Decisiones compartidas en anticoncepción. Experiencias de usuarios y profesionales, conflicto decisional y adherencia

Identifier:  TDX:4215

Handle: https://hdl.handle.net/20.500.11797/TDX4215

Authors:  Reyes Martí, Laura

Abstract:
Introduction Choosing a method of contraception is a decision that requires a healthcare atmosphere in which users and professionals can discuss which method is best suited to the users’ preferences, needs and state of health. However, this is not always the case, and the choice can lead to problems in terms of adherence to the chosen treatment and/or decisional conflict for users. Objectives The objective of this research is, on the one hand, to gain knowledge about the experiences and needs of users and professionals involved in decision-making around contraception and, on the other hand, to examine adherence to the contraceptive treatment chosen and whether there is decisional conflict with regard to this choice, in a sample of users. Methodology Mixed study. Qualitative research compiling experiences in contraceptive care, the results of which were subject to classification and analysis using a conceptual framework for high-quality counselling. The quantitative research analysed adherence to combined hormonal contraceptive (CHC) methods and used an experimental study to examine the effectiveness of a Decision Aid, with regard to decisional conflict. Results Users asked for more information, in an environment of incorrect assumptions and false beliefs. Professionals directed their advice towards the few methods with which they were familiar. 60.6% of the users were “non-adherent”, and more likely to forget to use the contraceptive method or have issues with the same. Greater decisional conflict in the group advised with the decision aid. Conclusions Dissatisfaction with the advice received. Professionals acknowledge a lack of knowledge and training, which made shared decision-making more difficult. The MMAS-4 scale, a quick and easy-to-use screening tool, is effective in detecting at-risk profiles in the care visit. Choosing a method does not create conflict. Use of the decision aid can lead to conflict, especially in the absence of effective communication.