| Objective:The present study was conducted to investigate and analyze the influencing factors of intrauterine device (IUD) utilization after an abortion in married female and to follow up the health conditions and side effects female concerned at one month or three months after IUD operation, raising corresponding measures and suggestions to address the potential problems. Then provide theoretical data for improving the quality of family planning services and switching the concept of family planning services, further reducing unintended pregnancy rate and repeat abortion rate and lowering the risk of abortion, enhancing the level of reproductive health in female.Method:Married and childbearing females who were administrated an artificial abortion at the family planning clinics of the first affiliated hospital of Guangxi medical university from September 2014 to May 2015 were enrolled in this study. In total,542 eligible subjects were recruited, and among them 209 cases chose to utilize the IUD after the abortion surgery and 333 cases did not. A interview was conducted to each subject by using a self-designed questionnaire and a follow-up regarding the health conditions and side effects in one month or three months after abortion was carried out in IUD utilized females. The data on paper-based questionnaires were transferred into computer using Epidata 3.1 software and double checked to establish a relevant influencing factors database on IUD utilization. SPSS 16.0 was used for all the statistical analyses and P< 0.05 was considered as significant differences. For the comparison of proportion data, Chi-square test was conducted; Multiple Response variable analysis was used for polynomial questions; Multivariate unconditional logistic regression models were used to estimate the related effects on IUD utilization.Results:1. There were statistical differences between IUD used female and unused female in age, education level, occupation, former contraceptive methods, the way of recognition of contraceptive methods and IUD (P<0.05).2. The utilization rate of IUD increased with age (OR=1.6-7.7, age<30 as reference), while the IUD utilization rate decreased with education level.3. The IUD utilization rate was higher in female with more time of pregnancy and delivery (OR=3.0, one pregnancy as reference; OR=4.1, one delivery as reference). Lower IUD utilization rate was observed in female with shorter interval of last delivery (OR=2.7-14.2, interval of last delivery≥11 years as reference).4. The recognition rate of the benefits of IUD and IUD can be used just after an abortion operation was higher in IUD used female than unused female (P<0.05). A significant difference was found between IUD used female and unused female in demand of childbearing in three years (P<0.05, OR=15.2). IUD used rate intended to decline with the IUD cost (OR=3.2-11.4).5. In multivariate unconditional logistic regression models analysis, after adjustment of other influencing factors, we found the main causes of IUD utilization in female after abortion were demand of childbearing (OR=24.0), IUD cost (OR=3.2-10.8), times of delivery (OR=3.5)and age (OR=1.1-3.3).6. Among the 209 IUD used females, the main reason for IUD utilization were:convenience (106,50.7%), safe (82,39.2%), unwilling to use acyeterion or condom (66,31.6%), highly effective contraception (57,27.3%) and no demand of childbearing in three years (55,26.3%).7. There were 137 (65.6%) subjects worried about the discomfort or side effects caused by IUD utilization, while 79 (37.8%) and 50 (23.9%) individuals reported abnormal symptoms after using IUD one month and three months, respectively.78 (37.3%) subjects worried menstruation change, but only 29 (13.9%) showed abnormal after utilizing IUD three months.75 (3^.9%) individuals were afraid of abdominal pain and lumbar acid, while only 10 (4.8%) appeared the symptoms after utilizing IUD three months.8. Among the influencing factors of IUD utilization in IUD unused subjects, the main reason was risk of IUD (246,73.9%), following by individual factors (241,72.4%) and family factors (185,55.6%). Policy, western culture and economic factors showed small effects on IUD using.9. For IUD unused subjects, they want to obtain the information of IUD were:which kind of IUD is better (101,3.3%), the effect of IUD (78,23.4%), whether IUD operation is painful (67,20.1%), if IUD will affect reproduction (62,18.6%) and the side effects of IUD (40,12%). They still need help from: doctors and nurses (124,37.5%), relevant text materials of IUD (119,36%).Conclusion:1. The main influencing factor of IUD utilization in married female after an abortion was the demand of childbearing, following by economic factor; times of delivery, age and the recognition of IUD can be used just after an abortion operation.2. The reasons for married female used IUD were the benefits of IUD, personal preferences, the responsibility of family contraception, government policy and individual disease treatment.3. The change of menstrual bleeding patterns, abdominal pain and lumbar acid, infection, IUD drops off, pregnancy with IUD were the main factors of married female worried before they utilizing IUD, while these abnormal symptoms rarely happened after IUD utilization.4. For IUD unused female, the main reason for refusing to use IUD was they had a demand of childbearing in three years, and worry about change in menstrual bleeding patterns, the sense of foreign body, afraid of abdominal pain and lumbar acid followed by. |
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