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Authors
Abstract(s)
ntrodução: Apesar da possibilidade de acesso a informação fidedigna, quer através dos
programas escolares de educação sexual, quer através do aconselhamento contracetivo no
Serviço Nacional de Saúde, a falta de conhecimentos dos adolescentes sobre contraceção
em Portugal é significativa. O número de gravidezes na adolescência, apesar de em
decrescendo, continua a ser problemático, assim como os comportamentos sexuais de
risco a que se sujeitam, constituindo um problema de saúde pública.
Objetivo: Com este estudo, pretende-se averiguar as fontes de informação e nível de
conhecimento dos adolescentes sobre contraceção, caracterizar as suas práticas mais
comuns e apurar se existem diferenças entre sexos. Pretende-se propor uma abordagem
diferente da educação sexual escolar, em parceria com profissionais de saúde qualificados,
visando melhorar o conhecimento global e o uso adequado de contraceção por jovens.
Materiais e Métodos: Foi desenvolvido um estudo observacional, transversal, através
de um questionário, a jovens do ensino secundário de três escolas da cidade da Covilhã,
região da Beira Interior. Foi aprovado pela Direção Geral de Educação e pela Comissão de
Ética da Universidade da Beira interior. O questionário, desenvolvido pelos autores, era
constituído por três secções com perguntas de escolha múltipla, “Sim/Não” e de resposta
aberta. Para a análise estatística foi utilizado o SPSS (Statistical Package for Social
Sciences) versão 28.
Resultados: Foram obtidas 266 respostas válidas ao questionário. A amostra era
constituída por 65,4% participantes do sexo feminino e 34,6% do sexo masculino com uma
média de idade de 16,18±1,10 anos. Avaliando os conhecimentos sobre contraceção,
verificou-se que sobre todos os contracetivos questionados se observou algum grau de
conhecimento, tendo sido o Preservativo masculino o mais conhecido (97,3%), seguindose o Preservativo feminino (91,6%) e a Contraceção de emergência (81,4%). A principal
fonte de informação contracetiva foi a internet (77,2%), seguida pelas aulas (72,6%).
Apesar de apenas 12,2% ter referido ter consultas para esclarecimento de dúvidas e 33,6%
consultas de planeamento familiar, a maioria dos que frequentaram ficou satisfeita e
voltaria. As vantagens dos métodos hormonais mais reconhecidas foram os benefícios não
contracetivos, como o controlo do ciclo (80,4%) e do fluxo menstrual (70,6%), enquanto
os efeitos secundários (71,6%) e a dificuldade de obtenção (89,9%) foram as principais
desvantagens reportadas. 95,2% reconhece a necessidade de consultar um médico antes
de iniciar a utilização destes métodos. Relativamente ao preservativo, as vantagens mais
apresentadas foram a eficácia contracetiva (68,1%) e a prevenção de Infeções sexualmente
transmissíveis (64,6%), enquanto as desvantagens foram o risco de rotura (60,6%) e a diminuição do prazer sexual (27,8%). O principal motivo para utilizarem a contraceção foi
a prevenção de gravidez (60,3%) e o local de obtenção mais frequente foi o centro de
saúde/hospital (58%). O método hormonal mais usado foi a pílula hormonal combinada
(75,4%) e o seu uso foi incentivado principalmente pelo parceiro (93%) e profissional de
saúde (66,7%). Quanto à sexualidade, 28,9% dos inquiridos eram sexualmente ativos, com
uma idade média de início da atividade sexual de 14,97±1,41 anos. O preservativo
masculino foi o método de eleição na primeira relação sexual (76,6%), seguido da “Dupla
contraceção” (17,2%). O facto de não terem pensado no assunto foi o principal motivo para
não terem usado contraceção. Apesar de 76,5% considerar que o preservativo deve ser
usado em todas as relações sexuais, apenas 46,7% o faz, sendo o parceiro habitual o
principal motivo para não o fazerem (62,5%). A maioria dos jovens teve apenas 1 parceiro
sexual, no entanto 33,8% revelou ter tido mais que 1 (média 2,8±1,08). A contraceção de
emergência já foi utilizada por 20,4% das jovens. 5,6% das raparigas já esteve grávida.
Quanto a comportamentos sexuais de risco, 47,4% dos jovens teria uma relação sexual
com alguém que se negasse a usar preservativo, 37,8% fê-lo após consumo de
álcool/drogas e, desses, 21,9% considerou que isso influenciou a sua atitude preventiva.
Discussão: Neste estudo e de acordo com a evidência científica, os jovens demonstraram
ainda um conhecimento deficitário sobre contraceção. Por vezes baseiam as suas escolhas
em informações erradas, contribuindo para práticas sexuais inseguras. Há ainda
diferenças entre sexos relativamente aos conhecimentos e práticas sobre contraceção.
