Nabulo Harriet, Ruzaaza Gad, Mugabi Francis, Bajunirwe Francis
Department of Nursing, Mbarara University of Science and Technology, Department of Nursing, Mbarara, Uganda.
Department of Community Health, Mbarara University of Science and Technology, Mbarara, Uganda.
J Glob Health Rep. 2021;5. doi: 10.29392/001c.19464. Epub 2021 Mar 3.
Eclampsia is among the leading causes of maternal mortality. It is a serious hypertensive complication of pregnancy and increases the risk of cardiovascular disease in later life. Pregnancy-related hypertension complications predispose to chronic hypertension and premature heart attacks. A significant proportion of women with preeclampsia/eclampsia does not reach the formal healthcare system or arrive too late because of certain traditional or cultural beliefs about the condition. The older, senior women in the community are knowledgeable and play a significant role in decision making regarding where mothers should seek maternal health care. Therefore, the purpose of this study was to explore the perceptions of older and senior women regarding the manifestation of, risk factors and possible causes of preeclampsia/eclampsia.
We conducted a qualitative study in rural Southwestern Uganda. The key informants were senior, older women including community elders, village health team members and traditional birth attendants who were believed to hold local knowledge and influence on birth and delivery. We purposively selected key informants and data were collected till we reached saturation point. We analyzed data using an inductive thematic approach to identify themes.
We interviewed 20 key informants with four themes identified. The '' theme emerged from the subthemes of confusion with other conditions, spiritual beliefs and high blood pressure. The '' theme emerged from the subthemes of oedema-related illnesses, poverty-induced malnutrition, and strained relationships. The '' theme emerged from the consistent mention of traditional herbal treatment, seek medical help, spiritual healing, emotional healing and corrective nutrition as potential solutions. The theme '' emerged from the mention of pregnancy complications like premature delivery, child loss, operative delivery like caesarian section delivery as well as death. There was no identifiable local name from the interviews. Women carried several myths regarding the cause and these included little blood, witchcraft, ghost attacks and stress from strained relationships including marital tension. Women were generally aware of the outcomes of eclampsia, mainly that it kills.
Eclampsia is associated with significant myths and misconceptions in this rural community. We recommend interventions to increase awareness and dispel these myths and misconceptions, increase access to antenatal preeclampsia surveillance, and facilitate timely referral for basic maternity care as means for early detection and management of preeclampsia.
子痫是孕产妇死亡的主要原因之一。它是一种严重的妊娠高血压并发症，会增加日后患心血管疾病的风险。与妊娠相关的高血压并发症易引发慢性高血压和过早心脏病发作。由于对该病症存在某些传统或文化观念，很大一部分先兆子痫/子痫患者未进入正规医疗体系或就诊过晚。社区中的老年女性知识渊博，在决定母亲应前往何处寻求孕产妇保健方面发挥着重要作用。因此，本研究的目的是探讨老年女性对子痫前期/子痫的表现、危险因素及可能病因的看法。
我们在乌干达西南部农村地区进行了一项定性研究。关键信息提供者为老年女性，包括社区长者、村卫生团队成员和传统助产士，她们被认为拥有当地知识且对分娩有影响力。我们有目的地选择关键信息提供者，收集数据直至达到饱和点。我们采用归纳主题分析法对数据进行分析以确定主题。
我们采访了20名关键信息提供者，确定了四个主题。“[第一个主题]”主题源自与其他病症混淆、精神信仰和高血压等子主题。“[第二个主题]”主题源自与水肿相关疾病、贫困导致的营养不良以及紧张关系等子主题。“[第三个主题]”主题源自一致提及的传统草药治疗、寻求医疗帮助、精神治疗、情感治疗和纠正性营养等潜在解决方案。“[第四个主题]”主题源自提及的早产、流产、剖宫产等手术分娩以及死亡等妊娠并发症。访谈中未发现可识别的当地名称。女性对病因持有多种误解，包括血少、巫术、鬼魂攻击以及紧张关系（包括婚姻紧张）带来的压力。女性普遍知晓子痫的后果，主要是会致死。
在这个农村社区，子痫与重大的误解和错误观念相关。我们建议采取干预措施，提高认识并消除这些误解和错误观念，增加产前子痫前期监测的可及性，并促进及时转诊以获得基本孕产妇保健，作为子痫早期发现和管理的手段。
