e1814

Bitzer, J., Gemzell-Danielsson, K., Roumen, F., Marintcheva-Petrova, M., van Bakel, B. & Oddens, B. J. (2012). The CHOICE study: Effect of counselling on the selection of combined hormonal contraceptive methods in 11 countries. The European Journal of Contraception & Reproductive Health Care, 17(1), 65-78. https://doi.org/10.3109/13625187.2011.637586 https://doi.org/10.3109/13625187.2011.637586

Brault, M. A., Curry, L. A., Kershaw, T. S., Singh, K., Vash-Margita, A. & Camenga, D. R. (2021). Supporting Patient-centered Communication on Adolescent Sexual and Reproductive Health - Perspectives to Build an Appointment Planning Tool. Journal of Pediatric and Adolescent Gynecology, 34(5), 725-731. https://doi.org/10.1016/j.jpag.2021.04.009 https://doi.org/10.1016/j.jpag.2021.04.009

Carbone, S. L., Guillen, M., Ramirez, J. J., Vargas, S. E., Lu, C. F., Getz, M. L., . . .Tong, I. (2020). ‘I feel like a person has a right to use a product to protect themselves…’: a qualitative study of the risk–benefit calculus on women’s contraceptive use and choice. Sexual Health, 17(3), 262-269. https://doi.org/10.1071/SH19197 https://doi.org/10.1071/SH19197

Charles, C., Gafni, A. & Whelan, T. (1997). Shared decision-making in the medical encounter: what does it mean? (or it takes at least two to tango). Social science & medicine, 44(5), 681-692. https://doi.org/10.1016/S0277-9536(96)00221-3 https://doi.org/10.1016/S0277-9536(96)00221-3

Chen, M., Lindley, A., Kimport, K. & Dehlendorf, C. (2019). An in-depth analysis of the use of shared decision making in contraceptive counseling. Contraception, 99(3), 187-191. https://doi.org/10.1016/j.contraception.2018.11.009 https://doi.org/10.1016/j.contraception.2018.11.009

Cohen, R., Sheeder, J., Kane, M. & Teal, S. B. (2017). Factors associated with contraceptive method choice and initiation in adolescents and young women. Journal of Adolescent Health, 61(4), 454-460. https://doi.org/10.1016/j.jadohealth.2017.04.008 https://doi.org/10.1016/j.jadohealth.2017.04.008

Creswell, J. W. & Poth, C. N. (2018). Qualitative inquiry & research design: choosing among five approaches (4. utg.). SAGE Publications.

De nasjonale forskningsetiske komiteene. (2019, 14. november 2021). Generelle forskningsetiske retningslinjer. https://www.forskningsetikk.no/retningslinjer/generelle/

Dehlendorf, C., Fox, E., Sobel, L. & Borrero, S. (2016). Patient-Centered Contraceptive Counseling: Evidence to Inform Practice. Current Obstetrics and Gynecology Reports, 5(1), 55-63. https://doi.org/10.1007/s13669-016-0139-1 https://doi.org/10.1007/s13669-016-0139-1

Dehlendorf, C., Grumbach, K., Schmittdiel, J. A. & Steinauer, J. (2017). Shared decision making in contraceptive counseling. Contraception, 95(5), 452-455. https://doi.org/10.1016/j.contraception.2016.12.010 https://doi.org/10.1016/j.contraception.2016.12.010

Dehlendorf, C., Kimport, K., Levy, K. & Steinauer, J. (2014). A Qualitative Analysis of Approaches to Contraceptive Counseling. Perspect Sex Repro H, 46(4), 233-240. 10.1363/46e2114. https://doi.org/10.1363/46e2114 https://doi.org/10.1363/46e2114

Dehlendorf, C., Levy, K., Kelley, A., Grumbach, K. & Steinauer, J. (2013). Women's preferences for contraceptive counseling and decision making. Contraception, 88(2), 250-256. https://doi.org/10.1016/j.contraception.2012.10.012 https://doi.org/10.1016/j.contraception.2012.10.012

Fox, E., Reyna, A., Malcolm, N. M., Rosmarin, R. B., Zapata, L. B., Frederiksen, B. N., . . .Dehlendorf, C. (2018). Client Preferences for Contraceptive Counseling: A Systematic Review. American Journal of Preventive Medicine, 55(5), 691-702. https://doi.org/10.1016/j.amepre.2018.06.006 https://doi.org/10.1016/j.amepre.2018.06.006

