Oral contraceptives, sociocultural beliefs and psychiatric symptoms

Utilization pattern and side effect profile of oral anticonceptives: A community-based cross-sectional study among Saudi women

BACKGROUND

The rapid change in the socio-demographic pattern and changing beliefs toward fertility and birth spacing have resulted in a notable increase in the use of oral anticonceptives in the Saudi Arabian community. However, information on the current utilization of oral anticonceptives and attitudes toward their use remains sparse.

OBJECTIVE

The present study evaluated the utilization pattern of oral anticonceptives, attitude toward pill use, and incidence of side effects among Saudi women.

SETTING

The study was conducted in a community setting in Jazan, Kingdom of Saudi Arabia.

METHODS

Eligible Saudi women routinely using oral anticonceptive pills were invited to participate in this prospective, cross-sectional survey. Data were collected using a standardized, pretested, semi-structured questionnaire. Jazan was selected as it recorded the highest number of women using contraceptives in Saudi Arabia.

MAIN OUTCOME MEASURE

The pattern of pill utilization, attitude toward pill use, and incidence of side effects.

RESULTS

A total of 496 women consented to participate in this study. Most of the respondents (87.5%) were using or had used oral anticonceptives for birth control. In nearly half (49.2%) of participants, oral pills were advised by a gynaecologist, and approximately two-thirds (69.0%) were using or had used combined oral anticonceptives. Nearly two-thirds (63.1%) of respondents preferred pills over other contraception methods due to their ease of use. More than one-third (39.3%) of participants agreed that oral pills are safe. Approximately half (53.2%) of participants were aware that a missed pill must be taken immediately after recalling that a dose was missed. A total of 69.6% of participants experienced at least one side effect, of which mood swings (61.1%), weight gain or increase appetite (42.2%), decreased libido (34.1%), and nausea (31.2%) were most common.

CONCLUSION

Saudi women had a high acceptance rate for oral anticonceptives as a legitimate method to prevent unintended pregnancy. This was associated with a modest degree of understanding about their risks and benefits. Pharmacists should provide up-to-date information and counsel patients about the use and side effects of oral anticonceptives.

Current knowledge, attitude, and patterns of oral contraceptives utilization among women in Jordan

Background

Studies exploring the knowledge, attitude and patterns of OCs use among women in Jordan are lacking. The aim of this study was to assess knowledge, attitude, and patterns of oral contraceptives (OCs) utilization among women in Jordan.

Methods

A face-to-face questionnaire inquiring demographic information and issues related to knowledge and use of OCs was completed by women (n = 1571), who have had used OCs at least once in their lifetime. A model was created to assess the effects of knowledge, attitude and previous experience on the patterns of OCs utilization.

Results

Jordanian women exhibited positive attitudes towards OCs efficacy and safety. This positive attitude was approvingly associated with the patterns of use. However, only half of participating women reported that they knew how to use OCs. About 60 % of women received recommendations for OCs use from a physician. Moreover, women’s knowledge about OCs mechanism of action was obtained namely from physician (29.9 %). Side effects were reported in 75.1 % of participating women. Reported side effects were headache (41.2 %), mood swings (35.5 %), irritability (33.5 %) and weight gain (28.7 %). Interestingly, the occurrence of side effects was the main reason for OCs discontinuation.

Conclusion

The study showed that women who have positive attitude toward OCs tend to utilize them more appropriately. However, there is still need for educational programs to enhance knowledge about OCs utilization in Jordan.

Electronic supplementary material

The online version of this article (doi:10.1186/s12905-015-0275-1) contains supplementary material, which is available to authorized users.

Arab culture and mental health care

This selective review describes recent literature and the author's experience with mental illness and mental health care, and the impact of cultural transformation on mental health in some Arab Islamic cultures, particularly in Egypt, Qatar and Kuwait. Traditional extended Arab families provide a structure for their members that may sometimes prevent and or compensate for the effects of parental loss and mental disability. The role of traditional families in the care of members and in medical decision-making is discussed. The impact of cultural change on Arab culture is also examined, as is the effect of intergenerational conflict in traditional families.

Jordanian married Muslim women's intentions to use oral contraceptives

BACKGROUND

High fertility rates and moderate to low contraceptive use in the Arab Islamic countries, and Jordan in particular, are issues of international nursing importance.

AIM

By using the Theory of Planned Behaviour (TPB) as the conceptual framework, the relationships between married Jordanian Muslim women's previous contraceptive use, type of experience, and intention to use oral contraceptives (OCs) were examined. The relationship between selected demographic variables and intention to use OCs was also examined.

METHODS

The study was part of a large cross-sectional survey. The Intention to Use Oral Contraceptive Tool was used to elicit participants' intentions and beliefs regarding oral contraceptive use.

SAMPLE

The study sample was composed of 245 Jordanian married Muslim women.

RESULTS

Results revealed a significant relationship between previous oral contraceptive use and intention to use OCs. The relationships between type of experience, whether successful or unsuccessful, with previous OC use, and intention to use OCs were not significant.

