Barriers to Intrauterine Device Use at an University-Based Women’s Clinic

Read  full  paper  at:

http://www.scirp.org/journal/PaperInformation.aspx?PaperID=52161#.VIZQXGfHRK0

ABSTRACT

Objective: The purpose of this study was to determine the barriers to intrauterine device (IUD) use at a University-Based Women’s Clinic. Methods: This study is a cross-sectional survey of a convenience sample of subjects receiving obstetrical care at a University-Based Women’s Clinic. Eligible women who consented to participate self-administered a 16-question survey during a routine prenatal visit. Descriptive statistics were used to report participants’ demographics and history of contraception use. Additionally, subjects were asked if they would consider IUD use in the future. Results: A total of 160 women participated in this study. The average age of this sample was 24.9 (SD = 6.3). The majority were in low income and low education categories. Only 5% of women reported previous IUD use. 27% of women surveyed desired more information regarding IUD contraception. 19% of participants would consider using an IUD in the future and 25% would consider IUD in the future if they knew more about them. Insurance and financial constraints were cited as barriers to IUD use. 4% of the sample reported that they had used an IUD previously and were unhappy with it due to pain and discomfort. 18% would not consider an IUD because they had heard about side effects. 68% of the surveyed sample reported unintended pregnancies. Conclusion: The two most common barriers to IUD use in this patient population was lack of knowledge and concern about side effects. Increasing patients’ knowledge of IUDs has the potential to increase IUD utilization in this clinic population which reported a 68% rate of unintended pregnancy.

Cite this paper

Ragland, D. , Paykachat, N. and Dajani, N. (2014) Barriers to Intrauterine Device Use at an University-Based Women’s Clinic. Open Journal of Obstetrics and Gynecology, 4, 1058-1064. doi: 10.4236/ojog.2014.416145.

