Psychological Symptoms Among Obstetric Fistula Patients Compared to Gynecology Outpatients in Tanzania.
Psychological Symptoms Among Obstetric Fistula Patients Compared to Gynecology Outpatients in Tanzania.
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DOI：
10.1007/s12529-015-9466-2
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发表时间：
2015-10
影响因子：
2.7
通讯作者：
Masenga GG
中科院分区：
文献类型：
--
作者：
Wilson SM;Sikkema KJ;Watt MH;Masenga GG
产科瘘管是一种在撒哈拉以南非洲流行的分娩伤害，导致无法控制的尿液和/或粪便泄漏。研究已经记录了产科瘘管的社会和心理后遗症，包括心理健康障碍和社会孤立。这项横断面研究试图量化产科瘘管患者的心理症状和社会支持，并与未患产科瘘管的女性患者进行比较。研究对象为坦桑尼亚摩西乞力马扎罗基督教医疗中心的妇科患者(n=144)，他们来自瘘管区(n=54)和妇科门诊(n=90)。措施包括先前有效的心理测量问卷，由坦桑尼亚护士口头回答。比较产科瘘管患者和妇科门诊患者之间的结果变量，控制背景人口统计学变量和多重比较。与妇科门诊患者相比，产科瘘管患者报告的抑郁、创伤后应激障碍、躯体主诉和适应不良应对的症状明显更高。他们还报告说，他们的社会支持明显减少。产科瘘管修复术患者较妇科门诊患者有更严重的心理困扰。为了解决这些心理健康问题，临床医生应该让产科瘘患者进行有针对性的心理健康干预。
Obstetric fistula is a childbirth injury prevalent in sub-Saharan Africa that causes uncontrollable leaking of urine and/or feces. Research has documented the social and psychological sequelae of obstetric fistula, including mental health dysfunction and social isolation. This cross-sectional study sought to quantify the psychological symptoms and social support in obstetric fistula patients, compared with a patient population of women without obstetric fistula. Participants were gynecology patients (N = 144) at the Kilimanjaro Christian Medical Center in Moshi, Tanzania, recruited from the Fistula Ward (n = 54) as well as gynecology outpatient clinics (n = 90). Measures included previously validated psychometric questionnaires, administered orally by Tanzanian nurses. Outcome variables were compared between obstetric fistula patients and gynecology outpatients, controlling for background demographic variables and multiple comparisons. Compared to gynecology outpatients, obstetric fistula patients reported significantly higher symptoms of depression, posttraumatic stress disorder, somatic complaints, and maladaptive coping. They also reported significantly lower social support. Obstetric fistula patients present for repair surgery with more severe psychological distress than gynecology outpatients. In order to address these mental health concerns, clinicians should engage obstetric fistula patients with targeted mental health interventions.