Bashah Debrework Tesgera, Worku Abebaw Gebeyehu, Mengistu Mezgebu Yitayal
School of Nursing, College of Medicine and Health Sciences, University of Gondar, P. O. Box 196, Gondar, Ethiopia.
Department of Reproductive Health, Institute of Public Health, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia.
BMC Womens Health. 2018 Jun 20;18(1):106. doi: 10.1186/s12905-018-0605-1.
Women with fistula live in a state of distress and in fear of their future life. An obstetric fistula has a devastating impact on affected women and their families. The objective of this systematic review was to synthesize the evidence from published articles on the consequences of obstetric fistula on women who endure the condition.
The consequences were systematically reviewed from purely qualitative and mixed method primary studies. The literatures were searched through the search engines Google, Google scholar, Hinari using Pub Med data bases, and citation tracking. Relevant source of publications were searched for primary qualitative studies by formulating search protocol using related search terms. Time (articles published between January first of 2007 and 30th September 2016), participants (women who experienced obstetric fistula due to obstructed labor complications), types of study (purely qualitative and mixed method primary articles), findings (reporting consequences/impacts of obstetric fistula) were used as inclusion criteria. The quality appraisal tool for qualitative studies and the critical appraisal skills program were used to appraise the quality of the studies. The findings of sixteen studies were included in the review. The data were collected and then a thematic framework approach was applied for analysis.
The thematic categories shared across most studies were related to the physical challenges of losing body control, women's social and family relationships, and the challenges of losing income. Obstetric fistula has far reaching consequences on women's physical well being, social and marital relationships, mental health and economic capacity. Fistula also challenged women coping abilities.
The consequences of obstetric fistula are far more than the visible medical condition. Little evidence is available on mental health, child and fertility issues, and coping mechanisms. Therefore, further researches shall be aimed at addressing the understudied area and suitable interventions shall be offered to improve women's overall quality of life.
患有瘘管病的女性生活在痛苦之中，对未来生活充满恐惧。产科瘘管病对受影响的女性及其家庭具有毁灭性影响。本系统评价的目的是综合已发表文章中关于产科瘘管病对患病女性影响的证据。
从纯定性和混合方法的原始研究中系统评价其影响。通过谷歌、谷歌学术、使用PubMed数据库的Hinari搜索引擎以及引文追踪来检索文献。通过使用相关检索词制定检索方案，搜索相关出版物来源以查找原始定性研究。时间（2007年1月1日至2016年9月30日发表的文章）、参与者（因产程梗阻并发症而患有产科瘘管病的女性）、研究类型（纯定性和混合方法的原始文章）、结果（报告产科瘘管病的后果/影响）用作纳入标准。使用定性研究质量评估工具和批判性评估技能计划来评估研究质量。十六项研究的结果被纳入该评价。收集数据后，采用主题框架方法进行分析。
大多数研究共有的主题类别与失去身体控制的身体挑战、女性的社会和家庭关系以及失去收入的挑战有关。产科瘘管病对女性的身体健康、社会和婚姻关系、心理健康和经济能力都有深远影响。瘘管病也挑战了女性的应对能力。
产科瘘管病的后果远不止是可见的医疗状况。关于心理健康、儿童和生育问题以及应对机制的证据很少。因此，进一步的研究应旨在解决这些研究不足的领域，并应提供适当的干预措施以提高女性的整体生活质量。