References

[1] Thonneau, P.F. and Thierry, E.A. (2008) Contraceptive Efficacy of Intrauterine Devices. American Journal of Obstetrics and Gynecology, 19, 248-253. http://dx.doi.org/10.1016/j.ajog.2007.10.787
[2] Trussell, J., Lallac, A.H., Doan, Q.V., Reyes, E., Pinto, L. and Gricar, J. (2009) Cost Effectiveness of Contraceptives in the United States. Contraception, 79, 5-14.
http://dx.doi.org/10.1016/j.contraception.2008.08.003
[3] Trussel, J., Hassan, F. and Lowin, J. (2014) Achieving Cost-Neutrality with Long-Acting Reversible Contraceptive Methods. Contraception.
http://www.ncbi.nlm.nih.gov/pubmed/25282161 http://dx.doi.org/10.1016/j.contraception.2014.08.011
[4] American College of Obstetricians and Gynecologists (2006) Noncontraceptive Benefits of the Levonorgestrel Intrauterine System. Obstetrics & Gynecology, 10, 1479-1482.
http://www.ncbi.nlm.nih.gov/pubmed/16738186
[5] Zhou, L. and Xiao, B. (2001) Emergency Contraception with Multiload Cu-375 SL IUD: A Multicenter Clinical Trial. Contraception, 64, 107-112. http://dx.doi.org/10.1016/S0010-7824(01)00231-1
[6] The World Health Organization (2008) Medical Eligibility Criteria for Contraceptive Use, 2008 Update. http://whqlibdoc.who.int/hq/2008/WHO_RHR_08.19_eng.pdf?
[7] American College of Obstetricians and Gynecologists (2011) Long-Acting Reversible Contraception: Implants and Intrauterine Devices. Obstetrics & Gynecology, 118, 184-196.
http://dx.doi.org/10.1097/AOG.0b013e318227f05e
[8] United Nations (2011) World Contraceptive Use.
http://un.org/esa/population/publications/contraceptive2011/contraceptive2011.htm
[9] Buhling, K.J., Zite, N.B., Lotke, P. and Black, K. (2014) Worldwide Use of Intrauterine Contraception: A Review. Contraception, 89, 162-173. http://dx.doi.org/10.1016/j.contraception.2013.11.011
[10] American College of Obstetricians and Gynecologists (2009) Increasing Use of Contraceptive Implants and Intrauterine Devices to Reduce Unintended Pregnancy. Obstetrics & Gynecology, 114, 1434-1438. http://dx.doi.org/10.1097/AOG.0b013e3181c6f965
[11] US Department of Health and Human Services (2012) Healthy People 2020. Family Planning Topic Area. http://www.healthypeople.gov/2020/topicsobjectives2020/overview.aspx?topicid=13
[12] Finer, L.B. and Henshaw, S.K. (2006) Disparities in Rates of Unintended Pregnancy in the United States, 1994 and 2001. Perspectives on Sexual and Reproductive Health, 38, 90-96.
http://dx.doi.org/10.1363/3809006
[13] Blumenthal, P.D., Voedisch, A. and Gemzell-Danielsson, K. (2010) Strategies to Prevent Unintended Pregnancy: Increasing Use of Long-Acting Reversible Contraception. Human Reproduction Update, 17, 121-137. http://dx.doi.org/10.1093/humupd/dmq026
[14] Guttmacher Institute (2013) Unintended Pregnancy in the United States.
http://www.guttmacher.org/pubs/FB-Unintended-Pregnancy-US.html
[15] Brown, S.S. and Eisenberg, L. (1995) The Best Intentions: Unintended Pregnancy and the Well-Being of Children and Families. National Academy Press, Washington DC.
[16] Sonfield, A., Kost, K., Gold, R.B. and Finer, L.B. (2011) The Public Costs of Births Resulting from Unintended Pregnancies: National and State-Level Estimates. Perspectives on Sexual and Reproductive Health, 43, 94-110. http://dx.doi.org/10.1363/4309411
[17] Rubin, S.E., Fletcher, J., Stein, T., Segall-Gutierrez, P. and Gold, M. (2011) Determinants of Intrauterine Contraception Provision among US Family Physicians: A National Survey of Knowledge, Attitudes and Practice. Contraception, 83, 472-478.
http://dx.doi.org/10.1016/j.contraception.2010.10.003
[18] Stubbs, E. and Schamp, A. (2008) The Evidence Is In. Why Are IUDs Still Out? Family Physicians’ Perceptions of Risk and Indications. Canadian Family Physician, 54, 560-566.
http://www.ncbi.nlm.nih.gov/pubmed/18411385
[19] Fleming, K.L., Sokoloff, A. and Raine, T.R. (2010) Attitudes and Beliefs about the Intrauterine Device among Teenagers and Young Women. Contraception, 82, 178-182.
http://dx.doi.org/10.1016/j.contraception.2010.02.020
[20] Chiou, C.F., Trussell, J., Reyes, E., Knight, K., Wallace, J., Udani, J., Oda, K. and Borenstein, J. (2003) Economic Analysis of Contraceptives for Women. Contraception, 68, 3-10.
http://dx.doi.org/10.1016/S0010-7824(03)00078-7
[21] Gariepy, A.M., Simon, E.J., Patel, D.A., Creinin, M.D. and Schwarz, E.B. (2011) The Impact of Out-of-Pocket Expense on IUD Utilization among Women with Private Insurance. Contraception, 84, e39-e42. http://dx.doi.org/10.1016/j.contraception.2011.07.002
[22] Secura, G.M., Allsworth, J.E., Madden, T., Mullersman, J.L. and Peipert, J.F. (2010) The Contraceptive CHOICE Project: Reducing Barriers to Long-Acting Reversible Contraception. American Journal of Obstetrics & Gynecology, 203, 115.e1-115.e7. http://www.ncbi.nlm.nih.gov/pubmed/20541171
[23] Dehlendorf, C., Foster, D.G., Bocanegra, H.T., Brindis, C., Bradsberry, M. and Darney, P. (2011) Differences in Contraception among Low-Income Women: Methods Received By Family PACT Clients, California, 2001-2007. Perspectives on Sexual and Reproductive Health, 43, 181-187.
http://dx.doi.org/10.1363/4318111
[24] Guttmacher Institute (2014) State Facts about Unintended Pregnancy: Arkansas.
http://www.guttmacher.org/statecenter/unintended-pregnancy/pdf/AR.pdf
[25] Centers for Disease Control (1983) Elevated Risk of Pelvic Inflammatory Disease Among Women Using the Dalkon Shield. MMWR, 32, 2221-2222.
[26] Russo, J.A., Miller, E. and Gold, M.A. (2013) Myths and Misconceptions about Long-Acting Reversible Contraception. Journal of Adolescent Health, 52, S14-S21.
http://dx.doi.org/10.1016/j.jadohealth.2013.02.003
[27] Stanwood, N.L. and Bradley, K.A. (2006) Young Pregnant Women’s Knowledge of Modern Intrauterine Devices. Obstetrics & Gynecology, 108, 1417-1422.
http://dx.doi.org/10.1097/01.AOG.0000245447.56585.a0
[28] Whitaker, A.K., Johnson, L.M. and Harwood, B. (2008) Adolescent and Young Adult Women’s Knowledge of and Attitudes toward the Intrauterine Device. Contraception, 78, 211-217. http://dx.doi.org/10.1016/j.contraception.2008.04.119
[29] Dehlendorf, C., Levy, K., Ruskin, R. and Steinauer, J. (2010) Health Care Providers’ Knowledge about Contraceptive Evidence: A Barrier to Quality Family Planning Care? Contraception, 81, 292-298. http://dx.doi.org/10.1016/j.contraception.2009.11.006
[30] Harper, C.C., Blum, M., de Bocanegra, H.T., Darney, P.D., Speidel, J.J., Policar, M. and Drey, E.A. (2008) Challenges in Translating Evidence to Practice: The Provision of Intrauterine Contraception. Obstetrics & Gynecology, 111, 1359-1369. http://dx.doi.org/10.1097/AOG.0b013e318173fd83                eww141209lx
Advertisements

