女性生殖器切割术后身体并发症与 12 岁冈比亚女童心理健康的关系：一项基于社区的横断面研究。
The association between physical complications following female genital cutting and the mental health of 12-year-old Gambian girls: A community-based cross-sectional study.
机构信息
Norwegian Centre for Violence and Traumatic Stress Studies, Oslo, Norway.
The University of Oslo, Institute of Clinical Medicine, Oslo, Norway.
出版信息
PLoS One. 2021 Jan 22;16(1):e0245723. doi: 10.1371/journal.pone.0245723. eCollection 2021.
BACKGROUND
Female genital cutting (FGC) involve an acute physical trauma that hold a potential risk for immediate and long-term complications and mental health problems. The aim of this study was to examine the prediction of depressive symptoms and psychological distress by the immediate and current physical complications following FGC. Further, to examine whether the age at which 12-year-old Gambian girls had undergone the procedure affected mental health outcomes.
METHOD
This cross-sectional study recruited 134 12-year-old girls from 23 public primary schools in The Gambia. We used a structured clinical interview to assess mental health and life satisfaction, including the Short Mood and Feeling Questionnaire (SMFQ), the Symptom check list (SCL-5) and Cantril's Ladder of Life Satisfaction. Each interview included questions about the cutting procedure, immediate- and current physical complications and the kind of help and care girls received following FGC.
RESULTS
Depressive symptoms were associated with immediate physical health complications in a multivariate regression model [RR = 1.08 (1.03, 1.12), p = .001], and with present urogenital problems [RR = 1.19 (1.09, 1.31), p < .001]. The girls that received medical help following immediate complications had a lower risk for depressive symptoms [RR = .73 (.55, .98), p = .04]. Psychological distress was only associated with immediate complications [RR = 1.04 (1.01, 1.07), p = .004]. No significant differences in mental health outcomes were found between girls who underwent FGC before the age of four in comparison to girls who underwent FGC after the age of four.
CONCLUSION
Our findings indicate that the immediate and long-term complications following FGC have implications for psychological health. Only a minimal number of girls received medical care when needed, and the dissemination of health education seems crucial in order to prevent adverse long-term physical and psychological health consequences.
背景
女性生殖器切割（FGC）涉及急性身体创伤，存在立即和长期并发症以及心理健康问题的潜在风险。本研究旨在探讨 FGC 后即刻和当前身体并发症对抑郁症状和心理困扰的预测作用。此外，还研究了 12 岁冈比亚女孩接受该手术的年龄是否会影响心理健康结果。
方法
本横断面研究招募了来自冈比亚 23 所公立小学的 134 名 12 岁女孩。我们使用结构化临床访谈评估心理健康和生活满意度，包括短情绪和感觉问卷（SMFQ）、症状检查表（SCL-5）和坎特里尔生活满意度阶梯。每个访谈都包括关于切割程序、即刻和当前身体并发症以及女孩接受 FGC 后的帮助和护理的问题。
结果
在多变量回归模型中，抑郁症状与即刻身体健康并发症相关[RR=1.08（1.03，1.12），p=0.001]，与当前泌尿生殖问题相关[RR=1.19（1.09，1.31），p<0.001]。接受即时并发症医疗帮助的女孩出现抑郁症状的风险较低[RR=0.73（0.55，0.98），p=0.04]。心理困扰仅与即刻并发症相关[RR=1.04（1.01，1.07），p=0.004]。在 FGC 年龄在 4 岁以下的女孩与 FGC 年龄在 4 岁以上的女孩之间，心理健康结果没有发现显著差异。
结论
我们的研究结果表明，FGC 后的即刻和长期并发症对心理健康有影响。只有极少数女孩在需要时接受医疗护理，而传播健康教育似乎至关重要，以防止出现不良的长期身体和心理健康后果。
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