DETERMINANTS OF CONTRACEPTIVE USE AMONG WOMEN OF REPRODUCTIVE AGE IN GREAT BRITAIN AND GERMANY II: PSYCHOLOGICAL FACTORS

Autor: Oddens Bj
Rok vydání: 1997
Předmět:
Zdroj: Journal of Biosocial Science. 29:437-470
ISSN: 1469-7599
0021-9320
DOI: 10.1017/s0021932097004379
Popis: Psychological determinants of contraceptive use were investigated in Great Britain and Germany, using national data obtained in 1992. It was hypothesised that current contraceptive use among sexually active, fertile women aged 15-45 was related to their attitude towards the various contraceptive methods, social influences, perceptions of being able to use a method correctly and consistently, a correct estimation of fertility, and communication with their partner. Effects of age and country were also taken into account. The attitude of respondents towards the various contraceptive methods was ambivalent and no method was seen as ideal. On medical methods (OCs, IUDs and sterilisation) many respondents expressed doubts as to their safety for health. Social influences most frequently concerned the use of OCs. Respondents considered themselves able to use oral contraceptives correctly, but expressed general fear about intrauterine devices and sterilisation, and many women believed they were not able to use condoms and periodic abstinence consistently. Multifactorial analyses revealed that current contraceptive use was principally determined by social influences, attitude and self-efficacy with respect to medical methods. Age and country, and, for use of unreliable methods, fertility awareness also played a role. Communication with the partner was less relevant. Contraceptive choice (and the use of non-medical methods) depended greatly on encouragement to use and being in favour of medical methods. A lack of social support for use of medical methods and a negative attitude towards them was related to higher use rates of condoms, periodic abstinence, withdrawal and reliance on 'luck'. In the case of withdrawal and/or no method, underestimation of fertility played an additional role. Contraceptive choice appears to be determined more by a general like or dislike of medical methods rather than on a weighing of the merits of individual available methods.This study concludes that within specific contexts a number of psychological factors affect contraceptive usage. Contraceptive decisions in Germany and Great Britain were affected by attitudes toward oral contraceptives (OCs), IUDs, and sterilization, and the perceived social influences of these contraceptive methods. Attitudes and perceived social influences of OCs, IUDs, and sterilization were associated with use of condoms, periodic abstinence, and withdrawal or no method use. Age and country also influenced the decision to use contraceptives. Fertility awareness influenced use of unreliable methods. Communication between partners had a small influence. Higher use of condoms, periodic abstinence, withdrawal, and reliance on "luck" was associated with a lack of social support for use of medical methods and a negative attitude towards use of medical methods. Persons who underestimated their fertility potential were at higher risk of relying on withdrawal and/or no method at all. Findings suggest that choice in a developed country was related to approval or disapproval of medical methods rather than an evaluation of the benefits of individual methods available. Analysis is based on the theoretical models of Ajzen and Fishbein, which models suggest that use of a contraceptive method is based on rational intention to use the method concerned, and rational intention is determined by attitudinal and subjective norms. The sample includes 967 reproductive-age women in Great Britain and 1064 reproductive age women in reunified Germany. The survey was used in 1992 in both countries. Indices were constructed for measuring attitude, the social influences concept, self-efficacy, and communication. Analysis includes multiple logistic regression models and principal components and segmentation analysis.
Databáze: OpenAIRE
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