Apesar de muitos rapazes conhecerem a maioria dos métodos contracetivos, as raparigas
revelam maior conhecimento sobre os métodos disponíveis, vantagens, benefícios não
contracetivos, riscos associados e desvantagens. As motivações para utilizarem
contraceção são também diferentes e as raparigas revelam um maior envolvimento com os
profissionais de saúde.
Conclusão: Há necessidade de melhorar o conhecimento e adesão dos jovens à
contraceção e de uma abordagem mais pró-ativa por parte dos profissionais de saúde, que
devem aproveitar, de forma oportuna, todos os momentos em contacto com adolescentes
para explorar estes temas. Devem ser desenvolvidos planos de atuação diretamente nas
escolas tentando alcançar o maior universo de jovens possível, uma vez que apenas uma
percentagem reduzida dos adolescentes procura os serviços de saúde. Seria conveniente
ainda intervir sobre os professores e pais, no que toca a estes aspetos, de forma a tornar a
abordagem mais abrangente e contínua no ambiente escolar, familiar e entre os próprios
adolescentes.
Introduction: Despite the possibility of accessing reliable information, either through school programs on sex education or through contraceptive counseling at the National Health Service, the lack of knowledge among adolescents about contraception in Portugal is significant. The number of teenage pregnancies, despite decreasing, continues to be problematic, as well as the risky sexual behaviors to which they are submitted, constituting a public health problem. Objective: With this study, we intend to verify the sources of information and the level of knowledge of adolescents about contraception, characterize their most common practices and determine whether there are differences between the sexes. It is intended to propose a different approach to school sex education, in partnership with prepared health professionals, aiming to improve global knowledge and adequate use of contraception by adolescents. Materials and Methods: An observational, cross-sectional study was carried out, through a questionnaire, with young people from secondary education from 3 schools in the city of Covilhã, Beira Interior region. It was approved by the Direção Geral de Educação and by the Ethics Committee of the University of Beira interior. The Questionnaire, developed by the authors, consisted of three sections with multiplequestions, “Yes/No” and open-response questions. For the statistical analysis, SPSS (Statistical Package for the Social Sciences) version 28 was used. Results: There were 266 valid responses to the questionnaire. The sample consisted of 65.4% female participants and 34.6% male participants with a mean age of 16.18±1.10 years. Evaluating knowledge about contraception, it was found that about all the contraceptives questioned some degree of knowledge was obtained, with the male condom being the most known (97.3%), followed by the female condom (91.6%) and the Emergency contraception (81.4%). The main source of contraceptive information was the internet (77.2%), followed by classes (72.6%). Although only 12.2% referred consultations to clarify doubts and 33.6% family planning consultations, most of those who attended were satisfied and would return. The most recognized advantages of hormonal methods were non-contraceptive benefits, such as cycle control (80.4%) and menstrual flow regulation (70.6%), while side effects (71.6%) and difficulty in obtaining (89.9%) were the main disadvantages reported. 95.2% recognize the need to consult a doctor before starting to use these methods. Regarding the condom, the most achieved advantages were contraceptive efficacy (68.1%) and the prevention of sexually transmitted infections (64.6%), while the disadvantages were the risk of rupture (60.6%) and the reduction of the sexual pleasure (27.8%). The main reason for using contraception was to prevent pregnancy (60.3%) and the most frequently mentioned place to obtain it was the health center/hospital (58%). The most used hormonal method was combined hormonal pill (75.4%) and its use was mainly encouraged by the partner (93%) and by a health professional (66.7%). As for sexuality, 28.9% of respondents were sexually active, with an average age of onset of sexual activity of 14.97±1.41 years. The male condom was the method of choice for the first sexual intercourse (76.6%), followed by “double contraception” (17.2%). The fact that they hadn’t thought about it was the main reason for not using contraception. Although 76.5% consider that condoms should be used in all sexual relations, only 46.7% do so, with the usual partner being the main reason for not doing so (62.5%). Most young people had had only 1 sexual partner, however 33.8% revealed having had more than 1 (mean 2.8±1.08 partners). The emergency contraception has already been used by 20.4% of young people. 5.6% of girls have already been pregnant. As for risky sexual behavior, 47.4% of young people would have a sexual intercourse with someone who refused to use a condom, 37.8% did so after consuming alcohol/drugs and, of these, 21.9% considered that it influenced their preventive attitude. Discussion: In this study and according to scientific evidence, young people still have a deficient knowledge about contraception. Sometimes they base their choices on wrong information, trusting unsafe sexual practices. There’s still a difference between the sexes in terms of knowledge and practices about contraception. Although many know most contraceptive methods, girls demonstrate greater knowledge about available methods, advantages, non-contraceptive benefits, associated risks and benefits. The motivations for using contraception are also different and girls reveal a greater involvement with health professionals. Conclusion: There’s a need to improve young people's knowledge and adherence to contraception and a more proactive approach on the behalf of health professionals, who must take advantage, in every moment of contact with adolescents to explore these topics. Action plans should also be developed directly in schools, trying to reach the largest possible universe of young people, since only a small percentage of adolescents seek health services. It would also be convenient to intervene with teachers and parents, regarding these aspects, to make the approach more comprehensive and continuous in the school, family environment and among the adolescents themselves.
