Warren Alpert Medical School of Brown University, Providence, RI.
University of Rwanda, College of Medicine and Health Sciences, School of Medicine, Kigali, Rwanda.
Ann Glob Health. 2015 Sep-Oct;81(5):636-44. doi: 10.1016/j.aogh.2015.12.005.
Urogenital fistula is a debilitating condition that women can develop following obstructed labor. The primary objective of this study was to reveal illness narratives of Rwandan women with urogenital fistula to appreciate their unique experiences. The secondary aim was to identify common themes that emerged when women discussed their experiences living with fistula.
Women presenting for urogenital fistula repair at Kibagabaga Hospital were asked to participate in the study. Eleven participants were asked questions designed to elicit their understanding of their condition and the social and emotional consequences of their fistula. All interviews were anonymous. Transcribed interviews were examined for relative themes to categorize responses into larger domains.
Common themes were identified from the interviews on topics of what barriers existed to having a successful delivery, the socioeconomic and psychosocial consequences of developing a fistula, and each woman's understanding of her fistula. Excerpts from patients' illness narratives illustrated these themes.
These narratives can be used to appreciate the variations in each woman's understanding of her medical condition and the changes that occurred in her life as a result of her fistula. Through patients' narratives, physicians can improve their appreciation of cultural differences to design targeted educational and preventive interventions.
尿生殖瘘是一种使女性在分娩受阻后可能患上的使人虚弱的疾病。本研究的主要目的是揭示卢旺达女性尿生殖瘘的疾病叙述，以了解她们独特的经历。次要目的是确定女性在讨论其瘘管生活经历时出现的共同主题。
在基巴加巴加医院接受尿生殖瘘修复的女性被要求参与这项研究。询问了 11 名参与者一些问题，旨在了解她们对自身状况的理解，以及瘘管对其社会和情感的影响。所有访谈均为匿名。对转录后的访谈进行了相对主题检查，以将回复分类为更大的领域。
从访谈中确定了一些共同的主题，涉及到成功分娩存在哪些障碍、发生瘘管后的社会经济和心理社会后果，以及每位女性对其瘘管的理解。患者疾病叙述的摘录说明了这些主题。
这些叙述可以用来了解每个女性对其医疗状况的理解的变化，以及她的瘘管对其生活产生的变化。通过患者的叙述，医生可以更好地了解文化差异，从而设计有针对性的教育和预防干预措施。