Fulcher, K., Drabkin, M., Gibson, J., Francoeur, J., Eurchuk, A., Weaver, M., . . .Lachowsky, N. J. (2021). Contraceptive decision-making and priorities: What happens before patients see a healthcare provider. The Canadian Journal of Human Sexuality, 30(1), 56-64. https://doi.org/10.3138/cjhs.2020-0052 https://doi.org/10.3138/cjhs.2020-0052

Furu, K., Aares, E. B., Hjellvik, V. & Karlstad, Ø. (2021). Hormonal contraceptive use in Norway, 2006-2020, by contraceptive type, age and county: A nationwide register-based study. Norsk epidemiologi, 29(1-2). https://doi.org/10.5324/nje.v29i1-2.4046 https://doi.org/10.5324/nje.v29i1-2.4046

Goldhammer, D. L., Fraser, C., Wigginton, B., Harris, M. L., Bateson, D., Loxton, D., . . .Lucke, J. C. (2017). What do young Australian women want (when talking to doctors about contraception)? BMC Family Practice, 18(1), 35-35. https://doi.org/10.1186/s12875-017-0616-2 https://doi.org/10.1186/s12875-017-0616-2

Grant, R. L., Paul, R., Zeal, C., Madden, T. & Politi, M. C. (2020). Decisional conflict associated with clinicians discouraging particular contraceptive methods. Journal of Evaluation in Clinical Practice, 26(6), 1612-1619. https://doi.org/10.1111/jep.13364 https://doi.org/10.1111/jep.13364

Helse- og omsorgsdepartementet. (2020, juni 2022). Handlingsplan for fortsatt reduksjon i antall svangerskapsavbrudd. https://www.regjeringen.no/contentassets/59df2395e37f473b93e2da02db01f69c/hod-handlingsplan.pdf

Helsedirektoratet. (2020, 12. januar 2022). Prevensjon: Helsestasjon for ungdom skal gi prevensjonsveiledning og sikre tilgjengelig og sikker prevensjon. https://www.helsedirektoratet.no/retningslinjer/helsestasjons-og-skolehelsetjenesten

Helsedirektoratet. (2021, 23. desember 2021). Leger, helsesykepleiere og jordmødre kan rekvirere hormonell prevensjon til personer under 16 år. https://www.helsedirektoratet.no/faglige-rad/rekvirering-av-hormonell-prevensjon

Hirth, J. M., Dinehart, E. E., Lin, Y.-L., Kuo, Y.-F. & Patel, P. R. (2021). Reasons why young women in the United States choose their contraceptive method. Journal of Women's Health, 30(1), 64-72. https://doi.org/10.1089/jwh.2019.8182 https://doi.org/10.1089/jwh.2019.8182

Levy, K., Minnis, A. M., Lahiff, M., Schmittdiel, J. & Dehlendorf, C. (2015). Bringing patients' social context into the examination room: An investigation of the discussion of social influence during contraceptive counseling. Women's Health Issues, 25(1), 13-21. https://doi.org/10.1016/j.whi.2014.10.001 https://doi.org/10.1016/j.whi.2014.10.001

Lukasse, M., Baglo, M. C. G., Engdal, E., Lassemo, R. & Forsberg, K. E. (2021). Norwegian women's experiences and opinions on contraceptive counselling: A systematic textcondensation study. European Journal of Midwifery, 5(2), 4-8. https://doi.org/10.18332/ejm/132224 https://doi.org/10.18332/ejm/132224

Mahony, H., Spinner, C., Vamos, C. A. & Daley, E. M. (2021). Social Network Influences on Young Women's Choice to Use Long‐Acting Reversible Contraception: A Systematic Review. Journal of midwifery & women's health, 66(6), 758-771. https://doi.org/10.1111/jmwh.13280 https://doi.org/10.1111/jmwh.13280

Malterud, K. (2017). Kvalitative forskningsmetoder for medisin og helsefag (4. utg.). Universitetsforlaget.

Marshall, C., Guendelman, S., Mauldon, J. & Nuru‐Jeter, A. (2016). Young women's contraceptive decision making: do preferences for contraceptive attributes align with method choice? Perspectives on sexual and reproductive health, 48(3), 119-127. https://doi.org/10.1363/48e10116 https://doi.org/10.1363/48e10116

Marshall, C., Kandahari, N. & Raine-Bennett, T. (2018). Exploring young women's decisional needs for contraceptive method choice: a qualitative study. Contraception, 97(3), 243-248. https://doi.org/10.1016/j.contraception.2017.10.004 https://doi.org/10.1016/j.contraception.2017.10.004

