Each year, approximately 800,000 cases of pelvic inflammatory disease (PID) are diagnosed in the United States. Although PID is an acute disease, poorly managed PID has significant chronic implications; women with PID may develop chronic pelvic pain, ectopic pregnancy, and tubal infertility. At least 20% of PID cases occur in adolescents, who are at increased risk for subsequent STIs and PID. Many adolescents and young adult women (?young women?) fail to fully engage in self-care behaviors and adhere to the current Centers for Disease Control and Prevention (CDC) treatment recommendations. The proposed study will employ a convergent mixed methods design within the infrastructure of the Technology Enhanced Community Health Nursing (TECH-N; 5R01NR013507) parent study, an ongoing randomized controlled trial to improve health outcomes among young women with PID. The proposed study will engage 100 non-pregnant 13- to 25- year-old females diagnosed with mild to moderate PID to examine social support, coping strategies, and self- care behaviors required for successful PID treatment: medication adherence, adherence to the 72-hour clinical follow-up visit, partner notification, sexual abstinence during the treatment period, and consistent condom use at the resumption of sexual intercourse. Guided by the Transactional Model of Stress and Coping, the study will integrate quantitative data from structured baseline and follow-up interviews with in-depth, semi-structured qualitative interviews of participants. To support the study, the Brief COPE instrument has been added to the TECH-N protocol to measure coping strategies. The combination of quantitative and qualitative research will examine barriers to and facilitators of PID self-care, while providing detailed, contextual information to achieve the following specific aims: 1) Determine the coping strategies and types of social support utilized by young women diagnosed with PID; 2) Examine the relationships among coping strategies, social support, and engagement in PID self-care behaviors among young women; and 3) Explore the experiences of young women diagnosed with and treated for PID. The study is aligned with the Wellness theme of the National Institute of Nursing Research (NINR), in that it seeks to identify factors that promote health and prevent illness among young women with PID. Understanding the factors associated with engagement in PID self-care behaviors is critical for the development of personally relevant, effective outpatient interventions for PID that empower young women to engage in behaviors that prevent adverse reproductive health outcomes. The training experience associated with the proposed research will capitalize on the applicant?s potential and provide essential training towards becoming an independent nurse scientist, with an emphasis on young women?s sexual and reproductive health.
Adolescents and young adult women (?young women?) diagnosed with pelvic inflammatory disease (PID) are at increased risk for subsequent sexually transmitted infections (STIs), recurrent PID, and adverse reproductive health outcomes. Little is known about the contextual influences on PID self-care behaviors among young women. Therefore, the purpose of this dissertation research training proposal is to examine the context and processes of PID self-care among young women, with a focus on coping strategies and social support, using the infrastructure of a large ongoing nurse intervention trial designed to improve reproductive health outcomes after a PID diagnosis.
