Terefe Ayana Benti, Ayalnew Bethelhem Sileshy, Gudeta Tolesa Gemeda, Mamo Getu Habte, Mengistu Girma Teferi, Abera Mangistu, Sori Seboka Abebe
Department of Nursing, College of Medicine and Health Sciences, Wolkite University, Wolkite, Ethiopia.
School of Medicine, College of Medicine and Health Sciences, Wolkite University, Wolkite, Ethiopia.
Sci Rep. 2025 Aug 30;15(1):31948. doi: 10.1038/s41598-025-17194-9.
Pelvic organ prolapse (POP) is relatively common healthcare issue due to its high prevalence, various adverse effects, and challenges for the healthcare system. Women in developing nations are at a higher risk of experiencing this condition. Although POP and its risk factors are more common in low-resource settings, women in these settings often choose not to seek medical attention. Evidence of these women's health-seeking behavior and its determinants is lacking in Ethiopia; particularly in the study area, no study was reported. The aim of this study was to asses determinants of healthcare-seeking behavior among women with symptoms of pelvic organ prolapse in the Gurage Zone in 2023. From March 1 to March 30, 2023, we conducted a community-based cross-sectional study in the Gurage Zone, utilizing a multi-stage systematic random sampling method to recruit participants. We collected data through structured questionnaires via face-to-face interviews and analyzed it using EpiData version 3.1 and the Statistical Package for the Social Sciences version 25. Logistic regression was employed to examine the relationship between independent variables and healthcare-seeking behavior among women experiencing pelvic organ prolapse symptoms. We incorporated variables with a p-value < 0.25 from the bivariate analysis into the multivariable model, identifying those with a p-value < 0.05 as statistically significant in the final analysis. We assessed the goodness of fit using the Hosmer and Lemeshow test. Results are presented as adjusted odds ratios with a 95% confidence interval. Out of 796 respondents, 248 (31.2%, 95% CI: 27.9, 34.7) of the women had reported symptoms of POP. The study showed that 73.4% (95% CI: [67.7-80.2%]) of women with symptomatic POP did not seek care. The factors associated with not seeking care included being a rural resident (AOR = 5.246; 95% CI [1.824, 13.282]), a lack of social support (AOR = 4.462; 95% CI [1.157, 6.692]), low income (AOR = 2.802; 95% CI [1.132, 7.634]), and fear of disclosure (AOR = 2.400; 95% CI [1.126, 6.261]). Around three quarters of women with symptoms of POP did not seek care. Factors such as residency, low income, lack of support, and fear of disclosure are significantly associated with the decision to seek care for POP symptoms. To address these challenges, it is crucial to implement targeted interventions aimed at improving healthcare access for rural populations, informing policymakers to consider implementing subsidized healthcare services, particularly for vulnerable populations, educational programs aimed at raising involvement of families, encouraging women to disclose their health issues and seek care are recommended by healthcare professionals and other concerned bodies.
盆腔器官脱垂(POP)是一个较为常见的医疗保健问题,因为其患病率高、具有各种不良影响且给医疗系统带来挑战。发展中国家的女性患这种疾病的风险更高。尽管盆腔器官脱垂及其风险因素在资源匮乏地区更为常见,但这些地区的女性往往选择不寻求医疗帮助。埃塞俄比亚缺乏关于这些女性就医行为及其决定因素的证据;特别是在研究区域,没有相关研究报道。本研究的目的是评估2023年古拉格地区有盆腔器官脱垂症状的女性就医行为的决定因素。2023年3月1日至3月30日,我们在古拉格地区开展了一项基于社区的横断面研究,采用多阶段系统随机抽样方法招募参与者。我们通过面对面访谈,使用结构化问卷收集数据,并使用EpiData 3.1版和社会科学统计软件包25版进行分析。采用逻辑回归分析有盆腔器官脱垂症状女性的自变量与就医行为之间的关系。我们将双变量分析中p值<0.25的变量纳入多变量模型,在最终分析中,将p值<0.05的变量确定为具有统计学意义。我们使用Hosmer和Lemeshow检验评估拟合优度。结果以调整后的比值比及95%置信区间表示。在796名受访者中,248名(31.2%,95%置信区间:27.9,34.7)女性报告有盆腔器官脱垂症状。研究表明,有症状的盆腔器官脱垂女性中,73.4%(95%置信区间:[67.7 - 80.2%])未寻求治疗。与不寻求治疗相关的因素包括居住在农村(比值比=5.246;95%置信区间[1.824,13.282])、缺乏社会支持(比值比=4.462;95%置信区间[1.157,6.692])、低收入(比值比=2.802;95%置信区间[1.132,7.634])以及害怕被他人知晓(比值比=2.400;95%置信区间[1.126,6.261])。约四分之三有盆腔器官脱垂症状的女性未寻求治疗。居住地点、低收入、缺乏支持以及害怕被他人知晓等因素与因盆腔器官脱垂症状而寻求治疗的决定显著相关。为应对这些挑战,实施有针对性的干预措施至关重要,这些措施旨在改善农村人口的医疗服务可及性,告知政策制定者考虑实施补贴医疗服务,特别是针对弱势群体,开展旨在提高家庭参与度的教育项目,鼓励女性披露自身健康问题并寻求治疗,医疗专业人员和其他相关机构建议采取这些措施。