CONCLUSION

Nursing implications regarding the provision of family planning services that are sensitive to Jordanian Muslim women's religious preferences are discussed.

Jordanian Muslim Women’s Intention to Use Oral Contraceptives

Oral contraceptives (OCs) are the second most popular method of contraception in Jordan; however, their use remains low compared with the intrauterine device. The purpose of this article is to report the effect of factors identified by The Theory of Planned Behavior (TPB) on Jordanian Muslim women’s intention to use OCs. TPB was used to develop an investigator-developed instrument, the Intention to Use Oral Contraceptive Tool (IUOCT). The IUOCT measured attitude (general attitude and attitudinal beliefs), social norms and perceived behavioral control factors in a total of 83 women participants. A stepwise regression analysis was calculated using the IUOCT subscales as predictors of Jordanian Muslim women’s intention to use OCs. The findings demonstrated that the attitude, specifically general attitude and positive beliefs, about OC use affect Jordanian Muslim women’s intention to use OCs. However, the findings provide limited support for social norms and perceived behavioral control as factors influencing Jordanian Muslim women’s intention to use OCs. The findings indicate that more attention should be devoted to health education programs on the benefits of using OCs rather than focusing only on correcting misinformation. Nursing implications and recommendations for future research are discussed.

Establishing reliability and validity of an instrument measuring Jordanian Muslim women's contraceptive beliefs

We tested the psychometric properties of an instrument entitled intention to use oral contraceptive tool (IUOCT). This instrument was developed to evaluate Jordanian Muslim women's intention to use oral contraceptives (OCs). We used the theory of planned behavior (TPB) as a conceptual framework for developing the IUOCT. The internal consistency of the IUOCT ranged from .70 to .94. The stability of IUOCT ranged from.79 to.85. Factor analysis identified four factors that represented the three constructs of the TPB. The known-group technique showed significant difference between past users and nonpast users of OCs. The predictive validity analysis showed that each scale contributed to the variability in the intention.

Health beliefs and practices among Arab women

The purpose of this article is to describe the healthcare beliefs and practices of Arab American women, specifically those regarding menstruation, pregnancy, childbirth, and family planning. The information in this paper is derived from the author's experience as a researcher, as an Arab healthcare provider, and from the literature. Guidelines for nurses who provide care to Arab American women are also presented.

Contraception in Jordan: a cultural and religious perspective

This report provides a content analysis of studies conducted with Jordanian women on contraception. Factors such as pressure to have children, number and gender of children, location of residence, influence of religion, level of education, age, employment status, source of contraceptive services and method of contraception are discussed. Non-demographic factors, such as social and psychosocial, were found to be only briefly investigated and discussed in the literature. Nursing implications discussed are conducting educational programmes, encouraging the participation of significant others and religious leaders, and using appropriate terminology when discussing contraception with Jordanian women.

Knowledge, Attitudes, and Practices of Family Planning among Currently Married Women in Jordan Badia

This article reports the results of the first household survey ever conducted in Jordan Badia to include questions on knowledge, attitude, and practices (KAP) among 15–49 currently married women in Jordan Badia toward family planning. The Jordan Badia is the eastern part of Jordan populated by Bedouins who make up about 7 to 9 percent of the 4.8 million total population of Jordan. Using convenience sampling procedure, a total of 450 respondents, 50 from each of nine villages, were selected for participation. The mean age of the study population was 30.9 years and the women's age at marriage ranged from 13 to 35 years, with a mean age at first marriage of 16.8 years. More than 37 percent of the women were illiterate. Over 91 percent of the women know about family planning, but proportions of ever-users or currently-users of contraception are found to be 35.7 percent and 31.7 percent respectively. The social support network, including the husbands, mothers, and mothers-in-law, was explored. Husbands' support for family planning was significantly higher ( p < 0.001, Chi Square test, df = 2) than the support of both the mothers and mothers-in-law. In view of the limited data-based literature in the area of family planning, findings of this survey can assist in the formulation of culturally appropriate population policy and viable family planning programs for this Bedouin community. Based on the results of this KAP survey, appropriate recommendations aiming at increasing the demand for family planning services among women in Jordan Badia are provided.

Contraceptive decision making in a sample of Jordanian Muslim women: delineating salient beliefs

In this article, the authors identify attitudes, normative beliefs, and behavioral control beliefs of Muslim Jordanian women with regard to avoiding unplanned pregnancy and using specific contraceptive methods. Based on Ajzen and Fishbein's theory of planned behavior, open-ended questions were used in audio-taped face-to-face interviews with 25 married 19-44-year-old Jordanian Muslim women. A majority of respondents interviewed were currently using an intrauterine device (IUD) for contraception. Few women were using oral contraceptives, condoms, or the rhythm method and none of them reported using foam or a diaphragm. Content analyses of narrative transcriptions suggest the individual's concerns for family and individual well-being, as well as husbands' and families' opinions, may influence women's contraceptive behavior in this population.