Initiating contraceptive use: how do young women decide?
White, J.E.
Pediatric Nursing 10(5): 347-352
1984
ISSN/ISBN: 0097-9805 PMID: 6567083 Document Number: 426254
This study was designed to identify relationships between the initiation of effective contraception, decision making, problem solving ability, and cognitive levels in adolescent females. The sample consisted of 100 adolescent females between 14-19 years who were selected from a population of 1st time patients at an urban, freestanding, family planning clinic serving adolescents from a variety of socioeconomic backgrounds. 60% of the participants were ages 15 and 16. Young women who met the following criteria were asked to participate: between the ages of 13-19; no previous use of a prescription contraceptive method; and intention to select oral contraceptives (OCs) as their birth control method. Instruments utilized included a Contraceptive Decision Making Sheet, developed from a form used by Sorenson in a large study of adolescent sexuality; Piagetian tasks; the Means End Problem Solving (MEPS) instrument; and the Decision-Making Interview Schedule. Participants were divided into 2 groups for the purpose of data analysis. Those termed "prompt initiators" had inititiated contraceptive use within 8 months after becoming sexually active. The "delayers" had initiated contraceptive use 1 year or more after becoming sexually active, with a range from 1 year to more than 4 years. 16 of the women were still virgins. Those who had begun having sexual intercourse had done so at an average of 15.25 years and had been sexually active, on the average, for almost 15 months. This study confirmed previous research indicating a positive relationship between age at 1st coitus and contraceptive use. Those who waited 12 months or longer before initiating contraceptive use experienced 1st sexual intercourse at a significantly younger age than those who waited 8 months or less. Cognitive development was related neither to age nor problem solving skills. The intuitive expectation that the older females would be more likely to function at higher levels was not validated. The level of cognitive development was not related to the interval of delay in using contraceptives. Women who were "prompt initiators" saw themselves as more susceptible to pregnancy than did the "delayers." The "prompt initiators" were somewhat more likely to expect no side effects from OC use than the "delayers." Outside influences were important in the adolescents' decision making. Nursing implications are considered.