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尊严的丧失:埃塞俄比亚西北部产科瘘女性的社会经历和应对方式。

The loss of dignity: social experience and coping of women with obstetric fistula, in Northwest Ethiopia.

机构信息

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.

出版信息

BMC Womens Health. 2019 Jul 1;19(1):84. doi: 10.1186/s12905-019-0781-7.

Abstract

BACKGROUND

Obstetric fistula is a debilitating condition resulted from poorly (un) managed prolonged obstructed labor. It has significant psychosocial and economic consequences on those affected and their families. Data regarding experiences and coping mechanisms of Ethiopian women with fistula is scarce.

METHODS

Qualitative design was employed with in depth interview technique by using open ended interview guide. Eleven fistula patients waiting for surgical repair at the fistula treatment center of Gondar Specialized Referral Hospital were selected with typical case selection. Thedata were audio-taped, transcribed and translated from Amharic to English. Open code version 4.03was used to organize data and identify themes for analysis.

RESULTS

The age of participants of the study ranged between 19 to 43 years. Ten of them were from rural areas. Regarding their educational status eight cannot read and write. Similar number were either separated or divorced. Six of them lived with obstetric fistula without treatment from one to five years. Five women related their condition to their fate. The women faced challenges in role performance, marital and social relationships and economic capability. Frequent bathing, use of stripes of old clothes as a pad, self-isolation and hiding from being observed, wearing extra clothes as cover, increasing water intake and reducing hot drinks and fluids other than water were the ways they have devised to cope with the incontinence.

CONCLUSION

The study participants reported that they experienced deep sense of loss, diminished self-worth and multiple social challenges. They coped with the incontinence in various ways among which some were non effective and might have continuing negative impact on woman's quality of life even after corrective surgery. Developing bridging intervention for early identification and referral could reduce period of women's suffering.

摘要

背景

产科瘘是一种由分娩过程中处理不当导致的慢性(或)长期梗阻引起的衰弱性疾病。它对受影响的妇女及其家庭造成了重大的心理社会和经济后果。关于埃塞俄比亚妇女的瘘管病经历和应对机制的数据很少。

方法

采用定性设计,使用深度访谈技术和开放式访谈指南。在贡德尔专科医院的瘘管治疗中心,选择了 11 名等待手术修复的瘘管病患者,采用典型病例选择。将数据从阿姆哈拉语转录并翻译成英语,使用开放代码版本 4.03 对数据进行组织并识别主题进行分析。

结果

研究参与者的年龄在 19 至 43 岁之间。其中 10 人来自农村地区。关于他们的教育状况,8 人不能读写。相似数量的人是分居或离婚。其中 6 人患有瘘管病但未接受治疗,时间从 1 年到 5 年不等。有 5 名妇女将自己的病情归因于命运。这些妇女在角色表现、婚姻和社会关系以及经济能力方面面临挑战。她们经常洗澡,使用旧衣服的布条作为护垫,自我隔离并避免被观察,穿额外的衣服作为遮盖物,增加水的摄入量,减少热水和除水以外的液体摄入,这些都是她们应对失禁的方法。

结论

研究参与者报告说,他们经历了深深的失落感、自我价值感降低和多重社会挑战。她们以各种方式应对失禁,其中一些方法并不有效,甚至可能对妇女的生活质量产生持续的负面影响,即使在接受矫正手术后也是如此。为早期发现和转介制定桥接干预措施,可以减少妇女的痛苦期。

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