2020 年，在埃塞俄比亚南部的一些综合医院和转诊医院中，与盆腔器官脱垂女性寻求治疗的延误相关的因素。
Factors associated with delay in seeking treatment among women with pelvic organ prolapse at selected general and referral hospitals of Southern Ethiopia, 2020.
机构信息
Department of Human Anatomy, College of Medicine and Health Sciences, Hawassa University, Hawassa, Ethiopia.
Department of Human Anatomy, School of Medicine, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia.
出版信息
BMC Womens Health. 2021 Mar 1;21(1):86. doi: 10.1186/s12905-021-01245-0.
BACKGROUND
Pelvic organ prolapse (POP) is the descent of the vaginal wall, cervix, uterus, bladder, and rectum downward into the vaginal canal. Its prevalence is higher among women in developing countries because women are more prone to risk factors. In Ethiopia, women with prolapse seek treatments at advanced stages of prolapse; hence, surgical management has been widely practicing. Therefore, it was found to be very important to conduct research that assesses factors hindering early treatments in Southern Ethiopia. This study aimed to find out factors associated with the delay in seeking treatment of pelvic organ prolapse among patients at selected general and referral hospitals of Southern Ethiopia.
METHODS
Cross-sectional study design was employed in 123 participants of seven randomly selected General and Referral Hospitals of Southern Ethiopia from February 01 to April 30, 2020, by using a structured questionnaire. Pre-trained two midwives in each center were deployed to collect data. Physicians performed diagnosis and physical examination. Data were entered and coded using EPI INFO version 7 and exported into SPSS version 25 for analysis. Bivariate and multivariable logistic regression analyses were performed. The goodness of fit was assessed by using the Hosmer and Lemeshow goodness test.
RESULTS
In this study, out of 123 clinically diagnosed POP cases, nearly half of them were stage III, and over one-third were stage IV. Therefore, 84.6% (104 participants) of the respondents were delayed for the treatment of POP. The mean length of delay for POP treatments was 36.41 ± 3.95 months. After adjusting for covariates, lack of supports [AOR (Adjusted Odds Ratio) = 5.2 (95% CI 1.4-19.5)], low-income [AOR = 5.8 (95% CI 1.1-19.66)], and fear of social stigma [AOR = 4.7 (95% CI 1.2-18.59)] were significant factors for delayed treatments.
CONCLUSIONS
Most of the POP patients were delayed for POP treatments. Factors like lack of support, low-income, and fear of losing social value/stigma were associated with treatment delay. Screening for the POP cases, educating (making awareness) the community about this devastating disease to facilitate early treatment and to avoid social stigma, and raising access to treatment by making the nearby hospitals equipped with facilities to treat POP are recommended.
背景
盆腔器官脱垂（POP）是阴道壁、宫颈、子宫、膀胱和直肠向下进入阴道管的下降。由于女性更容易受到危险因素的影响，发展中国家的女性 POP 患病率更高。在埃塞俄比亚，患有脱垂的女性在脱垂的晚期阶段寻求治疗；因此，广泛采用手术管理。因此，对评估埃塞俄比亚南部早期治疗障碍因素进行研究非常重要。本研究旨在了解与南部埃塞俄比亚选定的一般和转诊医院的盆腔器官脱垂患者治疗延迟相关的因素。
方法
2020 年 2 月 1 日至 4 月 30 日，采用横断面研究设计，在南部埃塞俄比亚的 7 所随机选定的一般和转诊医院中招募了 123 名参与者，使用结构化问卷进行。在每个中心培训了两名助产士来收集数据。医生进行诊断和体格检查。数据使用 EPI INFO 版本 7 输入和编码，并导出到 SPSS 版本 25 进行分析。进行了单变量和多变量逻辑回归分析。使用 Hosmer 和 Lemeshow 拟合优度检验评估拟合优度。
结果
在这项研究中，在 123 例临床诊断为 POP 的病例中，近一半为 III 期，超过三分之一为 IV 期。因此，84.6%（104 名参与者）的受访者延迟了 POP 的治疗。POP 治疗的平均延迟时间为 36.41±3.95 个月。在调整了协变量后，缺乏支持[调整后的优势比（调整后的优势比）= 5.2（95%置信区间 1.4-19.5）]、低收入[调整后的优势比（调整后的优势比）= 5.8（95%置信区间 1.1-19.66）]和对社会耻辱感的恐惧[调整后的优势比（调整后的优势比）= 4.7（95%置信区间 1.2-18.59）]是延迟治疗的重要因素。
结论
大多数 POP 患者延迟了 POP 的治疗。缺乏支持、低收入和对失去社会价值/耻辱感的恐惧等因素与治疗延迟有关。建议对 POP 病例进行筛查，教育（提高认识）社区了解这种破坏性疾病，以促进早期治疗并避免社会耻辱感，并通过使附近的医院配备治疗 POP 的设施来提高治疗机会。
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