Sanitation-related psychosocial stress: A grounded theory study of women across the life-course in Odisha, India
Sanitation-related psychosocial stress: A grounded theory study of women across the life-course in Odisha, India
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DOI：
10.1016/j.socscimed.2015.06.031
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发表时间：
2015-08-01
影响因子：
5.4
通讯作者：
Dreibelbis, Robert
中科院分区：
文献类型：
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作者：
Sahoo, Krushna Chandra;Hulland, Kristyna R. S.;Dreibelbis, Robert
虽然卫生干预措施主要侧重于儿童健康，但妇女因卫生设施不足而面临的独特健康风险正日益被视为一个优先问题。本研究探讨了在印度奥里萨邦的日常卫生实践中与卫生相关的心理社会压力源的范围。在2013年8月至2014年3月期间，我们在城市贫民窟、农村和土著村庄三个环境中对处于四个生命阶段的56名妇女进行了深入访谈：青少年、新婚、怀孕和成年妇女。使用扎根理论的方法，研究小组转录，翻译，编码和讨论采访使用详细的分析备忘录，以确定和表征在每个生命阶段和研究地点的压力。我们发现，卫生习惯不仅包括排便和排尿，还包括取水、洗涤、洗澡、月经管理和换衣服。在这些活动过程中，妇女遇到了环境、社会和性三大类压力，其强度因妇女的生命阶段、生活环境和卫生设施的使用情况而有所不同。环境障碍、社会因素和对性暴力的恐惧都助长了与卫生有关的心理社会压力。尽管妇女对卫生习惯做出了微小的改变，但她们无法显著改变自己的环境，特别是通过为卫生相关行为获得足够的隐私。需要更好地了解压力和适应行为的各种原因，以便为针对具体情况、对性别问题有敏感认识的卫生干预措施提供信息。(C)2015作者由Elsevier Ltd.发布。这是CC BY-NC-ND许可证下的开放获取文章（http：//creativecommons.org/licensesiby-nc-nd/4.0/）。
While sanitation interventions have focused primarily on child health, women's unique health risks from inadequate sanitation are gaining recognition as a priority issue. This study examines the range of sanitation-related psychosocial stressors during routine sanitation practices in Odisha, India. Between August 2013 and March 2014, we conducted in-depth interviews with 56 women in four life stages: adolescent, newly married, pregnant and established adult women in three settings: urban slums, rural villages and indigenous villages. Using a grounded theory approach, the study team transcribed, translated, coded and discussed interviews using detailed analytic memos to identify and characterize stressors at each life stage and study site. We found that sanitation practices encompassed more than defecation and urination and included carrying water, washing, bathing, menstrual management, and changing clothes. During the course of these activities, women encountered three broad types of stressors environmental, social, and sexual the intensity of which were modified by the woman's life stage, living environment, and access to sanitation facilities. Environmental barriers, social factors and fears of sexual violence all contributed to sanitation-related psychosocial stress. Though women responded with small changes to sanitation practices, they were unable to significantly modify their circumstances, notably by achieving adequate privacy for sanitation-related behaviors. A better understanding of the range of causes of stress and adaptive behaviors is needed to inform context-specific, gender-sensitive sanitation interventions. (C) 2015 The Authors. Published by Elsevier Ltd. This is an open access article under the CC BY-NC-ND license (http://creativecommons.org/licensesiby-nc-nd/4.0/).