Theory and Application of Tacit Knowledge Transfer

Read  full  paper  at:

http://www.scirp.org/journal/PaperInformation.aspx?PaperID=51216#.VFwZdmfHRK0

ABSTRACT

Tacit knowledge, regarding its essence, is a kind of “understanding”, comprehension, and the process of grasping and re-organizing experiences. Moreover, such ability can be controlled at will. However, spiritual understanding enables people to display the function of dominance and determination of knowledge. Therefore, this study first proposed the tacit knowledge transfer mode; there are two major strategies for the Tacit Knowledge Transfer Method (TKTM): depict the essence instead of the appearance and understand spiritually. In other words, it allows learners to represent the knowledge learned and transfer it into body memory in order to apply it to similar situations through deduction and inference. This study aims to integrate Tacit Knowledge Transfer Method (TKTM) into sketch instruction. The first phase was “knowledge accumulation”: we used “Mu” way to accumulate drawing knowledge. The phase two was “knowledge transfer”: we used “Lin” way to transfer drawing knowledge. In the process, the students in Department of Design are divided into the experimental group and the controlled group for comparisons. Having seven design experts evaluate the teaching effectiveness on the two groups (Mixed and anonymous), aiming at students’ learning achievement. The experiment concludes two main results: firstly, based on the expert evaluation scores, Tacit Knowledge Transfer Method (TKTM) proves the significant effect of Tacit Knowledge Transfer Method (TKTM) on Perspective Accuracy, Line Stability, and Form Expressivity of freehand sketch; secondly, from the experiment process and survey results, it was evident that Tacit Knowledge Transfer Method (TKTM) has direct correlation with participants’ assertiveness. If there is a conflict between norm knowledge the effectiveness of transfer will be reduced significantly.

Cite this paper

Chang, J. , Luh, D. , Kung, S. and Ueda, A. (2014) Theory and Application of Tacit Knowledge Transfer. Creative Education, 5, 1733-1739. doi: 10.4236/ce.2014.519193.

References

[1] Nonaka, I., & Takeuchi, H. (2004). The Essence of Innovation (with A. Katsumi). Tokyo: Nikkei BP.
[2] Ou, C. J. (2008). A Study on Industrial Design Final Sketches in the Phase of Developing Ideas. Master Thesis, Graduate Institute of Innovation and Design, National Taipei University of Technology.
[3] Polanyi, M. (1967). The Tacit Knowledge Dimension. London: Routledge & Kegan Paul.
[4] Stewart, T. A. (2002). The Wealth of Knowledge: Intellectual Capital and Twenty-First Century Organization. New York: Currency.
[5] Yi, J. (2006). Wang Qi Yue Recommend Copying Calligraphy (February 10, 2012).                         eww141107lx