Meier, S., Sundstrom, B., Delay, C. & DeMaria, A. L. (2021). “Nobody’s ever told me that:” Women’s experiences with shared decision-making when accessing contraception. Health Communication, 36(2), 179-187. https://doi.org/10.1080/10410236.2019.1669271 https://doi.org/10.1080/10410236.2019.1669271

Melo, J. M. D., Peters, M. M. P. H., Teal, S. M. D. M. P. H. & Guiahi, M. M. D. M. (2015). Adolescent and Young Women's Contraceptive Decision-Making Processes: Choosing “The Best Method for Her”. Journal of Pediatric and Adolescent Gynecology, 28(4), 224-228. https://doi.org/10.1016/j.jpag.2014.08.001 https://doi.org/10.1016/j.jpag.2014.08.001

Merki-Feld, G. S., Caetano, C., Porz, T. C. & Bitzer, J. (2018). Are there unmet needs in contraceptive counselling and choice? Findings of the European TANCO Study. The European Journal of Contraception & Reproductive Health Care, 23(3), 183-193. https://doi.org/10.1080/13625187.2018.1465546 https://doi.org/10.1080/13625187.2018.1465546

Minnis, A. M., Mavedzenge, S. N., Luecke, E. & Dehlendorf, C. (2014). Provider Counseling to Young Women Seeking Family Planning Services. Perspectives on Sexual and Reproductive Health, 46(4), 223-231. https://doi.org/10.1363/46e1414 https://doi.org/10.1363/46e1414

Nappi, R. E., Vermuyten, N. & Bannemerschult, R. (2021). Missed opportunities in contraceptive counselling: findings from a European survey-based study with simulated patient consultation. The European Journal of Contraception & Reproductive Health Care, 27(2), 85-94. https://doi.org/10.1080/13625187.2021.2010040 https://doi.org/10.1080/13625187.2021.2010040

Oppelt, P. G., Baier, F., Fahlbusch, C., Heusinger, K., Hildebrandt, T., Breuel, C. & Dittrich, R. (2017). What do patients want to know about contraception and which method would they prefer? Archives of Gynecology and Obstetrics, 295(6), 1483-1491. https://doi.org/10.1007/s00404-017-4373-1 https://doi.org/10.1007/s00404-017-4373-1

QSR International Pty Ltd. (2020) NVivo (versjon 1.0) [programvare]. QSR International Pty Ltd. https://www.qsrinternational.com/nvivo-qualitative-data-analysis-software/home

Pasient- og brukerrettighetsloven. (2001). Lov om pasient- og brukerrettigheter (LOV-1999-07-02-63). Lovdata. https://lovdata.no/lov/1999-07-02-63

Rubin, S. E., Felsher, M., Korich, F. & Jacobs, A. M. (2016). Urban adolescents' and young adults' decision-making process around selection of intrauterine contraception. Journal of pediatric and adolescent gynecology, 29(3), 234-239. https://doi.org/10.1016/j.jpag.2015.09.001 https://doi.org/10.1016/j.jpag.2015.09.001

Ræder, M. B., Johansen, M. & Offerdal, K. (2021, 11.11.21). Prevensjon. https://www.legeforeningen.no/foreningsledd/fagmed/norsk-gynekologisk-forening/veiledere/veileder-i-gynekologi/prevensjon/

Sangraula, M., Garbers, S., Garth, J., Shakibnia, E. B., Timmons, S. & Gold, M. A. (2017). Integrating long-acting reversible contraception services into New York City school-based health centers: quality improvement to ensure provision of youth-friendly services. Journal of Pediatric and Adolescent Gynecology, 30(3), 376-382. https://doi.org/10.1016/j.jpag.2016.11.004 https://doi.org/10.1016/j.jpag.2016.11.004

Steinberg, L. (2008). A social neuroscience perspective on adolescent risk-taking. Developmental review, 28(1), 78-106. https://doi.org/10.1016/j.dr.2007.08.002 https://doi.org/10.1016/j.dr.2007.08.002

Sucato, G. S., Bhatt, S. K., Murray, P. J. & Ott, M. A. (2011). Transdermal contraception as a model for adolescent use of new methods. Journal of Adolescent Health, 49(4), 357-362. https://doi.org/10.1016/j.jadohealth.2011.01.008 https://doi.org/10.1016/j.jadohealth.2011.01.008

World Health Organization. (2014). Ensuring human rights in the provision of contraceptive information and services: Guidance and recommendations. https://apps.who.int/iris/bitstream/handle/10665/102539/9789241506748_eng.pdf?sequence=1