Conhecimento, satisfação e repercussões clínicas relacionadas à contracepção permanente por inserção de dispositivo intra-tubário

Abstract

A cross-sectional study, a quantitative approach and a descriptive character, aimed at performing a situational diagnosis about the intra-tubal device of permanent contraception (ITD), in the perspective of users' knowledge and satisfaction, as well as health security. The population was composed of 32 women, living in Palmas-TO and submitted to the insertion of the DIT into a state public reference service. The data were collected from June to October 2017, using a semistructure interview and analyzed in the Stata Program version 14.0. Categorical variables were described by means of proportion and the continuous variables, by mean and standard deviation. Analyzes were made of associations between levels of knowledge or satisfaction according to the independent variables, using Fisher's test to test the proportions and Mann Whitney test for the means. The sociodemographic profile showed women with 35.2 ± 2.9 years of age, majority with fixed partnership and browns, high school as predominant level of education and occupied varied functions. The mean number of children was 2.8 ± 1.1. The mean waiting time for insertion of the DIT was 2.5 months. All the women inserted the DIT outside the puerperal pregnancy period. The mean age of the women at the time of the procedure was 31.9 ± 3 years. The main information provided to women was about the definiteness of the method and the freedom to give up at any time before its completion (96.9%). The majority (96.9%) of the women participated in educational activities. The women reported follow-up by multiprofessional team. 96.9% performed the pregnancy test. 10 (31.3%) women reported not having performed the confirmatory DIT test. There was no return consultation for 43.9% of the women, mainly because the service was not functioning (42.9%). The report of the clinical repercussions indicated pain during the procedure (n = 20) as the most common in this study. Other repercussions were also cited. The majority (93.8%) of the women had a satisfactory level of knowledge regarding the characteristics of the ITD. There was an association between participation in the educational activity and the level of knowledge satisfactory in relation to ITD (p = 0.000). The majority (96.9%) of the women also obtained satisfactory knowledge on the procedure and mechanism of action of the ITD and on the recommendations before and after the procedure. Of all knowledge variables, the clinical repercussions were the least known among women, with the majority (84.4%) classified as unsatisfactory. There was a statistically significant association between the separate marital status and the unsatisfactory level of knowledge regarding the clinical repercussions of ITD (p = 0.000). Having higher income was associated with unsatisfactory knowledge of women on clinical repercussions (2,843.18 ± 2.243,73 p = 0.031). The majority (78.1%) of women are fully satisfied with the method. It was evident in this study the assistance gap caused by the closure of the reference service, as well as weaknesses in counseling by the multiprofessional team, including the inefficiency of educational activities, perceived from the large number of women with unsatisfactory knowledge in variables indispensable to the process of free choice and clarified, as clinical repercussions and contraindications of the method.