Continued Compliance and Degree of Satisfaction in Nulligravida and Parous Women with Intrauterine Contraceptive Devices

Abstract

Purpose To evaluate the compliance and degree of satisfaction of nulligravida (has not given birth) and parous (had already given birth) women who are using intrauterine devices (IUDs).

Methods A cross-sectional cohort study was conducted comparing nulligravida and parous women who had had an IUD inserted between July 2009 and November 2011. A total of 84 nulligravida women and 73 parous women were included. Interviews were conducted with women who agreed to participate through telephone contact. Statistical analysis was performed with Student's t-test and Mann-Whitney test for numeric variables; Pearson's chi-square test to test associations; and, whenever pertinent, Fisher's exact test for categorical variables. A survival curve was constructed to estimate the likelihood of each woman continuing the use of the IUD. A significance level of 5% was established.

Results When compared with parous women, nulligravida women had a higher education level (median: 12 vs. 10 years). No statistically significant differences were found between the nulligravida and parous women with respect to information on the use of the IUD, prior use of other contraceptive methods, the reason for having chosen the IUD as the current contraceptive method, reasons for discontinuing the use and adverse effects, compliance, and degree of satisfaction. The two groups did not show any difference in terms of continued use of the IUD (p = 0.4).

Conclusion There was no difference in compliance or the degree of satisfaction or continued use of IUDs between nulligravida and parous women, suggesting that IUD use may be recommended for women who have never been pregnant.

Resumo

Objetivo Avaliar a adesão e o grau de satisfação de nuligestas e mulheres com partos anteriores usuárias do dispositivo intrauterino (DIU).

Métodos Realizamos um estudo de corte transversal comparando-se um grupo de nuligestas com mulheres com partos anteriores que tinham sido submetidas à inserção do DIU no período de julho de 2009 a novembro de 2011. Foram incluídas 84 nuligestas e 73 mulheres com partos anteriores. Uma entrevista foi realizada com as mulheres que concordaram em participar por meio de contato telefônico. Para se verificar as diferenças entre os dois grupos foram utilizados os testes “t” de Student e Mann-Whitney para as variáveis numéricas, e os testes qui-quadrado de associação e exato de Fisher, quando pertinente, para as variáveis categóricas. Realizou-se análise de sobrevivência de Kaplan-Meyer para continuidade do uso do DIU. Adotou-se o nível de significância de 5%.

Resultados As nuligestas apresentaram escolaridade (mediana: 12 anos) superior às mulheres com um ou mais partos anteriores (mediana: 10 anos). Não houve diferença entre as nuligestas e mulheres com parto anterior em relação à informação sobre o uso do dispositivo intrauterino (DIU), uso prévio de outros métodos contraceptivos, motivo da escolha do DIU como método contraceptivo atual, motivos para descontinuidade, efeitos colaterais, adesão e grau de satisfação. A continuidade do uso do dispositivo intrauterino foi diminuída com o passar do tempo em ambos os grupos e sem diferença significativa (p = 0,4).

Conclusão A adesão, o grau de satisfação e a continuidade do uso do DIU entre as nuligestas e mulheres com parto anterior são semelhantes, sugerindo que o DIU pode ser recomendado para mulheres que nunca engravidaram.

Keywords

intrauterine devices - family planning - contraception - patient satisfaction - gravidity

Palavras-chave

dispositivos intrauterinos - planejamento familiar - contracepção - satisfação do paciente - número de gestações

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