| Objective:To investigate the influencing factors of contraceptive behavior in patients with cesarean scar pregnancy(CSP);to explore the influence of Individualized education guidance supported by Nayue interviews based on IMB model on contraceptive knowledge,self-efficacy and choice of contraceptive methods in CSP patients.Methods:This research is divided into two parts.The first part is a qualitative research.Based on the philosophical thought of constructivism,the focus group interview method and the semi-structured interview method were used to interview the medical staff and CSP patients in the undergraduate office,so as to understand the illness experience of CSP patients,Contraceptive behavior misunderstandings and contraceptive needs,to explore the influencing factors of postoperative contraceptive behavior in CSP patients,and to formulate an acceptable interview strategy based on this.The second part is a quasi-experimental study.CSP patients who met the admission and discharge standards in the gynecology department of a tertiary hospital in Jinan were selected as the research objects,and the patients who were hospitalized from April to October 2020 were selected as the control group,and the period from January to June 2021.Hospitalized patients were the experimental group.In the end,54 cases were included in the control group,and 51 cases were included in the experimental group.The control group received conventional gynecological nursing intervention,and the intervention group received an individualized nursing program based on IMB,and the level of contraceptive knowledge,contraceptive self-efficacy,choice of contraceptive methods,and the incidence of unintended pregnancy were collected 6 months after the intervention to evaluate the effect of the intervention.SPSS 25.0 statistical software was used for analysis,count data were described by frequency and percentage;measurement data were described by mean ± standard deviation,median and quartile.For comparison of group values,t test were used for normal distribution,rank sum test was used for non-normal distribution,and chi-square test was used for rate comparison.Results:1.Influencing factors of postoperative contraceptive behavior in CSP patients:(1)Obstructive factors:①Lack of correct understanding of the disease;② Misunderstanding of contraceptive cognition;③ Chance of contraception;④Influence of others(partners,friends and elders).(2)Facilitating factors:①Perceived disease threat;②Perceived contraceptive benefits;③Correct guidance of professionals.2.Baseline data comparison:There were no significant differences in general data,disease-related data and contraceptive knowledge between the two groups(P>0.05),which were comparable.3.Comparing the scores of contraceptive knowledge,the scores of the control group before and after the intervention were(15.57±3.07)and(16.53±2.85)respectively;the scores of the experimental group before and after the intervention were(15.37±3.67)and(21.33±1.83)respectively,the difference between the two groups before and after the intervention was statistically significant(P<0.05);the difference between the two groups of contraceptive knowledge scores was statistically significant 6 months after the intervention(P<0.01).4.Contraceptive self-efficacy,the scores before and after the intervention in the control group were(41.26±4.23)and(42.38±5.30)respectively;the scores before and after the experimental group were(42.02±4.84)and(48.53±4.45)respectively,the contraceptive self-efficacy total score and each dimension score were compared between the two groups 6 months after the intervention,and the difference was statistically significant(P<0.01).There was no significant difference between the groups(P>0.05),but there was a statistical significance in the experimental group(P<0.01).5.The comparison of the effective and effective contraceptive measures in the two groups showed that the control group was lower than the experimental group,and the difference was statistically significant(P<0.05).6.The comparison of the incidence of unintended pregnancy 6 months after the intervene between the two groups showed that there were 4 cases of unintended pregnancy within 6 months after the intervene in the control group and 0 cases in the experimental group.There was no significant difference between the two groups(P>0.05).conclusions:(1)Obstructive factors affecting postoperative contraceptive behavior of CSP patients include:①Lack of correct disease awareness;②Misunderstanding of contraceptive cognition;③Chance of contraception;④Influence of others(partners,friends and elders).Promoting factors are:①Perceived disease threat;②Perceived contraceptive benefits;③Correct guidance from professionals.(2)Individualized education intervention based on the IMB model can improve the contraceptive knowledge level and contraceptive self-efficacy of CSP patients,implement effective contraceptive measures,reduce the incidence of postoperative unintended pregnancy in CSP patients,and ensure female reproductive health. |
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