Faculty of Nursing and Chiropody, University of Valencia, 46010 Valencia, Spain.
Department of Obstetrics and Gynecology, University Clinic Hospital, 46010 Valencia, Spain.
Int J Environ Res Public Health. 2021 Jul 5;18(13):7195. doi: 10.3390/ijerph18137195.
European healthcare systems are increasingly being challenged to respond to female genital mutilation (FGM). This study explores the FGM experiences of migrant women coming from FGM-practicing countries residing in a European host country. A qualitative phenomenological study was carried out and 23 participants were included. Data were collected through 18 face-to-face open-ended interviews and a focus group and were analysed using Giorgi's four-step phenomenological approach. Three main themes were derived: "FGM consequences", "healthcare received" and "tackling FGM". Participants highlighted obstetric, gynaecological and genitourinary consequences such as haemorrhages, perineal tears, caesarean delivery, risk of infection, dysmenorrhea, urinary tract infections and dysuria; consequences for sexuality, mainly, dyspareunia, loss of sexual interest and decreased quality of sexual intercourse; and psychological consequences such as loss of self-esteem, feelings of humiliation and fear of social and familial rejection. Women perceived a profound lack of knowledge about FGM from health providers and a lack of sensitive and empathetic care. Some women perceived threatening and disproportionate attitudes and reported negative experiences. Participants highlighted the importance of educating, raising awareness and improving prevention and detection strategies. The findings disclose the need to improve training and institutional plans to address structural and attitudinal barriers to health equity across migrant families in their host countries.
欧洲的医疗保健系统正面临越来越大的压力,需要应对女性割礼(FGM)问题。本研究探讨了来自实行女性割礼国家的移民女性在欧洲东道国的 FGM 经历。采用定性现象学研究方法,共纳入 23 名参与者。通过 18 次面对面的开放式访谈和一次焦点小组收集数据,并使用 Giorgi 的四步现象学方法进行分析。得出了三个主要主题:“FGM 的后果”、“所获得的医疗保健”和“应对 FGM”。参与者强调了产科、妇科和泌尿生殖系统方面的后果,如出血、会阴撕裂、剖腹产、感染风险、痛经、尿路感染和尿痛;对性行为的影响,主要是性交疼痛、性兴趣丧失和性生活质量下降;以及心理方面的影响,如自尊心下降、感到羞辱和害怕社会和家庭排斥。女性认为医疗服务提供者对 FGM 的了解甚少,缺乏敏感和富有同情心的护理。一些女性感到受到威胁和不成比例的态度,并报告了负面经历。参与者强调了教育、提高认识以及改善预防和检测策略的重要性。研究结果揭示了需要改进培训和机构计划,以解决东道国移民家庭中结构性和态度性的公平健康障碍。