Abstract
Objectivethe possibility of experiencing adverse reactions is an important aspect of contraceptive decision-making and information about this topic is highlighted as an essential aspect of contraceptive counseling. The aim of this study was to explore experiences of contraceptive counseling about potential adverse reactions of intrauterine contraception. Designexploratory qualitative study of messages in discussion boards, analyzed with inductive qualitative content analysis. Settingtwo large public Swedish web-based discussion boards about sexual and reproductive health. Participantsthreads related to the aim were identified through searches in the discussion boards during 2019 and 2020, resulting in in 43 included posters who had written 140 messages in total. Findingsthe themes ‘difficulties making an informed decision due to insufficient and untrustworthy information about adverse reactions’ and ‘feeling dismissed when communicating about experienced adverse reactions’ illustrate the results. Posters emphasized the importance of sufficient information about adverse reactions. However, professionals were perceived as overly optimistic regarding intrauterine contraception and focusing on mild or common reactions. The importance of feeling that their adverse reactions were acknowledged was articulated, but posters felt that some professionals dismissed the reactions when being told about it, resulting in frustration and dissatisfaction with care. The discussion boards contained narratives describing a resistance among professionals to send in a formal report about the adverse reaction. Key conclusionsaccording to statements made by posters who have experience of adverse reactions of intrauterine contraception, contraceptive counseling have room for improvement in regard to inclusion of comprehensive information about adverse reactions. The findings illustrate the importance that clients who experience adverse reactions of intrauterine contraception feel they are acknowledged and offered adequate support. Implications for practiceechoing guidelines for high-quality contraceptive counseling, the narratives provide further weight that professionals need to have adequate training and resources to offer comprehensive information about adverse reactions of intrauterine contraception. The findings call attention to the importance of follow-up services for clients who experience adverse reactions.
Highlights
Long-acting reversible contraception (LARC) are methods that require few administrations and have a contraceptive effect that lasts up to several years
According to statements made by posters who write about their experiences of contraceptive counseling regarding adverse reactions of intrauterine contraception, there seems to be room for improvement concerning the comprehensiveness of contraceptive counseling
Persons writing in discussion boards describe insufficient information about potential adverse reactions, which limited their ability of reaching informed decisions
Summary
Long-acting reversible contraception (LARC) are methods that require few administrations and have a contraceptive effect that lasts up to several years. Copper intrauterine devices and hormonal intrauterine systems are two types of LARC that have shown to be effective methods with high patient satisfaction and continuation rates (Kopp Kallner, 2018). Intrauterine LARC is recommended by organizations and experts as a suitable alternative for clients who want to avoid unintended pregnancy (Black et al, 2015; Committee on Practice Bulletins-Gynecology and Long-acting Reversible Contraception Work Group, 2017; National Institute for Health and Care Excellence, 2019; Swedish Medical Products Agency, 2014). Health professionals can promote informed decisions, higher continuation rates, correct usage of contraception, and greater client satisfaction (Schivone and Glish, 2017)
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