scholarly journals Contributo de fatores individuais, sociais e ambientais para a decisão de prosseguir uma gravidez não planeada na adolescência: Um estudo caracterizador da realidade portuguesa

2015 ◽  
Vol 33 (1) ◽  
pp. 19-38 ◽  
Author(s):  
Raquel Pires ◽  
Joana Pereira ◽  
Anabela Araújo Pedrosa ◽  
Duarte Vilar ◽  
Lisa Vicente ◽  
...  

Resumo Foi nosso objetivo explorar o contributo simultâneo de fatores individuais, sociais e ambientais e das possíveis interações entre eles para a decisão de prosseguir uma gravidez adolescente à luz do atual quadro legislativo que despenaliza a interrupção da gravidez por opção da mulher, em Portugal. A amostra foi constituída por 276 adolescentes que engravidaram de forma não planeada e contactaram com os serviços de saúde dentro do prazo legal que lhes permitiria optar pela interrupção: 133 adolescentes que prosseguiram a gravidez e 143 que a interromperam. Os dados foram recolhidos entre 2008 e 2013 em 53 serviços de saúde de todas as regiões. Não ter ponderado as duas alternativas possíveis (prosseguimento/interrupção), pertencer a famílias de baixo nível socioeconómico e com história de maternidade adolescente, ter abandonado a escola e residir em áreas com maior densidade populacional e onde a população feminina é menos escolarizada foram fatores explicativos do prosseguimento da gravidez. A menor idade da adolescente associou-se com o prosseguimento apenas quando não foram ponderadas ambas as alternativas. O efeito da religiosidade local variou de acordo com o envolvimento religioso da adolescente. Estes resultados têm importantes implicações para a prática clínica e investigação na área da decisão reprodutiva na adolescência.Abstract The aim of the current study was to explore the simultaneous contribution of individual, social, and environmental factors, as well as the possible interactions between them to the decision to continue an adolescent pregnancy after the abortion on women´s demand has been legalized in Portugal. The sample consisted of 276 adolescents who became unintentionally pregnant and contacted with healthcare services within the legal period for induced abortion: 133 adolescents who chose to continue the pregnancy and 143 who chose to terminate the pregnancy. Data were collected between 2008 and 2013, in 53 healthcare centers of all country areas. Not having thought about both available options (i.e., continuing vs. terminating the pregnancy), belonging to families of low socioeconomic status and with adolescent pregnancy history, having dropped out of school and having lived in areas with higher population density and less educated females predicted the decision to continue the pregnancy. The lower the adolescents’ age, the more frequent was the decision to continue the pregnancy, but only when adolescents’ had not thought about both options. The effect of local religiosity differed according to the adolescents’ religious involvement. These findings have important implications for clinical practice and research on adolescents’ reproductive decisions.

2014 ◽  
Author(s):  
Sarah Dayle Herrmann ◽  
Jessica Bodford ◽  
Robert Adelman ◽  
Oliver Graudejus ◽  
Morris Okun ◽  
...  

2020 ◽  
Vol 91 (6) ◽  
pp. 2042-2062
Author(s):  
Susana Mendive ◽  
Mayra Mascareño Lara ◽  
Daniela Aldoney ◽  
J. Carola Pérez ◽  
José P. Pezoa

BMJ Open ◽  
2021 ◽  
Vol 11 (5) ◽  
pp. e043547
Author(s):  
Donald A Redelmeier ◽  
Kelvin Ng ◽  
Deva Thiruchelvam ◽  
Eldar Shafir

ObjectivesEconomic constraints are a common explanation of why patients with low socioeconomic status tend to experience less access to medical care. We tested whether the decreased care extends to medical assistance in dying in a healthcare system with no direct economic constraints.DesignPopulation-based case–control study of adults who died.SettingOntario, Canada, between 1 June 2016 and 1 June 2019.PatientsPatients receiving palliative care under universal insurance with no user fees.ExposurePatient’s socioeconomic status identified using standardised quintiles.Main outcome measureWhether the patient received medical assistance in dying.ResultsA total of 50 096 palliative care patients died, of whom 920 received medical assistance in dying (cases) and 49 176 did not receive medical assistance in dying (controls). Medical assistance in dying was less frequent for patients with low socioeconomic status (166 of 11 008=1.5%) than for patients with high socioeconomic status (227 of 9277=2.4%). This equalled a 39% decreased odds of receiving medical assistance in dying associated with low socioeconomic status (OR=0.61, 95% CI 0.50 to 0.75, p<0.001). The relative decrease was evident across diverse patient groups and after adjusting for age, sex, home location, malignancy diagnosis, healthcare utilisation and overall frailty. The findings also replicated in a subgroup analysis that matched patients on responsible physician, a sensitivity analysis based on a different socioeconomic measure of low-income status and a confirmation study using a randomised survey design.ConclusionsPatients with low socioeconomic status are less likely to receive medical assistance in dying under universal health insurance. An awareness of this imbalance may help in understanding patient decisions in less extreme clinical settings.


Author(s):  
Kevin Kien Hoa Chung ◽  
Xiaomin Li ◽  
Cheuk Yi Lam ◽  
Chun Bun Lam ◽  
Wing Kai Fung ◽  
...  

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