Mafo Degge Hannah, Hayter Mark, Laurenson Mary
Faculty of Health and Social Care, University of Hull, Hull, UK.
Sexual and Reproductive Health, Faculty of Health and Social Care, University of Hull, Hull, UK.
J Clin Nurs. 2017 Jun;26(11-12):1445-1457. doi: 10.1111/jocn.13590. Epub 2017 Mar 10.
To review literature on the experiences of women with obstetric fistula, their lived experiences after treatment; and to provide evidence for future research.
Obstetric fistula is an injury most commonly resulting from a prolonged labour. Long eradicated in developed countries, obstetric fistula remains a public health issue in sub-Saharan Africa and Asia. This is a highly stigmatised health condition, and an understanding of the women's experience is required to inform holistic approaches for care and prevention.
A search of literature was conducted on databases of EBSCO host (Academic Search Premier, MEDLINE, PsychINFO, CINAHL), Web of Science; and websites of international organizations such as Women's Dignity Project and EngenderHealth. Keywords, Inclusion and exclusion criteria were defined and 25 articles published between 2004 to January 2015 were identified.
An integrative review of 25 articles was carried out.
Three broad themes were identified: Challenges of living with fistula; treatment and care experiences; and reintegration experiences of women after fistula repair.
Living with a fistula presents multidimensional consequences affecting women, families and communities. Accessing treatment is difficult and there are no standardised treatment packages. Surgical repairs were variable in their success rate. Some authors claim women resume normal lives irrespective of their continence status, whilst others claim they face discrimination despite being continent thereby hindering reintegration. Quality of life is diminished for those remaining incontinent. Post repair psychosocial support services are beneficial for reintegration, but research on programme benefits is limited. Therefore further research is required to support its benefits; and for policy development to meet care provision for women with fistula.
The review provides insights into avenues of improving care provision and delivery by health professionals and policy makers. It also exposes areas that need further research for quality care provision.
回顾关于产科瘘管病女性患者经历、治疗后的生活体验的文献；为未来研究提供证据。
产科瘘管病是一种最常见于产程延长导致的损伤。在发达国家早已根除，但在撒哈拉以南非洲和亚洲仍是一个公共卫生问题。这是一种备受污名化的健康状况，需要了解女性的经历以指导全面的护理和预防方法。
在EBSCOhost数据库（学术搜索大全、医学期刊数据库、心理学文摘数据库、护理学与健康领域数据库）、科学网以及诸如女性尊严项目和促进健康组织等国际组织的网站上进行文献检索。定义了关键词、纳入和排除标准，共识别出2004年至2015年1月期间发表的25篇文章。
对25篇文章进行综合综述。
确定了三大主题：瘘管病患者的生活挑战；治疗与护理经历；瘘管修复后女性的重新融入经历。
患有瘘管病会带来多方面后果，影响女性、家庭和社区。获得治疗困难，且没有标准化的治疗方案。手术修复成功率各不相同。一些作者称女性无论控尿状况如何都能恢复正常生活，而另一些作者则称她们即便能够控尿仍面临歧视，从而阻碍重新融入。对于仍失禁的女性，生活质量会下降。修复后心理社会支持服务对重新融入有益，但关于项目益处的研究有限。因此需要进一步研究以证实其益处；并制定政策以满足产科瘘管病女性的护理需求。
该综述为卫生专业人员和政策制定者改善护理提供途径提供了见解。它还揭示了需要进一步研究以提供优质护理的领域。