Introduction: Despite the possibility of accessing reliable information, either through school programs on sex education or through contraceptive counseling at the National Health Service, the lack of knowledge among adolescents about contraception in Portugal is significant. The number of teenage pregnancies, despite decreasing, continues to be problematic, as well as the risky sexual behaviors to which they are submitted, constituting a public health problem. Objective: With this study, we intend to verify the sources of information and the level of knowledge of adolescents about contraception, characterize their most common practices and determine whether there are differences between the sexes. It is intended to propose a different approach to school sex education, in partnership with prepared health professionals, aiming to improve global knowledge and adequate use of contraception by adolescents. Materials and Methods: An observational, cross-sectional study was carried out, through a questionnaire, with young people from secondary education from 3 schools in the city of Covilhã, Beira Interior region. It was approved by the Direção Geral de Educação and by the Ethics Committee of the University of Beira interior. The Questionnaire, developed by the authors, consisted of three sections with multiplequestions, “Yes/No” and open-response questions. For the statistical analysis, SPSS (Statistical Package for the Social Sciences) version 28 was used. Results: There were 266 valid responses to the questionnaire. The sample consisted of 65.4% female participants and 34.6% male participants with a mean age of 16.18±1.10 years. Evaluating knowledge about contraception, it was found that about all the contraceptives questioned some degree of knowledge was obtained, with the male condom being the most known (97.3%), followed by the female condom (91.6%) and the Emergency contraception (81.4%). The main source of contraceptive information was the internet (77.2%), followed by classes (72.6%). Although only 12.2% referred consultations to clarify doubts and 33.6% family planning consultations, most of those who attended were satisfied and would return. The most recognized advantages of hormonal methods were non-contraceptive benefits, such as cycle control (80.4%) and menstrual flow regulation (70.6%), while side effects (71.6%) and difficulty in obtaining (89.9%) were the main disadvantages reported. 95.2% recognize the need to consult a doctor before starting to use these methods. Regarding the condom, the most achieved advantages were contraceptive efficacy (68.1%) and the prevention of sexually transmitted infections (64.6%), while the disadvantages were the risk of rupture (60.6%) and the reduction of the sexual pleasure (27.8%). The main reason for using contraception was to prevent pregnancy (60.3%) and the most frequently mentioned place to obtain it was the health center/hospital (58%). The most used hormonal method was combined hormonal pill (75.4%) and its use was mainly encouraged by the partner (93%) and by a health professional (66.7%). As for sexuality, 28.9% of respondents were sexually active, with an average age of onset of sexual activity of 14.97±1.41 years. The male condom was the method of choice for the first sexual intercourse (76.6%), followed by “double contraception” (17.2%). The fact that they hadn’t thought about it was the main reason for not using contraception. Although 76.5% consider that condoms should be used in all sexual relations, only 46.7% do so, with the usual partner being the main reason for not doing so (62.5%). Most young people had had only 1 sexual partner, however 33.8% revealed having had more than 1 (mean 2.8±1.08 partners). The emergency contraception has already been used by 20.4% of young people. 5.6% of girls have already been pregnant. As for risky sexual behavior, 47.4% of young people would have a sexual intercourse with someone who refused to use a condom, 37.8% did so after consuming alcohol/drugs and, of these, 21.9% considered that it influenced their preventive attitude. Discussion: In this study and according to scientific evidence, young people still have a deficient knowledge about contraception. Sometimes they base their choices on wrong information, trusting unsafe sexual practices. There’s still a difference between the sexes in terms of knowledge and practices about contraception. Although many know most contraceptive methods, girls demonstrate greater knowledge about available methods, advantages, non-contraceptive benefits, associated risks and benefits. The motivations for using contraception are also different and girls reveal a greater involvement with health professionals. Conclusion: There’s a need to improve young people's knowledge and adherence to contraception and a more proactive approach on the behalf of health professionals, who must take advantage, in every moment of contact with adolescents to explore these topics. Action plans should also be developed directly in schools, trying to reach the largest possible universe of young people, since only a small percentage of adolescents seek health services. It would also be convenient to intervene with teachers and parents, regarding these aspects, to make the approach more comprehensive and continuous in the school, family environment and among the adolescents themselves.
Description
Keywords
Comportamento Sexual Adolescentes Conhecimento Contraceção Prevenção