Effect of nursing management protocol on IUDs performance

Intrauterine Devices [IUDs] remain an attractive birth-control option for many women who desire a highly effective form of birth control but cannot tolerate or do not want to use hormonal implants. However, fears about side effects, concerns about infection and infertility, lack of technical training for providers, and the time and costs involved in providing services combine to discourage their use. To assess the magnitude and types of problems associated with use of IUDS, and to examine the effect of a plan of nursing intervention on the performance of IUDs. The study was conducted in the Family planning outpatient clinic of Assiut University Hospital. A cross-sectional descriptive design, and a quasi-experimental research design with pre-post assessment were used. The assessment sample consisted of 409 women. The intervention group included 100 new IUD users who were randomly allocated into two equal groups of 50 women each. Subgroup A women received the intervention program without provision of prophylactic antibiotics, while subgroup B women received the program in addition to prophylactic antibiotics. The tools used for data collection were a structured interviewing questionnaire sheet for both the assessment and the intervention groups, and an examination form to record the clinical and laboratory findings of the intervention group. A follow-up sheet was used to record any possible complications one month after insertion. A pre-post-FU questionnaire form was used to assess women's knowledge and misconceptions before and after the intervention. The study started at the beginning of April 2002 and ended in October 2003. Only 17.6% of the women have reported no complications related to use of contraceptives. Vaginal bleeding and infection were the most common complications, 14.4% and 10.5%, respectively. The most common infection was Chlamydia [20.6%]. Subgroup A women [no-prophylactic antibiotic] had a higher incidence of erythema and vaginal discharge at the follow-up vaginal examination, compared to pre-program rate, 34.0% and 10.0%, respectively [p=0.004]. Also, women in subgroup A had a higher incidence of bacterial vaginosis [16.0%], compared those in subgroup B [4.0%], p=0.046. In subgroup B, positive chlamydial infection decreased from 34.0% at the preprogram exam to 10.0% at the FU [p<0.001], and other bacterial infections from 28.0% to 12.0% at the FU [p=0.046]. Statistically significant improvements in correct knowledge and misconceptions were revealed in all areas at the post-test and FU, p<0.001. Bleeding, infection, and dyspareunia were the most commonly reported problems among IUD users. Women had poor knowledge and many misconceptions about IUDs. The planned nursing intervention succeeded in improving their knowledge and correcting their misconceptions. Prophylactic antibiotics were also effective in reducing infections. Therefore, it is recommended to apply this intervention on a wider scale

comparative study of the clinical performance of norplant-2 versus norplant subdermal contraceptive implants

Three hundred and seventy-five fertile healthy women were randomized in the ration of 2: 1 to the use of either norplant-2 covered rods or norplant six capsules, respectively. They were followed up for a period of one year. The one year continuation rate was 86.0 +/- 2.3/100 women in norplant-2 group and 87.2 +/- 3.0/100 women in norplant group. The commonest causes of discontinuation in both groups were menstrual bleeding problems. The use of both types of implants is commonly associated with menstrual disruption but women commonly bear them particularly if they were counseled as regards the possibility of their occurrence. On the whole, manifestation of reduced menstrual bleeding are commoner amongst NORPLANT-2 users than NORPLANT users during the first year of observation. The latter group showed higher incidence of manifestation of increased bleeding than the former group. No significant effect could be found on the body weight or hemoglobin concentration of the users of both implants at the end of the first year of use. NORPLANT-2 is well comparable to the original NORPLANT six capsules system as regards its efficacy, continuation rates and side effects. However, it is superior to NORPLANT in its easy and less expensive manufacture and easier insertion as well as removal procedures in addition to its effect in reducing menstrual blood loss