产科瘘管修补术对埃塞俄比亚产妇抑郁和焦虑严重程度的影响。
Effects of surgical repair of obstetric fistula on severity of depression and anxiety in Ethiopia.
机构信息
Department of Health Studies, University of South Africa, Addis Ababa, Ethiopia.
Department of Health Studies, University of South Africa, Pretoria, South Africa.
出版信息
BMC Psychiatry. 2019 Feb 7;19(1):58. doi: 10.1186/s12888-019-2045-3.
BACKGROUND
The surgical repair of fistula can address the physical symptoms, but may not end the psychological challenges that women with fistula face. There are a few studies that focus on women with this condition in Ethiopia. Hence, the aim of this study was to determine the effects of surgical repair of obstetric fistula on the severity of depression and anxiety in women with obstetric fistula in Ethiopia.
METHOD
The study employed a longitudinal study design to investigate the changes in 219 women with obstetric fistula admitted to six fistula management hospitals in Ethiopia. The data were collected on admission of the patients for obstetric fistula surgical repair and at the end of six-month post repair. A structured questionnaire was used to obtain socio-demographic information and medical history of the respondents. Depression and anxiety symptoms were measured using the Patient Health Questionnaire (PHQ-9) and General Anxiety Disorder (GAD-7) scales. The data was entered using Epi-Data software and then exported to SPSS for further analysis. The Mann-Whitney-U test, the Kruskal-Wallis test and Paired t-test were performed to measure the change in psychological symptoms after surgical repair.
RESULT
Though 219 respondents were interviewed pre-obstetric fistula surgical repair, only 200 completed their follow up. On admission, the prevalence of depression and anxiety symptoms were 91 and 79% respectively. After surgical repair, the prevalence rate was 27 and 26%. The differences in the prevalence of screen-positive women were statistically significant (P < 0.001).
CONCLUSION
The study concluded that the severity of depression and anxiety symptoms decrease post-obstetric fistula surgical repair. However, a woman with continued leaking after surgery seems to have higher psychological distress than those who are fully cured. Clinicians should manage women with obstetric fistula through targeted and integrated mental health interventions to address their mental health needs.
背景
瘘管的手术修复可以解决身体症状，但可能无法结束瘘管女性面临的心理挑战。在埃塞俄比亚，有一些针对这种情况的女性的研究。因此，本研究旨在确定产科瘘管手术修复对埃塞俄比亚产科瘘管女性抑郁和焦虑严重程度的影响。
方法
本研究采用纵向研究设计，调查了 219 名在埃塞俄比亚六家瘘管管理医院接受产科瘘管手术修复的女性的变化。数据是在患者入院接受产科瘘管手术修复时和修复后六个月结束时收集的。使用结构化问卷获取受访者的社会人口统计学信息和病史。使用患者健康问卷（PHQ-9）和广泛性焦虑症（GAD-7）量表测量抑郁和焦虑症状。数据使用 Epi-Data 软件输入，然后导出到 SPSS 进行进一步分析。采用 Mann-Whitney-U 检验、Kruskal-Wallis 检验和配对 t 检验测量手术修复后心理症状的变化。
结果
尽管有 219 名受访者在接受产科瘘管手术修复前接受了采访，但只有 200 名完成了随访。入院时，抑郁和焦虑症状的患病率分别为 91%和 79%。手术后，患病率分别为 27%和 26%。筛阳性妇女的患病率差异具有统计学意义（P<0.001）。
结论
该研究得出结论，产科瘘管手术后，抑郁和焦虑症状的严重程度有所减轻。然而，手术后持续渗漏的女性似乎比完全治愈的女性心理困扰更大。临床医生应该通过有针对性的综合心理健康干预来管理产科瘘管女性，以满足她们的心理健康需求。
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