Coping Strategies, Social Support, and Self-Care Among Young Women with Pelvic Inflammatory Disease

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Date
2018-06-22
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Johns Hopkins University
Abstract
Pelvic inflammatory disease (PID), a spectrum of inflammatory disorders of the female upper genital tract, is a serious complication of sexually transmitted infections (STIs) that may lead to chronic pelvic pain, ectopic pregnancy, and tubal infertility. Although PID treatment is critical for the preservation of fertility and health-related quality of life, many young women diagnosed with PID do not fully adhere to treatment recommendations. Interventions focused on clinician practices, patient education, and behavioral modeling have generated limited improvements in outpatient PID treatment adherence among young women, thereby suggesting the influence of other determinants, such as psychosocial factors. Coping and social support are psychosocial factors that may affect PID self-management. A comprehensive literature review revealed a dearth of published research focused on coping with PID and related social support among young women. Guided by the Transactional Model of Stress and Coping, this dissertation study used a convergent mixed methods design to examine and explore the coping strategies, social support, and self-management behaviors (medication completion, clinical follow-up visit attendance, partner notification, and sexual abstinence) of 90 young women during the PID treatment period. Study participants comprised a subsample of young women enrolled in a randomized controlled trial of an outpatient intervention designed to reduce adverse outcomes after PID. Quantitative data were collected via audio computer-assisted self-interview and structured in-person interviews. Qualitative data collection consisted of semi-structured interviews with 18 participants to explore the experiences of young women diagnosed with and treated for PID. Quantitative results indicated that the social provision of opportunity for nurturance (perceived responsibility for others) was positively associated with medication completion (AOR=1.26, 95% CI: 1.00-1.59, p=0.05) and clinical visit attendance (AOR=2.43, 95% CI: 1.19-4.93, p=0.01). Qualitative findings revealed that upon learning about their diagnosis, young women were self-motivated to ameliorate PID. With support from family and friends, they incorporated PID self-management into their daily lives—which may not have been fully consistent with prescribed medical protocols. In conclusion, social support is associated with PID self-management among young women. Assessing young women’s coping and social support resources can inform a tailored plan for successful PID treatment.
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Keywords
Pelvic Inflammatory Disease, Adaptation, Psychological, Self Care, Adolescent Medicine, Young Adult, Social Support
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