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治愈之旅:尼日利亚中北部产科瘘管病幸存者的患病经历

Journey for a cure: Illness narratives of obstetric fistula survivors in North Central Nigeria.

作者信息

Degge Hannah M, Laurenson Mary, Dumbili Emeka W, Saxby Heidi, Hayter Mark

机构信息

Department of Health and Education, Coventry University, Scarborough, UK.

Faculty of Health Sciences, University of Hull, Hull, UK.

出版信息

Sociol Health Illn. 2024 Mar;46(3):437-456. doi: 10.1111/1467-9566.13715. Epub 2023 Oct 3.

Abstract

Obstetric fistula is a life transforming event resulting in embodied biographical disruption. Survivors suffer myriad long-term physical and emotional consequences. This paper is an account of a narrative inquiry, conducted with 15 fistula survivors in North-central, Nigeria, who described how their identities had been transformed by their condition. A narrative therapeutic approach, using Frank's 'chaos, restitution and quest' typology, was used to map their recovery narratives. 'Chaos', described by Frank as the opposite of restitution, dominated, with women losing hope of recovery. Women's shift towards 'restitution' began with treatment, but inadequate health-care access often delayed this process. In their quest narratives, women's life and identify changes enabled them to derive meaning from their experience of obstetric fistula within the context of their own lives. The findings highlight socio-structural factors raising the risk of obstetric fistula, which in turn causes biographical disruption and hampers sufferers' treatment and recovery. Rehabilitation should include income-generating skills to bring succour to survivors, particularly those whose incontinence persists after repairs.

摘要

产科瘘是一种改变人生的事件,会导致个人经历的中断。幸存者会遭受无数长期的身体和情感后果。本文讲述了一项叙事探究,研究对象是尼日利亚中北部的15名瘘管幸存者,他们描述了自己的身份如何因病情而改变。采用了叙事治疗方法,运用弗兰克的“混乱、恢复和探索”类型学来梳理他们的康复故事。弗兰克将“混乱”描述为与恢复相反的状态,这种状态在故事中占主导地位,女性失去了康复的希望。女性向“恢复”的转变始于治疗,但医疗保健服务不足常常延误了这一进程。在她们的探索故事中,女性生活和身份的变化使她们能够从自己在产科瘘经历的背景中找到意义。研究结果凸显了增加产科瘘风险的社会结构因素,而这反过来又会导致个人经历的中断,并阻碍患者的治疗和康复。康复应包括创收技能,以帮助幸存者,尤其是那些修复后仍存在尿失禁问题的幸存者。

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