"I am alone and isolated": a qualitative study of experiences of women living with genital fistula in Uganda.
"I am alone and isolated": a qualitative study of experiences of women living with genital fistula in Uganda.
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DOI：
10.1186/s12905-015-0232-z
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发表时间：
2015-09-10
期刊：
影响因子：
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通讯作者：
Faxelid E
中科院分区：
文献类型：
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作者：
Barageine JK;Beyeza-Kashesya J;Byamugisha JK;Tumwesigye NM;Almroth L;Faxelid E
在全球范围内，估计有200万至300万妇女患有生殖器瘘，年发病率为5万至10万妇女。受影响的妇女在其社区内保持沉默，她们的经历往往不被注意。我们的目标是探索患有生殖器瘘的乌干达妇女的经历，了解她们的生活是如何受到影响的，以及她们是如何应对这种情况的。我们对56名在乌干达穆拉戈医院寻求治疗的生殖器瘘患者进行了8次焦点小组讨论（fgd）。对数据进行转录和定性内容分析。患有瘘管病的妇女生活在身体上发生了变化，生活充满挑战，在社会上被剥夺和孤立，在心理上受到侮辱和沮丧，婚姻和性生活不再快乐。这些女性的经历充满了生活变化和应对策略，她们使用了以问题为中心和以情绪为中心的应对策略来应对挑战。他们想出了减少尿液气味的方法，以减少耻辱感、排斥和孤立。在努力应对的过程中，她们发现自己是孤独和孤立的。妇女要么孤立自己，要么被社会孤立，包括被近亲和丈夫孤立。她们的性生活不再愉快，一般来说，女性感到失去了婚姻和性权利。患有瘘管病的妇女在生活中做出调整，以应对身体、社会、心理和性方面的挑战。她们采用以问题为中心和以情绪为中心的应对方式，尽量减少她们的孤立感，以及与瘘管病有关的排斥和耻辱。这些发现对于为受瘘管病影响的患者、家庭和社区成员提供咨询至关重要。在类似情况下，保健方案应超越瘘管闭合，并以社区和家庭为目标，以减少患有生殖器瘘管病的妇女所面临的耻辱和孤立。
Globally, 2–3 million women are estimated to have a genital fistula, with an annual incidence of 50,000–100,000 women. Affected women remain silent within their communities, and their experiences often go unnoticed. Our objective was to explore the experiences of Ugandan women living with genital fistulas to understand how their lives were affected and how they coped with the condition. We conducted 8 focus group discussions (FGDs) with 56 purposively selected women with a genital fistula seeking treatment at Mulago Hospital, Uganda. Data were transcribed and analysed using qualitative content analysis. Women with a fistula were living a physically changed and challenging life, living socially deprived and isolated, living psychologically stigmatised and depressed, and living marital and sexual lives that were no longer joyful. The women’s experiences were full of life changes and coping strategies, and they used both problem- and emotion-focused coping strategies to deal with the challenges. They devised ways to reduce the smell of urine to reduce the stigma, rejection and isolation. While trying to cope, the women found themselves alone and isolated. Women either isolated themselves or were isolated by society, including by close relatives and their husbands. Their sex lives were no longer enjoyable, and generally, women felt a loss of their marital and sexual rights. Women with a fistula make adjustments in their lives to cope with the physical, social, psychological and sexual challenges. They use both problem- and emotion-focused coping to minimise their sense of isolation, as well as the rejection and stigma associated with fistula. These findings are essential for counselling patients, families and community members affected by a fistula. In similar contexts, health programmes should go beyond fistula closure and target communities and families to reduce the stigma and isolation faced by women with genital fistula.